KFP – Education in General Practice

Emily Tran, aged 34, is a GP registrar in her first term of general practice training. She has been placed at a busy suburban practice with four other GPs. You are her supervisor. This is her first GP placement following hospital rotations. She presents to you at the end of her morning session looking flustered and upset.

Emily tells you she saw a 62-year-old male with a history of T2DM and smoking who presented with mild chest discomfort. She did not arrange any investigations, and the patient has since called back reporting worsening symptoms and was advised by the receptionist to attend the emergency department. She is concerned she may have missed something serious and is worried about patient harm and professional consequences.

Medications: Not available

Past history: Type 2 diabetes mellitus, hyperlipidaemia, smoker (20/day)

Psychiatric history: Nil known

Social history: Lives alone

Emily is visibly distressed and says, “I don’t think I can do this. I’m going to fail my term and hurt someone.”

What are the most appropriate immediate actions in this situation? Select three (3) from the following list:

Sophie Nguyen, aged 28, is a final-year medical student on placement at your general practice. You are a GP registrar in your second term. As part of your term project, you’ve been asked to provide structured teaching to medical students. Sophie has expressed interest in improving her confidence with musculoskeletal examinations and has asked if you would observe her assessing a patient with shoulder pain.

You observe her history and examination and note that while she is thorough and empathetic, she misses the key features of a rotator cuff tear and seems unsure about further management. She appears nervous during the presentation and avoids eye contact when summarising findings to the patient.

After the consultation, you are tasked with giving Sophie feedback. You also need to complete a teaching skills reflection form for your training portfolio.

What are the most appropriate steps to provide effective feedback and facilitate learning? Select four (4) from the following list:

Daniel O’Brien, aged 37, is a GPT2 registrar working in a mixed billing regional general practice with five other GPs. You are his supervisor. Daniel is originally from Ireland and obtained his Australian medical registration two years ago after completing AMC clinical exams. He previously completed a GPT1 term in a metropolitan practice with positive supervisor feedback.

In the past month, the practice manager and two reception staff have raised concerns about Daniel’s communication with patients. They report that several patients have complained about feeling ‘rushed’ or ‘not listened to’. One patient has made a formal complaint after feeling ‘dismissed’ when presenting with back pain. The practice nurse also raised that Daniel declined to participate in team handover meetings and appears disengaged.

You have noticed that Daniel appears withdrawn and avoids informal discussions in the tea room. During a recent direct observation, you noticed him provide accurate but brief explanations and miss opportunities for patient-centred care.

You plan a scheduled educational review with Daniel to address these concerns.

What are the most appropriate components of your approach to managing this situation? Select four (4) from the following list:

Amara Patel, aged 31, is a GPT3 registrar working four days per week in your metropolitan group practice. You are one of two supervisors overseeing her final six months of general practice training. Amara is well-regarded by patients and staff and has consistently performed at or above the expected standard in previous terms.

Over the past month, you have noticed changes in Amara’s behaviour. She has become increasingly withdrawn, has missed two recent teaching sessions without explanation, and appears visibly tired. She made two minor documentation errors last week and has been observed becoming tearful after a difficult consultation involving family violence. The practice nurse quietly mentions that Amara seems ‘overwhelmed’ and ‘not herself’.

At your next scheduled supervision session, Amara sits down with you and quietly admits, “I’m exhausted all the time. I feel like I’m failing my patients and I’m not sure I can keep going like this.”

What are the most appropriate actions at this point? Select three (3) from the following list:

Dr Ravi Sharma, aged 42, is an international medical graduate (IMG) working under level 1 supervision on a limited registration pathway. He is completing his placement in a rural general practice under your supervision. Ravi previously worked as a GP in India for over ten years. He is clinically competent, with strong diagnostic and procedural skills, but has recently encountered difficulties in communication and cultural expectations.

The practice nurse has reported that Ravi does not routinely ask patients about alcohol use or sexual history, and has appeared uncomfortable discussing reproductive health with female patients. There was also an incident where Ravi laughed nervously during a mental health consultation, which the patient interpreted as dismissive. Ravi explains to you that in his previous practice context, these topics were rarely raised, and he feels uncertain how to approach them appropriately in Australia.

What are the most appropriate supervisory actions to support Ravi’s development in this context? Select four (4) from the following list:

Sarah Hocking, aged 36, is a GPT1 registrar working in your busy urban group practice. She is enthusiastic and has shown strong clinical knowledge, but struggles with time management. She frequently overruns her consultation slots and often misses lunchtime teaching due to running late. Sarah expresses frustration that she is not getting enough teaching, saying, “I want to learn, but I just can’t keep up — every session is overwhelming.”

The practice is fully booked most days, and you, as her supervisor, are also under time pressure. The practice manager has asked whether Sarah’s teaching could be ‘cut back’ to avoid affecting workflow. You are preparing for your next teaching session and want to ensure Sarah gets meaningful supervision despite the constraints.

What are the most appropriate strategies to support teaching in this situation? Select three (3) from the following list:

David Brooks, aged 29, is a GPT1 registrar in your inner-city general practice. He is conscientious and well-read but lacks confidence in making independent prescribing decisions. You’ve noticed that he frequently interrupts consultations to ask for supervisor input about routine prescriptions, such as starting antihypertensives or antibiotics. Nursing staff have also mentioned that he double-checks every immunisation schedule with them, even when standard.

In a recent case discussion, David expressed fear about ‘doing the wrong thing’ and being reported. He says, “It’s not that I don’t know the guidelines — I’m just scared I’ll make a mistake and someone will be harmed.”

You are planning your next teaching session with David, focused on improving his confidence and safe prescribing autonomy.

What are the most appropriate strategies to support David’s development? Select four (4) from the following list:

Julia Mendes, aged 33, is a GPT2 registrar in your mixed billing practice. She is clinically competent and well-liked by patients, but during a recent case discussion she expressed frustration with differing clinical opinions among GPs. She says, “Everyone does things differently — I don’t know who to follow.”

When discussing a case of a 52-year-old woman with mild hypertension, Julia seemed unsure whether to start medication or focus solely on lifestyle. She admitted she had not reviewed any current guidelines and said, “I just do what my hospital consultants used to do.”

You decide to structure your next teaching session around developing Julia’s skills in applying evidence-based practice in general practice.

What are the most appropriate approaches for this session? Select four (4) from the following list:

Rebecca Lin, aged 34, is a GPT3 registrar completing her final term in a large regional general practice. As part of her preparation for Fellowship, she has been asked to participate in supervising a final-year medical student one day per week. Rebecca is confident in clinical care but expresses anxiety about teaching. She says, “I don’t know what to say. What if I teach them the wrong thing?”

During her first teaching session, she focused entirely on didactic explanation, without engaging the student in discussion or checking understanding. The medical student appeared disengaged. Rebecca asks you for feedback on how to improve as a clinical teacher.

What are the most appropriate strategies to support Rebecca’s development as a teacher? Select four (4) from the following list:

Tom Halliday, aged 30, is a GPT2 registrar working in your accredited teaching practice. He is enthusiastic and proactive, with an interest in improving patient outcomes. In a recent teaching session, he expressed interest in contributing to a quality improvement (QI) activity in the practice. The practice has recently identified suboptimal follow-up of abnormal cervical screening results as a clinical risk area.

You and the practice team decide this would be a suitable QI project for Tom to lead under supervision. Tom is keen but unsure where to start and says, “I’ve never done a project before — I don’t want to mess it up.”

What are the most appropriate steps to support Tom in undertaking this QI project? Select four (4) from the following list:

Layla Hussein, aged 32, is a GPT1 registrar in her third week at your suburban general practice. You are her nominated supervisor. Late on a Friday afternoon, Layla accidentally prescribed methotrexate weekly but documented it as a daily dose in the notes. The pharmacist noticed the error, contacted the practice, and the prescription was corrected before the medication was dispensed.

The pharmacist has since emailed the practice manager expressing concern and requesting reassurance that prescribing processes are being adequately supervised. Layla is visibly shaken and says, “I could have seriously harmed that patient. I don’t think I’m cut out for this.”

What are the most appropriate immediate supervisory actions in this situation? Select four (4) from the following list:

Samira Khan, aged 35, is a GPT2 registrar working in a multidisciplinary general practice in a regional centre. The clinic includes GPs, practice nurses, a diabetes educator, a mental health nurse, and visiting allied health professionals. Samira is competent and enthusiastic but tends to manage patients independently and rarely liaises with other team members.

During a teaching session, you discuss a patient with poorly controlled diabetes. Samira had adjusted the patient’s medication without notifying the diabetes educator, who had also made recent changes. Samira says, “I didn’t realise I should have spoken to her — I just assumed she was doing something different.”

You identify this as an opportunity to build interprofessional collaboration and education into Samira’s training plan.

What are the most appropriate supervisory strategies to support Samira’s development? Select four (4) from the following list:

James Huynh, aged 31, is a GPT1 registrar in your outer-metropolitan general practice. He is diligent, punctual, and reads widely, but struggles to apply theoretical knowledge in real-time consultations. During a teaching session, he says, “I’m good at study, but when I’m in front of a patient, I freeze up or forget what I’ve read.” He adds that he feels more confident when given a clear structure or decision pathway.

You reflect that James may have a more analytical, reflective learning style and is still adapting to the uncertainty and pace of general practice.

What are the most appropriate educational strategies to support James’s development? Select four (4) from the following list:

Elise Turner, aged 29, is a GPT3 registrar in your mixed billing practice. She is six months away from sitting the RACGP Fellowship exams and has begun expressing anxiety about her readiness. She says, “I know the content, but I panic when I’m under pressure — especially with clinical reasoning questions.”

Elise has consistently met clinical benchmarks in the practice but becomes flustered in role-plays and struggles to verbalise her thought process. She has been avoiding practice KFP and OSCE sessions because she feels “they just highlight what I’m doing wrong.”

You want to support Elise’s preparation without increasing her anxiety or undermining her confidence.

What are the most appropriate strategies to support Elise’s exam preparation? Select four (4) from the following list:

Maya Kapoor, aged 34, is a GPT2 registrar in your regional group practice. You have noticed that she receives verbal feedback well but often doesn’t recall it or act on it in future consultations. During her mid-term review, Maya mentions she finds it hard to remember feedback unless it is written down. She says, “By the time I reflect on it later, I’ve already forgotten the details.”

You decide to introduce a structured feedback tool to help consolidate learning and promote reflective practice.

What are the most appropriate strategies to improve the effectiveness of feedback for Maya? Select four (4) from the following list:

Adil Farouk, aged 38, is a GPT1 registrar placed at your rural practice. During a recent teaching session, you noticed that he rarely refers to guidelines such as the RACGP Red Book or Therapeutic Guidelines, and instead relies heavily on previous hospital protocols. When asked about antibiotic choices or preventive screening, Adil provides reasonable answers but cannot always justify them with current evidence.

When you discuss this with him, Adil says, “I didn’t realise those were part of what we use in general practice. I’ve just been doing what I learned in the hospital.”

You decide to support him in becoming more familiar with general practice decision support resources.

What are the most appropriate strategies to promote guideline-based practice? Select four (4) from the following list:

Nicole Barrett, aged 30, is a GPT2 registrar working in a busy suburban general practice. After a difficult consultation with a patient who became angry about not receiving antibiotics, Nicole comes to you visibly upset. She says, “He yelled at me, told me I was useless, and stormed out. I felt completely powerless and started doubting myself. I don’t know how to handle people like that.”

This is not the first time Nicole has had trouble managing challenging patient interactions, particularly around expectation management and boundary setting. She is clinically competent but avoids confrontation and often yields to patient pressure.

You recognise this as a teaching opportunity to build Nicole’s skills in managing difficult interactions.

What are the most appropriate strategies to support Nicole in this area? Select four (4) from the following list:

Aliyah Rahimi, aged 36, is a GPT2 registrar who has just returned to your practice after 10 months of extended parental leave. Before her leave, Aliyah was progressing well and demonstrated strong clinical knowledge and rapport with patients. On her return, she reports feeling ‘rusty’ and uncertain, especially with MBS billing, new guidelines, and software updates. She says, “I feel like I’ve lost my rhythm — everything takes me longer.”

She’s concerned about falling behind and feels pressure to perform at the same level as before. You are her nominated supervisor.

What are the most appropriate strategies to support Aliyah’s safe and confident reintegration? Select four (4) from the following list:

Jordan Blake, aged 28, is a GPT1 registrar six weeks into his term at your busy metropolitan practice. He is clinically competent but tends to focus consultations on the presenting issue without clearly safety-netting or planning follow-up. During a direct observation, you noted that a patient with abdominal pain was discharged without any documented instructions or review plan. When asked, Jordan says, “I didn’t think it was serious — I just told her to come back if it gets worse.”

The practice nurse has also mentioned that patients sometimes leave confused about what to do next or when they’ll be contacted with results.

You recognise this as a common early registrar issue and decide to address it through supervision and teaching.

What are the most appropriate strategies to improve Jordan’s safety netting and handover skills? Select four (4) from the following list:

Emma Zhou, aged 32, is a GPT2 registrar working in your semi-rural general practice. She presents after a challenging situation involving a long-term patient who brought her a gift and then asked if she would join him for a drink outside work. Emma reports feeling uncomfortable but unsure how to respond. She says, “He’s been my patient for months, and I didn’t want to offend him, so I just laughed and changed the subject.”

Emma is now worried that she didn’t set a clear boundary and asks for advice about how to handle these situations in future.

What are the most appropriate educational and supervisory actions in this situation? Select four (4) from the following list:

Nathan Doyle, aged 30, is a GPT1 registrar working at your rural general practice. The practice provides after-hours care on a rotating basis. Nathan is scheduled for his first solo after-hours shift next weekend. He appears anxious and asks, “What if I see something serious? I won’t have anyone to ask.” He adds, “I’ve never worked completely alone before — I don’t want to miss something or make a wrong call.”

You are responsible for coordinating registrar rostering and clinical oversight. You want to support Nathan’s safety, confidence, and learning during after-hours shifts.

What are the most appropriate supervisory strategies in this situation? Select four (4) from the following list:

Claire Moss, aged 33, is a GPT2 registrar at your inner-regional group practice. During a teaching session, she mentions being unsure how well she manages preventive care in her chronic disease patients. She says, “I feel like I focus too much on the acute stuff and forget to follow up screenings or checks.”

You suggest she complete a small clinical audit on diabetes management as a learning exercise. Claire is unsure where to start, saying, “Isn’t that more for practice managers? What would I even look for?”

You decide to guide Claire through the process and use the audit as a teaching opportunity.

What are the most appropriate steps to support Claire in completing this learning audit? Select four (4) from the following list:

Rohan Iyer, aged 29, is a GPT1 registrar placed at a mixed billing urban practice with a significant Aboriginal and Torres Strait Islander patient population. He has recently seen a 56-year-old Aboriginal woman for diabetes care but felt unsure about how to raise issues of social context, cultural beliefs, or past negative healthcare experiences. Rohan says, “I didn’t want to offend her or get it wrong, so I just stuck to the clinical stuff.”

He’s aware that culturally safe care is important but feels underprepared. You are his supervisor and want to support his development in this area.

What are the most appropriate educational strategies to support Rohan’s engagement with Aboriginal and Torres Strait Islander health? Select four (4) from the following list:

Grace Tan, aged 30, is a GPT1 registrar in your mixed billing practice. She presents after reviewing a patient with non-specific fatigue and intermittent headaches. The examination and investigations are unremarkable. Grace says, “I feel like I must be missing something — I don’t want to overlook a serious diagnosis.”

She admits she finds it difficult to tolerate uncertainty and often orders more tests or refers early to reduce her anxiety. Grace says, “I’m scared of being blamed if I get it wrong.”

You recognise this as a common issue in early general practice training and want to support her confidence in managing clinical ambiguity.

What are the most appropriate strategies to support Grace’s development in managing diagnostic uncertainty? Select four (4) from the following list:

Benji Wallace, aged 34, is a GPT2 registrar at your mixed billing suburban practice. You recently reviewed his notes during a routine supervisor audit and noticed that many entries lack key details — including no documentation of consent discussions, examination findings, or safety netting. In some cases, the notes only include diagnoses and medications.

When you raise this with Benji, he says, “I thought brief notes were better. I don’t want to waste time writing essays — and no one reads them anyway.”

You decide to address this as a teaching priority to ensure safe, medicolegally sound documentation.

What are the most appropriate strategies to support Benji’s development in clinical documentation? Select four (4) from the following list:

Leila Santos, aged 31, is a GPT2 registrar in your metropolitan teaching practice. After a pharmaceutical rep visit, she mentions that she received a free sample of a new SGLT2 inhibitor and was considering offering it to her next diabetic patient “to see how they go with it.” She adds, “The rep said it has fewer side effects than metformin — it sounds great.”

Leila has not yet checked guidelines or consulted any independent sources. She seems unaware of potential ethical concerns regarding pharmaceutical influence on prescribing behaviour.

You decide to use this as a teaching opportunity to discuss ethical prescribing and conflict of interest.

What are the most appropriate educational responses to support Leila’s professional development? Select four (4) from the following list:

Mark Delaney, aged 29, is a GPT1 registrar at your metropolitan general practice. During a teaching session, he admits that he tends to “skip the prevention stuff” in consultations, especially when the patient presents with a clear acute concern. He says, “There’s just not enough time — I feel awkward bringing up smoking or weight when they came in for a script.”

You review several of Mark’s notes and notice limited documentation of preventive health discussions. This includes missed opportunities for smoking cessation, alcohol screening, and cardiovascular risk assessment in appropriate patients.

You decide to focus upcoming teaching on helping Mark integrate health promotion into routine general practice.

What are the most appropriate teaching strategies to support Mark in this area? Select four (4) from the following list:

Amira El-Khoury, aged 35, is a GPT3 registrar in your regional group practice. She recently reviewed an 84-year-old patient with multiple comorbidities who was on 13 regular medications. Amira continued the medications without changes, saying, “He’s stable — I didn’t want to rock the boat.”

During a teaching session, you ask whether she considered a medication review. Amira replies, “I feel out of my depth with polypharmacy — I don’t know which ones are still needed or how to stop them safely.”

You decide to use this as a teaching opportunity to build confidence in safe, evidence-based prescribing and deprescribing in older adults.

What are the most appropriate teaching strategies to support Amira’s learning? Select four (4) from the following list:

Jackson Li, aged 32, is a GPT2 registrar in your mixed billing practice. He recently failed to follow up an abnormal cervical screening result due to a misfiled alert in the EMR. The patient returned two months later, and the result was discovered incidentally. Fortunately, there was no harm, and the patient has since had appropriate follow-up. Jackson is distressed and says, “I feel like I let her down. I keep replaying it in my head.”

He has started double-checking everything obsessively and appears anxious in consultations. You recognise this as both a learning opportunity and a wellbeing issue.

What are the most appropriate steps to support Jackson’s development and recovery? Select four (4) from the following list:

Sofia Karim, aged 34, is a GPT2 registrar working in your urban general practice. She recently saw a 67-year-old male patient with poorly controlled type 2 diabetes, ischaemic heart disease, osteoarthritis, and chronic kidney disease. Sofia managed the acute concern (foot ulcer) well but admitted feeling overwhelmed by the complexity of his overall care. She says, “There are so many problems — I never know where to start or what’s most important.”

Her notes show reactive care focused on single issues, with little documentation of coordinated management planning. You identify this as a chance to build her skills in structured multimorbidity management.

What are the most appropriate strategies to support Sofia’s learning? Select four (4) from the following list:

Ella Thompson, aged 30, is a GPT1 registrar at your suburban general practice. She recently saw a 15-year-old girl presenting with fatigue and irregular periods. During the consult, the patient hesitated when discussing her sexual history and asked, “Are you going to tell my mum?” Ella reassured her verbally but didn’t clearly explain the boundaries of confidentiality or document the conversation in the notes.

After the consult, Ella asks you, “What exactly are the rules? I felt awkward — I wasn’t sure if I should ask more questions or just move on.”

You decide to use this case as a teaching opportunity around adolescent health and the principles of confidentiality, communication, and medico-legal responsibilities.

What are the most appropriate strategies to support Ella’s development in this area? Select four (4) from the following list:

Anthony Nguyen, aged 31, is a GPT2 registrar working full-time in your busy outer-metropolitan practice. Lately, he’s been quieter in team meetings and has started arriving late to sessions. He recently missed a teaching session without explanation. During a supervision catch-up, he says, “I’m exhausted. I’m not sleeping well, I feel like I’m always behind, and I’m starting to dread going in every day.”

He hasn’t had any significant clinical performance issues, but you’re concerned about early signs of burnout. Anthony is reluctant to take time off, saying, “I’ll just fall further behind.”

What are the most appropriate strategies to support Anthony at this point? Select four (4) from the following list:

Fatima Rahman, aged 30, is a GPT1 registrar at your suburban general practice. She recently saw a 45-year-old man with a changing pigmented lesion on his back. She took a photo and documented it as “likely seborrhoeic keratosis,” but did not perform dermoscopy or arrange follow-up. When you review the case later, you ask about it, and Fatima says, “I didn’t want to overreact — I didn’t feel confident calling it a melanoma either.”

Fatima admits she’s unsure how to approach uncertain skin lesions and feels nervous about missing a serious diagnosis. She says, “I’ve seen lots of moles, but I don’t know what I should be worried about.”

You decide to use this as a teaching opportunity about managing diagnostic uncertainty in dermatology and safety netting practices.

What are the most appropriate strategies to support Fatima’s development? Select four (4) from the following list:

Thomas Webb, aged 28, is a GPT1 registrar at your busy urban general practice. You’ve received feedback from reception that his appointments consistently run 15–20 minutes late, impacting the clinic schedule. In teaching sessions, Thomas admits, “I try to do everything in one go — I feel bad asking patients to come back.” He often appears flustered at the end of the day and struggles to complete documentation on time.

You observe several of his consultations and note that he lacks a structured approach and often loses focus when patients present with multiple issues.

What are the most appropriate teaching strategies to help Thomas improve consultation efficiency and structure? Select four (4) from the following list:

Isaac Mensah, aged 30, is a GPT2 registrar in your inner-city general practice. He recently saw a 22-year-old man requesting STI screening. Isaac performed the requested tests but did not ask about the patient’s sexual practices, partner gender, or HIV risk. When asked about this during a teaching session, he replies, “I didn’t want to make him uncomfortable. I didn’t know how to ask those questions without sounding rude.”

You review his notes and find no documentation of sexual history or risk assessment. You decide to support Isaac’s development in taking inclusive, sensitive, and clinically appropriate sexual histories.

What are the most appropriate teaching strategies to support Isaac in this area? Select four (4) from the following list:

Priya Das, aged 33, is a GPT2 registrar at your inner-regional general practice. She recently reviewed a patient with osteoarthritis who was reluctant to start NSAIDs due to a previous gastric ulcer. Priya prescribed naproxen and a PPI, saying, “That’s what we do — I explained it was safe.” The patient later declined the prescription, feeling unheard and worried about side effects.

During debrief, Priya says, “I thought I was doing the right thing — he just didn’t want to follow advice.” You recognise an opportunity to support her development in shared decision-making and patient-centred consultation skills.

What are the most appropriate educational strategies to support Priya’s learning? Select four (4) from the following list:

Luke Sorenson, aged 34, is a GPT2 registrar working at your mixed billing general practice. He recently saw a 63-year-old woman with chest pain but attributed it to musculoskeletal strain and sent her home with analgesia. The patient later presented to ED with a STEMI and required stenting. Luke is distressed and says, “I feel awful. I keep thinking about what I missed.”

You are his supervisor and decide to use a structured significant event review (SER) process as both a learning and support tool.

What are the most appropriate steps to facilitate registrar learning and reflection through this event? Select four (4) from the following list:

Sarah McKinnon, aged 29, is a GPT1 registrar working at your regional practice. Since starting, she has conducted several telehealth consultations due to patient preference and COVID-related restrictions. During supervision, you notice that her notes from phone consults are brief, often lacking examination proxies or safety-netting. When asked, she says, “It’s harder to assess people on the phone — I’m not really sure what to document.”

Sarah also expresses concern about medico-legal risk, saying, “I feel uncomfortable making management decisions without seeing the patient.”

You decide to support Sarah’s development in safe and effective telehealth practice.

What are the most appropriate teaching strategies to support her? Select four (4) from the following list:

Briony Walsh, aged 30, is a GPT1 registrar at your outer-metropolitan practice. She recently saw a 47-year-old man presenting with vague symptoms of fatigue, insomnia, and poor concentration. Briony ruled out organic causes but felt unsure whether the presentation reflected depression, anxiety, or stress. She prescribed a multivitamin and asked the patient to return in a fortnight. In your supervision meeting, Briony says, “I didn’t feel confident enough to ask about mood or suicide — what if I made it worse?”

You see this as an opportunity to build Briony’s skills in managing mental health presentations and diagnostic uncertainty.

What are the most appropriate strategies to support Briony’s development? Select four (4) from the following list:

Mei Lin, aged 31, is a GPT1 registrar at your metropolitan practice. She recently saw a 62-year-old woman from a Mandarin-speaking background presenting with hypertension and dizziness. Mei speaks some Mandarin but is not fluent. She conducted the consultation in basic English, with the patient nodding frequently but offering little detail. No interpreter was used. Later, the patient’s daughter contacted the practice, confused about the plan and medications.

When you discuss the case, Mei says, “I thought she understood. I didn’t want to make her feel uncomfortable by suggesting an interpreter.”

You decide to address this as a teaching opportunity around culturally responsive care and safe use of interpreters.

What are the most appropriate teaching strategies to support Mei’s development? Select four (4) from the following list:

Daniel Fraser, aged 29, is a GPT1 registrar working in your group practice. You notice that several of his patients have re-presented to other GPs in the clinic due to unclear follow-up plans. In one case, a patient with elevated blood pressure was told “we’ll check it again sometime,” but no recall or review was arranged. When discussed in supervision, Daniel says, “I just assumed they’d come back if needed — I didn’t think I had to organise it.”

You decide to address this as a key learning issue around continuity of care, follow-up systems, and registrar accountability.

What are the most appropriate strategies to support Daniel’s learning and clinical practice? Select four (4) from the following list:

Layla Osman, aged 32, is a GPT2 registrar at your outer-metro general practice. During a supervision meeting, you review her recent consultations and note that several eligible patients with diabetes and hypertension have not had chronic disease management plans initiated. Layla says, “I wasn’t sure if I could bill those items, or whether I should wait until I know the patients better.”

You also notice that her documentation of care planning discussions is minimal, with no reference to allied health involvement. Layla admits, “I find the MBS stuff confusing, and I don’t want to get it wrong.”

You decide to use this as a teaching opportunity on chronic disease management planning and appropriate use of Medicare item numbers.

What are the most appropriate teaching strategies to support Layla? Select four (4) from the following list:

Hassan Malik, aged 28, is a GPT1 registrar working in your urban general practice. During a teaching session, he discusses a patient with poorly controlled type 2 diabetes who is not adhering to dietary advice or medications. Hassan says, “I explained everything clearly, but she just doesn’t seem to follow through. I think she’s just not motivated.”

You review the consultation notes and notice technical language and minimal exploration of the patient’s understanding or beliefs. You suspect low health literacy may be affecting the patient’s engagement with care.

You decide to support Hassan’s development in communicating with patients with varying levels of health literacy.

What are the most appropriate strategies to support his learning? Select four (4) from the following list:

Emily Patterson, aged 29, is a GPT1 registrar at your regional practice, which has a high proportion of Aboriginal and Torres Strait Islander patients. She recently saw a 42-year-old Aboriginal man for a repeat script but did not initiate any preventive health checks. When asked, she says, “He seemed well and didn’t raise any concerns, so I didn’t want to push anything.”

You review the patient’s record and note he has not had an Adult Health Check (MBS 715) or any screening bloods in over two years. Emily admits she isn’t confident in the specific preventive guidelines for Aboriginal and Torres Strait Islander patients and feels uncomfortable initiating this without a clear reason.

You decide to support her development in this area of culturally responsive, preventive healthcare.

What are the most appropriate teaching strategies to support Emily? Select four (4) from the following list:

Clare Morrison, aged 35, is a GPT2 registrar working in a rural general practice. She presents to supervision feeling uncertain about a recent encounter. A patient she sees regularly at the practice is also her children’s schoolteacher and recently added her on social media. Clare accepted the request but now feels uncomfortable after the patient commented on one of her posts related to parenting. Clare says, “I didn’t want to offend her by declining, but now I feel like I’ve blurred the line.”

You recognise this as an opportunity to explore professional boundaries in rural settings and support Clare to manage dual relationships appropriately.

What are the most appropriate strategies to support Clare’s development in this area? Select four (4) from the following list:

Amelia Grant, aged 30, is a GPT1 registrar in your metropolitan practice. She recently saw a 38-year-old woman for anxiety who, during the consult, disclosed that her partner was controlling, had isolated her from family, and occasionally “lost his temper.” Amelia acknowledged the disclosure but felt overwhelmed and ended the consult with a mental health care plan. In supervision, she says, “I didn’t know what to do — I felt out of my depth.”

Her notes lacked a safety assessment or follow-up plan. She admits, “I was worried I’d say the wrong thing or make it worse.”

You recognise this as a vital opportunity to teach safe, supportive responses to domestic and family violence (DFV).

What are the most appropriate teaching strategies to support Amelia? Select four (4) from the following list:

Jonathan Reed, aged 30, is a GPT1 registrar at your suburban family practice. He recently conducted a 4-year-old health check but documented only weight, height, and vision. When asked, he says, “The mum said he was doing fine, and he was playing happily — I figured that was enough.” He did not perform a formal developmental screen or ask about language, behaviour, or school readiness.

You review the case and note that the child had not had any previous developmental assessment, and the immunisation status was incomplete. You decide to address this in teaching to build Jonathan’s confidence in paediatric development review and anticipatory guidance.

What are the most appropriate teaching strategies to support Jonathan’s development? Select four (4) from the following list:

Matthew Tran, aged 34, is a GPT2 registrar working at your mixed billing suburban practice. He recently reviewed an 82-year-old woman who lives with her son. She presented with vague dizziness and anxiety. During the consult, she hesitantly mentioned that her son often shouts at her and manages all her finances. She quickly changed the subject. Matthew noted her concerns in the history but did not explore further or arrange follow-up.

In a teaching session, Matthew says, “I wasn’t sure what to do — I didn’t want to make things worse or jump to conclusions.” You recognise this as an opportunity to teach about elder abuse and the GP’s role in early identification and safe response.

What are the most appropriate teaching strategies to support Matthew? Select four (4) from the following list:

Julia Han, aged 31, is a GPT1 registrar at your inner-city practice. She recently saw a 43-year-old man requesting a medical certificate for two weeks off work for “stress.” He appeared well and stated, “I just need a break.” Julia felt pressured and issued the certificate but felt uneasy afterwards. In a supervision session, she says, “I didn’t want to argue. I wasn’t sure what I’m supposed to write or whether I could say no.”

She did not document the clinical justification or any mental health assessment. You identify this as an opportunity to teach ethical certification, medico-legal responsibilities, and assessment of work capacity.

What are the most appropriate strategies to support Julia’s learning? Select four (4) from the following list:

Samantha Boyd, aged 33, is a GPT3 registrar at your accredited training practice. During a tutorial, she asks about ways to improve care beyond the consult room. She says, “I’ve heard about audits and QI projects, but I’m not sure how they actually help — aren’t they just for accreditation?” You see this as an ideal opportunity to introduce quality improvement (QI) as a core general practice skill and learning opportunity.

What are the most appropriate strategies to support Samantha’s development in this area? Select four (4) from the following list: