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YEAR 2 COMMUNITY TRAINING Guy Bradley-Smith

YEAR 2 COMMUNITY TRAINING Guy Bradley-Smith. 20 th Oct 2010. Introductions. Previous experience? Any particular requirements from session? Please sign attendance sheet Locum fees Record of training. Summary of session. PCMD News Tomorrow’s Doctors 2009 Quality Assurance

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YEAR 2 COMMUNITY TRAINING Guy Bradley-Smith

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  1. YEAR 2 COMMUNITY TRAININGGuy Bradley-Smith 20th Oct 2010

  2. Introductions • Previous experience? • Any particular requirements from session? • Please sign attendance sheet • Locum fees • Record of training

  3. Summary of session • PCMD News • Tomorrow’s Doctors 2009 • Quality Assurance • Training Requirements & assessments • Curriculum overview • Year 2 curriculum in general • Year 2 community placements • Indicative timetable for attachment • Student Assessments • Competencies • Professionalism judgements • IT and EMILY • Evaluation and feedback

  4. PCMD news • Professor Steve Thornton is the new Dean.  Joins us 1 September 2010 from the University of Warwick Medical School.  Obs & Gynae Researcher.  • Vice Dean, Prof. John Bligh has moved to Cardiff • Decreasing SIFT • Training Requirements

  5. Tomorrow’s Doctors 2009 TEACHERS • Quality assurance of teaching and assessments - Visits • Training of providers and assessors – records & update • Equality and Diversity – all teachers need to have completed training The South West Peninsula Deanery offers an equality and diversity e-learning module that takes 1 ½ hours and includes a printable certificate. Valid for 3 years. www.peninsuladeanery.nhs.co.uk Modules on Equality and Diversity are also available on e-GP (supported by the RCGP) www.e-lfh.org.uk

  6. Training Requirements Staff Training mandatory to carry out assessments. Must be updated every two years.

  7. Quality Assurance Visits • Observe assessments • Year 3 & 4 Clinical Reasoning • In vivo competencies • Year 5 Patient Based Presentations • Year 5 POISE

  8. Life sciences Clinical Skills Public Health Human Sciences PPD Curriculum overview “Clinical Practice” “Clinical Learning” “Clinical Care” Yr 5 Yr 1 and 2 Yr 3 and 4 Electives SSU SSU Clinical skills Clinical skills Clinical skills Community Community Shadowing F1 Pathways Life cycle Clinical Blocks Year 1 Normal function Year 2 Abnormal function Yr 3&4 Yr 5

  9. Community Years 1+2 Clinical skills Conception Fetal life SSU Infancy Childhood SSU Adolescents Young adults Maturity 1 Maturity 2 SSU Old age 1 Old age 2 SSU

  10. Year 2 structure • monthly GP attachments • followed the same week by feedback/jigsaw sessions • attachments include clinical skills assessment • case following

  11. GP placements • 1 Pair of students for a whole day • Attendance is mandatory • once a month • 6 placements in total • £2124 per pair of students pa • Locum payment for training

  12. GP placements • seeing patients with the GP • interviewing patients • practical procedures eg, BP, venepuncture • using patients to learn - Logbook • mini case presentations – for jigsaw • longer presentations – Longitudinal • clinical skills • time allowed for Self directed learning (SDL) • internet access helpful • Involvement with other parts of practice life: Admin/management/PAMs/GP registrar/Practice meetings • will bring their own stethoscopes • discuss dress code if necessary

  13. Top tips • Ask students what case unit they are studying, what clinical skills they have been taught and what competencies need assessing • Ask what the next Jigsaw (see next slide) is about and what they are researching for it • Make links, where possible, to 1 and 2 • Offer as much exposure to patients as possible • Give them a chance to play an active role in a consultation either by asking questions from the side or offering them your chair at the start of a consultation • Explain to the students about what you are asking/examining and quiz them about it • At the end of the day spend 15 minutes, ask what they have learned, what questions they may have and give them something to research before your next meeting (and make a note of it!)

  14. Patient consent • Patients booking for appointments should be alerted to the possible presence of medical students • Verbal consent must be obtained before the start of any consultation involving a student • a wish not to be involved must be respected • Posters, and flyers about PMS student teaching for the waiting area are available from Wonford PMS

  15. Home visits • is a valuable learning experience and a large part of General Practice • Patient consent must be obtained, and recorded, prior to any visits including a student • Students should always be accompanied by a healthcare professional or a fellow student • after discussion, further visits may be made by the student on their own but must not include any examination of the patient • GP remains responsible for any arrangements

  16. Feedback/Jigsaw • 3-4 Hrs – 1-2 days after GP attachment • Groups of 8-10students • Briefing and debriefing, feedback, exploration, reflection • Medically qualified facilitators • Topic guide available at http://emily.pms.ac.uk

  17. Jigsaw themes • Chronic disease management • Health beliefs and coping strategies • Change cycle • Communicating risk • Mental health • Capacity/consent • Carers

  18. Assessment at PMS • Continuous KSA • Knowledge: Applied knowledge test (AMK) • Skills: Clinical skills labs, ISCEs (In vitro) Competencies in practices (In vivo) • Attitudes: Portfolio analyses (Theory) Judgements: Small group tutors and Placement providers (2 per year)

  19. Assessment at PMS • Continuous KSA • Knowledge: Applied knowledge test (AMK) • Skills: Clinical skills labs, ISCEs (In vitro) Competencies in practices (In vivo) • Attitudes: Portfolio analyses (Theory) Judgements: Small group tutors and Placement providers (2 per year)

  20. AMK - Applied Medical Knowledge • 125 questions in 2 hrs, negatively marked - ¼ mark off for wrong answer • clinical vignettes with 5 possible answer stems • same exam all years • students should follow ‘growth curve’ • aggregate scores important • try it yourself!!

  21. Applied Medical Knowledge – Progress Test

  22. Clinical Skills • CSRC @ Heavitree Hospital – Open evenings • Week 1 of Year 1 • Nurses and sessional doctors • Examination skills • Communication skills • Course notes • Students use each other to practice on where possible • Regular in-house competency testing

  23. Clinical Skills Clinical competencies: Summative assessment 4 competencies: Examination of CVS, RS and GI systems and Observed History Mark forms supplied Expect faltering performance, slower than a GP would do it but more extensive with main elements (inspection, palpation, percussion, auscultation: IPPA) present. only 1 attempt in community Remediation in clinical skills in event of non satisfactory performance (student self refers) Keep copies of the assessment grades for this and other community based assessments (Yellow part of triplicate form) Must be attempted before mid-April 2011

  24. Clinical Skills – in vivo Remember They are only at the start of Year 2 This is about the process not the detection of physical signs students know when they are to be tested there is a need to strike a balance between what we, as experienced GPs, do and what they have been taught 1 Formative assessment allowed Rest are Summative 1 doctor watching is hard, several doctors watching is intimidating ++

  25. CRSC manuals • Today, intend looking at the examination of the • Respiratory system • CRSC manuals • Mark sheets

  26. Clinical Skills Respiratory: CSRC Year 1 Young Adult 6

  27. Assessment Form

  28. Assessment discussion

  29. Clinical Skills competencies Week 1 Settle in Week 2 CVS Week 3 Respiratory / 1st PPD Week 4 Abdominal Week 5 Observed history Week 6 Final PPD

  30. Clinical Skills competencyassessments • Please: • If you have 2 students, only examine 1 at a time • Fill in the mark sheets and return to Kelly Lewis at the PMS St Lukes site in May 2011 • Remember that an unsatisfactory mark does NOT mean they will fail the year, but is a clear pointer to a need to improve and they will be assessed again in the CSRC

  31. Professionalism (PPD) judgements • 2 per year • Paperwork sent by locality office (Feb and June) • Don’t be afraid to use borderline • Remediation with Academic Tutors • Contact PMS administration if a student is absent without your prior knowledge – this carries an automatic ‘unsatisfactory’ at the end of year PPD judgement

  32. Assessments in Community module • Professionalism judgement at end of attachment (summative) • Professionalism judgement at end of jigsaw sessions (summative) • Summative assessment of clinical skills • Concerns made to academic tutor or jigsaw facilitator: Think before giving students benefit of doubt. • Lateness / DNA: olive.thomas@pms.ac.uk

  33. IT • Electronic web based resources EMILY http://emily.pms.ac.uk • Honorary contracts (Free BMJ Learning!!)

  34. Evaluation and Feedback • Feedback forms collected from students at end of the year • Comments from these forms will be fed back to placement providers • Additional feedback from jigsaw facilitators

  35. Questions?? and thank you for coming

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