Huisartsgeneeskunde: aantrekkingskracht en beroepstrouw ... - Lirias

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32 Making General Practice Attractive: Encouraging GP attraction and Retention KCE Reports 90 3.4.1.3 Interviews 3.4.1.4 Analysis All medical faculties of seven Belgian universities o sent an e-mail letter to their seventh year medical students (total n = 768). The letter provided basic information on the study aim and tackled practical issues and info on compensation (2 movie tickets). A balanced sample (see appendix 3.4.) was taken out of the total list of interested students (n = 102), based on a predetermined set of criteria: • specialization choice: first choice is general practice / first and second choice are not general practice, • gender: total sample contains approximately 50 % male and 50% female students, • university: at least 2 students of each medical faculty because the academic culture also influences the specialty choice (see chapter 2). The selected students were contacted to arrange the interview. Three interviewers (two in Flanders (HB, LS) and one in Walloon (CD)) performed the 24 interviews. All conducted a pilot interview and another researcher provided a feedback. The interviewers agreed on the final version and on interview strategies. The interviewer could probe areas suggested by the respondents’ answers, picking up information and in this way exploring specific topics. This could be done by prepared questions or just by asking for more detail and depth. Interviews were performed at the student’s university and took between 30 minutes and one hour. All interviews were audiotaped and transcribed verbatim. A grounded theory approach (constant comparison method) was used to analyze the data. Open coding is the first step in the analytic process. In the process of coding, pieces of text were identified and labeled. In a second step these open codes were grouped into concepts (axial coding) 128 . Two researchers coded (LS; HB) independently two Dutch interviews, followed by identifying primary codes and organizing a list of concepts (coding frame). Four more Dutch interviews were then coded using this coding frame, and in this way performing a constant comparison of the concepts in the new interviews. Extra themes emerging from those 4 interviews were agreed upon in consensus. The French-speaking researcher, who independently developed primary codes and a list of concepts, coded three French interviews. During a meeting the 3 researchers compared themes and concepts and decided which topics should be integrated into the quantitative questionnaire. It was agreed upon that the Dutch and French speaking researchers continued to use their own concept lists to code the remaining interviews. A constant comparison of concepts in each group was in this way guaranteed. One researcher (HB) aggregated the concepts further into the final concept list. The two other researchers (LS, CD) independently checked and confirmed this concept list (see appendix 3.5.). 3.4.2 Quantitative survey study This part triangulates the results of the qualitative part and offers further quantitative data, so triangulating data of the qualitative study. The same three sub questions were o UA, UG, VUB, KULeuven, ULG, UCL and ULB
KCE Reports 90 Making General Practice Attractive: Encouraging GP attraction and Retention 33 addressed. A transversal study was conducted in the entire population of 7th year medical students of Belgian universities during the academic year 2007-2008. 3.4.2.1 Quantitative instrument The items of the questionnaire were derived from the literature review detailed above and from the interviews with students in the qualitative part of the study. The interview guide and the three sub-questions (factors influencing before and during medical school and attracting students to choose the GP profession) provided a basis to draft the questionnaire. The chronological order of the specialty process was the frame for the questionnaire as in the qualitative study. To enable the students to oversee the total package of questions, the questionnaire was divided into five parts. Each part referred to questions from the qualitative study. • Part I: Personal data This part explores some socio-demographic factors p and analyses the student’s choice for his/her university. • Part II: Choice to study medicine This part analyses the factors that influenced the students to choose for medicine study. Determining factors emerging from the qualitative study were included (question 12). It also explores if the students already had any idea about their future specialty when they began their academic studies. • Part III: Choice of the discipline of specialty This part investigates the specialty preferences. Questions 17 and 18 were added based on the qualitative results. • Part IV: Contact with general practice This part focuses on the role of the university in the decision making process for the specialty i.e., the influence of the curriculum and the contacts with general practice and patients. This part also analyses the student’s perception about the profession of general practitioner 23 , 129 and the factors that influenced this perception. A few questions originating from the qualitative results were added to the questions selected from the literature (question 23). In question 26 the personal GP was added as an information source on the image students have of a GP because that seemed important from the results of the qualitative part. • Part V: Professional life Finally, a self-assessment tool 130 explores the values and perception of the students (2 categories: “choose another specialty than GP”; “choose to become a GP”) in relation with their future professional life. The final question explores the student’s opinion about statements to make general practice more attractive in the future. The preliminary instrument was developed in Dutch and the draft version was adapted after a feedback from the steering group and 12 students of a pilot sample. Those students were students who were, the year before, in their 7 th year of medical study at the Ghent University. In particular, the initial questionnaire was too long. To increase the response rate we shortened and simplified the form. The final version was a multiple-choice questionnaire i.e., the students ticked their answers and the time to fill the questions did not exceed twenty minutes. Subsequently, a French-speaking researcher (CD) translated the questionnaire into French and a translator not involved in the project performed back translation. A few corrections and additional clarifications improved the final version after this translation. The final versions of the questionnaire are in appendix 3.6. and 3.7. p Some questions were adopted from the questionnaire in ‘Career Preference of Medical Students and Career Choice of Recent Graduates’ Marc Soethout (p. 156).
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Huisartsgeneeskunde: aantrekkingskracht en beroepstrouw ... - Lirias

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