GETTING THE MOST OUT OF YOUR TRAINING

(HDR/ cluster/ ES/CS/ compassion))

Miller’s Pyramid

In Vivo

In Vitro

Knowledge in context

Half Day Release? To keep the main thing as the main thing:

Towards Independent General Practice Evidence based and safe Holistic Deepening the art of good communication Imposed/ committed time for reflection Developing leadership and independent learning

- So that your consultations and work will be Practical and thoughtful and compassionate Marginalising & managing risk in good clinical decisions

And so to be able to pass MRCGP: WPBA/ ePortfolio (ARCP’s) CSA AKT

Half Day Release?

Getting the most out of it Try to think about topic a bit before arriving – what do you

feel your difficulties are? Get there on time if you can Try to sit where you can really be involved and be active Ask, questions, be critical (!) and, yes, interrupt! Volunteer to do the hot topic Think – how will this change what I do now and in GP Take a few minutes at the end to note down questions and

reflections – we often learn best when things either surprise us or increase our anxiety a bit!

Ensure you put a Log entry in each time – makes sure you reflect (puts the learning deeper) proves you are involved and proves you were there in both body and mind!

Let us know when you can’t be there – e-mail is best

Cluster Groups

The course is equally divided into 5 cluster groups each looked after by one course organiser

The groups are mainly geographic and means you should not be in a cluster led by your ST3 trainer

(Your ST3 trainer is your Educational Supervisor for all 3 years)

Outside of term times your cluster group meets every Thursday afternoon – it is usually led/ facilitated by one/some of the ST3/2’s in the group – more later...

Cluster Groups

KingsfieldYardley WoodGreenridgeHollywoodHall GreenHawkesleyGoodrest CroftWest Heath

KarisLordswoodHarborneRidgeacreShenleyQuinbourneWoodgate ValleySelly Park

Graeme: David:

Cluster Groups

Bartley GreenJiggins LaneNorthfield (Tudor)Northfield (Ali)Woodland RdWeoley ParkMillenium

AshtreeGrantonWychall LaneKings NortonCoftonCornhillAll SaintsMaypole

Joyce: Will:

Cluster Groups

The WandBournbrook/VarsityBelle VueBath RowWake GreenGriffins BrookBaldwins LaneUniversity Med Practice

Malcolm:

Cluster groups

Is part of working week (ST2GP and ST3) Make sure you are getting e-mails from TPD and

rest of group Volunteer to bring a case, or look up part of the

topic to present Find at least one ‘buddy’ within the cluster from

each of the years Don’t be afraid to e-mail questions around the

group and to TPD Make sure you record your attendance and let

us know when you can’t be there

Accountability: e-portfolio: must show reflection and content of the

afternoon Trainers to be keeping account of their own trainees and

sessions. Keep TPD and your trainer ‘in the loop’ re content E-portfolio for each member reviewed also by TPD

Ideas Invite a trainer with expertise to do a cluster group

tutorial/ moderate so that participating practices reduce tutorial time for that week.

Arrange educational visits to other clinical areas - e.g.occ. health, rehab centre, ENT etc.

Cluster groups

Useful links

Website: http://sbvts.weebly.com/ David Taylor:galltay@hotmail.com Graeme Fleming: graeme.fleming1@nhs.net Joyce Williams: joycewilliams@nhs.net Malcolm Laird: drmjlaird@btinternet.com Will Drever: william.drever@nhs.net http://www.rcgp.org.uk/training-exams/gp-c

urriculum-overview.aspx West midlands deanery, super condensed

curriculum guide

Your Educational Supervisor

S/he is your main advocate and mentor for your training from now

You should aim to meet with your ES (trainer) within 2 months of starting and certainly at least twice a year for formal reviews – generally December and May (before ARCP) - more about that later

Don’t be too wary of ‘summative’ as opposed to ‘formative’ assessment, but respect their busy-ness and need to plan ahead.

BUT – keep in touch with your E.S. – will help to keep you grounded in primary care – e-mail best.

S/he is your guide through the system the more dialogue you have the better and s/he will be keeping a longitudinal eye on how your training is progressing overall – has access to all your e-portfolio

Try to use an educational session or two to sit in with your trainer for part of a clinic during ST1 to help keep focus

Perhaps make yourself available to go to the occasional practice social function if possible

If you cannot sort it out with your ES then we are always here to help...

Remember when you are in a practice you are employed by that practice and under contract to them but responsibility for your education remains with the deanery.

Your Educational Supervisor

Your Clinical Supervisor

Usually your consultant when in hospital post or your GP trainer when in ST 2 GP post

Will have limited access to your e-portfolio Will not generally have an eye to the final goal but will have

good ideas for your 6 months Meet within 2/12 : learning needs and questions. Record this meeting on e-portfolio (PPM) Respect their need for warning re CBD/ CEX/ MSF/CSR etc. –

pick your time wisely, be flexible Know how to generate ticket codes and print things off CSR towards the end (note ARCP in May/June) – do second

PPM Think about your response to feedback....

ARCP

Annual (!) In May/June(LTFT more complicated)(you will be informed of date) – assessment of competency progression

All areas of e-portfolio reviewed by a panel of 4/5 TPD and an administrator (ESR x 2, L Logs, WPBA’s, PDP, Ed notes, curriculum / competency coverage x13, your and ES assessment of competency areas)

ESR must be signed off 2-8 weeks before Form R Outcomes Be available on the day – phone – takes precedence –

may be phoned or have to attend on appt. that day (WBA)

Johari Window

Johari Window

Getting help with areas: 2) ‘Receive’ feedback – from all

sources. 3) Use reflection to share

with your supervisors – openness pays off so seek help early

4) Most Difficult Video – as early as poss. Shared consultations Random Case Analysis

Getting Feedback

Normal distribution of Innovation

Innovators

2.5%

(Risk takers)

Early Adopters

13.5%

(critical

Thinkers)

Early

Majority

34%

(Leader-ship role)

Late

Majority

34%

Laggards

16%

(Healthy sceptic)

Num

bers

Time taken to adopt changeAdapted from R. Kew 2002

Shock

Denial

Blame

Self-blame

Bargaining

Resolution

Feelin

g o

f S

ati

sfa

cti

on

Getting Feedback

“Appraisal for the apprehensive” Chambers,Wakley, Field,Ellis: Ratcliffe 2003

Giving and getting Feedback

Defensive responses: Receiver:

Blame – ‘not my fault’ Denial – ‘I can’t see a problem with that’ Rationalisation – ‘ I’ve had a bad week…’ Anger – ‘I’ve had enough of this’ Dismissal – ‘It’s a pointless tick-box exercise – what do they

know!’ Giver:

Obligation – ‘I’m duty bound..’ Moralist – ‘It’s for your own good’ Fudging – can’t get to the point Minimising – ‘Don’t worry about this, its no big deal’ Colluding – ‘You’re probably right, I’m over reacting’

Unconscious Incompetence- Don’t know I don’t know

Conscious Incompetence- Know I don’t know

Conscious Competence- Know I know

Unconscious competence- Don’t know I know

And Finally

A word about Our best teacher......

Empathy in patient care…“a cognitive attribute that involves an ability to understand the patient’s inner experiences and perspective and a capability to communicate this understanding.”

“As far as clinical medicine goes, the benefits of a broader perspective can easily be explained: a skilled and knowledgeable doctor might know what to do, he or she might even know how to do it, but only the educated and wise doctor will know whether to do it, or when. Only a humane doctor can fully communicate - listen, understand, and advise.” Bruce Charlton, BJGP (1993)