Reflections on the experience of NSW: Moving from a PMC to IMET to CETI to HETI.
A 20 year journey
Professor Steven Boyages Clinical Education and Training Institute
9th November 2011
Timeline and Definitions
Postgraduate Medical Council (PMC)
Institute of Medical Education and Training (IMET)
Clinical Education and Training (CETI)
Health Education and Training Institute (HETI)
Constants of health
• Clinician patient relationship
• Clash of cultures
Change Drivers
• Patient experience and safety
• Staff experience and safety
• Demography
Resilience
• Individual, self efficacy, social cognitive theory
• Organisational
Adaptability and Agility
• New models of education and learning
• Technology
Health is a knowledge based profession
• Research
• Development
Generate Knowledge
• Education
• Training
Impart Knowledge
• Care
• Prevention
Apply
Knowledge
Constants of Health TO RECHON him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look up his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according the law of medicine, but to none others. (Hippocrates 460-370 BC)
High Touch High
Tech
Team and Workflow
Platform
Technology
Platform
Health work is a balanced matrix
Institute of Medical Education and Training (IMET)
Vocational Networks
HSP
Postgraduate Medical Council
Standards & Accreditation Allocation, Supervision
Changing Health Patterns
Need for new models of care
Technology Increasing consumer
expectations
Rising cost of health care
The Perfect Storm
Future workforce growth at Feb 2010 Future industry job growth – Australia 5 years from 2009-10 to 2014-15
(‘000) - DEEWR projections
Clinical Education and Training Institute (CETI)
Allied Health
Nursing
Medical
Oral Health
Rural
Centre for Learning and
Teaching
Institute of Medical Education and Training (IMET)
Vocational Networks
HSP
Postgraduate Medical Council
Standards & Accreditation Allocation, Supervision
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What are we trying to do?
To improve teamwork, communication and
collaboration for safer patient-centred care, and
better staff experiences
Why are we trying to do this?
Increased staff motivation, well-being and retention
Decrease in staff turnover
Increased patient and carer satisfaction
Increased patient safety
Increase in appropriate use of specialist clinical resources
Reductions in patient mortality and critical incidents
Increase in access to and coordination of health services
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What do we mean by Team Work?
Interprofessional Education (IPE)
Occasions when two or more professions learn from, with and
about each other to improve collaboration and the quality of care
Interprofessional Practice (IPP)
Occurs when two or more professions work together as a team with
a common purpose, commitment and mutual respect (Freeth et al,
2005).
Team Health
Foundations – Right Start
• Individual
• Roles and Responsibilities
• Risks and Rewards
High Performance Teams
• Roles
• Reflection
• Respect
• Resilience
Advanced Settings of Care
• Advanced Clinical Modules
• Simulation
What Is Self-Efficacy?
According to Albert Bandura, self-efficacy is “the belief in one’s capabilities to organize and execute the courses of action required to manage prospective situations” (1995, p. 2).
In other words, self-efficacy is a person’s belief in his or her ability to succeed in a particular situation. Bandura described these beliefs as determinants of how people think, behave, and feel (1994).
Sources of self efficacy
1. Mastery Experiences • "The most effective way of developing a strong sense of efficacy is through mastery experiences," Bandura
explained (1994). Performing a task successfully strengthens our sense of self-efficacy. However, failing to adequately deal with a task or challenge can undermine and weaken self-efficacy.
2. Social Modeling • Witnessing other people successfully completing a task is another important source of self-efficacy.
According to Bandura, “Seeing people similar to oneself succeed by sustained effort raises observers' beliefs that they too possess the capabilities master comparable activities to succeed” (1994).
3. Social Persuasion • Bandura also asserted that people could be persuaded to belief that they have the skills and capabilities to
succeed. Consider a time when someone said something positive and encouraging that helped you achieve a goal. Getting verbal encouragement from others helps people overcome self-doubt and instead focus on giving their best effort to the task at hand.
4. Psychological Responses • Our own responses and emotional reactions to situations also play an important role in self-efficacy.
Moods, emotional states, physical reactions, and stress levels can all impact how a person feels about their personal abilities in a particular situation.
• Bandura, A. (1995). Self-Efficacy in Changing Societies. Cambridge University Press.
Review Article American Medical Education 100 Years after the
Flexner Report
Molly Cooke, M.D., David M. Irby, Ph.D., William Sullivan, Ph.D., and Kenneth M. Ludmerer, M.D.
N Engl J Med Volume 355(13):1339-1344
September 28, 2006
Health Education and Training Institute
Undergraduate
Vocational Training
Leadership and Management
Clinical
Clinical Education and Training Institute (CETI)
Allied Health
Nursing
Medical
Oral Health
Rural
Institute of Medical Education and Training (IMET)
Vocational Networks HSP
Postgraduate Medical Council
Standards & Accreditation
Allocation, Supervision
HETI Function Domains
Undergraduate clinical placements
Vocational Education and Training
Post graduate clinical prevocational and vocational training
Management and Leadership Development
Staff Shortages
Competency gaps
Poor staff utilisation and productivity
Poor Staff Morale
Increased Medical Error
Poor Economic Development
“Storm Damage”
Reflections
Constants of health
• Clinician patient relationship
• Clash of cultures
Change Drivers
• Demography
• Patient experience and safety
• Staff experience and safety
Resilience
• Individual, self efficacy, social cognitive theory
• Organisational
Adaptability and Agility
• New models of education and learning
• Technology