ROLE AND RESPONSIBILITIES OF POSTGRADUATES IN

MEDICINE Dr.T.V.Rao MD

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Medicine is a imperfect science, loaded with difference of opinions, many conflicts, matters

dealt carelessly leads to litigations and increased human suffering or even death,

HOW SAFELY WE PRACTICE MAKES DIFFEENCE TO OUR CARRER

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Who is a Post graduate Trainee

•There is increasing discussion about” a Trainer or post graduate is a person with some seniority within the clinical team

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Never forget every postgraduate is Student and an Expert in Emergency Hours

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Patient safety •Patient safety is at the core of standards. Just as

good medical students and doctors make the care of their patients their first concern, so must the organisations that educate and train medical

students and doctors. In non-clinical learning environments, there should also be a culture of

promoting patient safety AS IN LABORATORY MEDICINE

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Why we should create a Better learning environment

• The learner’s* ability to develop the appropriate professional values, knowledge, skills and behaviours is influenced by the learning environment and culture in which they are educated and trained.

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Patient protection is a priority

•Patient safety is inseparable from a good learning environment and culture that values and supports learners and educators. 28-06-2016 Dr.T.V.Rao MD 7

All Trainees should be kept under observation at least in the early period of Training

•Clinical Supervisor This is a consultant who has a clearly defined responsibility to oversee and manage an individual trainee’s clinical training and performance within the department for the period of that specific clinical placement28-06-2016 Dr.T.V.Rao MD 8

Patient Safety is a top priority

•we will now make sure that education and training takes place where patients are safe, the care and experience of patients is good, and education and training are valued.28-06-2016 Dr.T.V.Rao MD 9

Never leave the Gaps Hand over the Matter for better running of the matters

•Ensure safe handover. They should ensure that the care of patients during the period of duty has been safely handed over to any incoming clinician emergency duty post graduate 28-06-2016 Dr.T.V.Rao MD 10

MEDICAL DOCUMENTATION WHAT YOU WRITE IS LEGALLY DONE

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Medical Documentation• In the legal system,

documentation is regarded as an essential element. Extending the risk management dimension, failure to document relevant data is itself considered a significant breach of and deviation from the standard of care.

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However documentation is part of legal jeopardy

• Of course, protection from legal jeopardy is far from the only reason for documentation in clinical care

• The patient's record provides the only enduring version of the care as it evolves over time and a reference work of value in emergency care, research, and quality assurance.

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Document appropriate records

•Writing more is not the solution; simply writing with greater efficiency will cut down on time spent in documentation.

•Appropriate decisions saves the life and the Doctors Insittuions

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Pitfalls and Pointers in Documentation

• The primary pitfall in documentation is attempted alteration. The most critical advice in documentation is that one should never attempt to change an existing record. Do not insert, use little arrows, add inter-lineations, etc

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Our proper records defend us

•Within the nightmare of a malpractice suit brought against a physician, a solid documented chart in one's hand is universally recognized as one of the critical elements of the best defence.

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Our Aim is to Make the Good Medical Practices work in all Hospitals

• Learners receive educational and pastoral support to be able to demonstrate what is expected in Good medical practice and to achieve the learning outcomes required by their curriculum.

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Good Teacher will make good Students

• They are expected to maintain and continue to develop knowledge and skills on an ongoing basis through continuing professional development. Educators are involved in and contribute to the learning environment and culture.

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Role of Post Graduate Directorone of the Academic person can be nominated

•Be familiar with the individual’s learning objectives, ensure that the trainee has a timetable which enables them to gain the desired experience and be able to credibly test completion of these objectives28-06-2016 Dr.T.V.Rao MD 19

Managing Doctors in Training

•Managing doctors in training is complex due to the dual role that trainees are in. • They are in a training programme and so are the responsibility of the Deanery and their team. • They are supported in their training locally by employer and the medical education team

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Learning New Information is a priority

Journal Club is easier option

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Definition •A journal club is a group of individuals who meet regularly to critically evaluate recent articles in the academic literature, generally of some branch of science as Medicine, science or philosophy. Journal clubs are usually organized around a defined subject in basic or applied research. 28-06-2016 Dr.T.V.Rao MD 22

Purpose and Goal of Journal Club

•The goal of Journal Club is to introduce medical Students, resident doctors, or even senior faculty to the principles of clinical topics, scientific topics in relation to health care required to critically appraise published clinical research literature.

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Valuable part of Journal Club • The value of a journal club is

that it can promote a better understanding of the research process and an improved ability to critically appraise research. Reading and critiquing research is most beneficial for critical care doctors and nurses, as it facilitates the evaluation of research for use in clinical practice.

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Present the article with Scientific Basis• Based on what you are

currently learning and what you already know, read the article with a critical eye. Consider hypothesis, study design, bias, methods of analyses used, etc. How can readers make sense of the numbers in the tables? Are the results reproducible?

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Purpose of the presentation •The general purpose of a journal club is to facilitate the review of a specific research study and to discuss implications of the study for clinical practice.

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Cut and Paste is OK in presentation of complex tables

• Typically, cut and paste tables and figures. Since you'll have already distributed hardcopies of the article, don't worry too much about reformatting tables for readability on the screen Just point to the sections of interest and let the audience flip through their hardcopies to read the data directly.

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Must come to some conclusions at the end of presentationConclude by Managing Presentation

•Conclusions/ Implications (1 slide)• Strengths

(1 slide)• Weaknesses

(1 slide)• Discussion Points

(1 slide)

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Please inform the participants on the Matters you are presenting

• Post and distribute copies of the research article and the journal club discussion questions to interested persons

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Mentor's Role•Help residents identify appropriate article that fits pre-specified design of the month. Meet with residents 1-2 weeks before Journal Club to discuss paper and prepare. Lead a 30-40 min. discussion of the paper and related topics in critical appraisal following the residents' presentation at Journal Club.

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Residents Role• Residents and Post graduates

select a recent article and clear it with assigned Journal Club mentor. ( Can be HOD or Senior Faculty ) They read the article and arrange a meeting with the mentor at least one week before Journal Club to discuss strengths and weaknesses, identify teaching points, and outline approach to presentation. 28-06-2016 Dr.T.V.Rao MD 31

Select an article•Consider articles on

topics of interest to you that will generate conversation. Also consider topics discussed at the Journal Club meetings earlier in the year…variety is a good thing

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Updating the people on Information •A journal club has been

defined as an educational meeting in which a group of individuals discuss current articles, providing a forum for a collective effort to keep up with the literature

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Never Forget to Incorporate the following matters

• It should outline "Hypothesis/Goal;“ "Study Design;" "Setting;“ "Participants;" "Data Collection;“ "Main Outcome;“ "Analytic Method."

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Encourage more people view your presentation

•eg, encourage more attendance, hold more than one session, programs can be uploaded in internet the session for those unable to attend. 28-06-2016 Dr.T.V.Rao MD 35

Mentor's Role•Help residents identify appropriate article that fits pre-specified design of the month. Meet with residents 1-2 weeks before Journal Club to discuss paper and prepare. Lead a 30-40 min. discussion of the paper and related topics in critical appraisal following the residents' presentation at Journal Club.

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Trouble Shooting A number of tricks seemed to help. Answering individuals’ own questions is central to both education and motivation. 28-06-2016 Dr.T.V.Rao MD 37

Presentation not more than 15 minutes

•Must be limited to 15 minutes to allow plenty of time for teaching and discussion

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Encourage greater participation from many experts

• Early on, people seem keen to come up with questions focused on the rare, unusual, and wonderful diagnoses they have bumped into rather than questions about their everyday practice

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Encourage greater participation from many experts

• Early on, people seem keen to come up with questions focused on the rare, unusual, and wonderful diagnoses they have bumped into rather than questions about their everyday practice

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Feed back is essential to know what the people except from us

• Evaluate the journal club (eg, at the end of the session, gather feedback from participants). Determine how the next journal club meeting could be made more beneficial,

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Make your Program Interesting •Rule of thumb Oral 10%

Visual 35% Oral & 65% Visual Source: Najjar, LJ (1998) Principles of educational multimedia user interface design

•Use combinations of text and images which are memorable.”

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Soon you have to Write a synopsis and present before

the Ethical Committee

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Do not worry It is easier if you think wisely and supported by your seniors and Mentor •Rather than being daunted by the enormity of such a

task, break it down. Do it step by step.

• The first step, of course, is realizing that you're going to have to write a synopsis -- if you intend to present, that is. The best time to realize this is just before you sit down with your manuscript for the final reading preparatory to declaring the thing completed.

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Write an Appropriated Synopsis

• First, acceptable length. One guideline is to allow one synopsis page for every twenty-five pages of manuscript, I personally consider two pages ideal, and have distilled synopses down to a single tight page. If you've written a thoroughly intriguing synopsis, don't worry if it's ten or more pages long -- but it had better be gripping.

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Make matters simple

•Our actions to be

•Simple

•Sweet and

•Smart

•But not long jargons

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Make it Interesting it is the face of your work

• Edit, edit, edit, if you have to! Always keeping in mind that the synopsis must remain interesting and supply the necessary information. Yes, this is the hardest part. Don't know what to cut? Lose the adjectives and adverbs; keep the motivation and "flavor" of the story

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Prepare your Synopsis with Dedication

• Sit down to that final reading with a pen and paper beside you. As you finish reading each chapter, write down a one- or two-paragraph summary of what happened where, and to which character, in that chapter28-06-2016 Dr.T.V.Rao MD 48

Your Thesis is passport to attend University

Examination

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Don’t omit any of these:

• Title (and title page) -conveys a message

•Abstract - for the librarian

•Contents Listing - shows the right things are there

•Acknowledgements - get your supervisor on your side!28-06-2016 Dr.T.V.Rao MD 50

What can be content of best Thesis Work

• Introduction - says “I am going to look at the following things”.

•Review of Previous Work -show you know the subject

•Philosophy of Approach -show you can pick out important ideas succinctly

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What can be content of best Thesis Work

•Plan to Impress - show you approached the problem in a systematic way

•Description of the work - details, so that others can follow what you did

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Making a good content of Thesis

•Critical analysis of the results - show you know its limitations

• Future Work - show you know what’s missing

•Conclusions - repetition of the intro, but with reference to the detail.

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Complete with Caution and integrity

•References - Cover the field; examiners will look for the key references

•Appendices - Nitty Gritty details that would clutter your eloquent description

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Not good Ideas in Thesis writing

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Bibliography• Keep a database of complete references• Use a consistent citation style• Use a tool• Bibtex, Refer, Endnote, ProCite, or whatever.• New tools: Mendeley, Zotero, CiteULike,…• Attention to detail is important• Get the spellings right• Keep complete references• page numbers, volume numbers, editors names, locations and dates for

conference• proceedings, etc

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Find out what the local rules are for citation style

• If there are no local rules, use [Author, Year] format

• This improves readability by saving the reader flicking to the back

• Assume the reader is familiar with the main references

• But that doesn’t mean you should skip them!

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Be familiar with Thesis writing from beginning of your post graduation

•Start writing today (never tomorrow)

• Make up a title page for inspiration

• Write down your argument succinctly

• Turn the argument into a chapter plan

• Maintain a binder of stuff to put into these chapters

• Don’t be afraid to change the plan28-06-2016 Dr.T.V.Rao MD 58

My Advice to all before I complete the Topic

•Never forget you are the Future Leaders of Profession Tomorrow think different, work hard and do things with sincerity as

there are no short cuts in Medicine

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Emerging Challenge to Many who

Wish to be Promoted

Publish or Perish

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