Guy Rocher

The development of self-efficacy beliefs during general practice vocational training: An exploratory study

Introduction: Retention of general practitioners (GPs) is crucial to ensure appropriate primary care. However, some recently qualified GPs feel unprepared for practice, which may lead them to leave the profession or restrict their scope of practice. The development of self-efficacy beliefs during vocational training may be an important factor in this phenomenon. Methods: Five focus groups with a total of 28 GP trainees and recent graduates were conducted in Belgium and France. Initial analysis using the immersion-crystallisation method was followed by analysis using Banduras self-efficacy framework. Results: Participants described beginning their training with low self-efficacy beliefs. Most participants described how they overcame stressful situations. Some, however, seemed to be developing avoidance strategies. Successfully resolving patient problems, sharing experiences with peers and receiving positive feedback from supervisors, colleagues and patients were conducive to the development of positive self-efficacy beliefs. Discussion: Although low self-efficacy beliefs are natural at the beginning of training, participants seemed to develop in two ways, either overcoming their fears or avoiding them. Identifying the pattern of trainees’ responses to allow tailoring of interventions should be investigated by those who run training programs. Interventions could include reassurance, peer interaction and an appropriate degree of autonomy.

General practice as seen through the eyes of general practice trainees: A qualitative study

Objective. To explore the perceptions of general practice trainees regarding their discipline and to compare these spontaneously expressed views with recently proposed definitions of general practice. Material and methods. A qualitative focus-group study was conducted in one Belgian and two French medical schools. Twenty-eight trainees took part (16 from Belgium and 12 from France). The transcripts were analysed by the immersion crystallization method. Results. The participants in this study seemed prepared to take on the many responsibilities outlined in various definitions of general practice, but feared personal commitment to accessibility and continuous care. Being skilled clinicians and patients’ advocates formed their “raison d’être” in the healthcare system. They were reluctant to act as gatekeepers within the system, a role that might jeopardize their advocacy function for their patients. They mentioned the lack of appeal of entrepreneurship aspect of practice. Participants reported that training settings typically offer traditional models of practice, which sometimes led them to feel estranged from a profession that they felt needs reorganization. Conclusions. Participants’ descriptions generally coincided with official definitions of general practitioners’ tasks, except for practice management and gate-keeping aspects. They were willing to accept the burden of general practice as long as responsibility could be shared and as long as there was freedom for flexible progress along a modern career track.

Inter-Generation Occupational Mobility in the Province of Quebec

This study deals with what P. Sorokin calls “inter-generation occupational mobility”.1 It endeavours to ascertain the extent to which occupation is transmitted from father to son, and the occupational transfers that occur when sons do not follow their fathers’ occupations. Similarity of occupation between father and son is called occupational stability; change of occupation from father to son is referred to as occupational mobility. Our study is concerned with occupational stability and occupational mobility.