ReCEnT is an ongoing educational-research project. It is centred on a cohort study of GP registrars’ in-consultation clinical and educational experience.
In ReCEnT, registrar and practice demographics are documented. Once in each of their three general practice terms, registrars record the patient, consultation and educational aspects of 60 consecutive office-based consultations. From these data, detailed individual feedback reports are produced and are used to prompt registrar reflection on their practice and training program. The collected data are also used for research into registrars’ training and practice and as a resource for registrar research training.
The ‘micro-level’ educational aspects of the project largely involve registrar reflection on their clinical practice consideration of the content of their personal feedback report. At the ‘macro-level’ ReCEnT data informs content and organizational aspects of the GP Synergy education and training program.
From a research perspective, a basic task of ReCEnT is to document the epidemiology of Australian general practice vocational training (what patients and conditions registrars see and what registrars do during consultations). Analyses of registrars’ clinical exposures involving higher level general practice constructs (e.g. continuity of care, care of chronic disease, management of undifferentiated fatigue, aspects of pathology test ordering and the sources of in-consultation information and advice accessed by registrars) is the next level of enquiry in ReCEnT.
The cohort design of the project allows longitudinal analyses, so enabling inferences of causality in registrars’ clinical experiences and behaviours. ReCEnT also provides a framework for evaluations of educational innovations nested within the cohort study. This represents a translational research–education model whereby ReCEnT data are used to identify evidence–practice gaps. Further ReCEnT data concerning the context of these evidence–practice gaps then informs the construction of educational interventions. The effectiveness of the subsequent interventions can be measured by further rounds of ReCEnT data collection.
We are also using ReCEnT data to investigate inter-practice variability in various clinical parameters of teaching practices (such as antibiotic prescribing rates for respiratory tract infections).