Family practice
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The London Academic Training Scheme (LATS) provides a 1-year training programme in research methods and teaching for GPs who have recently finished vocational training. This paper describes an adult educational approach to learning about research methods through teaching as part of the LATS trainees' weekly academic programme. ⋯ The active involvement of learners as teachers is a practical and rewarding means of using adult educational principles in providing an academic programme.
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Randomized Controlled Trial Clinical Trial
Changing attitudes to infection management in primary care: a controlled trial of active versus passive guideline implementation strategies.
When attempting to implement evidence-based medicine, such as through clinical guidelines, we often rely on passive educational tactics, for example didactic lectures and bulletins. These methods involve the recipient in relatively superficial processing of information, and any consequent attitude changes can be expected to be short-lived. However, active methods, such as practice-based discussion, should involve recipients in deep processing, with more enduring attitude changes. In this experiment, the aim was to assess the efficacy of an active strategy at promoting deep processing and its effectiveness, relative to a typical passive method, at changing attitudes between groups of GPs over 12 months across an English Health District. ⋯ An active educational strategy attracted more participation and was more effective at generating deep cognitive processing than a passive strategy. A large improvement, lasting for at least 12 months, in attitude-compliance with guidelines on the optimal treatment of infections was imparted by the active processing method. A typical passive method was much less popular and had an insignificant impact on attitudes. The findings suggest that initiatives aiming to implement evidence-based guidelines must employ active educational strategies if enduring changes in attitude are to result.
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There is little evidence about the management and course of chronic low back pain in primary care. ⋯ A variety of options for the treatment and referral of chronic low back pain patients is available for and used by GPs. Efforts should be made to establish which diagnostic and therapeutic procedures are the most effective for chronic low back pain.
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We aimed to determine whether stethoscopes and otoscopes used in community paediatric clinics harboured pathogenic micro-organisms, and, if so, which measures could prevent this. ⋯ Fomites can harbour potentially pathogenic bacteria, and with the increasing trend for children with more complex medical problems to be managed in an ambulatory setting, often by physicians who also work in hospitals, there is a real risk of spreading potentially serious infections to such patients. Simple cleansing with alcohol effectively eliminates the bacterial contamination of the fomites, and should be encouraged.