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Title: A real-world competency framework for evidence-based general practice
Author: Galbraith, Kevin
ISNI:       0000 0004 7653 8931
Awarding Body: University of Oxford
Current Institution: University of Oxford
Date of Award: 2018
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BACKGROUND: Evidence-Based Health Care (EBHC) has become established as a cornerstone of modern medicine. Its guiding principle is that decisions should be based upon an integration of the best available evidence from research, the practitioner's expertise and the patient's values. General Practitioners (GPs) describe numerous constraints to EBHC. They lack an EBHC competency framework that acknowledges these constraints. The aim of this thesis was to construct such a framework for use in performance appraisal and routine practice. METHODS: A multi-source synthesis was conducted in three stages: (1) a synthesis of qualitative and quantitative evidence from the research literature about EBHC competence in general practice resulted in five themes, which formed the basis of a preliminary 'straw model' competency framework; (2) a Delphi process among a panel of experts refined the straw model framework and generated a further seven themes; (3) themes from stages 1 and 2 were synthesised, resulting in a final real-world competency framework for general practice. A content analysis was carried out on a sample of GP performance appraisals to determine the content validity of the new framework. It also generated behavioural descriptors for emerging and full competence, and illustrative clinical vignettes to assist GPs in its application. RESULTS: The real-world framework comprised three competencies: (1) mindfulness in one's approach towards EBHC itself, and to the influences on decision-making; (2) pragmatism in one's approach to finding and evaluating evidence; and (3) knowledge of the patient as the most useful resource in effective communication of evidence. The content validity of the new framework was confirmed. CONCLUSION: A new real-world EBHC competency framework was developed for use in GPs' performance appraisals and in their routine practice. Behavioural descriptors and illustrative vignettes accompany the framework to assist its application.
Supervisor: Heneghan, Carl ; Ward, Alison Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available