Incorporating the views of prospective trainers and trainees into Malta’s proposed specialist training programme in family medicine

Abstract

Introduction: As obligatory specialist/vocational training needs to be introduced in Malta following EU accession in 2004, the Malta College of Family Doctors has prepared a Specialist Training Programme in Family Medicine. To facilitate its launch, potential GP trainers/trainees were invited as stakeholders to participate in a pre-implementation evaluation of the programme. Method: After a draft questionnaire was pre-tested through focus groups, participants' views were gathered quantitatively using scales to rate a number of closed statements regarding the programme and its sections. Qualitative open-ended questions also allowed them to highlight strengths and provide constructive feedback regarding any required improvements and perceived barriers. Results: Twenty-seven from 58 questionnaires were returned. Although the majority of participants thought that the programme and its sections are specific, attainable, relevant and timed, only a minority agreed that they are easily measurable. The strengths mentioned most were the various methods of assessment (41 %), experience in relevant hospital specialities (37%), preparation and updating of trainers (30%) and equal emphasis given to community and hospital training (26%). The improvements seen as most needed were the identification of resources (22%), the acquisition of competences (19%) and their assessment (19%). The main barriers identified were the use of trainees just as locums (41 %), poor attitudes among the various stakeholders (37%) and difficulties in coordinating assessment methods (26%). Discussion: To assist the programme's implementation, the development of a comprehensive curriculum is needed, with special attention given to measurability in general and assessment in particular. Adequate resources are needed to assist motivated one-to-one training complemented by protected group learning activities. The community and hospital competences necessary to ensure optimal family practice should be assessed by an independent examination board using formative and summative methods. The whole process should be monitored responsibly and with authority by a central supervisory body representing all the stakeholders.