Supporting the Primary Care Workforce Through Training in Advanced Generalist Practice: An Evaluation of the Catalyst Program

Abstract

Introduction: As a workforce crisis is causing recruitment and retention issues for new to practice GPs, we designed Catalyst, a one-year pilot career development program aiming to help new to practice GPs develop the skills of advanced generalist practice and build capacity for the complex work of primary care. In this paper, we report the findings of our evaluation of Catalyst. Methods: We used normalization process theory to investigate how Catalyst was contributing to the participants' understanding and implementation of generalist practice. We conducted 36 interviews and six focus groups investigating the participants' clinical practice and experience with the program and analyzed data using framework analysis. Results: Establishing a shared language and reframing professional identity helped GPs develop an understanding of their role through generalist lenses. Generalist practice was legitimized by access to scientific evidence and facilitated interactive learning. Integration of scientific, applied knowledge and quality improvement work fostered the enactment of such practice. Structured reflection and research-informed quality improvement projects contributed to the participants' awareness of the primary care context. Discussion: Knowledge creation activities observed through interactive learning and the integration of different types of knowledge facilitated the implementation of advanced generalist practice. The participants valued the community of practice gained through the program and would come to rely on programs designed to encourage networking and enable peer support. Finally, research-informed quality improvement projects built to analyze problems and monitor solutions are crucial for an early career physician to develop a sense of agency that shapes their primary care practice.