Background
Trust between GP supervisors and GP registrars is the cornerstone of a successful training relationship.
Aim
To explore the role of self-disclosures on trust in the GP supervisor-registrar relationship.
Method
GPSA and GPRA members completed an anonymous online survey about their exposure to disclosures (9-item, 5-point scale from ‘Not at all’ to ‘Often’), and the impact of disclosures on trust (9-item, 5-point scale from ‘Strongly erodes’ to ‘Strongly builds’) in the GP supervisor-registrar relationship.
Results
A total of 58 GP supervisors (mean age = 51.4±10.5, 55% women) and 58 GP registrars (mean age =34.7±6.1, 66% women) were recruited in 2022. For GP supervisors, trust was built when GP registrars made more disclosures about their past (ρ = .32, p < .05) and present (ρ = .32, p < .05) experiences; intimate (ρ = .62, p < .001) and non-intimate (ρ = .50, p < .001) information, similar (ρ = .32, p < .05) and dissimilar (ρ = .36, p < .01) issues to those of supervisors, and their experiences in supervision (ρ = .39, p < .01). For GP registrars, trust was built when GP supervisors shared more disclosures about intimate information (ρ = .48, p < .001), their experiences in supervision (ρ = .46, p < .001), and similar issues to those of registrars (ρ = .39, p < .01). Exposure to disclosures about failures built trust for GP supervisors and GP registrars (4.43 vs 4.55 respectively, z = -.58, p > .05); more exposure increased trust for GP registrars (ρ = .27, p < .05) but not for GP supervisors (ρ = .22, p > .05).
Discussion
Increased exposure to self-disclosures is associated with greater trust in the GP supervisor-registrar relationship. Research is needed to identify self-disclosure boundaries to optimise trust in the GP supervisor-registrar relationship.

At the conclusion of my presentation attendees will take away:
1. Exposure to professional or personal disclosures generally increases trust in the GP supervisor-registrar relationship
2. Disclosures about failure experiences build trust for GP supervisors and GP registrars
3. GP registrars build trust with GP supervisors by revealing a broad array of personal and professional matters

Introduction –
Medical training in rural areas is delivered in an environment which is restricted in human, physical and financial resources. Video reflexive ethnography (VRE) is a research approach that allows more authentic exploration of workplace interactions and can provide a better understanding of interactions between individual’s engagement and the learning opportunities (also called affordances). This knowledge will provide opportunities to improve rural workplace learning for medical trainees. This research project explored the question ‘What are the affordances and constraints of clinical settings for enriching medical trainee learning and how are clinicians engaging with these affordances?’

Methods -
Data were gathered from fifteen rural primary care professionals working across two settings (a community general practice and a rural hospital) using VRE encompassing workplace observations, and video footage used in reflexive interviews. Thematic framework analysis informed by interdependent learning theory was used for data analysis.

Results -
Affordances of the rural settings pertained to immersive practice, practice community, and practice curriculum. The study highlighted the diverse learning opportunities available in rural practice, the opportunities available for learning during service delivery and the support provided by the entire multidisciplinary rural practice community to support trainee learning. Trainers and trainees engaged in workplace affordances to enable learning by delivering care, learning through modelling, developing learning relationships, and community immersion.

Conclusion-
Our findings demonstrate the interdependence between workplace affordances and engagement. The rural workplace affords trainee's a variety of learning opportunities and trainers play a key role in noticing and signposting the available learning affordances for trainees. The effectiveness of learning for trainees is then dependent on how they choose to engage with the workplace affordances. This presentation provides practical suggestions which can be used by medical trainers to promote affordances in rural learning environments and to facilitate trainee engagement with the affordances.

1. An understanding of the learning opportunities (affordances) available to medical trainees completing clinical placement in rural settings based on Billett (2002) interdependence learning theory 2. An understanding of the interplay between learning affordances of rural practice and how trainees and trainers engage with these affordances. 3. Practical examples of how medical trainers can facilitate trainee engagement in rural learning affordances to help overcome the resources constraints expereinced in rural clinical and learning environments.

As Family Medicine (FM) is increasingly recognized as critical to effective health systems in the post-Covid world, there is momentum to establish the specialty though education and training reform. Cambodia is in the early phase of development, whereas Indonesia and Egypt have decades of experience. In this presentation, sentinel events in the journey establishing FM in each country will be described. Effective strategies will be highlighted, and barriers discussed.
In Cambodia, the medical education system is tightly controlled by the Ministry of Health (MOH). Reform has focused on faculty development and developing leaders as champions of FM and medical education. In 2022, Family and Community Medicine is adopted by the MOH as one of six core-competencies for doctors. Persistent challenges include entrenched biases against creating a specialty of FM and traditional exclusion of private and community practices in medical education.
Advocacy at the university, local and national level in the 1990s led to the development of FM from brief trainings to formal FM specialist programs in Indonesia. Progress was accelerated through the inclusion of ‘primary care doctor’ in the Indonesian Medical Education Act 20 in 2013, followed by regulations and the work of the National Taskforce of Family Medicine. Challenges remain in professional acknowledgement of FM specialists, i.e., incentives and practice authority.
In Egypt, FM was introduced in the 1970s with advocacy by the MOH that led to specialized FM training. Later, universities began FM departments and specialty training programs. The MOH initiated a health system reform in the 1990s including FM as a main pillar. Challenges include political changes preventing further expansion, community recognition for family physician and the career pathway.
Following brief presentations, lessons learned and common issues will be identified. Strategies for continued progress will be discussed. Finally, a roadmap to FM development in LMICs may emerge.

1. Discuss challenges to FM development in low and moderate income countries.
2. Explain strategies used in three countries to establish Family Medicine as a medical specialty.
3. Discuss lessons learned and strategies for FM development in LMICs.