Educating the clinical trainer: professional gain for the trainee? A controlled intervention study in general practice

Number of patients in practice (%)

 <2,000

17.9

32.0

9.4

 2,000–2,500

29.3

44.0

34.5

 >2,500

51.1

20.0

52.0

Location of practice (%)

 Village

17.9

32.0

32.2

 Small town

9.2

4.0

12.3

 City

29.3

28.0

29.8

 Big City

42.4

28.0

22.8

Trainer/trainee couples (%)

 ♂ + ♂

13.8

40.0

21.7

 ♀ + ♀

32.5

20.0

17.4

 ♀ + ♂/♂ + ♀

53.6

40.0

60.8

Knowledge

  Mean (SD)

T1

16.5 (3.8)

15.9 (3.0)

16.2 (3.7)

15.1 (3.7)

15.5 (3.5)

14.9 (4.4)

T2

18.2 (4.1)

22.4 (3.6)

T3

18.0 (4.3)

15.1 (3.6)

19.0 (3.7)

15.4 (3.9)

16.9 (4.1)

16.7 (2.6)

 Mean Δ^a

T3–T1

1.5

0.8

2.8

0.3

1.4

2.2

 p Δ^a (Int-Cont)

0.00*

0.02*

 ES^b

0.81

0.37

Attitude

  Mean (SD)

T1

3.3 (0.2)

3.3 (0.2)

3.3 (0.3)

3.3 (0.3)

3.3 (0.2)

3.3 (0.2)

T2

3.4 (0.2)

3.3 (0.2)

T3

3.4 (0.3)

3.3 (0.2)

3.7 (0.8)

3.3 (0.3)

3.3 (0.3)

3.5 (0.7)

 Mean Δ^a

T3–T1

0.1

0.0

0.4

0.0

0.0

0.2

 p Δ^a (Int-Cont)

0.15

0.43

 ES^b

0.50

0.00

RoMAT Caring Attitude

  Mean (SD)

T1

4.3 (0.6)

4.3 (0.5)

4.4 (0.5)

T3

4.3 (0.5)

4.3 (0.5)

4.3 (0.6)

 Mean Δ^a

T3–T1

0.0

0.0

−0.1

 p Δ^a (Int-Cont)

0.87

 ES^b

0.00

RoMAT Effectiveness

  Mean (SD)

T1

4.1 (0.5)

4.0 (0.6)

4.2 (0.5)

T3

4.1 (0.5)

4.1 (0.5)

4.0 (0.5)

 Mean Δ^a

T3–T1

0.0

0.1

−0.2

 p Δ^a (Int-Cont)

0.48

 ES^b

0.00

Weight change

0.03*

Bf 1<>2

0.46

0.32

0.94

 (1) <0

4.5

2.30–6.70

0.05

−0.07 to 0.16

0.23

−0.25 to 0.71

0.07

−0.21 to 0.36

 (2) =0

1.3

−0.33 to 2.90

0.11

0.04–0.18

−0.01

−0.19 to 0.16

0.20

−0.15 to 0.19

 (3) >0

1.5

−0.10 to 3.10

0.08

−0.06 to 0.13

−0.00

−0.13–0.13

0.02

−0.14 to 0.17

Years of experience as trainer

0.14

0.04*

0.25

0.05*

 (1) <6

3.0

1.50–4.40

0.12

0.05–0.20

−0.03

−0.25 to 0.18

−0.07

−0.24 to 0.10

 (2) ≥6

1.5

0.09–2.90

0.01

−0.06 to 0.08

0.10

−0.02 to 0.22

0.13

0.01–0.25

No. of GPs in practice

0.68

0.95

0.02*

Bf 1<>2

0.08

 (1) 1

2.3

0.37–4.20

0.08

−0.02 to 0.18

0.37

0.02–0.71

0.17

−0.10 to 0.45

 (2) 2

2.1

−0.00 to 4.10

0.06

−0.04 to 0.17

−0.16

−0.43 to 0.11

−0.18

−0.43 to 0.06

 (3) ≥3

0.9

−0.95 to 2.60

0.05

−0.09 to 0.19

0.01

−0.10 to 0.25

0.08

−0.11 to 0.26

 (4) Health centre

2.2

−0.04 to 4.50

0.03

−0.07 to 0.13

0.06

−0.06 to 0.18

0.12

−0.07 to 0.31

No. of patients in practice

0.81

0.30

0.04*

Bf 2<>3

0.01*

Bf 1<>3

 (1) <2000

1.5

−1.10 to 4.00

−0.02

−0.14 to 0.10

0.14

−0.04 to 0.33

0.30

0.10–0.50

 (2) 2,000–2,500

2.5

0.35–4.60

0.10

−0.00 to 0.20

0.22

−0.04 to 0.48

0.14

−0.07 to 0.35

 (3) >2,500

2.1

0.77–3.50

0.06

−0.01 to 0.13

−0.10

−0.25 to 0.05

−0.10

−0.23 to 0.03

1

I believe it is necessary to educate obese patients on the health risks of obesity

1

2

3

4

5

2

Obesity is a chronic disease

1

2

3

4

5

3

I make accommodations for obese patients

1

2

3

4

5

4

Obesity is associated with serious medical conditions

1

2

3

4

5

5

Physicians should be role models by maintaining a normal weight

1

2

3

4

5

6

A 10 % reduction in body weight is sufficient to significantly improve obesity-related health complications

1

2

3

4

5

7

I would spend more time working on weight management issues if my time was reimbursed appropriately

1

2

3

4

5

8

I feel competent in prescribing weight loss programmes for obese patients

1

2

3

4

5

9

Most obese patients are well aware of the health risks of obesity

1

2

3

4

5

10

Medications to treat obesity should be limited to short-term (< 3 months) use

1

2

3

4

5

11

Most obese patients could reach a normal weight (for height) if they were motivated to do so

1

2

3

4

5

12

Most obese patients will not lose a significant amount of weight

1

2

3

4

5

13

I have negative reactions towards the appearance of obese patients

1

2

3

4

5

14

If a patient meets the appropriate criteria for obesity surgery, I would recommend an evaluation by a surgeon

1

2

3

4

5

15

Medications to treat obesity should be used chronically

1

2

3

4

5

16

I am usually successful in helping obese patients lose weight

1

2

3

4

5

17

For most obese patients, long-term maintenance of weight loss is impossible

1

2

3

4

5

18

It is acceptable to use ‘scare tactics’ to obtain compliance of the obese patient

1

2

3

4

5

19

I feel uncomfortable when examining an obese patient

1

2

3

4

5

20

It is difficult for me to feel empathy for an obese patient

1

2

3

4

5

1

Has excellent clinical reasoning skills

EF

1

2

3

4

5

2

Conveys empathy for patients

CA

1

2

3

4

5

3

Communicates well with patients and relatives

CA

1

2

3

4

5

4

Understands learners’ needs and is committed to the growths of learners

EF

1

2

3

4

5

5

Establishes rapport with learners

CA

1

2

3

4

5

6

Has a positive attitude towards learners

CA

1

2

3

4

5

7

Demonstrates enthusiasm for one’s work

CA

1

2

3

4

5

8

Is patient

CA

1

2

3

4

5

9

Has a positive interaction with other health care workers

CA

1

2

3

4

5

10

Makes learning exciting and stimulating

EF

1

2

3

4

5

11

Has self-confidence

EF

1

2

3

4

5

12

Is available for learners

CA

1

2

3

4

5

13

Is honest and has integrity

CA

1

2

3

4

5

14

Has leadership qualities

EF

1

2

3

4

5

15

Is aware of his/her role model status

EF

1

2

3

4

5

16

Is nice and easy to work with

CA

1

2

3

4

5

17

Is professionally competent in difficult clinical situations and able to cope with adversity

EF

1

2

3

4

5