Download pdf - Professionalism Lesson Plan FULL · 2019-02-25 · Bethany Lloyd, Year 5, University of Aberdeen ([email protected]) Professionalism Lesson Plan Designed to be run by any

BethanyLloyd,Year5,UniversityofAberdeen([email protected])

ProfessionalismLessonPlanDesignedtoberunbyanymedicaloralliedhealthprofessionalforgroupsofideallylessthan30medicalstudentstoallowforwholegroupdiscussion,althoughcanbeusedforlargergroups.Aim:Toengagemedicalstudentsinacreativeandfunactivity,approachingprofessionalismfromasimilarlyvulnerableperspectivetothatapatientmaybein.LearningPoints:1.Professionalismisimportanttobeagoodmedicalstudentordoctorandallaspectsofitshouldbeconsidered.2.Whatthe4domainsusedintheGMC’s“Achievinggoodmedicalpractice:guidanceformedicalstudents”are,andwhateachoftheseincludes.2.Begintohaveanawarenessofthe14subtopicsusedinthisguidance,andexploringpotentialpitfallsofneglectinganysingleoneoftheseareas.Overview:Astheleaderofthislesson,youwillguideparticipantsthroughascenariowhichencouragesthemtothinkthroughthequalitiesandcharacteristicstheywouldliketoseeinanytrustedprofessional,particularlythoseinhigh-risksituations.Itiskeythatyouinitiallydonotrelatethelessontomedicalpracticeatall.Thestudentswillbesplitintoteamsof4-6individuals,andinformedthattheyhavebeeninvitedtoaskydivingsession.Onarrivalatthe“skydivingcentre”,theteamisrequiredtocreateanexhaustivelistofthecharacteristicstheywouldliketheirinstructortohave,sothatjusttherightpersoncanbefound.TheyarethenencouragedtorelatethecharacteristicstheyhavecomeupwithtotheframeworkgivenintheGMC’s“Achievinggoodmedicalpractice:guidanceformedicalstudents”,andconsidertheimplicationoflackinganyspecificaspectsofprofessionalism,firstlyinthescenarioofskydiving,andsecondlyinmedicalpractice.Thefollowingscriptcanbeusedflexibly,withadditionalactivitiestodevelopthis15-minuteactivityintoanhour-longsessionifrequired.

Basicstructure:1. Introduction“story”withexamplefromthe“previousskydivingteam”2. Give15blankcardstowriterequirementsoftheirskydivinginstructor3. Sort15whitecardsintothe4DOMAINheadings,(ifthereareanyblankwhite

cardstheycancompletethemnow).4. Relatethisexercisetomedicine,givethe14SUBHEADINGcardsandmatch

themtothewhitecards5. ForanyunmatchedSUBHEADINGcardsturnthemoverandaskstudentstoread

the“consequence”intheirgroup.6. (Optional:addupa“score”basedonSUBHEADINGcardstheydid/didn’tmatch)7. DiscusstheSUBHEADINGcardstheydidnotmatchtoanywhitecards.What

wouldbeapossibleoutcomeoflackingthisinmedicalpractice?


PREPARATION:

• ReadtheGMC’s“Achievinggoodmedicalpractice:guidanceformedicalstudents”,andensurethatyouarefamiliarwiththesummaryshownbelow.

• Preparea“pack”foreachteam,includingo 15blankwhitecards(seeAppendix1,alternativelyblankbusinesscardscanbeused)o 1singlesidedreusableinvitationcard(seeAppendix2)o 4singlesidedreusableDOMAINcards(seeAppendix3)o 14doublesidedreusableSUBHEADINGcards(seeAppendix4)

• Preparetheroomwithseparatetablesforeachgroup,largeenoughtospreadthecardsouton,andanoptional“leadershipboard”fortheteamscores.

Summaryof“Achievinggoodmedicalpractice:guidanceformedicalstudents”forthislessonNB:forthepurposesofthislessonthe4mainheadingsarereferredtoasDOMAINSandthe14categoriesbeneaththesearereferredtoasSUBHEADINGSDomain1:Knowledge,skillsandperformance(3)

a) Developandmaintainprofessionalperformanceb) Applyknowledgeandexperienceinpracticec) Recordworkclearly,legiblyandaccurately

Domain2:Safetyandquality(3)a) Contributetoandcomplywithsystemstoprotectthepatientsyouareresponsibleforb) Respondtoriskstosafetyc) Protectpatientsandcolleaguesfromanyriskposedbyyourhealth

Domain3:Communication,partnershipandteamwork(4plusconfidentiality)a) Communicateeffectivelyb) Workcollaborativelywithcolleaguesc) Continuityandco-ordinationofcared) Establishandmaintainpartnershipswithpatients

Domain4:Maintainingtrust(4)a) Showrespectforpatientsb) Treatpatientsandcolleaguesfairlyandwithoutdiscriminationc) Actwithhonestyandintegrityd) Openaboutlegal/disciplinaryproceedings

NB:Mostoftheresourcesforthislesson(excludingtheblankwhitecards)canbelaminatedandre-usedtominimizewastage.Ifre-usingthecardsisnotfeasible,anotheralternativeistoremovethebackgroundcoloursfromAppendix3andAppendix4.


LESSONSCRIPT(anyboxesinpalegreyareadditionalexpansionactivitiesthatcanbeusedifmoretimeisavailable)Sectionslabeled“T”aretobedoneasawholegroup,eggroupdiscussions.Sectionslabeled“G”areforthesmallgroupandshouldhaveminimalinputfromthesessionleader.Time Items

neededActivity

1min Assignstudentstoteamsof4-6individualsatthestartofthelesson.Aimformixedteamsratherthangroupsoffriends.Directthemtothealreadysetouttables,eachofwhichshouldhavethe“invitation”cardonit,facedown.

Youcouldaskthewholegrouptolineupinorderofshoesize,birthday,furthestdistancetravelledthatday,etc,perhapsevenwithoutspeakingandthendivideintoteamsaccordingly.Thiswouldgivearandomselectionforeachteam,andwouldalsohelpthegroupasawholetorelaxandengagewithactivities.

(Whiteboardorflipchart)

Itmighthelpencouragegroupcommunicationatthisstagetodiscussasawholegroupwhatthestudents’expectationsareofa“lessononprofessionalism”.Ifyouhaveawhiteboard,youcouldwritedownsomewordstheywouldusetodescribeit.Trytoencouragehonestyratherthanthe“rightanswer”.Forexample,theymightsay“interesting”,“unnecessary”,“difficult”,“relevant”,“boring”or“practical”.Ifstudentsarereluctanttospeakup,youcouldtrygivingeachofthemapieceofpapertowritedownonewordtodescribetheirexpectationsandhaveallofthestudentsrevealtheircardssimultaneously.Itcouldhelprapportifyoushareyourexpectationstoo!Trytoalsoelicitwhattheythinktheyknowaboutprofessionalismsofar.AretheyawareoftheGMCguidanceformedicalstudents?Havetheyreadit?

2-3min

Invitationcard(scoreboard)

Explainbrieflytothewholegroupthattodayyouarelookingatprofessionalismandintroducethescenario.Itisimportanttotryandavoiddirectlyrelatingittomedicineatthispoint,astheaimistoengagetheteamsinlateralthinkingaboutprofessionalism.Forexample,youmightsay:Asyouknow,overthenext20minuteswearegoingtobethinkingaboutwhatprofessionalismmeans.Wehavesplityouintoteamsfortheactivitieswewillbedoing.Iwillexplainwhattodoaswegoalong.Youwilleachneedapen,butIwillprovideeverythingelse.[ifscoringpointsfortheteams,explainatthispointthattherewillbepoints(andpossiblyprizes!)basedonhowwellyourteamdoesintheactivities]Youmighthavenoticedthatthereisacardonyourtable.Pleaseturnitover!


[Giveafewsecondsforeveryoneintheteamtoreadit]IwouldliketoaddmycongratulationstothoseoftheNationalCommitteeforMedicalStudentAttire.Welldone!Eachofyourteamshaswontheopportunitytogoskydiving.Howexciting!UnfortunatelyIhavejustspokentothereceptionistattheskydivingcentre,andshehastoldmethatalloftheirusualinstructorsarecurrentlyunavailable.Sheismorethanhappytofindanewinstructorforyou,butneedsyoutospecifyEXACTLYwhatyouwantofthem.Sheissurethanshecanguaranteeanycharacteristicsyouaskfor,butanycharacteristicsthatyoudon’tmention,yourinstructorwon’thave.Thegroupbeforeyouaskedherforaninstructorwhowas“honestandreliable”butdidn’tsay“qualified”sosheemployedthelocalbakerandhasn’tseenthemsince.Iamgoingtogiveyou15whitecardstowritedownyourrequirementson.Youwillhave3minutestotryandthinkofasmanyasyoucan,butdon’tworryifyouhaven’tfinishedallofthewhitecards,therewillbeanopportunitytoaddtothemlater.

3-4min

15whitecards,pens

GivetheteamssometimetowritedowncharacteristicsKeepaneyeonhowmanyofthewhitecardseachteamhasfilledin.Tryandstopthemwhentheyhavedoneroughly10,orafter3-4minutes.

2-3min

4domaincards Explaintothewholegroupthatyouhavesomeheadings,which

coverdifferentareasofprofessionalismtheymightwanttothinkabout.Giveeachteamasetofthe4colouredDOMAINcards.Askthemtodividethewhitecardsbetweenthesecategories,andgivethemsometimetocompleteanyremainingwhitecards.

1-2min

Explaintothewholegroupthatwhenpeopleareskydiving,theyhavetotrusttheirinstructorwiththeirlife.Oftenwhenpeopleparticipateinactivitieslikeskydiving,theyhavelittleknowledgeofthespecificprocessesthatneedtobecompleted,althoughtheymayhavesomeideasaboutwhattoexpect.Theirideasmayprovetobecorrectorincorrect,buttheyneedtotrusttheresponsibleinstructortobehaveinasafe,professionalmanner.Thisissimilarinlotsofwaystomedicine,whereyouwillhavepatientspotentiallytrustingyouwiththeirlife,withoutnecessarilyknowingwhetherwhatyouaredoingissafeorcorrect.TheGMChaveproducedadocumentcalled“Achievinggoodmedicalpractice:guidanceformedicalstudents”,whichlaysouttheaspectsofprofessionalismtheyrequirefrommedicalstudents.Theysplitthese14aspectsinto4domains;theDOMAINcardsIgaveyouinthelastactivity.


2-4min

14attributecards

Nextgivetheteamsthe14SUBHEADINGcards,whichfitintothe4domains.WithoutturningtheseovertheyshouldmatchthewhitecardstotheSUBHEADINGcardsintheirteams.[Teamsmayneedsomehelptostartthisoff.Trytocirculatebetweentheteamstogiveextrainformationonanyofthesubheadingsifneeded.ThereissomeoverlapbetweentheSUBHEADINGcards.Theremaybesomethingstheyhavewrittendownthatdon’tfitintoanyofthesubheadingsordomains.Youmightwanttobringthisupinthediscussion]Itwilllooksomethinglikethis:(inthisexampletheyhave3unpairedSUBHEADINGcards)

1-2min

Askthegroup:DoyouhaveSUBHEADINGcardsleftoverthatyoudidn’tmatchanyofthewhitecardsto?AsktheminteamstoturnoveranyoftheSUBHEADINGcardswhichareunpairedandreadthe“consequences”oftheirinstructornotdemonstratingthataspectofprofessionalism.IftheyhavelotsofunpairedSUBHEADINGcards,theyshouldchoosejust2or3toreadtheconsequencesfor.Theconsequencesaredramaticexamplestomakeanimportantandmemorablepoint:thereispotentialforharmifANYaspectofprofessionalismisneglected.

Scoreboard,pens

Forscoring:+20pointsforanyoftheSUBHEADINGcardsthatarepaired.Forexampleifateamhaswritten“complieswithsafetyprocesses”they


wouldget+20pointsformatchingwithSUBHEADINGCard“Contributetoandcomplywithsystemstoprotecttheskydiversyouareresponsiblefor”.Iftheyhadalsowritten,“helpsdevelopsafetysystems”onanotherwhitecardtheywouldnotgetanyextrapointsasthisisalsocoveredbythesamesubheading.PointsaredeductedforeachoftheSUBHEADINGcardsthattheydidnotmatchanythingto,accordingtothescoresontheback.Addupatotalscoreperteam.

2-3min

Together:AsktheteamstochooseoneoftheirunpairedSUBHEADINGcards.Encouragediscussionasawholegroup(orinteamsifshortontime)aroundthequestionsinAppendix5.Ifyouareshortontime,focusonthequestionslistedhere(q1,q3).Aimtokeepthediscussionpracticalratherthantheoretical.1.Whydoyouthinkyoudidn’tconsiderthisaspectofprofessionalismwhenyouwerediscussingitasateam?3.Canyouthinkofsomeimplicationsofnothavingitifyouwereamedicalstudent?NB:akeypointintheusefulnessofthislessonasalearningexperienceisinrelatingtheseattributesbacktomedicalpractice,throughthelensofconsideringthemselvesan“injuredparty”.Theaimisthatstudentswillrememberindividualcharacteristicsmorereadily,particularlywiththememorable“consequences”onthecards.

YoucanrepeatthesequestionsforoneortwomoreoftheunpairedSUBHEADINGcards.Ifyouaredoingthis,youmightwanttoencourageteamstochoosesubheadingsfromdifferentdomainswherepossible.Ifyouhavelonger,youcouldgiveteamsonefulldomainfrom“Achievinggoodmedicalpractice:guidanceformedicalstudents”tolookoveranddiscussthepoints.Aimtokeepthediscussionpractical-dotheythinkthisguidanceisthingstheydoinpracticethemselves?Ifnot,whynot?Isthereanythingtheywouldadd?

1min SummarisewhattheyhavelearntandclosethesessionIfyouareshortontimeyoucanbrieflysummarise.Otherwiseyoucouldgoroundandhaveeachstudentsay1thingthattheyhavelearnt,or1thingtheyenjoyed/1thingtheywouldimprove.Ifyouhavekeptscores,announcethewinnersatthisstageandcongratulatethem.Ifyouhaveasmallprizeitcanmakethismorefun.Thankthestudentsandclosethesession



APPENDIX1:BLANKCARDSFORCHARACTERISTICSLISTTopreparecards-cutalongthedottedlines



APPENDIX2:INVITATION


APPENDIX3:DOMAINCARDSTopreparecards-cutalongthedottedlines

DOMAIN1:KNOWLEDGE,SKILLSANDPERFORMANCE

DOMAIN2:SAFETYANDQUALITY

DOMAIN3:COMMUNICATION,PARTNERSHIPANDTEAMWORK

DOMAIN4:MAINTAININGTRUST


APPENDIX4:SUBHEADINGCARDSTopreparecards-cutalongthedottedlines,thenfoldalongthecentraldoublelinetocreateadoublesidedcard. Attribute Consequence

Domain1

Know

ledge,Skillsand

Pe

rformance

Developandmaintainprofessionalperformance

- Acquireknowledgeandskillsasastudent(goodattendance,respondingtofeedback,reflecting)

- Maintain/improveasaprofessional.

Youfailtorequirethatyourinstructorisqualifiedorhasmaintainedtheirqualifications.Asaresult,thereceptionistcallsinthelocalbakerwhooncewentonaskydivein1963andthinkshecanmakeastabatit.Unfortunatelyhedoesn’treallyrememberitaswellashethoughtanddoesn’tpullthecorduntiltoolate.

Domain1

Know

ledge,Skillsand

Pe

rformance

Applyknowledgeandexperienceinpractice

- Workwithintheircompetence- Behaveprofessionallyegnotlate,

professionaldress- Gainingconsent

Youfailtorequirethatyourinstructorappliestheirknowledgeandskillsinaprofessionalmanner.Therefore,sheturnsup2hourslate,bywhichtimethepilothasleft.Shedecidestoflytheplaneherselfasalthoughnotqualifiedtodoso,sheisfriendswithapilotwhohastalkedherthroughitbefore.Itturnsoutshecantakeoff,butnotlandtheplane.

Domain1

Know

ledge,Skillsand

Pe

rformance

Recordworkclearlylegiblyandaccurately

- Goodcontinuity,goodteamwork,safehandoversfromoneprofessionaltoanother

Youfailtorequirethatyourinstructormakesarecordofanythingclearly.Assuch,althoughshecheckstheweatherreportbeforeyouleave,shewritesitdownonascrapofpapertotakewithher.Shortlybeforejumping,shelooksatitbutitunsurewhethershehaswrittenNWorNEforthewindspeed.Sheguesseswrongandyouareblown50milesoffcourse,outtosea.

Domain2

Safetyand

Quality

Contributetoandcomplywithsystemstoprotecttheskydiversyouareresponsiblefor

- complywithsystemsdiligently- seektoimprovesystems- openandhonestfollowing

significantevents

Youdonotrequirethatyourinstructorisdiligentincomplyingwithsafetysystems.Theinstructorcannotbebotheredfollowingallofthesafetychecksbeforeheleavesandsoforgetstochecktheparachute.Whenitopensonthedescentitisimmediatelyobviousthatithasalargeripinit,whichbecomesrapidlyworse.Unfortunatelyhealsodidn’treadtheinstructionsindicatingthatyoushouldalsohaveareserveparachute.


Do

main2

Safetyand

Quality

Respondtoriskstosafety

- responsibilityofthewholeteam- includesprotectingdignityand

comfort

Youfailtorequirethatyourinstructorwillrespondtosafetyrisks.Asyoutakeoff,younoticethattheplanedoorislooseandmentionthistotheinstructor.Sheshrugsandtellsyouthatthisisthepilot’sresponsibility,whoyoucannotcontactasheisinthecockpit.Therattlingbecomesworseandat10,000ftthedoorfallsoff.

Domain2

Safetyand

Quality

Protectskydiversandcolleaguesfromanyriskposedbyyourhealth

- Seekadvicefromsuitablecolleagues

- Includesimpactofstressoranxiety

- EngagewithOccupationalHealth

Youfailtorequirethatyourinstructorisdiligentaboutprotectingyouandhiscolleaguesfromrisksposedbyhisownhealth.Asaresult,thereceptionistemploysaninstructorwhohasrecentlyreturnedfromaskydivingexpeditioninTanzaniaandhasmalariawithafeverof410C.Ontheascentintheplanehebecomesdeliriousandonthefree-falllosesconsciousness.Youdonotknowhowtoactivateorsteertheparachute.

Domain3

Commun

ication,

Partne

rship,Teamwork

Communicateeffectively

- Clearcommunicationandlistening

- Takeintoaccountlanguageandotherbarrierstocommunication

Youdon’trequirethatyourinstructorhasgoodandclearcommunication,andsothereceptionistemploysafriendlyItalian.Unluckilyhedoesn’tspeakanyEnglishandyoucan’tspeakanyItalian.Whenyouhaveopenedthedooroftheplaneyouthinkhesays“go,I’mready”;hewasactuallysaying“wait,Ineedtheparachute”

Domain3

Commun

ication,

Partne

rship,Teamwork

Workcollaborativelywithcolleagues

- Adaptbehaviorasnecessarytoimproveteamworking

- Treatallmembersoftheteamwithrespect

Yourinstructorisnotrequiredtohavegoodinter-professionalworkingrelationships.Thereceptionistcontactsanoldinstructorwhowasaskedtoleaveafterpunchingthepilot.Thepilothasnotforgivenhim,andtellshimtojumpwhentheyareflyingoveranactivesurface-to-airmissiletestsite.

Domain3

Commun

ication,

Partne

rship,Teamwork

Continuityandco-ordinationofcare

- Safetransferbetweendifferentprofessionalsandsettings

- Sharerelevantinformation

Youdon’taskforaninstructorwiththeabilitytopassoninformationwell.Theinstructororganizestheparachutes,butaccidentallyleavesthembehind.HecallshisslightlydeafGrantopickthemup,whocallsherslightlyblindfriend,whopicksupthewrongbag.Youdon’trealizeuntilyouhavejumpedthatitonlyholdsdirtylaundry.


Domain3

Commun

ication,

Partne

rship,Teamwork

Establishandmaintainpartnershipswithskydivers

- Treatthemasindividuals- Listentothemandtreatthem

fairly,withrespect- Beclearaboutroles

Youdonotaskforaninstructorwhowantstoworkwithskydivers.Thereforewheneveryouoffertohelphesays,“Iamtheinstructor,Iknowbest.”Whenyouarereadytojump,youthinkyouseesomestormyweathercoming,butdon’tfeelcomfortablespeakingup.Itturnsouttobeahurricane,whichyoumeethalfwaydown.

Domain4

MaintainingTrust

Showrespectforskydivers

- notpursuingimproperorsexualrelationshipswithskydivers

- notexpressingpersonalbeliefsindistressingways

- honestyifsomethinghasgonewrong

Youdonotaskforaninstructorwhoshowsrespectforthoseintheircare.Yourinstructorbehavesoddlyontheflightup,askingwhichgirlsareinrelationships.Whenthedoorisopenedhedeclareshimselfa“Beyonceworshipper”andstateshewilloffer“singleladyhumansacrifices”.Heforcefullyaskswhowantstogooutthedoorfirst.

Domain4

MaintainingTrust

Treatskydiversandcolleaguesfairlyandwithoutdiscrimination

- donotdelayhelpbecauseyoubelievetheskydiverhascontributedtotheproblem

- awareofunconsciousbias

Youdonotrequirethatyouinstructortreatallskydiversfairly.Hejokesthatthewomenshould“stayonthegroundandmakesandwichesforwhentheygetback”.Itturnsoutthepilotisactuallyfemaletoo,andrefusestoflytheplane.Thereforenobodycangoskydiving.

Domain4

MaintainingTrust

Actwithhonestyandintegrity

- honestinallregards.Including:experience,qualifications,plagiarism,yourownhealth,communicationwithpatientsandcolleagues,finances,insurance.

Youdonotaskforaninstructorwhobehaveswithhonestyandintegrity.Sherealizesshortlyaftertakeoffthatsheforgottopackenoughparachutesforalltheparticipantsbutdoesn’twanttoadmitthemistake,sosheputsajumperintheemptybagtopaditout.Oneofyoupullstheripcordondescent,toreleaseonlyafluffypurplefleece

Domain4

MaintainingTrust

Openaboutlegal/disciplinaryproceedings

- honestduringlegalproceedings- informsemployersofany

convictionsorcautionsimmediately

- Withinandoutsidework

Youdidn’taskforaninstructorwhowasopenaboutlegalanddisciplinaryproceedings.Itturnsoutthatheisontherunfromthepolice,andwhenyouaskhisnameherepeatedlysays“JohnSmith”inaheavilyaccentedvoice.Theplaneseemstobetakinglongerthanyouwouldexpect,andwhenyoulandafterthedive,thetreeslooksuspiciouslytropical;thesandsuspiciouslywhite.


APPENDIX5:Questionsfordiscussion

1. Whydoyouthinkyoudidn’tconsiderthisaspectofprofessionalismwhenyouwerediscussingitasateam?

2. Canyouthinkofatimewhenyousawthisbeingneglectedinmedicalpractice,maybebyafellowmedicalstudent,aconsultant,anFY,anurseoranyoneelse?Whathappened?

3. Whatmightbetheimplicationsofdisregardingthisaspectofprofessionalismasamedicalstudent?Orapracticingdoctor?

4. Whatcouldyoudotoensurethatyouputthisintopracticenowandinthefuture?

5. Howcomfortablewouldyoufeelchallengingsomeoneelseaboutthis?Whatiftheyweresignificantlymoresenioregyourconsultantorsupervisor?Whatiftheywereanothermemberofthemulti-professionalteamegaphysiotherapist,dietician,nurse?