Cabin Fever: an innovation in faculty development for rural preceptors

Australian College of General Practice (RACGP), has outlined a curriculum and specific competencies. There is increased awareness of the distinct set of skills required by GPs working in prison settings. Continuing professional development programmes do not specifically target the needs of prison GPs, although many of the competency areas will be relevant to the prison setting. There was a perceived lack of a comprehensive approach to identifying and meeting the training needs of GPs in our state, and perhaps nationally. What was done The first stage of this study involved 10 interviews, 8 with prison GPs and 2 with people whose roles were closely linked to prison health care. The interviews with GPs explored their perceptions of gaps in their knowledge and skills. The themes to emerge from these data were presented at a group meeting of 3 prison GPs and the director of the Prison Health Service. The themes were refined following the feedback at that meeting. The second stage involved the development of a questionnaire based on the competencies outlined by the RACGP, to be sent to GPs working in prisons in 4 states. The respondents were asked to rate the importance of these competencies to their work in the prison setting. Evaluation of results and impact From the data generated in stage 1, emergency medicine, management of fractures and mental health were identified as the main areas where skills needed to be acquired or refreshed. It became clear that prison GPs had no formal networking process for sharing best practice, reflecting on critical incidents or suggesting prisonspecific training. There were different views across urban and rural settings, reflecting the fact that rural GPs tended to have had radiology training – a need identified by urban GPs. Prison GPs were often treating people who would have been referred for specialist treatment (e.g. psychiatry) had they been outside the prison setting. The data from the questionnaires suggested that many competencies were rated as highly important by most respondents, with the highest ratings falling in the clinical areas of mental illness and substance abuse. Competencies rated as less important fell into the clinical area of dentistry and the ‘organisation and legal’ domain. In Australia, GPs in prisons often also work outside the prison setting. They need to balance their CPD activities to meet both roles. These data can inform policy on education and training for prison GPs. The study has also highlighted the need for a formal network within and across states to share best practice and develop appropriate training programmes. Correspondence: Alison Jones, Department of General Practice, University of Adelaide, Adelaide, South Australia 5005, Australia. Tel: 00 61 8 8303 6276; Fax: 00 61 8 8303 3511; E-mail: alison.jones@adelaide.edu.au