• Aust Fam Physician · May 2014

    Case Reports

    We live in testing times - teaching rational test ordering in general practice.

    • Simon Morgan and Justin Coleman.
    • MBBS, MPH, FRACGP, is a general practitioner and medical educator, General Practice Training - Valley to Coast, Newcastle, New South Wales.
    • Aust Fam Physician. 2014 May 1; 43 (5): 273-6.

    BackgroundPathology, imaging and other tests have an essential role in the diagnosis and screening for disease in medical practice. However, over-testing has recently emerged as a significant issue and has implications for the patient, doctor and health system. Vocational training is arguably the most critical period in the development of future patterns of clinical practice for the GP. This includes the development of test ordering behaviour. The general practitioner (GP) supervisor, therefore, has a key role to play in educating registrars to avoid over-testing.ObjectiveIn this article, we discuss general approaches and practical strategies for GP supervisors to teach their registrars rational test ordering.DiscussionTeaching should take a patient-centred focus and an emphasis on fostering a greater tolerance of uncertainty. Role modelling and demonstrated use of relevant clinical guidelines is a strong influence on registrar behaviour. Specific strategies for teaching rational test ordering include random case analysis, investigation audit, topic tutorials and use of targeted resources.

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