Australian general practice registrars and their experience with postpartum consultations: A cross-sectional analysis of prevalence and associations

Sophia Hill; Amanda Tapley; Mieke L van Driel; Elizabeth G Holliday; Jean Ball; Andrew Davey; Irena Patsan; Neil Spike; Kristen Fitzgerald; Simon Morgan; Parker Magin

doi:10.1111/ajo.13034

Australian general practice registrars and their experience with postpartum consultations: A cross-sectional analysis of prevalence and associations

Aust N Z J Obstet Gynaecol. 2020 Apr;60(2):196-203. doi: 10.1111/ajo.13034. Epub 2019 Jul 7.

Authors

Sophia Hill¹, Amanda Tapley^{2

3}, Mieke L van Driel⁴, Elizabeth G Holliday³, Jean Ball⁵, Andrew Davey^{2

3}, Irena Patsan^{2

3}, Neil Spike^{6

7}, Kristen Fitzgerald⁸, Simon Morgan⁹, Parker Magin^{2

3}

Affiliations

¹ Hunter New England Local Health District, Newcastle, New South Wales, Australia.
² NSW & ACT Research and Evaluation Unit, GP Synergy, Newcastle, New South Wales, Australia.
³ School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
⁴ Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
⁵ Clinical Research Design, Information Technology and Statistical Support (CReDITSS) Unit, Newcastle, New South Wales, Australia.
⁶ Eastern Victoria GP Training (EVGPT), Melbourne, Victoria, Australia.
⁷ Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia.
⁸ General Practice Training Tasmania (GPTT), Hobart, Tasmania, Australia.
⁹ GP Synergy, Newcastle, New South Wales, Australia.

PMID: 31281967
DOI: 10.1111/ajo.13034

Abstract

Background: In Australia, general practitioners (GPs) are recognised as an essential source of postpartum care. However, there remains a paucity of research pertaining to this, and in particular, to that of GP trainees (in Australia, termed 'registrars'). Previous post-graduate experience in obstetrics and gynaecology (O&G) is not a prerequisite for GP training, and thus, it is imperative that vocational training provides adequate exposure to postpartum consultations.

Aim: To investigate the prevalence and associations of Australian GP registrars' (trainees') experience in postpartum care.

Materials and methods: A cross-sectional study employing data from the Registrar Clinical Encounters in Training (ReCEnT) project. ReCEnT is an ongoing cohort study where GP registrars record 60 consecutive consultations mid-way through each training term. The outcome variable was postpartum problem/diagnosis (compared to all other problems/diagnoses). The independent variables included registrar, practice, patient, consultation, clinical and educational factors. Analyses employed univariate and multivariable regression.

Results: Analysis included 2234 registrars (response rate 96.1%), 289 594 consultations, and 453 786 problems/diagnoses. Postpartum care (897) comprised 0.2% (95% CI: 0.19-0.21) of all problems/diagnoses in 0.3% (95% CI: 0.27-0.31) of all consultations. Significant multivariable associations included registrar's gender (female) and obtainment of post-graduate O&G qualifications. Postpartum consultations were longer and resulted in more learning goals being generated.

Discussion: An overall low prevalence was established. Both male registrars, and those without pre-existing O&G qualifications, may have particularly limited experience. These findings should inform educational policy and practice regarding postpartum care experience in general practice training.

Keywords: education; family practice; general practice; graduate; medical; postpartum period.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Australia
Cohort Studies
Cross-Sectional Studies
Female
General Practice
General Practitioners / education*
Humans
Logistic Models
Male
Postnatal Care / statistics & numerical data*
Postpartum Period
Prevalence
Referral and Consultation / statistics & numerical data*

Grants and funding

Australian Department of Health/International