Abstract
OBJECTIVES--To examine the content of hospital obstetric vocational training for general practice, the beliefs of general practitioner trainees about this training, and their perceived competence at practical obstetric procedures and the effect of training. DESIGN--Confidential postal questionnaire. SUBJECTS--A random one in four sample of all general practitioner trainees in the United Kingdom on vocational training schemes or in training practices in Autumn 1990. MAIN OUTCOME MEASURES--Trainees' competence and beliefs on Likert scale, numbers of procedures witnessed and performed, type of maternity care trainees intended to provide. RESULTS--Of 1019 trainees sent questionnaires, 765 (75.1%) replied; 517 had done some hospital obstetric training. After six months as a senior house officer 232/367 (63%) believed they were competent to perform a normal delivery unaided, 228 (62%) to manage a severe postpartum haemorrhage, and 227 (62%) to resuscitate a newborn infant. 272 (35.6%) trainees intended to provide intrapartum care and 56 (7.5%) to book home deliveries in the future. Hospital training increased confidence in performing most obstetric procedures in all trainees. However, a greater proportion of trainees who intended to provide full care than shared care felt competent at performing a normal vaginal delivery (63% (170/272) full v 45% (215/473) shared), low forceps delivery (38% (103) v 17% (79)), manual removal of placenta (24% (65) v 17% (82)), and intubating a neonate (42% (114) v 34% (161)). Trainees who had done any obstetric training were less likely to think that training encouraged future provision of intrapartum care (113/509 (22%) training v 65/213 (31%) no training). CONCLUSION--Hospital vocational obstetric training increases the perceived competence of trainees but fails to encourage them to use obstetric skills.
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- Coupland V. A., Green J. M., Kitzinger J. V., Richards M. P. Obstetricians on the labour ward: implications of medical staffing structures. Br Med J (Clin Res Ed) 1987 Oct 24;295(6605):1077–1079. doi: 10.1136/bmj.295.6605.1077. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Crawley H. S., Levin J. B. Training for general practice: a national survey. BMJ. 1990 Apr 7;300(6729):911–915. doi: 10.1136/bmj.300.6729.911. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Grant J., Marsden P., King R. C. Senior house officers and their training. I. Personal characteristics and professional circumstances. BMJ. 1989 Nov 18;299(6710):1263–1265. doi: 10.1136/bmj.299.6710.1263. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hare M. J., Miles R. N., Lattimore C. R., Southern J. P. "Short report" staffing in practice: five years' experience of a consultant based service in obstetrics and neonatal paediatrics. BMJ. 1990 Mar 31;300(6728):857–859. doi: 10.1136/bmj.300.6728.857. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marsh G. N., Cashman H. A., Russell I. T. General practitioner participation in intranatal care in the northern region in 1983. Br Med J (Clin Res Ed) 1985 Mar 30;290(6473):971–973. doi: 10.1136/bmj.290.6473.971. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Reeve H., Bowman A. Hospital training for general practice: views of trainees in the North Western region. BMJ. 1989 May 27;298(6685):1432–1434. doi: 10.1136/bmj.298.6685.1432. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith L. F., Jewell D. Contribution of general practitioners to hospital intrapartum care in maternity units in England and Wales in 1988. BMJ. 1991 Jan 5;302(6767):13–16. doi: 10.1136/bmj.302.6767.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Street P., Gannon M. J., Holt E. M. Community obstetric care in West Berkshire. BMJ. 1991 Mar 23;302(6778):698–700. doi: 10.1136/bmj.302.6778.698. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Towler J. Midwives' units - wishful thinking or reality? Midwives Chron. 1984 Jan;97(1152):3–5. [PubMed] [Google Scholar]
- Young G. L. General practice and the future of obstetric care. Br J Gen Pract. 1991 Jul;41(348):266–267. [PMC free article] [PubMed] [Google Scholar]