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YEAR 2 COMMUNITY TRAINING Dr Colan Robinson. SUMMARY. Curriculum overview Year 2 curriculum in general Year 2 community Indicative timetable for attachment Student Assessments Competencies (DVD) Professionalism judgements Evaluation and feedback.
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SUMMARY • Curriculum overview • Year 2 curriculum in general • Year 2 community • Indicative timetable for attachment • Student Assessments • Competencies (DVD) • Professionalism judgements • Evaluation and feedback
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 Yr 1&2 Yr 3&4 Yr 5
Life Sciences Curriculum Overview Clinical Skills Clinical Learning Clinical Care Clinical Practice Public Health Human Sciences Year 1 Year 2 Year 3 Year 4 Year 5 PPD SSU SSU SSU SSU Elective Year 1: Human Life Cycle Normality F1 Doctor Life Cycle Pathways Clinical Blocks Clinical Skills Clinical Skills Clinical Skills Clinical Skills Clinical Skills Community Community Community Community
Life Sciences Curriculum Overview Clinical Skills Clinical Learning Clinical Care Clinical Practice Public Health Human Sciences Year 1 Year 2 Year 3 Year 4 Year 5 PPD SSU SSU SSU SSU Elective Year 2: Human Life Cycle Pathology F1 Doctor Life Cycle Pathways Clinical Blocks Clinical Skills Clinical Skills Clinical Skills Clinical Skills Clinical Skills Community Community Community Community
Life Sciences Curriculum Overview Clinical Skills Clinical Learning Clinical Care Clinical Practice Public Health Human Sciences Year 1 Year 2 Year 3 Year 4 Year 5 PPD SSU SSU SSU SSU Elective Year 3: Pathways Acute Care 1 Ward Care Integrated Ambulatory Care F1 Doctor Life Cycle Pathways Clinical Blocks Clinical Skills Clinical Skills Clinical Skills Clinical Skills Clinical Skills Community Community Community Community
Life Sciences Curriculum Overview Clinical Skills Clinical Learning Clinical Care Clinical Practice Public Health Human Sciences Year 1 Year 2 Year 3 Year 4 Year 5 PPD SSU SSU SSU SSU Elective Year 4: Pathways Acute Care 2 Continuing Care Oncology & Palliative Care F1 Doctor Life Cycle Pathways Clinical Blocks Clinical Skills Clinical Skills Clinical Skills Clinical Skills Clinical Skills Community Community Community Community
Life Sciences Curriculum Overview Clinical Skills Clinical Learning Clinical Care Clinical Practice Public Health Human Sciences Year 1 Year 2 Year 3 Year 4 Year 5 PPD SSU SSU SSU SSU Elective F1 Doctor Year 5: Clinical Blocks Immediate Care Medicine Surgery Community Specialty Life Cycle Pathways Clinical Blocks Clinical Skills Clinical Skills Clinical Skills Clinical Skills Clinical Skills Community Community Community Community
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
Problem Based Learning – Fortnightly Triggers • Clinical Skills • Life Science Resource Centres • Community Placements • Plenaries • SSU’s • Jigsaw = Reflective feedback
Small Group Learning • All students • Every year • Facilitated groups of 8-9 students • Explore students development and professional growth • Specific topics – e.g. ethics, public health
Human structure Physiology Pathology Microbiology etc Examining a patient Identity Experience of illness Health beliefs Cultural beliefs Feelings Knowledge and skills Views & opinions Taking a history etc. Person Body Context Population health Inequalities in health The environment Family Social support Culture Poverty Employment,school etc.
GP Placements • Monthly attachments x 6 • Followed the same week by feedback/jigsaw sessions • Attachments to include protected assessment of clinical competency x 4 in addition to supervised experience with feedback
GP Placements • A pair of students for whole day • Possibly best viewed as two half-days, one for experience and one for competency • 2 – 4 patients/hour (instead of 6) • Do rather than observe (Hx and practice competency) • Opportunistic v invited patients • One patient with a chronic illness
Sample Day in Surgery • 08:45 – 09:00 Discuss plan for day and expectations • 09:00 – 10:00 One case each for competency • 10:00 – 10:30 Coffee • 10:30 – 12:30 Half hour appointments, observe one student taking history whilst other can take history on a patient and swop, feedback. • 12:30 – 13:00 One visit or with nurse • 13:00 – 14:00 Lunch • 14:00 – 16:00 4 x Half hour appts, each student taking turns to take history • 16:00 – 16:30 Feedback on session, plan for next one.
Assessment at PMS • K S A • Continuous assessment • Knowledge: AMK: Applied knowledge test • Skills: • Clinical skills labs, ISCES (In vitro) • Competencies in practices (In vivo) • Attitudes: • Portfolio analyses to Academic Tutors (Theory) • Judgements: Small group tutors and Placement providers (2 per year)
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 • There is a recommended technique: • First run through of easy questions • Then questions less sure about • Whittle down to 3 worth a guess?
Applied Medical Knowledge (AMK) – The Progress Test (from PCMD assessment unit)
CLINICAL SKILLS • Clinical compentencies summative assessment • 4 Main systems exams: Observed History, CVS, RS, GI • Marking criteria supplied • Expect faltering performance but main elements of inspection, palpation, auscultation etc should be present. • Remediation in clinical skills in event of non satisfactory performance. • Keep copies of the assessment grades (and other community – based assessments)
Professionalism (PPD) judgements • 2 per year • Paperwork sent by locality office (Feb and June) • Attendance and Dress Code • Don’t be afraid to use borderline • Remediation with Academic Tutors
ASSESSMENTS IN PRACTICE - SUMMARY • Summative assessment of 4 clinical competencies (Yr end ISCE in June) • 2 x Professionalism judgement (Feb and May/June)) • Concerns made to academic tutor or jigsaw facilitator: Think before giving students benefit of doubt. • Lateness / DNA: susan.osborne@pms.ac.uk
Other roles • Academic Tutor • SSU provider • Small Group Facilitator • Year 5 students
EVALUATION AND FEEDBACK • Feedback forms collected from students at end of the year. • Comments from these forms will be fed back to placement providers. • Addittional feedback from jigsaw facilitators.
THANK YOU Colan.robinson@pms.ac.uk