HARROGATE STS INTRODUCTION DAY

1. DR RICHARD HALL HARROGATE STS INTRODUCTION DAY 11.8.11

2. PROGRAMME • 1215-1300 Lunch • 1300-1400 Introduction to Harrogate STS (Richard Hall) • 1400-1500 Work Place Based Assessments (Chris Walsh) • 1500-1515 Coffee/tea break • 1515-1545 Vital facts for ST1s- Dr M Locke • 1545-1630 Small group work • 1630-1700 Looking at portfolios- introduction

3. Our educational philosophy. How to work together and group rules Planning your learning Assessments Communication skills E-portfolio Some housekeeping matters CONTENT

4. INTRODUCTIONS • Facilitators Richard Hall and Chris Walsh-Harrogate STS • APD John Hain • Introductions -all new Harrogate STS trainees • STS Administrator. Mrs Lisa Adams. Strayside Education Centre, Harrogate Hospital. Telephone 01423 553094. lisa.adams@hdft.nhs.uk • WEBSITE http://www.harrogategpsts.co.uk/

5. To consider the statutory educational requirements. To look at the (hopefully not new to you) concept of adult learning. Plan your learning-study leave budgets! How to engage with the e-portfolio AIMS

6. Start to think about looking after yourself. Start to think about the consultation process. Consider the organisation of primary care. Accelerate learning Dealing with uncertainty To consider comparisons between primary and secondary care. Aims - Getting YOU To:-

7. PHILOSOPHY • 3 years isn’t long enough to learn all the skills and knowledge for a lifetime in practice. • Some of the stuff you learnt in medical school is out of date (most of what I learnt) • General practice is a lot about rather soft knowledge, not so much the hard facts of textbooks.

8. PHILOSOPHY CONT • These skills remain constant despite changing knowledge and the changes of deckchairs in health delivery structures • A good GP is particularly skilled in higher order social skills that revolve around consultation and interpersonal skills

9. “The purpose of adult education is to help them to learn, not to teach them all they know and thus stop them from carrying on learning” Rogers 1988 ADULT LEARNING

10. ICE BREAKER • GETTING TO KNOW YOUR GROUP • HOPES AND FEARS

11. GROUP LEARNING • Most of the work you will be doing is in small groups. • What skills does this develop?

12. Group Rules Confidentiality – Respect Listening Contributing in a dominant way Contributing in a passive way

13. AIT AKT ARCP CSA WPBA DOPS COT CBD NOE Acronym quiz

14. WHAT IS INVOLVED WITH STS • REGISTER AIT @ RCGP • GET LOST IN SEA OF ACRONYMS • ATTEND HDR-80% • KEEP ePORTFOLIO UP TO DATE • EDUCATIONAL SUPERVISION • ARCP PANELS • CONTRACTS • OOH • HAVE FUN

15. HDR • Thursday afternoons 2-5pm • Attendance “Mandatory” –80% attendance – either HDH or equivalent approved education. • If there is no HDR session then you should be in practice/ hospital post. • If you are unable to attend please inform Lisa well in advance (as it counts towards your study leave) • Timekeeping/Respect • Mobile phones Off –unless on call. • Parking

16. 15 days every 6 months, including HDR. Plan ahead and discuss with your trainer / clinical supervisor/educational supervisor Must be in PDP. Must be relevant and local. Apply well in advance – 4 weeks notice - using the forms available from Lisa Adams. Remember budget is limited to £400pa-approval TPD discretion. STUDY LEAVE

17. EDUCATIONAL SUPERVISION • 1 ES allocated for whole scheme • Meetings 1 in first 2m • Then 6 monthly- • Role of ES • Guide through WPBA • Facilitate PDP • Assess progress to competences • Report pre ARCP • Pastoral

18. OOH • 36 hours in 6m • Book via website-Linda parkinson Linda.Parkinson@hdft.nhs.uk Or Jude Partridge-Judith.Partridge@hdft.nhs.uk • Telephone triage/pcc consults/home visits • Book sessions early –difficult just pre ARCP • With trainer or approved supervisor or partner of practice where work.

19. Components:- 1 AKT – applied knowledge test 2 CSA – clinical skills assessment 3 WPBA – workplace based assessment. nMRCGP

20. The AKT is designed to test the application of knowledge and interpretation of information Each question is intended to explore a topic of which an ordinary GP could be expected to have a working knowledge AKT

21. An “evolution” from the previous MCQ A three hour, 200 item multiple-choice Delivered on a computer terminal at an invigilated test centre Offered initially three times a year Oct/Nov, Jan/Feb, April/May No limit to the number of attempts A pass will be valid for three years only Can be attempted at any time during GP specialist training (GPST), but most appropriately at end ST2-beginning ST3 AKT Format:

22. Question writing • Scenarios derived from clinical work • Practice issues • Topical • All questions are referenced and the draft questions are then carefully scrutinised by a panel of other question writers. • Remember that all question writers are working GPs

23. AKT subjectcontent • Core clinical medicine and its application to problem solving in a general practice context • 80% of items • Critical appraisal and evidence based clinical practice • 10% of items • Ethical and legal issues as well as the organisational structures that support UK general practice • 10% of items

24. AKT Stats –May 2011 • Pass mark 69% • Overall pass rate 72.6% • ST2 75% /ST3 81.9% 1st time takers • The mean scores by subject area were: • 'Clinical medicine' 74 % • ‘Evidence interpretation’ 74 % • ‘Administration questions’ 73 % • See regular feedback RCGP

25. CSA • Takes place in the ‘NLA Tower’ in Croydon • 13 patients – all trained simulators of which 12 scenarios are assessed. • 10 minute consultations at the end of which buzzer will sound – 2 minutes then next buzzer and new consultation begins • Patients and assessors come to you • OK to examine (not intimate examinations!) if appropriate. You may be given a card of relevant findings

26. CSA Continued:- • Bring your own equipment – stethoscope, sphyg., patella hammer, auri/ophthalmoscope, PEFR meter/ mouthpieces etc (typical Drs. Bag and it’s all on the website www.rcgp.org.uk) • domains assessed – data gathering, technical and assessments skills, clinical management skills and interpersonal skills. • 4 Grades – CP, MP, MF, CF

27. Results given via ePortfolios after approximately 3 weeks as grades of the 12 assessed cases and an overall pass or fail. 4 sittings per year – Feb/May/September and November – dates on website There are periodic “Mock CSA’s” run locally either at scheme level or Deanery – get your name down and have a go! CSA Continued:-

28. Data On CSA-May 2011 • Overall Pass rate 64% • The mean score for the entire cohort was 77.2 out of 117 • The pass rate for first time applicants was 77.9% • Pass rate 4th time applicants 30% Pass Rates by Country of Qualification • UK Graduates 91.6% (AKT-90%) • EEA Graduates 72.0%(AKT-65%) • Non EEA Graduates 54.0%(AKT-70%)

29. CSA -marking • 13 cases • Each case is marked by a different examiner • 3 domains-carry equal weight -3 per case • Data Gathering • Clinical Management • Interpersonal Skills • Total –from all 13 cases-no standard-total 117

30. CSA-tests the following areas • Primary Care Management - recognition /management of common medical conditions   • Problem Solving Skills - gathering / using data for clinical judgment, choice of examination, investigations and their interpretation. Demonstration of a structured and flexible approach to decision making. • Comprehensive Approach - proficiency in the management of co-morbidity and risk. • Person-centred Care - communication with patient and the use of recognised consultation techniques to promote a shared approach to managing problems. • Attitudinal Aspects - practising ethically with respect for equality and diversity, with accepted professional codes of conduct. • Clinical Practical Skills - proficiency physical examinations and using diagnostic/therapeutic instruments

31. ePortfolio nMRCGP components –WPBA/AKT/CSA “The Curriculum” HDR CONTRACTS Educational Supervison CSR reports ARCP panels-how to prepare What is a good log entry Consultation skills TOPICS

32. HARROGATE STS WEBSITE-http://www.harrogategpsts.co.uk/updates/index.html YORKSHIRE AND HUMBER SCHOOL OF PRIMARY CARE-http://www.yorksandhumberdeanery.nhs.uk/general_practice/ BRADFORD STS-www.bradfordvts.co.uk PENNINE STS-www.pennine-gp-training.co.uk LINKS

33. Finally Learning Should be fun

34. You will decide ! “Leaders” have two roles “Facilitator” Encourage active participation and identification of learning needs. “Expert” Experienced GP Ideas to cover in small groups

35. GP culture v secondary care Consultation process Difficult consultations Role of video Adult learning/ Styles Hospital jobs Half/Day release TOPICS

36. Team building activity • 40 mins /4 groups • Design a marketing plan for marketing the Harrogate Vocational training scheme. • Appoint a team leader • Give a presentation for about 5 mins at end (use as many of team as possible-and ensure mix all ST groups). • Target audience FY2s applying for GP Training • You can use any resources visual aids,leaflets , even song ,dance and humour • Max points for variety of resources used and interest.