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Family Practice Vol. 20, No. 2, 207-212
© Oxford University Press 2003

Education in Primary Care

Effect of extension of postgraduate training in general practice on the acquisition of knowledge of trainees

Anneke WM Kramer, Herman Düsman, Lisa HC Tan, Koos JM Jansena, Richard PTM Grolb and Cees PM van der Vleutenc

a National Centre for Evaluation of Postgraduate Training in General Practice (SVUH), Utrecht,
b Centre for Quality of Care Research, Universities of Nijmegen and Maastricht and
c Department of Educational Development and Research,
University of Maastricht, The Netherlands.

Correspondence to AWM Kramer, Mauritsstraat 92, 3583 HV Utrecht, The Netherlands; E-mail: Carol_ann{at}tiro.nl

Background. Postgraduate training in general practice aims to develop clinical competence. However, little is known about its effect on trainees’ development of competence.

Objective. Our aim was to investigate whether 3 years of postgraduate training in general practice leads to a higher level of knowledge than 2 years training while maintaining the same structure and educational objectives.

Methods. This retrospective study had a mixed longitudinal design. Trainees of the Dutch postgraduate training in general practice participated. Knowledge was assessed by written progress testing of knowledge relevant to general practice embedded in real life situations. Test results were collected from 1992 to 1999. The results of trainees who received the 2-year and 3-year curriculum were compared.

Results. Both curricula started with the same entrance level and showed the largest acquisition of knowledge at the start and towards the end of training. Both curricula showed stagnation in growth at the end of the training period in which trainees rotate through hospitals, nursing homes and mental health institutions. The level of knowledge at the end of training was significantly higher for the 3-year curriculum.

Conclusion. This study shows that postgraduate training contributes to an increase in knowledge and that a 3-year programme leads to a higher level of knowledge than a 2-year programme. The stagnation in growth found at the end of rotations through hospitals, nursing homes and mental health institutions questions the impact of these rotations on the development of competence and the efficacy of the training as a whole. Further study is needed to draw more firm conclusions.

Keywords. Clinical competence, curriculum, education, educational measurement, family practice, graduate.


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