Rheumatology education and management skills in general practice: a national study of trainees.

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Abstract
OBJECTIVE--To evaluate current rheumatology education and skills during vocational training in general practice. METHODS--A postal questionnaire survey was sent to all general practice trainees who were in United Kingdom training practices in June 1992. A second survey was made of general practice trainers in the UK. RESULTS--Questionnaires were returned by 1624 trainees, representing 70% of all trainees known to be in a training practice on 1 April 1992. Of the 1075 responders who were at the end of their trainee year, 35% had not received any tutorials on rheumatological topics with their trainer, and only 43% had experienced specific rheumatology teaching on local day release courses. Although 84% of these trainees had injected or aspirated the knee, fewer than 40% had acquired shoulder injection skills. Lack of experience was matched by low reported confidence. Trainees rated the amount of their rheumatology education as inadequate. Nine hundred trainers returned questionnaires--a response rate of 33%. Their estimate of the amount of local training provided was similar to that among the trainees, but this sample of trainers reported a higher level of practical teaching than the trainees indicated they had received. CONCLUSIONS--Rheumatology education during vocational training needs to be improved, particularly the component provided by trainers and local day release courses. This process might be facilitated by the development of a standard rheumatology curriculum which could be incorporated into all training schemes.