title: We live in testing times - teaching rational test ordering in general practice.
abstract: BACKGROUND
  Pathology, imaging and other tests have an essential role in the diagnosis and screening for disease in medical practice. However, over-testing has recently emerged as a significant issue and has implications for the patient, doctor and health system. Vocational training is arguably the most critical period in the development of future patterns of clinical practice for the GP. This includes the development of test ordering behaviour. The general practitioner (GP) supervisor, therefore, has a key role to play in educating registrars to avoid over-testing.
  
  
  OBJECTIVE
  In this article, we discuss general approaches and practical strategies for GP supervisors to teach their registrars rational test ordering.
  
  
  CONCLUSIONS
  Teaching should take a patient-centred focus and an emphasis on fostering a greater tolerance of uncertainty. Role modelling and demonstrated use of relevant clinical guidelines is a strong influence on registrar behaviour. Specific strategies for teaching rational test ordering include random case analysis, investigation audit, topic tutorials and use of targeted resources.
authors.affiliation: MBBS, MPH, FRACGP, is a general practitioner and medical educator, General Practice Training - Valley to Coast, Newcastle, New South Wales.
authors.forename: Simon
authors.initials: S
authors.lastname: Morgan
authors.forename: Justin
authors.initials: J
authors.lastname: Coleman
mesh_terms: D001315:Australia; D019937:Diagnostic Techniques and Procedures; D058006:General Practice / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care; D010818:Practice Patterns, Physicians'; D013663:Teaching / Q000379:methods*; D019564:Unnecessary Procedures