The PQRST framework for case discussion: a pilot evaluation

Simon Morgan, Samia Toukhsati, Pemra C. Unalan, Carla Taylor, Mehmet Ungan

Keywords: case discussion, general practice, teaching, on the job learning, assessment

Background:

Case discussion is a very common activity in general practice training and is used for both clinical oversight and teaching purposes [1]. In 2021, a new framework for registrar-initiated case discussion in the general practice setting was published in Australia, the so-called “Problem, Question, Reason, Solution, Teach” (PQRST) model. It comprises five steps, namely:
P: What is the patient’s problem?
Q: What is the registrar’s question?
R: How well does the registrar reason?
S: What is the solution?
T: What can be taught?
Recent research has highlighted the value of the PQRST as a means by which to clarify areas of competency and learning needs in Australian general practice training [2], a setting where registrars consult independently with patients, but practice under the supervision of accredited GP trainers. This is analogous to the European context. It is of interest to evaluate the value of the PQRST as a tool to support case discussion for teaching in European general practice on the job learning activities.

Research questions:

What is the utility, acceptability, and value of the PQRST as a model for case discussion in European general practice training?

Method:

Quasi-experimental, mixed methods pilot study involving GP supervisors, comprising a pre-post evaluation of a webinar-based educational intervention and demonstration of the PQRST framework both in practice teaching and assessment. Survey data will be imported into SPSS for analyses.

Results:

Conclusions:

This project will produce new knowledge about the utility of the PQRST framework as a case discussion tool in GP supervision in European general practice clinical environments based training. This has potential to inform GP supervision, improve GP training, and improve patient health and safety.
1. Ingham G, Morgan S, Kinsman L, Fry J. Are GP supervisors confident they can assess registrar competence and safety, and what methods do they use? Aust Fam Physician 2015;44(4):236–40.

Points for discussion:

2. Morgan S, 2. Toukhsati SR, Taylor CJ. It’s as easy as PQRST – a new tool for effective case discussion. Paper presented at ANZPME2023; 2023 Nov 15-15; Perth, Australia

Do you need or use case discussion and supervision in general practice as a teaching tool in your country?

How to configure the "case discussion and supervision tool" to use it for training and for an objective assesment purposes?

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