ABSTRACT
The nine learning objectives consider aspects of your learning that are all achievable in the general practice setting, and are designed to be as relevant to those who will not eventually specialize in general practice as to those who will. The sections can be considered separately, but they do interrelate, and there are cross-references. Much of the activity leading to the achievement of these learning objectives is based in clinical practice (i.e. seeing and consulting with patients yourself, ideally in a separate room from your tutor but in close proximity, and with supervision and sanctioning of your decisions by your tutor). Reflection on your performance in those consultations will yield interesting and useful information, so we encourage you to keep a log diary of your clinical sessions. Reading the chapter, especially the thinking and discussion points and practical exercises, will indicate the sort of information you could record in your diary. Log diaries can be updated between consulta-
tions with patients or by reviewing the notes at the end of a clinical session. Sometimes it is useful to use different techniques, recording immediately after a consultation is more influenced by the emotional impact of the individual consultation (an important factor that has to be considered in its own right), whereas recording at the end may illuminate how one consultation affected others in the same session. Take opportunities to discuss more than indi-
vidual patients with your tutor; consider how your performance is changing, evolving or getting stuck. Ensure you consider the big picture as well as individual scenarios; take opportunities to see common ground, similarities between patient scenarios or between management strategies, as well as the differences – this will enable you to generate
ideas within a consultation even when the case itself is not one you have encountered before, Don’t worry, no one knows all the answers to
everything, you are here to learn, and your supervisor will check your consultations. Try to use a problem-solving approach, to be prepared to justify your thought processes, and to safety-net and follow-up your patients. You will already have developed or be develop-
ing your own personal style. An aspect of this individuality is that we do not respond in the same way to patients, and some consideration of the impact different patients have on us as individuals is necessary so we understand how this can influence our decision making. These are good areas for discussion in one-to-one tutorials, or group sessions with your peers. In group sessions, everyone is a source of infor-
mation, expertise and views, and all contribute; you are all responsible jointly for each other’s learning. Functions of group sessions may include:
■■ sharing individual experiences, learning vicariously about unusual presentations,
■■ sharing ideas of expected levels of competence, ■■ providing support for each other, ■■ debating difficult or sensitive issues in a protected environment,
■■ practising peer review and receiving constructive criticism,
■■ working collaboratively on a particular topic, ■■ practising skills through role plays and group discussion,
■■ recruiting expert support in certain shared areas of learning need.
