PRIMARY-CARE CONSULTATION SKILLS TRAINING - IMPLEMENTING A NEW TRAINING-PROGRAM FOR SENIOR HOUSE OFFICERS IN AN ACCIDENT AND EMERGENCY DEPARTMENT

Senior house officers (SHOs) in Accident and Emergency (A&E) departmen ts see many patients who present with primary care problems. Until now , most SHOs have lacked postgraduate training in primary care skills t o enable them to meet these patients' needs effectively. This paper de scribes an innovative training programme that has been developing at K ing's College Hospital, London. It identifies a new opportunity for ge neral practitioners to contribute to the postgraduate medical educatio n of hospital junior medical staff. The training programme was designe d to give A&E SHOs protected time in which to reflect on strengths and weaknesses in relation to primary care consultations and learn from t heir experiences. Its aim was to improve the assessment and management of patients, and to encourage a problem solving approach within the A &E setting. The programme, established in 1992, was developed through collaboration between the departments of A&E Medicine and General Prac tice and Primary Care. Evaluation has been a central theme in its deve lopment, and has been used to ensure that the training meets the needs of each individual set of SHOs and of the department. It has been use d in establishing agreement about the training's value and benefits. T he authors discuss some of the methodological difficulties encountered in evaluating this type of educational initiative.