A National Survey on the Educational Value of the Italian General Practice Training Components as Perceived by Primary Care Physicians

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Abstract
Background: General practice/family medicine (GP/FM) is a distinct academic and clinical discipline centered around comprehensive, continuing and person-centered care. The present study aimed to assess trainees’ perceptions of utility and quality of the principal components of postgraduate GP/FM training in Italy, and to investigate factors associated with these perceptions. Methods: A national survey was conducted by emailing an anonymous self-reported questionnaire to all trainees or doctors who already completed the Italian GP/FM training. Multivariate multiple regression was used to modeling multiple responses to utility and quality of scores (ranging 1–10) of various educational components of GP/FM training, expressing the results as adjusted regression coefficients (aRC) with 95% confidence intervals (95%CI). Results: Cross-regional differences were observed, with lower quality of hospital training rotations perceived by respondents from Friuli Venezia Giulia and 3 Southern regions (Abruzzo, Calabria and Lazio) compared with Lombardy (reference). However, perceived utility and quality of both health district and hospital training were rated lower than general practitioner rotations. Negative scores on both perceived utility and quality of all educational components were consistently expressed by doctors undertaking extra job during the GP/FM training and by those who believed meritocracy was not considered for appointment of seminar teachers. Overall, only a minority (28.17%) of respondents perceived the overall training program as adequately preparing for an independent GP/FM profession, but respondents who answered that the GP/FM training adequately prepares for the job were more likely to provide positive scores on utility and quality of all components of the program. Conclusions: This national survey found substantial cross-regional differences in the educational value of various components of the Italian GP/FM training. GP/FM rotations were consistently perceived as highly useful and characterized by substantial active involvement by trainees. Nevertheless, only a minority of respondents perceived the overall program as adequately preparing for an independent GP/FM profession. These findings may suggest that the educational value of individual rotations may not automatically translate into a perception of coherent and holistic training for the future profession. Future research should complement trainee perceptions with objective assessment of competencies and longitudinal evaluation of preparedness for independent practice.

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