Table 2 Results on what trainees learned

Collaboration

 Knowledge about the working environment

• What happens with the patient after referral to IM

• Knowing what an IM-trainee does

• GP sees a different population

• What diagnostic tests are possible in a GP-practice

• In the hospital everything is easily arranged but for a GP that is different

• GP has a different way of working and sees the patient in a different way

• Put yourself in position of the GP

• GP has to make a difficult decision: referral or not?

• IM-trainees are more aware of what happens before referral to IM

• Both trainees learned what each other’s training looks like

 Knowledge about the medical knowledge of the other professional

• IM-trainees learn a lot that GP-trainees do not learn

• Maybe GP-trainees do not ask themselves why they do certain blood tests and maybe they do not know what blood tests are clinically relevant to send along with the consultation (since a lot of consultations were about blood tests) Maybe GP-trainees find it hard to identify topics for consultations. Maybe that is why they bring questions that you can look up in literature

• IM-trainees might know better where to search for information in literature

 Collaborative attitude

• The approach was pleasant

• GP-trainees are taken seriously

• Challenge to see the patient through the eyes of the GP

• For GP-trainees, the programme promotes the approachability of the specialist in the hospital

• GP-trainees feel that they are taken seriously

• IM-trainees take the programme seriously

Consultation

• To formulate a good question

• To give a clear summary of the case

To formulate a good answer

Uncertainty about written communication: is it clear? Does it come across as patronising?

• GP-trainees learned to formulate a good question

• IM-trainees learned to formulate a good answer

• IM-trainees are insecure about sending an explanation with the consultation answer: “Can I just do that?”

• IM-trainees do not want to come across as being pedantic

Knowledge acquisition

• Gain knowledge for the next patient

Gain knowledge beyond own subspecialty in IM

• GP-trainees acquired medical knowledge in general

• For IM-trainees it’s good to consider that you can do a lot without blood tests

Professionalism

• Be more involved with the patient or in patient care

• Develop a critical attitude: what do I look up myself? What will I do with the answer of the IM-trainee?

• Take responsibility for own consultation

Be more critical towards GP-trainee (e.g.: ask why GP-trainee did certain blood tests)

• For GP-trainees, the programme promotes an investigative approach

• IM-trainees learned to be independent and take responsibility

Health advocacy

• Programme could possibly bridge the gap between primary and secondary care

• Nice intervention for doubtful cases

• Patient receives customized advice

• Patient gets to hear what happens after referral to the hospital

• Patients receive secondary intervention at the GP practice and do not need to arrange transport to the hospital

• This programme could possibly reduce the amount of referrals required

• A higher level of health care in the GP practice is cheaper

• Programme reduces the amount of referrals required