Changing landscape of rural
general practices

The coronavirus pandemic has initiated significant changes that have
the potential to transform how general practitioners and trainees work
and learn in the longer term. The interactional and relational qualities
of patient consultations have been modified by the intr oduction of
consultations at a physical distance, the enhanced use of elect ronic
technology (e.g., tele-medicine, referrals and prescriptions),
tighter management of face-to-face patient attendance, and
fluctuating patient loads. If there are ongoing changes in the kinds
of interactions and activities that comprise the daily work of rural
general practices, there will be consequences for the professional
development of general practitioners and their staff, but also t he
kinds of training that will be afforded trainees (including students,
junior doctors and GP registrars) during their time in these practices.

Consequently, the trainees’ learning landscape has been disrupted
and ‘tried and tested’ strategies supporting lear ning through
practice may no longer be the most appr opriate approaches for
supporting learning in these practices. For example, in futur e
there may be fewer opportunities for face-to-face engagement
with supervisors and patients, and the potential for an incr eased
sense of isolation (Cantillon et al., 2016). Whilst not intende d, these
changes have provided a dress rehearsal for how rural general
practice and training might be reconstituted and re-imagined
in the future. We now have a unique opportunity to r eview and
reappraise the activities, interactions and pressure points of work,
learning and supervision in rural training practices. This includes
appraising the opportunities to apply the lear nings from remote
supervision models (Wearne et al., 2013, 2015) more broadly
and extend the roles of other members of the practice team (e.g.,
practice manager, receptionists, nursing staff) in supporting and
sustaining effective trainee learning in rural general practice.

The project

The project – Reimaging and reconstituting training
for rural general practice in a changing landscape – is funded by
Rural Medical Education Australia (RMEA). The project’s aims are
to:

• learn what changes to practice have arisen thr ough the recent pandemic,
• identify which new capacities are required, and
• identify and appraise existing and new workplace training strategies that can be adopted to sustain meaningful learning through practice.

The bulletin attached here presents the research questions, provides an overview of the processes and refers to some findings from the first and second phases of the project.