Distance education. Part 7. Evaluation of the Graduate Diploma of Family Medicine. Does a distance education course for GPs influence their reported clinical and professional practice?
BACKGROUND
Course evaluation is essential for continuous enhancement of teaching. This evaluation aimed to assess the impact of the Graduate Diploma of Family Medicine on the clinical practices, community activities, learning styles and personal lives of its graduates.


METHODS
Cross-sectional postal questionnaire survey of all 1993 to 1997 graduates of the Graduate Diploma in Family Medicine (n = 233).


RESULTS
A response rate of 70% was achieved. Male respondents felt that they treated a greater variety of conditions (p = 0.04), had undertaken more procedural work (p = 0.03), and had increased procedural confidence (p = 0.009) compared to female respondents, while the female respondents referred more (p = 0.03). Solo practitioners tended to look for evidence in clinical decision making (p = 0.006) and applied critical appraisal techniques when reading medical information provided by pharmaceutical representatives (p = 0.04). Group practitioners tended to participate in more research projects (other than drug trials) than solo practitioners (p = 0.03). There was a difference between full and part time general practitioners, even after controlling for gender, with the former more certain that general practice is where they wanted to be (p = 0.005), they also felt more competent in interpreting data, e.g. ECGs (p = 0.013). More male students indicated they preferred a reflective learning style than females (p = 0.04).


CONCLUSIONS
The clinical electives of the Graduate Diploma in Family Medicine had the most significant impact on the clinical practices of full time GPs who were predominantly male graduates. Gender differences were apparent in styles of practice as males tended to conduct more procedural work, while female graduates preferred the gatekeeper role and referred more. The course also impacted on the students' approach to evidence in their clinical decision making. They were more critical of medical information provided by pharmaceutical representatives who are one of the major sources of CME for many GPs. Future evaluations should be based on experimental and quasi-experimental designs in order to measure changes in student perceptions and clinical practice, as well as more objective measures of learning styles.
Piterman
L
L
Department of Community Medicine and General Practice, Monash University. leon.piterman@med.monash.edu.au
McCall
L
L
D000328:Adult; D000368:Aged; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D003625:Data Collection; D020375:Education, Distance / Q000706:statistics & numerical data*; D004503:Education, Medical, Graduate / Q000706:statistics & numerical data*; D004521:Educational Measurement; D005194:Family Practice / Q000193:education* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D020399:Practice Management; D011336:Probability; D015397:Program Evaluation; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014739:Victoria