How to use AJGP for your CPD
Each issue of the
Australian Journal of General Practice (
AJGP) has a focus on a specific clinical or health topic.
Many GPs find the entire issue of interest and of relevance to their practice; some GPs find one or more articles in the journal relevant.
You can use
AJGP for your CPD. If you want to use the entire issue for CPD, you must work your way carefully through each article in the issue and complete the Clinical challenge. When you do this, take time to read the articles carefully and critically, and think carefully about how you might adjust your practice in response to what you have learned.
We recommend that you access
AJGP, the articles and the Clinical challenge through
gplearning (Activity ID: 1004190). You can also opt to complete this issue’s Clinical challenge measuring outcomes (MO) activity on heat health for 5 hours MO. When you complete the articles and the Clinical challenge options, your CPD hours are automatically credited to your CPD account.
If you work through the full issue of
AJGP and complete the Clinical challenge, you will receive 10 CPD hours (five hours’ Educational Activities and five hours’ Reviewing Performance).
If you do not want to do the full
AJGP issue, and you prefer to select one or more articles to read, you can QuickLog the CPD hours directly through your myCPD dashboard. As guidance, each article in
AJGP would provide 1–2 CPD hours, split half Educational Activities and half Reviewing Performance.
You can do self-directed MO CPD related to this issue. Choose any topic that is relevant to you. Like all CPD you can do this alone, with a colleague, in a group, and assist/support your practice manager or PHN.
Consider conducting a review of your practice’s capacity and capability to manage a disaster in your setting. You can choose any potential disaster that is relevant to you. Use the criteria outlined in Table 1 of the focus article ‘Disaster planning in general practice’.
An evaluation might take you several MO hours whereas a more comprehensive Plan-Do-Study-Act approach would provide at least 10 hours of MO CPD. Login to myCPD to access activity templates and to record your MO CPD hours.
These questions are based on the Focus articles in this issue. Please choose the single best answer for each question.
Case 1
Following extensive local bushfires in his community, Jason, a teenager aged 16 years, presents to you for referral for mental health support.
Question 1
During the 2019–20 Black Summer bushfires, which major health challenge was identified requiring management?
- Heat stroke
- Arthropod diseases
- Air contamination
- Allergic rhinitis
Question 2
In Australia, which two natural disasters have the greatest mortality rate?
- Heatwaves, floods
- Floods, hurricanes
- Heatwaves, bushfires
- Bushfires, floods
Question 3
The definition of climate distress is:
- psychological state overwhelmed by climate change
- distress due to changing seasons
- poor adaptation to different climates
- distress due to hot weather
Question 4
In patients with severe mental illness, significant risk factors for heat-related morbidity include poor physical health, poverty and:
- inadequate water intake
- infrequent exercise
- prescribed medications
- technology paranoia
Case 2
You are a general practitioner working in a rural flood-prone area of your state. You arrange a team meeting to discuss preparedness for emergencies prior to the next flood season.
Question 5
In addition to increased rates of diabetes, hypertension, asthma and cerebrovascular events, which other medical condition observes an increased rate of presentation in disaster-affected communities?
- Gallstone disease
- Myocardial infarction
- Otitis media
- Tension pneumothorax
Question 6
In the event of a natural disaster, who is responsible for activation of the emergency plan?
- Practice manager
- Senior clinician
- Emergency coordinator
- Emergency services
Question 7
The Royal Australian College of General Practitioners’ Standards for general practice describe requirements for practice accreditation with regards to disaster planning. Which of the following options does it include?
- Having a disaster plan
- Storing back-up files onsite
- Having three emergency coordinators
- Diverting patients to emergency departments
Question 8
The four phases of disaster management include prevention, preparedness, response and:
- restitution
- review
- remorse
- recovery
Case 3
Yvette, a woman aged 43 years, is involved in a multi-train collision. First responders have arrived onsite to assist with medical emergencies.
Question 9
Major Incident Medical Management and Support (MIMMS) training is intended to support which process of a disaster response?
- Offline patient record access
- Maintaining core clinic infrastructure
- Manage patient complaint processes
- Mass casualty incident response
Question 10
Which international framework identifies chronic disease healthcare as a major disaster healthcare demand?
- The Sendai Framework 2015–30
- The Kyoto Protocol 1997
- The Paris Agreement 2016
- The Montreal Protocol 1987
These questions are based on the Focus articles in this issue. Please write a concise and focused response to each question.
Case 1
Following extensive local bushfires in his community, Jason, a teenager aged 16 years, presents to you for referral for mental health support.
Question 1
Describe the general practitioner role of providing trauma-informed and person-centred care in managing mental health conditions impacted by climate change-related events.
Question 2
Summarise the main ways general practitioners can provide support to pregnant women and families with young children during and after a disaster.
Question 3
Describe three specific health issues that were related to or exacerbated by the Black Summer bushfires.
Question 4
Describe four factors that can contribute to climate distress in young people.
Case 2
You are a general practitioner working in a rural flood-prone area of your state. You arrange a team meeting to discuss preparedness for emergencies prior to the next flood season.
Question 5
Describe the role a general practitioner plays in dealing with the health impacts on chronic conditions observed following a natural disaster.
Question 6
List four population groups who might be identified as being at higher risk during natural disasters.
Question 7
List four medication-related challenges faced by individuals with chronic diseases during natural disasters.
Question 8
List six items you would consider including in a practice emergency kit to be used in response to a natural disaster.
Case 3
Yvette, a woman aged 43 years, is involved in a multi-train collision. First responders have arrived onsite to assist with medical emergencies.
Question 9
Describe three key disaster health management concepts that general practitioners need to understand to be effectively integrated into a disaster health management response.
Question 10
List four ways that Primary Health Networks can support general practitioners in disaster health management.
December 2024 Multiple-choice question answers
Answer 1: A
The use of a shared screen by a medical educator (ME) undertaking a remote external clinical teaching visit can be helpful because the ME is able to see how the registrar records in the medical record and uses appropriate online resources.
Answer 2: D
A prompt for a registrar to explore a patient’s expectations might include statements starting with ‘I hope …’.
Answer 3: B
Practical tips and model phrases suggested by Morgan and Wrigley for a safe and effective general practice consultation include tips and phrases related to using telehealth.
Answer 4: C
A recently emerged concept based on the diagnostic pause is the management pause.
Answer 5: C
Consultation skills include communication skills as well as skills such as relationship building, identifying agendas, shared decision making, time management and arranging follow-up.
Answer 6: D
Up to two-thirds of medical students state that negative comments about medical specialties would affect their specialty choice.
Answer 7: A
The Medical Schools Council and Health Education England have suggested strategies to target the undermining of general practice. This includes teaching students about the hidden curriculum and incorporating ‘undermining’ into faculty development.
Answer 8: D
The idea-generation phase of preparing a grant application includes generating a clear aim, forming a team and understanding the constraints.
Answer 9: C
You should allow at least three months to obtain ethics approval, particularly if it needs to go to the Human Research Ethics Committee full panel.
Answer 10: A
The 3Rs model of management of uncertainty includes:
- review (and reassure)
- refer
- Rx (treat)
December 2024 Short answer question answers
Answer 1
The efficiencies from a remote external clinical teaching visit (ECTV) compared to a face-to-face ECTV include time savings for visitors, with significantly less travel required; the cost savings for the training organisation; the ease and flexibility of organising for the practice managers; a greater pool of visitor experience from which to draw; and savings for the environment.
Answer 2
The disadvantages of undertaking a remote ECTV compared to a face-to-face ECTV include difficulty for the visitor hearing the consultation; reduced ability to observe non-verbal cues and body language; reduced human interaction between the registrar and visitor; reduced or altered ability to build rapport between the visitor and registrar, or between the visitor and the practice; reduced ability to observe clinical examination and procedures; and reduced ability to assess practice ‘vibe’ and overall registrar experience.
Answer 3
Preparation for a consultation can include organising your desk and room at the start of the day and between patients; completing and closing all previous patient records; reviewing the appointment book at the start of the session and preparing as able; checking whether you have seen the patient before (or as a parent of a child); reviewing the last visit and recent investigations or correspondence; and taking a break after a difficult or emotional consultation.
Answer 4
Questions registrars could ask themselves as part of a management pause include:
- Why am I choosing this intervention?
- What are the potential downsides?
- What are the potential alternatives?
- What is the patient’s perspective?
Answer 5
Tips that Dr Amina could use as part of gathering data include:
- summarising the history back to the patient
- exploring the meaning of potentially ambiguous terms
- using validated assessment tools
- examining the patient routinely
- exposing the patient adequately
- using checklists for physical examination in specific presentations.
Answer 6
Strategies Dr Amina could use to manage time in her appointments include:
- identifying the ‘list’ of problems early in the visit
- prioritising which is the most important issue for both the patient and the doctor
- asking patients to return for another visit
- signposting time.
Answer 7
The ‘hidden curriculum’ includes the values, influences and implicit sociocultural messaging delivered to students behind the scenes, within the organisational structure, that can drive perceptions of what is deemed ‘good’ and ‘bad’ medicine. The ‘hidden curriculum’ is where potential exposure to negative comments about general practice can influence students’ perspectives and consideration of the speciality that forms the cornerstone of healthcare in Australia.
Answer 8
When preparing a budget for a grant proposal the largest budget items tend to be salaries, which require you to forecast the time each team member will need to fulfil their duties. Also remember those individuals beyond the immediate research team (e.g., academic consultants, statisticians and steering committee members). You might need services and material resources, such as transcription, survey or software licences, or participant reimbursements.
Answer 9
Approaches that supervisors can take to teach the management of uncertainty include:
- making explicit the different paradigm operating in primary care
- normalising uncertainty
- demonstrating shared decision making
- encouraging safety netting and follow up
- exploring uncertainty by considering diagnostic options
- exploring uncertainty by considering management options.
Answer 10
The key themes found by Askew et al related to the barriers, motivators and enablers to becoming a GP supervisor were:
- being a good supervisor
- motivated by past experiences of supervision
- financial implications of being a supervisor
- factors unique to rural settings
- new models of supervision
- becoming a supervisor – how and when?