Operationalising generalism in medical education: a narrative review of international policy and mission documents

Ramanathan, A., Clarke, N., Foster, M., Pope, L. , Hart, N., Cheung, S., Kelly, M. and Park, S. (2023) Operationalising generalism in medical education: a narrative review of international policy and mission documents. Education for Primary Care, (Early Online Publication)

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Introduction: Despite moves across medical education to increase learning of generalist principles, a lack of clarity about what generalism means and how we should train doctors as ‘generalists’, has remained. This study explores how international, undergraduate and postgraduate, policy and educational mission documents characterise the practice and learning of generalism and how this can inform physician training. Methods: A narrative literature review was conducted based on policy and mission documents identified through grey literature searches and a wider systematic review looking at empirical texts. Texts published between 1999 and present and related to ‘generalism’ were eligible for inclusion. Texts were coded and codes were reviewed and grouped into key themes. Results: Thirty-four documents were included. Definitions vary: some described generalism as a basic skill, whilst others emphasised expertise. Factors which support learning generalism include: favourable financial outcomes; ageing populations; coordination of multidisciplinary care; demand for doctors with transferable skills; and patient expectations. Barriers to learning about generalism include: preference for specialisation; structure of undergraduate teaching and assessment; and the hidden curriculum. Solutions may include re-imagining generalists and specialists as being on a continuum as well as increasing exposure throughout medical education. Discussion: Whilst generalism is consistently positioned as valuable, less clarity exists about how best to operationalise this in medical education. Fundamental ideological and structural changes within teaching curricula and assessment, are necessary to improve generalist learning and to promote sustainable practice. Medical education needs careful, considered planning to ensure workforce expertise is meeting population needs.

Item Type:Articles
Status:Early Online Publication
Glasgow Author(s) Enlighten ID:Pope, Professor Lindsey
Authors: Ramanathan, A., Clarke, N., Foster, M., Pope, L., Hart, N., Cheung, S., Kelly, M., and Park, S.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
Journal Name:Education for Primary Care
Publisher:Taylor & Francis
ISSN (Online):1475-990X
Published Online:19 December 2023
Copyright Holders:Copyright © 2023 The Authors
First Published:First published in Education for Primary Care 2023
Publisher Policy:Reproduced under a Creative Commons licence

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