Primary health care is increasingly focused on the provision of chronic care illness under a multi-disciplinary care model. The capacity to continue to provide this model of care will, in part, depend on the training of future health professionals. One of the GP Super Clinics Program objectives relates to teaching and training of health professionals. Most of the GP Super Clinics have developed or are developing relationships with universities. Indeed, some have structural relationships and co-location of academic units with the GP Super Clinics. This is expected to facilitate a partnership approach to teaching and training of students in various disciplines.
Where relationships have been established between GP Super Clinics and universities, they appear to mostly one-way relationships. The GP Super Clinics have enabled the universities to provide much-needed placements for under-graduate students in a multi-disciplinary environment, which is consistent with the GP Super Clinics Program Objectives.
However, it does not appear to have changed the way students are trained in the university settings. It has been argued that teaching students at under-graduate level the importance of and skills in working in a multi-disciplinary environment means greater potential of application in their clinical experience.83 On return to the universities, students still undertake single-discipline learning which does not necessarily reflect patient profiles or future models of care under which they will provide services.
It is recognised that there are logistical difficulties for universities in introducing inter-professional education into the curricula. While single discipline teaching is obviously needed at times, there are many opportunities, such as through problem-based learning, where inter-professional learning could occur. Similarly, gaps between models of care for primary care and, in particular, chronic disease management and post-graduate training have been identified.84
The relationships between the GP Super Clinics and universities are in their infancy, and examples of teaching, training and research partnerships were not evident beyond co-location and provision of clinical placements. There are opportunities for universities and relevant colleges to show much greater leadership in teaching and training of health disciplines to reflect the demands of 21st century primary care practices than has been demonstrated in this evaluation. This will require a fundamental rethink of the way multi-disciplinary education can be provided in a way which more closely mirrors modern health care practice thus challenging the status-quo in current programs. Universities should be challenged as to why much of their problem-based learning approaches still occur in discipline silos, thus further perpetuating the silo mentality of health care.
Similarly, there are opportunities through partnerships with GP Super Clinics to undertake research with members of teams, where clinics are not merely points for data collection, but are places where questions can be determined collaboratively and research which meets needs of modern practices can be undertaken. Through a collaborative approach there is an opportunity to answer questions of relevance to patients, clinicians and policy makers in relation to primary care.
Key Learnings – Primary Care System
- If there is a commitment to increasing investment in primary health care by the Australian Government, measurement of its performance through efficient systems and robust data is required to determine return on investment and to drive quality through improvement of the system and services.
- Universities and relevant discipline-specific colleges should be encouraged to review their models of teaching and training to reflect the realities of modern day primary care.
83Sanson-Fisher RW, Baitch l, Peterson E. From bland to grand: an apporach to classification of inter-professional education for under-graduate health sciences. Focus on Health Professional Education: a Multi-Disciplinary Journal. 2005;7(1):34-48.
84Stevens DP, Bowen JL, Johnson JK, et al. A multi-institutional quality improvement initiative to transform education for chronic illness care in resident continuity practices. Journal of General Internal Medicine. 2010;25(S4):S574-580.