title: International sore throat guidelines and international medical graduates: a mixed methods systematic review.
abstract: AIM To examine national and international guidelines on sore throat management and subsequently, to explore the phenomenon of international medical graduates working in general and rural practice in New Zealand. METHOD Two separate systematic reviews were conducted that resulted in a contingent methodology. Contingent methodologies involve syntheses of data that are derived sequentially. The initial review for this study examined international sore throat guidelines and their key points. The results of this initial review resulted in the theory that international medical graduates may be unaware of the New Zealand specific sore throat guidelines and the problem of acute rheumatic fever in this country. The subsequent review examined the phenomenon of international medical graduates working in general or rural practice in New Zealand. Data sources were Medline, Google Scholar, Trip Database, and NHS Evidence, Embase and Scopus. Electronic databases were searched for relevant data published January 2000-December 2013. Additional hand searches found key references from articles and websites. RESULTS International guidelines for the management of sore throats differ from New Zealand guidelines. Of resource rich countries, New Zealand has the second highest number of international medical graduates: they may not use New Zealand specific sore throat guidelines. DISCUSSION Acute rheumatic fever is virtually eradicated in most resource rich countries. Rheumatic fever rates of among indigenous Māori and Pacifika people in New Zealand have failed to reduce over the last three decades. Knowledge and actions of international medical graduates in relation to sore throat management needs investigating. KEYWORDS Sore throats; acute rheumatic fever; clinical guidelines; international medical graduates; mixed methods review.
authors.affiliation: Senior Lecturer/Nurse Practitioner for Children and Young People, School of Nursing and Department of General Practice and Primary Health Care University of Auckland, Private Bag 92 019, Auckland 1142, New Zealand. Email: k.hoare@auckland.ac.nz.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Hoare
authors.affiliation: School of Nursing, University of Auckland, Private Bag 92 019, Auckland 1142, New Zealand.
authors.forename: Erin
authors.initials: E
authors.lastname: Ward
authors.affiliation: Elaine Gurr Chair of General Practice and Primary Health Care, Director of the Goodfellow Unit, Department of General Practice and Primary Health Care, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Physical Address: Tamaki Campus, 261 Morrin Road, Glen Innes, New Zealand.
authors.forename: Bruce
authors.initials: B
authors.lastname: Arroll
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005550:Foreign Medical Graduates / Q000706:statistics & numerical data*; D058006:General Practice / Q000592:standards; D019983:Guideline Adherence; D006801:Humans; D009520:New Zealand; D010612:Pharyngitis / Q000188:drug therapy* / Q000382:microbiology; D017410:Practice Guidelines as Topic; D012213:Rheumatic Fever / Q000175:diagnosis* / Q000178:diet therapy* / Q000382:microbiology; D019035:Rural Health Services / Q000592:standards
chemical_list: D000900:Anti-Bacterial Agents