Qualitative study of educational interaction between general practitioners and specialists

Objectives: To identify the main barriers to effective educational interaction between general practitioners and specialists and to suggest ways of overcoming these barriers. Design: Qualitative study using semistructured interviews and focus groups. A content analysis of the data was performed Setting: South and West Regional Health Authority. Subjects: 12 general practitioner principals and 12 hospital consultants were sampled purposefully and underwent a semistructured interview; a further 16 general practitioners and 16 hospital consultants similarly sampled made up four focus groups representing the two branches of the medical profession. Results: There was a mismatch between what the general practitioners wanted from specialists in educational terms, and what the specialists were providing. General practitioners wanted to learn information that was directly applicable to their clinical work and to use referrals as two way learning opportunities. They were not sufficiently explicit about their learning needs. Specialists preferred to concentrate on new developments in their subject and would benefit from learning different ways of teaching. The participants were willing to learn from each other. Three models of educational interaction were identified: traditional didactic lectures given by specialists to general practitioners, interactive clinically based teaching, and informal interaction based on referrals. Conclusions: The two main branches of the medical profession have to address several significant problems before the full potential of teaching and learning together can be realised.