Understanding the tutorial in General Practice: towards the development of an assessment tool

The tutorial between GP Trainer and GP Registrar is at the centre of learning and assessment in General Practice. However, the content and style of the tutorial is left to the discretion of the trainer themselves and the evaluation of this tutorial is carried out in an unsystematic way. Therefore, the present study aimed to explore what GPs believe constitutes a good tutorial in terms of the behaviour of the GP trainer and to develop a tool for assessing the quality of this component of GP education. Following discussions with Trainers and GP Registrars and after exploration of the literature, twenty Behavioural Indices (BIs) were identified as representing possible teaching practices in a one-to-one situation. Eighty six Trainers in the South Thames (West) Region (response rate 86%) then rated these twenty BIs in terms of their importance in a tutorial. The results showed that 'expressing opinion', 'asking open-ended questions', 'providing facts', 'checking knowledge', and 'responding to enquiry' were regarded as the most important components of the tutorial whilst 'correcting facts', 'disagreeing', 'being non-judgmental' and 'criticising' were seen as the least important. These BIs were then assessed to examine the extent to which they reflected the different roles for the Trainer. Provide support, encourage, respond to inquiry). The rankings of the roles indicated that the trainers regarded 'resource' as the most important role, followed by 'facilitator' then 'mentor' with 'critic' being rated as the least important role. The results therefore provide insights into what trainers believe constitutes a good tutorial and it is suggested that the questionnaire developed for this study could be used to train the trainers and to evaluate tutorials for GP assessment.