title: General practitioner trainees' in-consultation generation of clinical questions for later answering: prevalence and associations.
abstract: As well as generating patient-specific questions, patient consultations are a rich source of questions relating to clinicians' need to acquire or maintain wider clinical knowledge. This is especially so for GP trainees.
  
  
  
  To establish the prevalence and associations of GP trainees' generation of 'learning goals' (LGs: questions generated during clinical consultations for intended post-consultation answering). Also, to characterize the type of learning goals generated.
  
  
  
  A cross-sectional analysis (2010-15) of an ongoing cohort study of Australian GP trainees' consultations. Once each 6-month training term, trainees record detailed data of 60 consecutive consultations. The primary outcome was generation of an LG. Analysis was at the level of individual problem/diagnosis managed. The secondary outcome was the problems/diagnoses to which the LGs related.
  
  
  
  One thousand one hundred and twenty-four trainees contributed data for 154746 consultations including 222307 problems/diagnoses. LGs were generated for 16.6% [95% confidence intervals (CI) = 16.4-16.7] of problems/diagnoses, in 22.1% (95% CI = 21.9-22.3%) of consultations. Associations of LGs included patient factors: younger age and having seen the trainee previously; trainee factors: earlier training stage, being overseas-trained and the trainee's training organization; consultation factors: longer duration, addressing a chronic disease, referring the patient, organizing follow-up, organizing investigations and accessing in-consultation information. LGs were commonly generated for skin (12.9% of all learning goals), musculoskeletal (12.7%) and respiratory (8.7%) problems. LGs were generated for 31.8% of male genital, 27.0% of neurological and 23.3% of eye problems.
  
  
  
  Australian GP trainees frequently generate questions in-consultation to be pursued post-consultation. Prevalence, 'complexity' and familiarity of clinical topic area influenced LG generation.
authors.affiliation: Discipline of General Practice, University of Newcastle, Callaghan, New South Wales, Australia.|Research and Evaluation Unit, GP Synergy, Mayfield, New South Wales, Australia.
authors.forename: Parker
authors.initials: P
authors.lastname: Magin
authors.affiliation: Discipline of General Practice, University of Newcastle, Callaghan, New South Wales, Australia.|Research and Evaluation Unit, GP Synergy, Mayfield, New South Wales, Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Tapley
authors.affiliation: Discipline of General Practice, University of Newcastle, Callaghan, New South Wales, Australia.|Research and Evaluation Unit, GP Synergy, Mayfield, New South Wales, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Davey
authors.affiliation: Elermore Vale General Practice, Elermore Vale, New South Wales, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Morgan
authors.affiliation: Clinical Research Design IT and Statistical Support Unit (CReDITSS), Hunter Medical Research Institute, Newcastle, New South Wales, Australia.|School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Holliday
authors.affiliation: Clinical Research Design IT and Statistical Support Unit (CReDITSS), Hunter Medical Research Institute, Newcastle, New South Wales, Australia.|School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.
authors.forename: Jean
authors.initials: J
authors.lastname: Ball
authors.affiliation: Academic Unit of General Practice, Australian National University Medical School, Canberra, Australian Capital Territory, Australia.|Health Workforce Division, Department of Health, Canberra, Australian Capital Territory, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Wearne
authors.affiliation: Discipline of General Practice, University of Newcastle, Callaghan, New South Wales, Australia.|Research and Evaluation Unit, GP Synergy, Mayfield, New South Wales, Australia.
authors.forename: Kim
authors.initials: K
authors.lastname: Henderson
authors.affiliation: Discipline of General Practice, University of Newcastle, Callaghan, New South Wales, Australia.|Research and Evaluation Unit, GP Synergy, Mayfield, New South Wales, Australia.
authors.forename: Nigel
authors.initials: N
authors.lastname: Catzikiris
authors.affiliation: Discipline of General Practice, University of Newcastle, Callaghan, New South Wales, Australia.|Research and Evaluation Unit, GP Synergy, Mayfield, New South Wales, Australia.
authors.forename: Katie
authors.initials: K
authors.lastname: Mulquiney
authors.affiliation: Eastern Victoria GP Training, Hawthorn, Victoria, Australia.|Department of General Practice, University of Melbourne, Carlton, Victoria, Australia.
authors.forename: Neil
authors.initials: N
authors.lastname: Spike
authors.affiliation: General Practice Training Tasmania, Hobart, Tasmania, Australia.
authors.forename: Rohan
authors.initials: R
authors.lastname: Kerr
authors.affiliation: Discipline of General Practice, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Mieke
authors.initials: M
authors.lastname: van Driel
mesh_terms: D000328:Adult; D001315:Australia; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice / Q000193:education* / Q000706:statistics & numerical data*; D006801:Humans; D057226:Information Seeking Behavior; D007396:Internship and Residency; D007858:Learning; D008297:Male; D015995:Prevalence; D012017:Referral and Consultation; D013997:Time Factors
keywords: Australia; evidence-based medicine; family practice; general practice; information seeking behaviour; internship and residency