ORCID Profile
0000-0003-3586-4514
Current Organisations
The University of Newcastle
,
Royal Australian College of General Practitioners
,
The University of Hong Kong
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Publisher: CSIRO Publishing
Date: 09-12-2022
DOI: 10.1071/PY22202
Abstract: Background Practice managers and other administrative and management staff in Aboriginal Medical Services operate in a highly specialised cultural, social and administrative environment requiring a unique skill set. The TAFE NSW Diploma in Practice Management for Aboriginal Medical Services (DPMAMS) addresses the need for training in these skills. This study sought to explore DPMAMS graduates’ experiences of having undertaken the diploma course, and the effects on their subsequent work practice and career. Methods A qualitative study utilising in idual, semi-structured interviews conducted via videoconference and employing a thematic analysis approach was performed. Results Ten DPMAMS alumni participated. At the time of DPMAMS completion, two participants were Aboriginal Medical Services practice managers, two were reception staff, five were in non-practice manager administrative or management roles and one was in a clinical role. Principal themes in the study findings were related to (1) the rich and singular learning environment with emphasis on peer-to-peer learning (which also facilitated ‘communities of practice’ extending the collaborative learning model to post-DMAMS peer learning and support) (2) knowledge and subsequent professional and personal confidence (leading to taking on increased workplace responsibility including post-DPMAMS mentoring roles) (3) translational effects on personal work and professional performance (4) translational effects on work processes at the participants’ Aboriginal Medical Services and (5) the permeating influence of Aboriginal culture and commitment to Aboriginal communities. Conclusions The DPMAMS is an education/training program of perceived high value and fitness for purpose. The findings of utility of education that is empowered by culture, values and peer support may be applicable in wider settings.
Publisher: Mattioli1885
Date: 20-05-2021
DOI: 10.5826/DPC.1103A55
Abstract: Background: The management of psoriasis by general practitioners (GPs) is vital, given its prevalence, chronicity, and associated physical and psychosocial co-morbidities. However, there is little information on how GPs (including early-career GPs) manage psoriasis. Objectives: This study assessed the frequency with which Australian specialist GP vocational trainees (‘registrars’) provide psoriasis care and the associations of that clinical experience. Methods: A cross-sectional analysis was done of data from the ReCEnT study, an ongoing multi-site cohort study of Australian GP registrars’ experiences during vocational training. In ReCEnT, 60 consecutive consultations are recorded 3 times (6-monthly) during each registrar's training. The outcome factor for this analysis was a problem/diagnosis being psoriasis, and independent variables were related to registrar, patient, practice and consultation factors. This study analysed 17 rounds of data collection (2010-2017) using univariate and multivariable regression. Results: Data from 1,741 registrars regarding 241,888 consultations and 377,980 problems/diagnoses were analysed. Psoriasis comprised 0.15% (n=550) of all problems/diagnoses (95% CI, 0.13-0.16). Significant patient multivariable associations of a problem/diagnosis being psoriasis included age, gender, being new to a practice or a registrar, and psoriasis being an existing problem rather than a new diagnosis. Significant registrar associations included seeking in-consultation information/assistance, not scheduling a follow-up appointment, prescribing medication, and generating learning goals. Conclusions: Australian registrars have modest training exposure to psoriasis and may find psoriasis management challenging. Furthermore, continuity of care (essential for optimal chronic disease management) was modest. The findings have implications for GPs’ approaches to the management of psoriasis more widely as well for general practice education and training policies.
Publisher: Elsevier BV
Date: 02-2023
DOI: 10.1016/J.GIE.2022.09.020
Abstract: Computer-assisted detection (CADe) is a promising technological advance that enhances adenoma detection during colonoscopy. However, the role of CADe in reducing missed colonic lesions is uncertain. The aim of this study was to determine the miss rates of proximal colonic lesions by CADe and conventional colonoscopy. This was a prospective multi-center randomized tandem colonoscopy study conducted in three Asian centers. Patients were randomized to receive CADe or conventional white light colonoscopy during the first withdrawal of the proximal colon (cecum to splenic flexure), immediately followed by tandem examination of the proximal colon with white light in both groups. The primary outcome was adenoma olyp miss rate which was defined as any adenoma olyp detected during the second examination. 223 patients (48.6% male, median age 63 years) were enrolled and 7 patients did not have tandem examination, leaving 108 patients in each group. There was no difference in the miss rate for proximal adenoma (CADe vs conventional: 20.0% vs 14.0%, P=0.07) and polyp (26.7% vs 19.6%, P=0.06). The CADe group however had significantly higher proximal polyp (58.0% vs 46.7% P=0.03) and adenoma (44.7% vs 34.6% P=0.04) detection rates than the conventional group. The mean number of proximal polyp and adenoma detected per patient during first examination were also significantly higher in the CADe group (polyp: 1.20 vs 0.86 P =0.03 adenoma: 0.91 vs 0.61 P =0.03). Subgroup analysis showed that CADe enhanced proximal adenoma detection in patients with fair bowel preparation, shorter withdrawal time and endoscopists with lower adenoma detection rate. This multi-center trial from Asia confirmed that CADe can further enhance proximal adenoma and polyp detection, but may not be able to reduce missed proximal colonic lesions.
Publisher: Wiley
Date: 07-07-2019
DOI: 10.1111/AJO.13034
Abstract: In Australia, general practitioners (GPs) are recognised as an essential source of postpartum care. However, there remains a paucity of research pertaining to this, and in particular, to that of GP trainees (in Australia, termed 'registrars'). Previous post-graduate experience in obstetrics and gynaecology (O&G) is not a prerequisite for GP training, and thus, it is imperative that vocational training provides adequate exposure to postpartum consultations. To investigate the prevalence and associations of Australian GP registrars' (trainees') experience in postpartum care. A cross-sectional study employing data from the Registrar Clinical Encounters in Training (ReCEnT) project. ReCEnT is an ongoing cohort study where GP registrars record 60 consecutive consultations mid-way through each training term. The outcome variable was postpartum problem/diagnosis (compared to all other problems/diagnoses). The independent variables included registrar, practice, patient, consultation, clinical and educational factors. Analyses employed univariate and multivariable regression. Analysis included 2234 registrars (response rate 96.1%), 289 594 consultations, and 453 786 problems/diagnoses. Postpartum care (897) comprised 0.2% (95% CI: 0.19-0.21) of all problems/diagnoses in 0.3% (95% CI: 0.27-0.31) of all consultations. Significant multivariable associations included registrar's gender (female) and obtainment of post-graduate O&G qualifications. Postpartum consultations were longer and resulted in more learning goals being generated. An overall low prevalence was established. Both male registrars, and those without pre-existing O&G qualifications, may have particularly limited experience. These findings should inform educational policy and practice regarding postpartum care experience in general practice training.
Publisher: Springer Science and Business Media LLC
Date: 16-12-2022
DOI: 10.1186/S12875-022-01920-7
Abstract: During vocational general practice training, the content of each trainee’s (in Australia, registrars’) in-consultation clinical experience is expected to entail a breadth of conditions that exemplify general practice, enabling registrars to gain competency in managing common clinical conditions and common clinical scenarios. Prior to the Registrar Clinical Encounters in Training (ReCEnT) project there was little research into the content of registrars’ consultations despite its importance to quality of training. ReCEnT aims to document the consultation-based clinical and educational experiences of in idual Australian registrars. ReCEnT is an inception cohort study. It is comprised of closely interrelated research and educational components. Registrars are recruited by participating general practice regional training organisations. They provide demographic information about themselves, their skills, and their previous training. In each of three 6-month long general practice training terms they provide data about the practice where they work and collect data from 60 consecutive patient encounters using an online portal. Analysis of data uses standard techniques including linear and logistic regression modelling. The ReCEnT project has approval from the University of Newcastle Human Research Ethics Committee, Reference H-2009–0323. Strengths of the study are the granular detail of clinical practice relating to patient demographics, presenting problems/diagnoses, medication decisions, investigations requested, referrals made, procedures undertaken, follow-up arranged, learning goals generated, and in-consultation help sought the linking of the above variables to the presenting problems/diagnoses to which they pertain and a very high response rate. The study is limited by not having information regarding severity of illness, medical history of the patient, full medication regimens, or patient compliance to clinical decisions made at the consultation. Data is analysed using standard techniques to answer research questions that can be categorised as: mapping analyses of clinical exposure exploratory analyses of associations of clinical exposure mapping and exploratory analyses of educational actions mapping and exploratory analyses of other outcomes longitudinal ‘within-registrar’ analyses longitudinal ‘within-program’ analyses testing efficacy of educational interventions and analyses of ReCEnT data together with data from other sources. The study enables identification of training needs and translation of subsequent evidence-based educational innovations into specialist training of general practitioners.
Publisher: The Royal Australian College of General Practitioners
Date: 11-2019
Publisher: Public Library of Science (PLoS)
Date: 20-01-2023
DOI: 10.1371/JOURNAL.PONE.0280668
Abstract: Second-line pharmacotherapy for Type 2 Diabetes Mellitus (‘diabetes’) is necessary for optimal glycaemic control and preventing longer-term complications. We aimed to describe temporal trends in, and associations of, Australian general practitioner (GP) registrars’ prescription, and initiation, of ‘new’ second-line oral agents (dipeptidyl peptidase 4 inhibitors, sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide 1 agonists) compared to sulphonylureas. A longitudinal analysis (2010–2018) of data from the Registrar Clinical Encounters in Training project. Analysis included any diabetes problem/diagnosis that involved prescription of sulphonylureas or ‘new’ oral agents. Simple and multiple logistic regression models were fitted within the generalised estimating equations framework. 2333 registrars recorded 6064 diabetes problems/diagnoses (1.4%). 835 problems/diagnoses involved sulphonylurea or ‘new’ medication prescription. Of these, 61.0% [95% CI:57.4–64.4] involved ‘new’ medication prescription. 230 problems/diagnoses involved sulphonylurea or ‘new’ medication initiation, with 77% [95%CI:70.8–82.1] involving a ‘new’ medication. There was a significant 52% per year increase in prescribing (OR = 1.52[95% CI:1.38–1.68],p .001), and a 77% per (two-to-three-year) time-interval increase in initiation (OR = 1.77,[95% CI:1.30–2.43],p = .001) of ‘new’ medications compared to sulphonylureas. ‘New’ medications were prescribed less for non-English-speaking patients. There was some regional variation in prescribing. Registrar uptake of ‘new’ oral agents compared to sulphonylureas has increased rapidly.
Location: Australia
No related grants have been discovered for Irena Patsan.