ARE VOCATIONALLY TRAINED GENERAL-PRACTITIONERS BETTER GPS - A REVIEW OF RESEARCH DESIGNS AND OUTCOMES

Implicit and explicit in reviews of and changes to vocational educatio n for general practitioners in the 1990s is the challenge to defend th e assumption that vocationally trained GPs are better GPs. This paper provides a review of the international literature which has reported o n outcomes of general practice vocational training programmes. Through the review we identify both the types of research methodologies used (including a brief discussion of their strengths and limitations) and the outcomes reported of vocational training. Twenty-five studies on t he outcomes of vocational training are reviewed. These studies used mu ltiple data sources and one of four methodologies: pre- and post-train ing comparisons, analysis of learners' or teachers' accounts, audits o f general practice or analysis of examination pass rates. When collate d, the following range of outcomes from vocational training were ident ified: improved quality of patient care, increased knowledge, improved general practice skills, increased confidence and desirable GP attitu des and personality traits, increased adherence to practice guidelines and higher examination pass rates. The paper concludes with a summary of research and education issues which arise when we examine the ques tion posed at the outset: are trained GPs better GPs?.