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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:[email protected] Graeme Fleming: [email protected] Joyce Williams: [email protected] Malcolm Laird: [email protected] Will Drever: [email protected] 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)