title: Effect of extension of postgraduate training in general practice on the acquisition of knowledge of trainees.
abstract: BACKGROUND
  Postgraduate training in general practice aims to develop clinical competence. However, little is known about its effect on trainees' development of competence.
  
  
  OBJECTIVE
  Our aim was to investigate whether 3 years of postgraduate training in general practice leads to a higher level of knowledge than 2 years training while maintaining the same structure and educational objectives.
  
  
  METHODS
  This retrospective study had a mixed longitudinal design. Trainees of the Dutch postgraduate training in general practice participated. Knowledge was assessed by written progress testing of knowledge relevant to general practice embedded in real life situations. Test results were collected from 1992 to 1999. The results of trainees who received the 2-year and 3-year curriculum were compared.
  
  
  RESULTS
  Both curricula started with the same entrance level and showed the largest acquisition of knowledge at the start and towards the end of training. Both curricula showed stagnation in growth at the end of the training period in which trainees rotate through hospitals, nursing homes and mental health institutions. The level of knowledge at the end of training was significantly higher for the 3-year curriculum.
  
  
  CONCLUSIONS
  This study shows that postgraduate training contributes to an increase in knowledge and that a 3-year programme leads to a higher level of knowledge than a 2-year programme. The stagnation in growth found at the end of rotations through hospitals, nursing homes and mental health institutions questions the impact of these rotations on the development of competence and the efficacy of the training as a whole. Further study is needed to draw more firm conclusions.
authors.affiliation: National Centre for Evaluation of Postgraduate Training in General Practice (SVUH), Utrecht, The Netherlands. Carol_ann@tiro.nl
authors.forename: Anneke W M
authors.initials: AW
authors.lastname: Kramer
authors.forename: Herman
authors.initials: H
authors.lastname: Düsman
authors.forename: Lisa H C
authors.initials: LH
authors.lastname: Tan
authors.forename: Koos J M
authors.initials: KJ
authors.lastname: Jansen
authors.forename: Richard P T M
authors.initials: RP
authors.lastname: Grol
authors.forename: Cees P M
authors.initials: CP
authors.lastname: van der Vleuten
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004502:Education, Medical, Continuing; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D005194:Family Practice / Q000193:education*; D006801:Humans; D008137:Longitudinal Studies; D009426:Netherlands; D012189:Retrospective Studies