Setting benchmarks for women’s health and general practice training

For someone who had never previously undertaken any academic research, it could be said that Dr Rachel Turner achieved top marks for her first research project.
 
Dr Turner is the recipient of GP Synergy’s 2018 NSW/ACT Dr Charlotte Hespe Research Award for her work in women’s health; more specifically, long-acting reversible contraception (LARC).
 
Her project focused on general practice registrars’ prescribing of LARC and drew data from questionnaires and recent studies through the Registrar Clinical Encounters in Training Study (ReCEnT), which collects data on what general practice registrars are doing in consultation.
 
‘I was looking at general practice registrars’ prescribing of LARC, which includes IUD [intra uterine device], implant or injection, compared to the pill and vaginal ring. LARC methods are the most effective methods of contraception but the uptake of them in Australia is quite poor,’ Dr Turner told newsGP.
 
Dr Turner found that 25% of all contraception prescribed is for LARC.
 
‘There is something getting in the way that’s stopping general practice registrars from using these methods, even though they know it’s the right thing to do,’ she said.
 
With Dr Turner’s findings suggested that LARC prescribing is associated with a number of educational factors and barriers.
 
‘What we’ve seen is that those registrars prescribing LARC tend to seek help more than when they’re prescribing the non-LARC methods, that they take longer with the consultation, and they generate more learning goals – so they actually note down that they need to learn something here,’ she said.
 
‘We also saw that registrars who had done specific additional training on reproductive health are more likely to prescribe LARC.
 
‘It’s given us a really strong educational method that registrars are open to prescribing these methods, but they don’t always feel fully supported and know what to do.’
 
The questionnaire aspect to Dr Turner’s project involved looking at the barriers to prescribing LARC and what general practice registrars identified with the educational elements – whether they’d had difficulty accessing training or practise using these methods.
 
‘The questionnaire was sent out to all GP Synergy registrars and had two main purposes. One was to provide clinical vignettes to see hypothetically whether they would choose a LARC method versus a non-LARC method, so that we could marry that up with what they’re actually doing in practise from the ReCEnT data,’ Dr Turner said.
 
‘Looking at that, it’s been interesting in that the majority of registrars hypothetically choose LARC as the preferred contraceptive method for their patients.’
 
Dr Turner undertook her research as part of her 2018 academic post, and hopes to continue academic work to complement her clinical roles.
 
‘I’ve absolutely loved this year. I applied for the academic post having never done research before; really wanting to but not quite knowing how to get in to it,’ she said.
 
‘I’ve really enjoyed that balance between the clinical and the academic.’
 
After she completes her general practice training next year and starts work at Family Planning NSW, Dr Turner plans to continue her research in LARC, incorporating the work from her academic post that she feels has opened up new research opportunities.
 
‘Now that we’ve got this data saying that we need to improve the education of registrars [regarding prescribing LARC], hopefully we can do some research surrounding intervention to improve that training for registrars,’ she said.

academic post general practice registrar women’s health