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IMPROVING EDUCATION: TOPICS, TIMES AND TANTALISING TEASERS
DR DANI BACHMANNMBBS , B.APP.SC (EXSS)
PMCWA CO-CHAIRPERSON
PERI-OPERATIVE RMO SCGH
© 2015 Royal College of Physicians and Surgeons of Canada
• Where have we gone wrong ? Have we gone wrong?
• Why are junior doctors failing to access education?
• Is there sufficient education provided by hospitals?
• What motivates attendance where these sessions are available?
• What impedes attendance?
• And importantly…. How can we attempt to resolve it
• Understand motivations of JMOs to attend education
• Ascertain the preferred structure of educational sessions
• Identify optimal timing
• Unearth the major limitations to attendance
• Brainstorm solutions to counteract identified limits
• Survey of 16 targeted questions and two free text options• Employment Hx: PEHS, site, PGY level• Perceived educational availability• Personal motivators, stimulators,
barriers and preferences
• Distributed by PMCWA via PGME depts.
to prevocational trainees • Interns, Residents and Service Registrars• Across WA, incl WACHS
• Each PGME was given the opportunity to
substantiate educational opportunities
• What opportunities existed?
• Availability of sessions per week?
• Average attendance as a percentage of
the cohort?
HOSPITAL What educational opportunities are offered at
your site?
How many teaching sessions
are available per week?
On average, what portion of your
employed junior workforce are able to
attend teaching sessions?
Osborne
Park
Usually we have close to 100%
attendance from our JMO’s. They all
receive a page 30 minutes before to
remind them, and the Consultants
regularly attend so they are very
supportive of their JMO’s leaving the
Ward to attend the educational
sessions.
Joondalup
Health
Campus
We have started offering train the trainer courses
with our Training and Development department
2 Post Grad and many for
each department – please
see example of weekly
education calendar
70%+
Princess
Margaret
Hospital
RMO Protected Teaching Session (Weekly);
Senior RMO Teaching Session (6 per year); Step-
Up Course (Annual); Accidental Counsellor
(Annual); Inter-Professional SIM Sessions (10-12
per year); Grand Rounds (Weekly); Clinical
Paediatric Conferences (Weekly); Departmental
Teaching (As required); Seminars on Research
Methodology; FRACP Teaching.
RMO Protected Teaching
Sessions (1 ¼ hours every
Wednesday); Grand Rounds
(Every Thursday); Clinical
Paediatric Conferences
(Every Tuesday);
Departmental Teaching
(Weekly); Others as required.
Very difficult to give a figure but on a
whole all JMOs are/should be able to
attend teaching sessions. RMO
Teaching Sessions are protected.
Hollywood
Private
Hospital
Weekly – Specialist led Cardiology (1hr protected
session)
Weekly – Specialist led General Teaching (1hr
protected session).
Fortnightly – Specialist led Surgical Teaching
(interns only)
Monthly – Specialist led Psychiatry Teaching
All Registrars/RMOs/interns are invited
to attend these sessions (with the
exception of surgical teaching which is
for interns only). The majority of RMOs
and interns are able to attend these
planned teaching sessions
Fiona
Stanley
Hospital
Intern tutorial, weekly, 1hr
RMO tutorial, weekly, 1hr
Hospital grand round, weekly, 1hr
Perioperative tutorial series, weekly, 1hr (terms 1-
3)
Hospital Out of Hours Training, weekly, 2hrs
Turbo Hospital Out of Hours Training, monthly,
2hrs
Skills workshops – cardioversion, lumbar
puncture, airway management
Prescribing workshops – insulin and pain and
analgesia
RMO to Registrar step-up, twice yearly, two days
ALS-2, quarterly, two days
SimStart, twice yearly, three days
Mentoring workshop (for RMOs being mentors of
Interns), annually, 2hrs
As per previous question – I
have listed if weekly or not
Intern teaching is upwards of 80%.
However RMO teaching and grand
rounds is more like 15%
Sir Charles
Gairdner
Grand rounds, intern teaching, skills workshops,
medical and surgical lectures, simulation
workshops, clinical signs round, renal and
immunology teaching open to all, teaching on the
run workshops, RMO to Reg transition workshop,
ALS and MET workshops, CVC course
At least one a day
Depending on the sessions but an
average of 30 for the grand rounds, 50
for intern teaching, 20 for the medical
lectures and smaller numbers for the
skills and other workshops.
Armadale
Health
Service
See attached overview of Edu and Training at
ABTC. Terms also might have additional
Departmental teaching eg Paeds Radiology
fortnightly
Multiple, generally x2 – 3
teaching sessions per week
per JMO term are available.
Nearly 100% attendance at Intern VC,
ED JMO tutes and Gen Med
Departmental teaching when JMO’s are
rostered on. Other activities optional.
Skills workshops x6 per workshop. In
addition we try and roster all JMO’s to a
1 day RRAID course during their first or
second term here.
Fremantle
Hospital
Intern tutorial, weekly, 1hr, VC from FSH,
RMO tutorial, weekly, 1hr, VC from FSH ,
Hospital grand round, weekly, 1hr
Perioperative tutorial , 1 x per term , 1hr
Preoperative clinic x 1 per term , I hr
Sim (The deteriorating patient scenarios,
Alternate weeks, (4 JMOs rostered to attend each
fortnight)
There is also department teaching , these are not
organised by MEU
As previous question – I have
listed if weekly or not
Intern teaching is upwards of 95%. RMO
teaching 60%
Grand Round no states kept, this is a
multidisciplinary team education
Geraldton
Hospital
We like to do radiology teaching at 4 pm on tues,
didactic session at 4:30 tues, sim session on
thurs every week, focused lectures on thurs 2 pm.
Our junior rmo attendance is generally
100%. They seem to enjoy them.
Adobe Acrobat Document
C:\Users\he117108\Desktop\
JHC 31.10.2016.docx
Adobe Acrobat Document
C:\Users\he117108\Desktop\Postgrad Med Ed Calendar ABTC Nov 2016.docx
Adobe Acrobat Document
Sites• Secondary/Peripheral
vs Tertiary• Protected vs Non
Departments• General
Medicine• Emergency
Leadership• Seniority• Teams
Residents 55%
Interns30%
Service Registrar8%
Training Registrars
7%
Residents Interns Service Registrar Training Registrars
13.9
49.4
34.2
2.5
0
10
20
30
40
50
60
Daily Few per Week Weekly None
% identifi
ed a
s available
Perceived availability of sessions
97.9
87.9
83.7
81.7
70.2
66.3
57.5
0 20 40 60 80 100 120
Topic
Presenter
Senior/Team Involvement
Structure
Friends/Jnr Colleagues
Food/Beverage
CPD Points
0
10
20
30
40
50
60
70
Lecture Grand Round Teaching on the Run Simulation Procedural
Highly beneficial 18.8 14.9 44.8 55.8 60
Beneficial 68.2 50.7 44.2 35.7 36
Neutral 7.8 27.3 7.1 6.5 4
Minimally Beneficial 4.6 5.8 3.2 1.3 0
Not beneficial 0.6 1.3 0.7 0.7 0
% A
ppro
val
• Prior Knowledge of Topic
• Material distribution ?
• Interactivity
• Case based discussions
• Quizzes
• Lecturer
35.6
27.6
21
8.86.8
2
28.2
35.5
20.4
3.3
12.5
0
5
10
15
20
25
30
35
40
Lunch (12:00 -13:00)
Pre-Work (7:15 -8:00)
Afternoon (15:00) Post AM WR Post Work(17:30)
Weekends
Ideal
Realistic
Clinical Volume• Ben Hurr
AdministrativeTasks
• ABF, Training, streamlining and productivity
Support
• Senior awareness , assistance
• Registrar cover
• Ward cover
Paging• Appropriately graduated escalation by allied/nursing staff
• Hold vs divert vs Format
EducationalMaterial
Catering• Proximity to hospital cafes
• Provision of food / tea / coffee
Forgetfulness• Reminders to BasePage, CNM/CNC
• SMS notifications
….
• Topics• Procedural• MET, Common A/H Calls, Sims• Life Skills – communication, medico-legal, welfare, up-management, conflict
resolution, EOL discussions• Clinical topics (exact details can be provided)
• Times• Morning is least disruptive and therefore may be most well attended,
particularly if incorporated into rostered hours
• And Tantalising Teasers to stimulate change …
REFERENCES
• CANMEDS 2015 PHYSICIAN COMPETENCY FRAMEWORK. THE ROYAL COLLEGE OF PHYSICIANS AND
SURGEONS OF CANADA 2015.
• DEPARTMENT OF POST GRADUATE MEDICAL EDUCATION, MEDICAL EDUCATION OFFICERS
• ARMADALE KELMSCOTT HOSPITAL
• FREMANTLE HOSPITAL
• FIONA STANLEY HOSPITAL
• GERALDTON REGIONAL HOSPITAL
• HOLLYWOOD PRIVATE HOSPITAL
• JOONDALUP HEALTH CAMPUS
• OSBOURNE PARK HOSPITAL
• SIR CHARLES GAIRDNER HOSPITAL
1. Common calls/ METs – sims +++2. Life skills
o time management o dealing with bosseso Medicolegalo Team/Communication issueso Doctors welfareo Training programmes, pros and conso Surviving A/H and NDo Clinical Incident management
3. Cardiology o cases o ECGo Chest paino Arrythmia Mx
4. Diabetes – prescriptions 5. Radiology6. Psych emergencies and Code Black / Agitation Drugs7. End of life care 8. Anticoag9. AB choices10. NIV use and settings11. Pain management12. Hameatology13. Immunology14. Understanding Acid-Base15. Appreciation of beds, hospital management and flow
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