Addressing Barriers to GPR asking for advice.
General:
! Early clarity – setting ground rules.
! Open door policy. !
Physical – where the GPRs room is in relation to trainers etc.
! Phone v knock.
! Develop no blame elsewhere within practice – empower trainee to admit mistakes.
! Trainer sharing past mistakes with trainee.
! Set realistic expectations appropriate to stage of training – should be natural drop off from 3rd year through to end of 4th.
! Two way street by calling GPR into your room to show cases or discuss afterwards.
Under confidence:
!Highlight that uncertainty is uncommon even in experienced GPs.
! Emphasise that trainers prefer under confidence – safer and easier to deal with.
Over confidence:
!May be bravado.
!Create awareness.
! The problem may be picked up by case discussion, sitting in and/or video.
Fear and anxiety:
! Build relationships.
Lack of care / laziness:
! Confront head on.
! Collect evidence.
! Name the behaviour.
! Set expected standards.
! Modelling – ‘do as I do’.
Ethnic/cultural factors:
! Should GPR be seeing patients who are not known to trainer/ partners.
Trainer too discouraging.
! Practice visits.
! Practice reviews