Cetiscape 2 December 2010

Professor Boyages, CETI Chief Executive, announced that three positions will be created to form the Allied Health Clinical Education and Training Division within CETI, including an Allied Health Divisional Head position. The Area Directors of Allied Health and the Chief Allied Health Officer warmly welcomed this news during their second meeting with Professor Boyages and CETI General Manager Dr Heading.

The new division will provide support and expertise for an allied health education program in line with the aims and functions of CETI. It will lead the design, development, implementation and evaluation of state-wide clinical education and training strategies in collaboration with allied health clinicians. This will support safe and sustainable high quality allied health practice across NSW Health. Watch this space for further news about recruitment to these exciting new positions.

Other topics discussed at the meeting included identifying existing resources within CETI that might be adapted for use in allied health, developing networks to increase capacity within allied health and strategies to improve communication and collaboration in education and training across the range of allied health professions.

Clinical supervision resourceOne of the first resources within CETI to be adapted for allied health clinicians will be The Superguide: a handbook for supervising doctors in training. The Allied Health Directors have commenced a review of this practical guide for supervisors of junior medical officers. The guide includes many of the core elements common to sound, evidence-based supervision of health professionals in a clinical setting. To ensure that examples provided in the handbook are relevant, the Allied Health Directors will be seeking volunteers from allied health disciplines to help develop clinical scenarios for use within the allied health Superguide. Please contact your Area Director/Advisor of Allied Health if you are interested in being part of the working party to develop these clinical examples.

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CLINICAL EDUCATION& TRAINING INSTITUTE

Building 12, Gladesville Hospital, Victoria Road, Gladesville NSW, 2111 Editor: Craig Bingham

Locked Bag 5022, Gladesville NSW 1675 02 9844 6511

p: (02) 9844 6551 f: (02) 9844 6544 e: [email protected] [email protected]


cetiscape Issue 2 December 2010 Promoting excellence in clinical education www.ceti.nsw.gov.au page 1

Allied Health Clinical Education and Training Division to be established

Patricia Bradd1, Brenda McLeod2 and Richard Cheney31 SESIAHS Area Allied Health Director and Chair of the Area Allied Health Directors Group, 2 Chief Allied Health Officer, NSW Health, 3 Allied Health Advisor, Greater Western Area Health Service

In this issueNursing and Midwifery building a collaborative

partnership with CETI 2

Farewell Marie-Louise Stokes 3

Award: Improving cardiac care for Aboriginal communities 3

2010 CETI Awards: Dr Steve May, Dr Matt Stanowski 4

Racing to the Future: the 15th National Prevocational Medical Education Forum 2010 5

The Superguide: coming soon to a supervisor near you 6

Tribute to Professor Annemarie Hennessy, welcome to Professor Iven Young 7

NSW Health Expo and Awards 7

Rural Training Support Unit for Aboriginal mothers, babies and children 7

2010 NSW Rural and Remote Health Conference 8

Spring symposium: e-learning in medical education 10

E-learning resources: iNvestigate 11

Setting up safe handover 12

International medical graduates get ready for supervised training in NSW 13

Coming events 13

Progress in hospital skills 14

Leading the way: CETI’s leadership programs 15

National audit of medical internship acceptances 16

JMO Forum 2010 17

Leading ideas 18

NSW ranked against Australia and 10 countries 18

http://www.ceti.nsw.gov.au

Nursing and Midwifery have an exciting opportunity to work with CETI to identify areas for collaboration, as well as building a relationship that fosters an inter-professional approach to clinical education and training.

The Chief Nursing and Midwifery Officer, Adjunct Professor Debra Thoms has met with CETI’s Chief Executive, Professor Boyages, to discuss possibilities for collaboration.

Opportunities to be explored in the immediate future include:

the supervision abilities of the Nursing and Midwifery workforce and the development of tools to support the workforce into the future

the implementation of the transition to ED practice resource manual

developing e-learning modules to support the professional development of the nursing and midwifery workforce

developing modules that build the knowledge and skills required to support a team approach to patient care.

Nursing and Midwifery looks forward to building a partnership with CETI that supports and builds the education and training provided within and by the Nursing and Midwifery workforce and the opportunity to engage with other professions on inter-professional education and training strategies in the future.

More information: Mardi Daddo, Principal Adviser Nursing Strategy and Innovation, Nursing and Midwifery Office, NSW Health ([email protected]).



Allied health educatorsAllied health educators, both general and discipline-specific, are a critical part of the allied health workforce that is only just developing. To support existing allied health educators and promote development of these roles, it was agreed to explore the feasibility of an allied health educator network.

The value of allied health educators is already being demonstrated within the three paediatric child health networks (CHNs). Dr Maree Doble, Greater Eastern Southern Child Health Network (GESCHN), Sonia Hughes, Northern Child Health Network (NCHN) and Emma Geor, Western Child Health Network (WCHN) have been collaborating over the past five months to coordinate and facilitate clinical education for NSW Health allied health professionals who work with children. Their appointments were the outcome of two funded projects by the NSW CHNs which assessed and implemented recommendations in relation to the clinical support and education needs for allied health professionals working with children across NSW.

The highly successful GESCHN allied health TeleHealth program has resulted in a comprehensive allied health TeleHealth calendar being made available to paediatric allied health professionals for 2011. The CHN allied health educators are also working with clinicians from the three NSW tertiary children’s hospitals to provide educational workshops in 2011 on various topics, including cerebral palsy and paediatric feeding.

Allied to Kids, a monthly e-newsletter for allied health professionals, is produced by the CHN allied health educators, with contributions from clinicians across NSW. Secondments to the three children’s hospitals and specialty clinics for allied health professionals needing to up-skill in the clinical management of tertiary diagnoses have also

been expanded from GESCHN to state-wide and are being coordinated by the CHN allied health educators.

More recently, the CHN allied health educators have called for expressions of interest from allied health practitioners who wish to be involved in writing clinical practice guidelines on cerebral palsy and paediatric feeding. This project will provide an opportunity for allied health professionals to work closely with their nursing colleagues to enhance multidisciplinary care. The CHN allied health educators are also developing paediatric allied health webpages and a discharge/referral form for children being referred back to local centres from the tertiary children’s hospitals. This form is currently being trialed before being made available to all allied health professionals working with children across NSW.

Allied health learning and education planTo ensure that the Allied Health Clinical Education and Training Division is able to manage the professional development, education and training needs of the 23 allied health professions and associated assistant and technician workforce, work on a clinical education and training plan for allied health will continue. The plan will provide a framework for future development of allied health learning resources, a consultation mechanism for identifying priorities, and clinician networks to support the work of the division. It is envisaged that the division will develop resources and strategies to support in-house clinical education and professional development and supervision, training and education by allied health clinicians in the field.

This is an exciting time for allied health and the support of allied health clinicians will be critical to our success as the division develops.

Nursing and Midwifery building a collaborative partnership with CETI

Mardi DaddoPrincipal Adviser Nursing Strategy and Innovation, Nursing and Midwifery Office

http://www.ceti.nsw.gov.au



Farewell Marie-Louise StokesThe team at CETI will farewell Dr Marie-Louise Stokes at the end of January. We are delighted to see her talents recognised in her new position as Director of Education for the Royal Australasian College of Physicians, but sad to lose a great friend and colleague from our workplace.

Marie-Louise has been a committed advocate for postgraduate medical education for more than a decade. She was the NSW Health Department representative on the NSW Postgraduate Medical Council from 2000 to 2004. As Chair of the Education and Resource Development Subcommittee in 2003–2004, she supported the establishment of the NSW JMO Forum, the first JMO Forum in Australia and a body that has continued to thrive, contributing significantly to enhancing prevocational training.

Marie-Louise also made major policy contributions to the development of network-based specialist medical training. She played a leading role in a significant research project, The Delivery of Postgraduate Medical Training in NSW Health Services. This paper provided a framework to change and enhance the delivery of medical education. Marie-Louise was

the first Medical Advisor for the NSW Medical Education and Training Council (MTEC) when it was established in 2004, and carried on in this role when MTEC merged with the NSW PMC in 2006 to form the NSW Institute of Medical Education and Training.

At a national level, Marie-Louise has been a member of Australian Health Ministers’ Advisory Council working parties on specialist training outside public hospitals and general practice workforce. She has participated in medical school accreditation for the Medical Board of

Australia and, as a member of the Australasian Faculty of Public Health Medicine, serves on its Education Committee and NSW Regional Committee.

Throughout her career, Marie-Louise has shaped education with a collaborative spirit. Her combination of expertise, commitment, and an extraordinarily compassionate and supportive approach to the business of medical education will be missed by all at CETI, but are a gift to those lucky enough to work with her in the future.

— The CETI team

In 2010 the Institute of Rural Clinical Service and Teaching (now the Rural Division of CETI) helped fund a new cardiac care Aboriginal education initiative designed by the Ambulance Service of NSW. This funding enabled the Ambulance Service to develop a targeted cardiac health care message for Aboriginal community members in rural and remote locations. The initiative supported the evidence-based proposition that clinical intervention should be provided as soon as possible after the onset of symptoms. The significant adverse outcomes attributed to delay between symptom onset and treatment, particularly in the Aboriginal community, supported the introduction of this project.

The project educated the community about “THE 3 R’s” of a heart attack:

Recognising acute cardiac symptoms

Ringing triple zero

Responding to the Ambulance operator’s advice.

Interested paramedics apply to receive the Cardiac Care Aboriginal Education Package which includes a paramedic education refresher, tips on disseminating information

to local Aboriginals and a range of resources which highlight key program messages.

The project won an Excellence Award in the Management Practice Category at the 2010 Council of Ambulance Authorities (CAA) Ambulance Awards. The CAA Ambulance Awards were developed to acknowledge and encourage innovations from Ambulance Services throughout Australia, New Zealand and Papua New Guinea. These awards also provide

the platform for the industry to learn from each other and reduce duplication of effort.

There are four broad categories in which individuals or groups/units can enter their project, and four awards given for each category, ranging from the Excellence Award to a Commendation. The Management Practice Category encompasses any project which involves management culture, open communication, diversity of staff and treatment, accountability, management development, professional standards, or community education.

Award: Improving cardiac care for Aboriginal communities

Paul Stewart, Cardiac Care Manager, Ambulance Service NSW (right) accepting an award from Tony Ahern, Chair of the Council of Ambulance Authorities.

Dr Steve May wins NSW Geoff Marel Award

The Geoff Marel Award is an annual prize awarded by CETI, named in honour of Clinical Associate Professor Geoff Marel, a committed contributor to prevocational medical training and an advocate for trainee welfare who is remembered for his vision, creativity, insight and humanity The award recognises the work of an individual who has made a substantial contribution to the education and support of prevocational trainees.

Dr Steve May, Director of Prevocational Education and Training at Tamworth Rural Referral Hospital, is the winner of the Geoff Marel Award in 2010 in recognition of his outstanding contribution over many years to the education and welfare of junior doctors in New South Wales.

Dr May is well known at Tamworth for his work on behalf of junior doctors. His contributions to their education program, willingness to make himself available to them at all hours for advice and support, continuing enthusiasm and involvement in hospital committees and concern for the needs of each individual doctor have earned him the respect and admiration of his fellow staff at Tamworth and his fellow directors of training across NSW.

Dr Matt Stanowski wins NSW Junior Doctor of the Year Award

The NSW Junior Doctor of the Year Award is an annual prize awarded by CETI to a junior doctor who has made a substantial contribution to the education and support of prevocational trainees.

Dr Matt Stanowski, Resident Medical Officer at Nepean Hospital, is the winner of the 2010 NSW Junior Doctor of the Year Award in recognition of his outstanding contribution to the education and welfare of his fellow junior doctors.

Dr Stanowski’s work on JMO welfare, in particular the peer mentoring program at Nepean and the pilot of similar programs at other sites, has been a valuable innovation and a real benefit to new interns. He has taken an enthusiastic role as a JMO representative in hospital committees and the NSW JMO Forum, where he chaired the welfare working group.

CETI congratulates Dr May and Dr Stanowski, who will be formally presented with their awards at the NSW Prevocational Forum on Friday 12 August 2011.



2010 CETI Awards

Dr Steve May, a great teacher and advocate for the welfare of his trainees, has been Director of Prevocational Education and Training at Tamworth Hospital for nine years.

Dr Matt Stanowski, shown here at the graduation night of CETI’s leadership program. Among his other activities this year, Dr Stanowski completed the LEAP course and was a member of the team that presented the winning presentation at the course, with a proposal for “CAPS: Clinical acquisition of procedural skills”.

Glaring gaps and inequities in health persist both within and between countries ... New infectious, environmental, and behavioural risks, at a time of rapid demographic and epidemiological transitions, threaten health security of all. Health systems worldwide are struggling to keep up, as they become more complex and costly, placing additional demands on health workers.

Professional education has not kept pace with these challenges, largely because of fragmented, outdated, and static curricula ... mismatch of competencies to patient and population needs; poor teamwork; persistent gender stratification of professional status; narrow technical focus without broader contextual understanding; episodic encounters rather than continuous care; predominant hospital orientation at the expense of primary care; quantitative and

qualitative imbalances in the professional labour market; and weak leadership ...

We regard transformative learning as the highest of three successive levels ... Informative learning is about acquiring knowledge and skills; its purpose is to produce experts. Formative learning is about socialising students around values; its purpose is to produce professionals. Transformative learning is about developing leadership attributes; its purpose is to produce enlightened change ...”

— Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet 2010; 376: 1923–1958. www.thelancet.com

Recommended reading: transforming medical education

“

Racing to the futureCraig BinghamPrevocational Program Coordinator, CETI

“Innovation, Integration and Transformation” were the three themes of this year’s conference, an event attended by over 400 delegates from Australia, New Zealand and other countries.

InnovationWith the pressure of increasing numbers of prevocational medical trainees and ever-expanding domains of medical knowledge, innovation, especially the use of technology to augment the educational capabilities of clinician educators, is the essential oil of prevocational training. Several speakers presented innovations in e-learning. Keynote speaker Professor John Sandars made some important points about the deep objectives of e-learning:

Education is about enquiry and collaboration, and about life. It is not about preparing for life. We should not separate clinical education from the clinical immersion experience any more than we have to.

For clinicians as teachers, it is better to be the “guide on the side” than the “sage on the stage”: no longer the dispenser of wisdom but instead a navigator through seas of electronic information.

Ubiquitous technology leads to ubiquitous learning. This is not of itself a bad thing, but does mean that you can’t fully control the learning environment. If you want to ensure core curriculum coverage, you need to provide appropriate focused education.

Medical education in the next generation will require a mixture of learner enquirylearner participationlearner digital literacyproduction of appropriate

resources.

Integration National integration of medical training was high on the agenda this year. The establishment of the Medical Board of Australia and Health Workforce Australia has created an expectation that training accreditation, internship standards, trainee assessment and perhaps even workforce allocation will eventually move to a national model, although keynote presentations by Dr Joanna Flynn (Chair, Medical Board of Australia) and Mr Mark Cormack (Chief Executive Officer, Health Workforce Australia) reminded us that there was a long way to go.

Health Workforce Australia has a significant budget for developing expanded settings of training, supervisor training, simulation training and other initiatives; on the other hand, the Confederation of Postgraduate Medical Education Councils reported that funding for the Australian Curriculum Framework for Junior Doctors project had run out and that further development was suspended pending renewed support from the federal government.

TransformationWhat is the future of prevocational training?

Workplace-based assessment: Dr Julian Archer reported on experience in the UK Foundation Program, which suggests that 360o assessment and greater use of structured assessment tasks can provide more valid and reliable workplace-based assessment of junior doctors. However, Dr Archer sounded a cautionary note: assessors need training and a substantial level of commitment for these changes to work. He hinted that Australia could benefit from examining the UK experience with a sceptical eye on the evidence before adopting change.

More attention to supervisor training and support will be required, or a dwindling resource of senior clinicians will be swamped by rising numbers of trainees.

JMO ownership of their own training: The National JMO Forum and participation by JMOs in the conference were highlights of the meeting. Several JMO-initiated innovations and surveys were presented. There is yet more potential for JMOs to play a leading role in transforming JMO education.

More training in general practice and community settings. This is where the majority of doctors will work after training, so training in these settings is appropriate and becoming more common.

Simulation: Health Workforce Australia is promising significant funding, and the National JMO Forum has the widespread availability of high-fidelity simulation on its wishlist for the future.

CETI at the conferenceStaff from CETI played an active role. David Lochhead attracted plenty of interest from other States when he presented CETI’s online solution for administering the prevocational training



Dr John Sandars, University of Leeds.

application and allocation processes. Jackie O’Callaghan presented a streamlined solution for accrediting general practice training positions. Craig Bingham presented one of the largest studies at the conference: an evaluation of 3390 prevocational trainee assessments which raised serious questions about the effectiveness of current processes.

Next year:The conference will be held for the first time in New Zealand, with the theme of “bridging the gap” between undergraduate and vocational medical education.



CETI team members presented six posters at the National Prevocational Medical Education Forum, three of which were selected as finalists in the conference poster competition.

CETI’s new guide for supervisors of junior medical officers is now being distributed via training sites to all term supervisors in New South Wales.

The guide was developed in consultation with clinicians across the State by CETI’s Medical Division (IMET), and has been well received by its intended audience. Dr David Lester-Smith, Associate Director of Clinical Education, The Children’s Hospital at Westmead, writes:

There is truly something here for all clinical supervisors, whatever their level of previous experience. We all recognise good clinical supervision as key to sound clinical education and training, but know many colleagues find the role challenging. For most, without any formal guidance or training, supervision is an assumed skill. This is the first document I have read that usefully defines what supervision actually is and how to best supervise trainees, including hints on managing the trainee in difficulty. I am sure many colleagues will find valuable guidance and advice here.

The book is available at www.ceti.nsw.gov.au/prevocational.

For more information, or to order printed copies, contact: Prevocational Program Coordinator Craig Bingham (02 9844 6511, [email protected]).

The Superguidea handbook for supervising doctors in training

August 2010CONSULTATION DRAFT

IMET | RESOURCE

IMETNSW Institute of Medical Education and Training— a division of CETI

The Superguide: coming soon to a supervisor near you

16th Australasian Prevocational Medical Education Forum

6-9 November 2011 Auckland, New Zealand



From strength to strength Marie-Louise StokesSenior Medical Advisor, CETI

Tribute to Professor Annemarie Hennessy“If you want something done, ask a busy person.”

On 17 November, Professor Annemarie Hennessy completed her term as Clinical Chair of the NSW Basic Physician Training Council after four years in the role. During this time, Annemarie led CETI Medical Division’s (IMET’s) flagship networked training program with great flair, passion and a commitment to the values of excellence and equity that underpin the networks.

Anyone who knows Annemarie will tell you that they can’t see how she fits everything in: research and supervision of multiple PhD students, teaching (students, junior doctors, basic and advanced trainees), academic leadership as Foundation Professor of Medicine at the University of Western Sydney, clinical service work, work for the Royal Australasian College of Physicians and, fortunately for us, the Clinical Chair role. Somehow Annemarie manages to do all this and more.

During her time as Clinical Chair, Annemarie developed closer links with the networks and the College, negotiated changes to network structures (always a tricky undertaking) and steered the program towards a greater focus on education. Annemarie’s personable and straightforward approach earned great respect and appreciation among trainees, network directors, education support officers, directors of physician training and staff from CETI and NSW Health.

Thank you Annemarie.

Welcome to Professor Iven YoungCETI is delighted to welcome Iven Young as the incoming Clinical Chair of the NSW Basic Physician Training Council. Professor Young is a well known and respected senior respiratory physician and physician educator at the Royal Prince Alfred Hospital. He is Clinical Professor of Medicine at Central Clinical School, the University of Sydney, was Head of Respiratory Medicine at the Royal Prince Alfred Hospital for 17 years and was foundation Chair of the Royal Prince Alfred Basic Physician Training Network Governance Committee. Professor Young has first hand experience of implementing the network system and seeing its benefits and challenges. We warmly welcome him to the Clinical Chair role.

Professor Iven Young, the incoming Clinical Chair of the Basic Physicians Training Program, with the past Program Coordinator Ellen Rawstron and outgoing ClinicalChair, Professor Annemarie Hennessy.

NSW Health Expo and Awards

The Rural Division of CETI supported 39 delegates to attend the 2010 Health Expo and Awards. This program was introduced in 2006 in recognition of the difficulties faced by rural and remote health workers in attending such an event.

Over the years, several delegates have introduced programs or methods observed at the Expo, and others have been finalists in their own area health service quality awards. This year it was exciting to see 2008 delegate Rosanna Robertson of Shoalhaven presenting as a finalist.

Afterwards, Roseanna said “I was so inspired when I came here two years ago, that I decided I’d work on my own project — and here I am!”.

Roseanna’s project was titled “Shouldering Education; Enhancing Skills and Outcomes”. Roseanna analysed the use of electrical stimulation in occupational therapy stroke services in the Southern Hospital Network, then developed clinical guidelines and an education program. This led to the incorporation of electrical stimulation in all Southern Hospital Network occupational therapy stroke services.

Congratulations to Roseanna and the team.

Training Support Unit for Aboriginal mothers, babies and children

The Training Support Unit will support Aboriginal Maternal Infant Health Service staff in improving primary and community health services for Aboriginal people, particularly mothers and their babies.

The inaugural meeting of the implementation group was held at NSW Department of Health on 11 November. The membership of this group was reviewed and some new faces are invited to the December meeting.

Jennifer Wannan manages the unit within CETI’s Rural Division. Recruitment is under way for the remaining 11 positions in the Training Support Unit, and it is anticipated that the successful applicants will commence in the new year.

Planning has commenced for the biennial forum. Input and ideas are welcome, and can be forwarded to: Jennifer Wannan ([email protected]). The forum will be held in the first half of 2011 and will give service providers an opportunity to showcase their excellent work.

2010 NSW Rural and Remote Health Conference “Many paths to follow”

www.ircst.health.nsw.gov.au

RURAL DIVISION

The second NSW Rural and Remote Health Conference was held at Albury on 4th and 5th November.

Delegates were treated to a range of excellent speakers who supported the conference themes: • The path to a healthier community • The path to “closing the gap” • The path to a stronger workforce, and • The path to improving the quality of our services.

The Hon. Carmel Tebbutt, Deputy Premier and Minister for Health, ad-dressed the conference and reinforced her commitment to rural and remote health.

The conference was enhanced by a series of workshops provided by highly regarded academics and health and business professionals.





The Italian themed conference dinner was held on the banks of the lovely Murray River, which was in flood at the time.

The evening commenced with delegates designing their own pizzas, made in the city’s community wood fired pizza oven. This was followed by a very entertaining evening, which included the piano accordion, opera and some fabulous dancing (yes, there was even a conga line).

We were delighted to share the evening with some of our keynote speakers, including Prof. Stefan Grzybowski (pictured right with Dr Vahid Saberi), Dr Juanita Sherwood and Assoc. Prof. Sabina Knight (pictured below left).

Conference Dinner

www.ircst.health.nsw.gov.au

Rural Research Capacity Building Graduation One of the highlights of the conference dinner was the graduation ceremony for 11 research candidates, who have completed their projects: Tod Adams, SESIAHS; Cath Bateman, GSAHS; Jenni Devine, GSAHS; Kerith Duncanson, HNEAHS; Barbara Fetherston, GSAHS; Michelle Murray, HNEAHS; Rachael O’Brien, HNEAHS; Rachel O’Loughlin, GSAHS; Judy Reinhardt, NCAHS; David Schmidt, GSAHS; Christian Tremblay, NCAHS. These graduates are pictured below with Linda Cutler and Dr Austin Curtin.

Additional information about this program can be obtained by contacting Dr Emma Webster, Rural Research Project Officer at [email protected]

RURAL DIVISION

A special congratulations goes to Kerith Dun-canson, who won the “Best Report” award for her project: “Feeding Healthy Food to Kids randomized control trial: three month analysis”. This award includes sponsorship for attendance at a national or international conference where she has had an abstract accepted.

Kerith is pictured above with Dr Austin Curtin and Linda Cutler.

How best can we support e-learning in medical education and training? How can we increase access for clinicians and trainees to high quality e-learning resources? These are two important questions asked at a recent national symposium.

The symposium brought together practitioners and decision-makers in medical education and e-learning to share ideas and to propose solutions to challenges such as collaboration and sharing of resources, integration of e-learning into medical curricula, and identifying attributes of best practice in e-learning design. There were delegates from state government clinical education and training organisations (CETI, SAIMET, ClinEdQ, PMCV, PMCT), universities (Flinders, Melbourne, Griffith and the University of Western Sydney), hospitals and specialist colleges (ACEM, RACMA, RANZCOG, ANZCA).

Why e-learning?Symposium delegates acknowledged that e-learning covers a wide set of applications and processes, such as web-based learning, computer-based learning, virtual classrooms and clinics, and online collaboration.

The advantages of e-learning include:

potential savings compared with conventional training

the capacity to communicate consistent educational messages to learners and teachers across locations and at any time

potential for enhanced learning effectiveness with well designed e-learning programs.

Why collaborate?Collaboration between government clinical education and training institutes, universities, hospitals and specialist colleges will enhance the sustainability, integration and effectiveness of learning across clinical disciplines and for different levels of learners.

Other reasons for collaboration identified by delegates included:

the scope to provide economies of scale to fund the design of learning resources

the opportunity to reduce costs for software licensing and development

establishing relationships which allow the sharing of learning resources and the intellectual property to develop learning resources.

On the other hand, delegates acknowledged a number of challenges that needed to be addressed by their own organisations before collaboration could succeed, including:

difficulties with stakeholder engagement and agreement

varying compliance requirements

high rotation of technical staff to maintain and sustain a consistent effective approach to e-learning design

the potential costs involved in developing high quality e-learning resources (estimated to be between 15 and 20 hours for each hour of e-learning resource).

Integrating e-learning into curriculae-Learning is just one part of the learning design to support educational activities in medical education and training. There was consensus that blended learning is the favoured approach for curriculum development and learning design.

With careful targeting of appropriate learning outcomes, integrating e-learning into the curriculum can enhance learning. Delegates identified the following strategies to support this integration:

educators acting as curators of learning guides, resources and other materials for learners

educators assembling learning resources in content repositories and allowing content sharing and and appraisal across organisations and jurisdictions

enhancing the sharing of e-learning resources by clearly stating learning outcomes and specifically linking them to important components of curricula (such as core clinical skills and patient safety).

e-Learning best practiceDelegates identified attributes of best practice in e-learning design for clinical education. Discussion centred on three main aspects of e-learning design:

understanding the characteristics and needs of learners who will be using e-learning tools

design based on core effective principles of learning

opportunities for building learner communities.



Spring symposium: e-learning in medical educationHosted by South Australian Institute of Medical Education and Training (SAIMET) and Clinical Education and Training Queensland (ClinEdQ), Adelaide October 2010

Peter Davy Curriculum Developer, Medical Education and Training Team, CETI

Delegates identified specific attributes of best practice design based on these three points (see Box). Their list is not exhaustive, but does give important points to consider.

Where to now?Delegates were enthusiastic about advancing the discussions of this symposium. A webinar in six months was proposed.

One agenda item suggested for the webinar is to identify possible sources of e-learning project sponsorship and funding support.

Conclusionse-Learning provides a valuable set of tools to support clinician and trainee education, but it is just one part of the learning design to support medical education and training. The consensus at the symposium was that blended learning is the favoured strategy.

Sustainable e-learning will involve sharing of learning materials and collaboration between education organisations and jurisdictions.

Development of e-learning content needs to be measured; taking on too much all at once can result in expectations not being met and projects being disbanded or downgraded. Targeting important learning outcomes which are well aligned with e-learning delivery would be a good start to planning e-learning projects.



E-learning best practice

Understanding the learneranalysis of learning requirements

catering to the experience and maturity of learner, learning styles, and capacity and willingness to participate in e-learning

well-defined learning outcomes

control of screen information

capacity for self assessment and quizzes

content integration

document management

help facilities

simple user interface

communication interactivity

calendar to assist learner time management.

Core principles of learningstimulating and meaningful learning activity

motivation of learners and rewards for participation

transferability of skills/knowledge

quality of learning environment, including opportunity for prompt feedback and formative assessment

learner-centred focus of teachers.

Communities of learningclearly stated purpose for learning within communities

experienced teachers to guide learning in this context

appropriate use of synchronous and asynchonous tools

opportunities for group problem solving

maximising the level of interaction.

E-learning resources

iNvestigate is an interactive website designed for use by prevocational medical trainees which focuses on the appropriate and cost-effective use of diagnostic investigations. The project was funded by the Australian Government under the Quality Use of Pathology Program, and developed by a team led by Professor Rakesh Kumar, Professor of Pathology and Director of Academic Projects for the Faculty of Medicine, University of New South Wales.

iNvestigate allows trainees to role-play ordering tests and interpreting results based upon given case histories. The tool shows the cost of investigations, and allows users to compare their choices with those of an expert.

Three new cases by Dr Kate Webber have been added to iNvestigate, replacing the case used in the pilot version of the program.

See iNvestigate at https://investigate.med.unsw.edu.au

Handover is the transfer of patient care from one clinician to another. It is a crucial moment when information about the patient must be communicated effectively if patient care is to continue safely.

In 2008 the Special Commission of Inquiry into Acute Services in NSW Public Hospitals (Garling Report) recommended that each facility in NSW Health should have a mandated clinical handover policy within 18 months. This recommendation was supported in the government response to the report, Caring Together. Improving clinical handover is also a high priority at a national level (Australian Commission on Safety and Quality in Health Care, National Clinical Handover Initiative).

In 2009, the Acute Care Taskforce commenced the NSW Safe Clinical Handover Program and developed key principles for clinical handover that have been mandated for state-wide implementation. NSW is the first Australian jurisdiction to tackle system-wide improvement in clinical handover.

During implementation, many junior and senior clinicians reported that processes for handover at shift change were ad hoc or absent, and requested a specific focus on junior medical officers (JMOs). The literature has shown that failures of clinical handover are most likely when clinical staff are inexperienced, communication quality and content is suboptimal, there is a lack of standardised protocols and clinicians are fatigued.

In response, the Acute Care Taskforce began the JMO Clinical Handover Project in 2010.

Through early engagement of junior and senior clinicians from both metropolitan and rural facilities, the project developed three key elements for effective shift handover:

1 A standard communication framework for JMOs (ISBAR).

2 Senior leadership determining who and what should be handed over.

3 Standard key principles for locally appropriate implementation (so that the handover process is consistent, but locally appropriate).

These elements were tested through a consultative process across NSW and then pilot implementation at six hospitals: Wagga Wagga Base,

Dubbo Base, Campbelltown, Sutherland, Prince of Wales and John Hunter. Each site chose the scope for the local implementation based on their specific needs.

Representatives from CETI’s JMO Forum contributed to the piloting and evaluation process, attended each of the sites and conducted a qualitative review of the pilot based on interviews with local JMOs. The Acute Care Taskforce was impressed by the eager engagement to effect change and improve patient safety shown by this team of junior doctors, who gave a great deal of their own time to the project.

The importance of the program is highlighted through the key messages that have come directly from the JMOs:

Senior leadership is critical: executive and clinical leaders must model and reinforce the value of shift handover by leading handover, policy, training and aligning of rosters.

Involve JMOs in change: involving JMOs ensures that new processes meet their needs and gain their commitment.

Senior nursing involvement: significant value was reported by clinicians in all models where senior nurses were integrated into the handover.

Relationships = communication: an environment where all doctors feel comfortable to call and discuss clinical care develops a good culture for communication during and between shifts.

Education: doctors place high value on the teaching they can receive at handover, led by consultants. In some cases, education = sustainability.

Undergraduate education: junior and senior doctors have called for elements of JMO handover and ISBAR to be universally taught in undergraduate education.

Documentation not duplication: it is important to ensure that clinical documentation in the medical record is effective and not replaced by handover documentation.

ISBAR: junior and senior clinicians see value in ISBAR. They report that it should be used as a framework, not a rigid structure, to help effective communication.



Setting up safe handoverShireen Martin, Ian Richards and James DunneHealth Service Performance Improvement Branch, NSW Health

Hunter New England Health is acknowledged for developing this resource

IntroductIon

Background

assessment

recommendatIon

IsBar

Identify yourself (name/role/location)and give a reason for calling“I am calling because…”

Give the patients age/gender and status a: Stable (at risk of deterioration) b: Unstable

Give the relevant details:Presenting problems...?Clinical history...

Put it all together. Current condition/risks/needs“My assessment is….”

Be clear about what you are requestingTransfer/review/treatment? When should it happen?

R e m e m b e R

IsBar

sItuatIon

The Acute Care Taskforce and NSW Health are collaborating with CETI on system-wide implementation of the JMO clinical handover project in 2011. CETI has endorsed the project’s key elements and is working towards an appropriate accreditation standard.

Following consultation, the Acute Care Taskforce has developed a package of tools to support implementation that

will be sent to all facilities in the NSW prevocational training networks shortly.

All resources and project reports can also be downloaded from the Safe Clinical Handover web page: http://www.archi.net.au/e-library/safety/clinical/nsw-handover

For more information, please contact Shireen Martin, [email protected]

International medical graduates get ready for supervised training in NSW A new cohort of overseas-trained doctors have been

preparing for work in NSW with help from CETI. The group of 77 Australian Medical Council (AMC) graduates commence supervised training in January 2011 in hospitals across the state. While many of these AMC graduates have worked in medicine overseas, the transition to the Australian health care system can be daunting, particularly adapting to the hospital hierarchy, patient expectations and the Australian culture surrounding health care.

Each year CETI runs the AMC Pre-employment Program, which includes a one-week lecture series and clinical skills workshop followed by an observation placement in the hospital where the AMC graduates will be starting their supervised training.

This year the lectures and workshop were held at the Kolling Building, Royal North Shore Hospital, 22–30 November. The graduates learnt a range of survival essentials, including understanding the hospital hierarchy, managing the deteriorating patient, prescribing, documentation and working in a interprofessional team. During the clinical skills workshops the graduates had an opportunity to practice skills such as cannulation, airway management and advanced life support.

The program also gave the group an opportunity to network with each other and elect two of their colleagues as representatives to the NSW JMO Forum. Congratulations to Dr Juan Dong and Dr MD Masum Alam who will be the AMC graduate representatives for 2011.



Coming events

National Rural Health Conference scholarshipsThe 11th National Rural Health Conference will be held in Perth, 13–16 March 2011, and the Rural Division of CETI is funding 25 scholarships to assist health workers from rural and remote NSW to attend.

Twenty-five successful applicants were selected from 74 applications after a very competitive selection process. Successful applicants have itemised comprehensive learning objectives to be gained from attendance, the outcomes of which will be evaluated. Applicants were notified on 29th November.

Rural Allied Health Conference, 10-11 November 2011Preliminary planning has commenced for the 5th Rural Allied Health Conference, which is to be hosted by the North Coast Area Health Service. It will be held in Port Macquarie on 10-11 November 2011. Similar to previous conferences, it is anticipated that numerous pre conference workshops will be held preceding the conference. Additional information will be posted on the CETI Rural Division (IRCST) website early next year.

NSW Prevocational Forum, 11–12 August 2011If you are interested in prevocational medical education and training, keep 11–12 August 2011 free in your calendar so that you can attend this event.

How far has the Hospital Skills Program come since its launch in March 2010?

This was one of the topics discussed at the inaugural HSP Education Strategy Forum (23 November). Thirty-five people (including HSP Area Directors and Education Support Officers, HSP participants, CETI staff and HSP State Training Council members) attended the forum, which had a full day’s program of presentations and a plenary discussion.

Collaboration has been the buzz word for the Hospital Skills Program since it was developed and presentations and discussions during the Forum supported this approach.

Dr Danielle Morris, the HSP Area Director for Greater Western Area Health Service, presented on education initiatives used to promote the Hospital Skills Program within GWAHS.

GWAHS launched the Hospital Skills Program in conjunction with a two-day resuscitation procedures workshop on 6–7 November. More than 30 doctors from all over GWAHS attended the workshop which included practical skills stations for joint relocation, emergency delivery, plastering, airway management and emergency ultrasounds. Feedback from the workshop showed overwhelming support for the program, which allowed participants to refresh their procedural skills in emergency care and gave them an opportunity to network with other doctors across the greater western area.

Professor Graham Reece spoke on the Oasis Simulation Centre based in Blacktown and how HSP participants from Sydney West Area Health Service are able to access training provided there. The cost for training and education sessions is very reasonable and there is certification for any training provided. Professor Reece has indicated that training is available for all HSP participants regardless of which health service they are located in.

Dr Briege Hamill talked about sharing training resources between HSP and the emergency department and how this was

being achieved at Hunter New England Area Health Service. She showed other areas that providing education for both ED trainees and HSP participants was an opportunity for collaboration and networking which is not always possible.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists gave an update on the collaboration between CETI and RANZCOG and provided

attendees with a picture of content within the new RANZCOG Certificate, Diploma and Diploma Advanced which would articulate with the HSP Women’s Health Module. There was also an excellent section on online learning and how this would be incorporated into the courses provided.

Dr Alan Giles, the HSP Area Director from Sydney South West Area Health Service provided an entertaining session on the challenges in delivering education to CMOs in the south west and what he has learnt from this experience. To accommodate the different learning styles of HSP participants, Dr Giles suggested that the best method for providing education and training was a blended learning model that included online resources, lectures and face-to-face teaching.

The plenary discussion on progress and challenges for the HSP was lively, but the day’s presentations had demonstrated that the HSP has come a long way since the launch in March 2010. Area Directors and Education Support Officers have been appointed in all Area Health Services, which has provided an impetus which had been lacking, but the main achievement has been the engagement of doctors in the HSP. Most HSP participants have been receiving an enhanced level of education and training and have developed good communication networks, and there has been increasing engagement from doctors who will be providing the education and training as well as supervising and assessing the HSP participants. This has been the big step forward within the program, with many more steps to come in 2011.

Presentations from the HSP Education Strategy Forum are available on the CETI website: www.ceti.nsw.gov.au



Progress in hospital skills Alpana SinghActing Program Coordinator, CETI

Hospital Skills Program launch at GWAHS.

The Hospital Skills Program supports the training and professional development of non-specialist doctors working in NSW hospitals.

HOSPITAL SKILLS PROGRAM

CETI provides leadership in clinical education, and it also provides education in clinical leadership. Here are three programs that aim to build the leadership skills of our health workforce.

1 Rural Division: Leadership and Management Essentials Program

This is an experiential program for rural and remote health workers tailored to meet individual learning needs and offers core topics in leadership, management, communication and team building, and a selection of elective topics such as financial management, strategic planning, performance management and conflict resolution, depending on what each participant identifies in their personal development plan. It is conducted through distance education, monthly teleconferences and two two-day workshops in Sydney.

This year’s program is coming to an end in December with 27 of the original 32 participants completing all program requirements.

“I feel I have grown as a person, am more confident making decisions, am able to acknowledge that I made an error and apologise if needed, feel more confident delegating, am more in control of my emotions and more aware of how they can impact on the team,” wrote one participant in providing feedback. “I have learned techniques on how to get staff to be more responsible for their actions and also to give them the ability to make decisions.”

The program will run again in 2011. Application forms are available on the CETI Rural Division (IRCST) website (www.ircst.health.nsw.gov.au) and will close on 14 January 2011.

2 Rural Division: Clinical Team Leadership Program

This program for rural clinicians was modelled on the Clinical Excellence Commission’s clinical leadership program. The main modification was asking participants to pair with a GP to undertake a clinical practice improvement project.

The program aims are to:

increase the participants’ leadership and management skills and confidence

strengthen partnerships between public health services and GP-VMOs

increase the participants’ competence at leading a team-based clinical improvement project.

The program includes eight full-day workshops held in Sydney.

Workshops evaluations have shown high levels of satisfaction with the program content, organisation and presentation. Participants report that they have increased confidence

and competence in clinical leadership skills; that workshop learning objectives have been met; and that key learnings have come from group discussions and sharing ideas, as well as from the formal learning activities.

All participants have had a face-to-face feedback session about their 360o leadership survey report and have commenced developing their own personal learning development plan. This involves the participants using the various self reflection activities and the themes from the 360 report to establish personal goals and identify strategies in the areas of leadership styles, emotional intelligence, assertive communication and self care.

Each team has commenced planning a local clinical practice improvement project. From now until June 2011 the group will work on their projects, participate in monthly group teleconferences and have individual coaching with the facilitator, Jan Dent.

3 Medical Division: Future Leaders Development Program

Two programs in one (LEAP and LEAD), the Future Leaders Development Program has a stream for doctors in training and a second stream for senior doctors.

LEAP – the future LEAders development Program will be running for its third year in 2011. LEAP prepares doctors-in-training for leadership roles within the NSW public health system. No other program exists in NSW that is focused on the needs of doctors in training in relation to leadership skills for medical education and training.

LEAD – the LEAdership Development program in medical education and training for consultant medical practitioners in NSW focuses on the needs of consultant medical practitioners in relation to leadership skills for medical education

The aim of these programs is to deliver a high quality, innovative, interactive and inspirational leadership program for current and future clinician leaders in medical education and training within the NSW health system.

The major component of each program is five face-to-face workshops, a total of 10 days. Workshops are objective-driven, focusing on experiential learning through simulation group exercises, interactive lectures and feedback.

Skills learnt in the workshops are complemented and developed by an ongoing program of projects completed in syndicate groups, self-directed and web-based training, a mentor program and practical leadership experience in the workplace.

Applications for both 2011 programs will close on Friday 21 January 2011. For more information and an application form: go to www.ceti.nsw.gov.au and search for “future leaders”, or email <[email protected]>.



Leading the way

A national audit of intern acceptances of job offers has found 41 applicants who accepted more than one position. As one of these had accepted three positions, there were 42 intern positions that may have been made available for other applicants who had not at the time received an offer.

This was the first national audit of intern acceptances. It was conducted in August of all intern acceptances for the clinical year 2011 by the National Intern Allocation Working Party. The working party was set up in February 2010 under the oversight of the Confederation of Postgraduate Medical Education Councils to develop opportunities for sharing information related to multiple acceptances of intern offers across jurisdictions.

The working party was chaired by Professor Geoffrey Thompson, Chair of the South Australian Institute of Medical Education and Training (SAIMET), and included representatives from each of the jurisdictions responsible for intern recruitment policy or allocation, junior doctors, medical students and Health Workforce Australia. Project support was provided by CETI and SAIMET.

Reaching national agreement on what to audit and how it would operate was challenging. The working party had to overcome a number of hurdles, as set out below, in order to ensure participation by all of the jurisdictions.

Jurisdictions reached agreement to undertake the audit as a two-part pilot for 2011.

Part 1 – basic audit: Agreement to share intern acceptance information but not to follow-up individual applicants identified as having multiple acceptances. All of the jurisdictions participated in this part — Australian Capital Territory, New South Wales, Northern Territory, Queensland, South Australia, Tasmania, Victoria and Western Australia.

Part 2 – Extended Audit: Applicants identified as having accepted multiple positions were contacted and asked to decide which position they wished to accept for January 2011. Only four jurisdictions — Australian Capital Territory, New South Wales, Northern Territory, and South Australia — participated in the extended audit.

Key findings The total number of acceptances reported by jurisdictions by 27 August was 2697. The audit only examined 2313 intern acceptances as 384 applicants did not agree to their information being sent to the central administrator. Of these, 374 were Queensland applicants who were limited by local issues in their ability to ensure privacy law compliance.

Eighty-three duplicate acceptances were identified, which represented 4% of the total number of acceptances. Forty applicants had accepted two positions and one applicant had accepted three positions. At the time of the audit, there were potentially 42 positions which could have been freed up if all of the duplicate acceptances were resolved.

Next stepsA second audit is currently being conducting to see if the number of duplicate acceptances has changed and further audits are planned for early next year. The working party will be looking to build on the audit next year and are hopeful that all of the jurisdictions will participate in the full audit process for clinical year 2012. The working party will also be looking at other areas where national harmonisation of policies and processes would be beneficial.



National audit of medical internship acceptances

Kirsten CampbellProject Manager, CETI

Organisations responsible for intern allocation are different in each Jurisdiction making participation in a central process difficult.Early communication by the Jurisdictions about the audit ensured successful participation by all.

Intern allocation approached differently in each Jurisdiction – therefore process, communication and timings differed.

Following extensive discussion, agreement reached on a wash up process that took into account these differences.

Intern positions left vacant in January due to last minute withdrawals from interns who had been holding multiple acceptances.

Potential applicants advised about impact of holding multiple acceptances. Audit brought applicant decision making process forward so vacancies were known sooner.

Privacy concerns about sharing applicant information. Jurisdictions sought advice and locally accepted processes were implemented and integrated with the national process – audit split into two parts (Part 1 and Part 2).

Data on intern eligibility criteria collected and classified differently in each Jurisdiction.Agreed on a simple common dataset using MTRP classifications.

Jurisdictions concerned about conflict of interest of central administration.Confidentiality agreements drafted and signed by central administrator.

National agreement reached that all Jurisdictions would participate in a two part National Audit Pilot.

1. Buy-in

2. Process3. Communication

4. Privacy

5. Common Dataset

6. Confidentiality

The Finish

Clearing the “hurdles” to implement the National Audit of Intern Acceptances Process

It has been an exciting and innovative year at the JMO Forum. We began by introducing a new way of organising. We formed five portfolio groups, based on the feedback from the 2009 Forum – Education, Assessment, Supervision, Welfare, and Clinical Handover. The Forum members embraced the challenges of these portfolios with great enthusiasm and each group devised a list of goals and a plan of action.

The Education portfolio developed an intern teaching package. They recognised that there was a great potential for interns to receive varied and inconsistent teaching throughout all the hospital networks and that a unified lecture series could provide interns with a knowledge base that would lead to improved patient care and increased clinical confidence. The package includes a lecture series based on the Australian Curriculum Framework for Junior Doctors and on the experience of the JMOs in the group. The group then went on to provide an outline for each lecture. The package is to be given to each hospital network by the end of this year and it is hoped that this will be accepted as a useful tool for the provision of intern education. Westmead Hospital has already adopted it and will be using it in 2011.

The Assessment team have conducted research into the assessment process and the assessment forms currently used. They hope to work with CETI in 2011 to devise better assessment methods for meaningful feedback to trainees and term-specific required assessment.

The Supervision portfolio advised CETI on the Superguide, a handbook for supervisors that has now been published for all supervisors currently fulfilling this vital role in JMO training.

They also conducted a survey of JMOs asking about their supervision, and we look forward to hearing more about their findings and proposals to encourage more meaningful supervision in 2011.

The Welfare portfolio conducted a survey of JMOs and is working with the Doctors Health Advisory Service and the AMA Doctors in Training group to develop an online service to guide JMOs toward helpful websites and organisations when needed. Keeping junior doctors safe is a priority of the JMO Forum and we look forward to their ongoing work in 2011.

The Clinical Handover portfolio will not be continuing in 2011 — it has finished the task it set out to perform. The group worked with the Acute Care Taskforce to develop and pilot a better model for shift-to-shift clinical handover. The team found that when handover is conducted by a consultant and is used as a teaching opportunity the JMOs were more engaged and greatly benefited from the process. NSW Health’s Safe Clinical Handover program is now implementing the JMO Shift Handover project statewide (see page 12).

The Forum will be chaired by Dr Lucy Cho in 2011, and the consensus at the last JMO Forum was to continue with the portfolio format. We will be keeping the Education and Welfare portfolios, and merging Supervision and Assessment. We will also be introducing two new portfolios,

the focus of which is to be announced after the first meeting in March.

The tangible results achieved by the JMO Forum in 2010 are something that the whole Forum and the JMO body they represent can be very proud of. We all look forward to 2011, to meeting the new PGY1 representatives and to the great work that will continue.



JMO Forum 2010

Ricki SayersChair, NSW JMO Forum 2010

Need the advice, support or creative thinking of a representative group of junior doctors?

Contact the JMO Forum via CETI’s Prevocational Program Coordinator: Craig Bingham ([email protected], 9844 6511).

JMO FORUM

NEW SOUTH WALES

Members of the Education portfolio at the December meeting of the JMO Forum: (left to right) Dr Erin Stalenberg, Dr Ricki Sayers, Dr Helen Boyd, Dr Nishmi Gunasingam, Dr Vikas Gupta.

Dr Emma McCahon, convenor of CETI’s future leaders program (see page 15), spoke to the JMO Forum in December, and set her audience to work on one of the program’s fiendish creative thinking tasks. Below, left to right, Dr Christine Velayuthen, Dr Joanna Dargan and Dr Lucy Cho wrestle with spatial reasoning and non-verbal communication to make sense out of chaos.

Leading ideas

Emma McCahonClinical Lead, CETI Future Leaders Program

On 12 November I had the privilege to be on the panel judging the final project presentations from the doctors in training and consultants enrolled in the Future Leaders Development Program (see page 15). We heard five innovative and elegant project proposals tackling problems in medical education and training in the NSW health system. The judging panel was inspired but also torn as to which proposal deserved top honours.

Mr James Millar, ex-CEO of Ernst and Young, saw the huge benefits to the system in a simple yet effective mentoring program for doctors in training. Ms Bernie Harrison, Director of Organisation Development and Learning at the Clinical Excellence Commission, saw an exciting opportunity in an interprofessional learning program for new-starters. However, it was the CAPS program that caught the imagination of Professor Steven Boyages and the support of the panel. The Clinical Acquisition of Procedural Skills (CAPS) program is a framework to match teachers and trainees for opportunistic teaching of clinical skills in the clinical environment.

The highlight of the LEAP and LEAD programs this year for me has been the enthusiasm and hard work put in by both the participants and the faculty. The rich collaborative learning environment, the willingness to share experiences and the diversity of the groups shaped a unique experience for the participants, the faculty and myself. I am looking forward to LEAP and LEAD 2011 and the opportunities they will bring to influence and equip leaders in medical education and training in NSW.

NSW ranked against Australia and 10 countries

Deaths from heart disease and cancer have dropped dramatically in NSW over the past decade, making the state an international leader in this area, a new Bureau of Health Information report shows.

Healthcare in Focus: How NSW compares internationally, shows that with a 47% drop in heart disease deaths, NSW joins the Netherlands and Norway in leading the way on cardiovascular health gains.

The first annual report from the Bureau, Healthcare in Focus, compares NSW to the rest of Australia and 10 other countries. “The report shows NSW does well on the international stage but should seize opportunities to improve healthcare,” Bureau chief executive Dr Diane Watson said. “It also shows NSW gets value for its health dollar. There are some countries that spend much more than NSW and have worse health outcomes.”

The Bureau’s report finds that, in 2010, surveyed adults in NSW and in the rest of Australia are positive about the care they receive but say change is needed to make the healthcare system work better.

Healthcare in Focus uses almost 90 measures of performance to track care across NSW.

“Management of chronic disease, reducing unnecessary hospital use and better flow of patient information are all areas where improvements could have a significant impact,” Dr Watson said. “The Bureau’s report identifies areas where NSW can learn from its successes and focuses on where the state can do better in delivering high-quality, safe healthcare to people when they need it.”

Recently released: Hospital Quarterly shows elective surgery and emergency care on increase

The Bureau of Health Information’s second issue of Hospital Quarterly covers the July to September 2010 quarter, doubling the number of hospitals profiled from 40 to more than 80 and showing increased activity across elective surgery, admitted patient episodes and emergency department attendances.

Both reports and related materials are available at www.bhi.nsw.gov.au




Building 12, Gladesville Hospital

Victoria Road, Gladesville NSW, 2111

Locked Bag 5022

Gladesville NSW 1675

p: (02) 9844 6551

f: (02) 9844 6544

e: [email protected]

Cetiscape is distributed widely in the NSW Health system. Contributions to this newsletter on all subjects related to clinical education and training are invited.

Please contact the editor, Craig Bingham (02 98446511, [email protected]), to discuss potential contributions and receive guidelines for contributors.

The CAPS project team (left to right): Dr Mark Hohenberg, Dr Linda Xu, Dr Lydia So, Dr Matt Stanowski.

Health & Medicine

Cetiscape 2 December 2010