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The aim of this exploratory study was to capture and identify changes in clinical thinking amongst foundation trainees after a four-month attachment in general practice, and to develop a means of analysing the data collected to inform understanding about how clinical thinking develops and changes for a trainee - the learner - in the context of clinical experience. We use the term 'clinical thinking' consistently throughout our paper to refer to the trainees' general thinking about a case, and do so in the same way as other academics. Through the innovative use of Mind Maps, we have sought to demonstrate whether there was a significant change in the themes and key features contained in maps drawn by foundation year 2 trainees before and after an attachment in general practice, and to locate the nature of the change if present. Being able to identify such change is potentially valuable as it can assist in revealing a trainee's learning needs and shape future learning.

This paper presents an evaluation of attitudes towards a new PGCME for GP trainers in Wessex, UK, introduced in 2010. The course links the pre-existing experiential GP trainer course with an academic component validated by the University of Winchester (UoW). Data were collected through interviews with GP trainers who had completed the certificate, as well as the tutors who facilitate the trainer courses, and a thematic analysis of assignments submitted by the GP trainers. This evaluation suggests that the PGCME took time to become embedded in the GP trainer course but gradually gained acceptance by course tutors, though there was ambivalence about whether it should be mandatory or not. Both tutor group members and GP trainers expressed the view that the PGCME gave new opportunities for development as educators, and the assignments considered a broad range of topics in GP training. The impact of academic credentialing on GP trainer development is considered further.

Simulation has radically changed medical training and is set to continue to do so in the future. The branch of simulation that sees actors playing a role in training and assessment is long-established and well-developed. Typically actors have been used to play the role of patient. This innovation in communication skills teaching sees actors playing doctors (specifically GP trainees or GP appraisees), to enhance the continuing professional development of established GP trainers and appraisers. By using actors, scenarios drawing on typical encounters can be played up or down using techniques which are familiar to hi-fidelity electronic simulation. This flexibility enables the 'challenge' of the encounter to be tailored to the needs of the participants in order to maximise their learning. Feedback from participants at the workshops was positive, noting that the approach is both challenging and revealing of their own practice. More research is needed to develop this approach further and explore it's relevance to other areas of GP training and CPD.

This project adopted an 'evolving scenario' approach of an influenza pandemic to enhance factual and attitudinal learning in general practice registrars. The one-day session, held before the current outbreak, was based around a sequence of four video clips that portrayed the development and evolution of pandemic influenza through news flashes and pieces to camera. A short factual presentation was included. Small group discussions with plenary feedback followed each of these. Registrars were encouraged to consider their own feelings, what they needed as professional support at each stage, and what professional and personal issues a pandemic produced. A course structured in this way allowed participants at a training level to identify the major issues and consequences of an influenza pandemic. It was recognised that constructive preparation and planning for business continuity were possible. However, family illness and social consequences were recognised as causing a dissonance with professional practice that needs open debate.

A survey was undertaken of the application and reapplication forms used by all the UK deaneries for general practice (GP) specialty training. The aim of the survey was to identify similarities and differences between deaneries in terms of the content and nature of the information requested, and the relationship of that information to the Postgraduate Medical Education and Training Board's (PMETB) Quality Assurance Framework (QAF). The details requested on the application forms were compared to the guidance set out in Generic Standards for Training, in order to see if they reflected the areas and standards required by the PMETB for the quality assurance of medical education and training. Although many similar areas of information were requested in the application process, great variation was found across some items which were not attributable to regional or contextual differences. The survey also found that the majority of domains of Generic Standards for Training are not well covered in the paper application process. Although deaneries may view their application processes for trainer approval as robust, this paper makes a number of recommendations and argues for the development of a standardised form for the appointment of general practice specialty training (GPST) trainers across the UK, based upon the PMETB QAF.