Co mmunity Partnerships Program

1. Community Partnerships Program Dr. TangerineHolt Academic Convenor CPP Centre for Medical and Health Sciences Education

2. Purpose of Presentation • Provide an overview of the CPP Program and model • Provide an overview of CPP placement • Discuss strategies for successful placement implementation

3. CPP Goal and Objectives GOAL Develop a perspective on issues of social equity and justice, but particularly as they relate to the practice of medicine OBJECTIVES • Develop an understanding of social and public policy and how it impacts on individuals health. • Develop knowledge of barriers faced by people accessing social support services, their relevance to medicine and individuals health. • Develop an appreciation of how and why community organisations deliver their services. • Develop an understanding of the ‘whole person’ and in particular the social and economic context of health and illness.

4. CPP Structure and Key Partners Medical Curriculum Management Committee (MCMC) Year-2 Management Committee Assoc. Ben Canny and Dr Carol Lawson • CPP Strategic Management Committee • Chaired by Dr. Philip Mendes, Social Work Department • CPP Team • Key Partner Agency Representatives • CPP Operational Management Committee • Chaired by Dr. Tangerine Holt – CPP Academic Convenor • CPP Team • All Agency Representatives Faculty Field Liaison Officers (FFLO) Community Partners

5. Anglicare Brotherhood of St Laurence Child and Family Care Network City of Casey City of Monash Inner East Community Health Inner South Community Health Karingal, Monash, Mt Eliza, Wellington Secondary Colleges, and Beregarra Secondary College Living Room Primary Health Service for injecting drug users Central Bayside Community Health Caulfield Community Health First Step Program Ovulation Method Resource Centre Melbourne Citymission Monash Volunteer Resource Centre Salvation Army Primary Health; EastCare and Crisis Services divisions Wesley Mission Eastern Access Community Health Gellibrand Residential Services Health Works, Footscray Jewish Care Knox Community Health Moreland Community Health Ranges Community Health Whitehorse Community Health Southern Health Ashburton Support Services Knox Community Volunteers CPP Partners 2006

6. Chris Award for his work with Anglicare's Lazarus Centre for the homeless. Rahul successfully linked clients to appropriate health care services; and designed a brochure outlining healthcare issues among the homeless population. Lalor Melbourne Werribee N Dr. Philip Mendes, Chair of the CPP Management Committee presents Ms. Cindy Koletsis of Anglicare Victoria with a Certificate of Appreciation for her contribution to the CPP Program as a Supervisor in 2004. The faculty recognises the invaluable support and field education provided by hundreds of multi-disciplinary professionals at our partner agencies Clayton Campus Children and Youth Home- lessness Indigenous Australians Anglicare Victoria Brotherhood of St Laurence Caulfield Community Health Student reflection following a placement with a service supporting injecting drug users: “On reflection, many of my experiences and encounters have transformed my impressions of patient treatment and what it means to be a doctor when treating patients with sensitive and challenging social circumstances. It became increasingly evident that “treating” a patient spanned far beyond the provision of medications and procedures. Many in society aren’t afforded the same opportunities, therefore it seems fundamental to patient treatment that doctors have a firm understanding of the issues their patients are facing. The skills developed at my placement will hopefully benefit my outlook on medical practice for years to come.” Child & Family Care Network Adult & Family Turning Point Drug & Alcohol First Step Program City of Casey Local Government Whitehorse Community Health City of Monash Wesley Mission Inner East Comm Health MBBS Year 2 Theme 1 CPP Education, Employment & Training Aged Care W E Community Health Welfare Agencies Southern Health Inner South Comm Health Jesuit Social Services Salvation Army Jewish Care Ranges Community Health Secondary colleges Mt Eliza Karingal Secondary College Moreland Community Health Refugees & Migrants Mental health Monash Secondary College Monash Volunteer Resource Centre Mt Eliza Secondary College Melbourne Citymission Wellington Secondary College Living Room Primary Health Service Know Community Health Community Health Research & Social Policy Disability N Rosebud

7. CPP – An integral component of the MBBS • Hurdle requirement for all 2nd year MBBS students • CPP Model • 12-weeks = one-day per week (Tuesday) + a mini-block placement • Half cohort will complete in semester 3 / half in semester 4

8. 9. CPP Placement Report 1. Student and Field Educator Orientation 2. Student Submit Placement Preferences • Final Field Educator • Assessment 3. Students Allocated Placements Completion of Project/Activities Outlined in LA CPP Model 12 Weeks 78 hours • Students Interview with • Field Educators 7. FFLO Visits/Evaluation 5. Formulate learning Objectives – Personal, Field Educator, Community 6. Engage in activities 6. Integration Lecture

9. CPP Model – 2006 Semester 4 - 2006

10. CPP Model – 2006 Semester 4 – 2006 cont…

11. What are your expectations? Examples of Community-based Projects/Activities • Health promotion • Working with ANTAR to better understand Indigenous health and access issues • Resettlement of refugees • Mentoring programs for youth • Working with the elderly in low care and high facilities – social isolation, life books • Working with people with disabilities, developing care plans for people with ABI and Huntington’s disease • Working in drug and alcohol services – Needle and syringe program, harm minimisation, detox services • Community health – aged care, mental health, allied health • Researching and developing brochures outlining common medical issues and details of services available in the community for the homeless • Developing breakfast clubs for kids and high schools youth • Trained as crisis counsellors through Lifeline • Mentoring children in foster care or who are wards of the state • Evaluating the foster care system taking into consideration the role of carers • Development of a Food Co-operative in a public housing block which also led to the development of a funding proposal to sustain the continuity of the food co-operative for people who are marginalised in society • Addressing key mental health, grief, bullying, sex, drugs, and party culture issues in schools .

12. Supervision As an agency supervisor try to reflect on four important questions before engagement in student teaching: • What is my preferred learning style? • What content do I need to teach and how? • What is the student's preferred learning style? • Given the interaction of the student's preferred learning style, my own learning orientation, and the present teaching task, am I using the most appropriate teaching style for this educational process?

13. As an active learner As a conceptual learner As an experiential learner As a reflective learner As an agency supervisor: Do I take a very active, leading role or do I become more inactive and expect the student to responsibly contribute their ideas or doubts? Do I encourage risk-taking and creativity in students' thinking and actual work? Do I actively engage in assessing the learning environment of the agency and the interactive process of field instruction? Do I help students to know when they may be lacking objectivity or blocking work progress? Do I take a more active role in teaching and encourage students to observe my own work? Links between learning style preference and teaching style behaviour

14. Reflective Practice (Donald Schön) Reflective Practice involves thoughtfully considering one’s own experiences in applying knowledge to practice while being coached by professionals in the discipline. • The basic premise is that practice is marked by uncertainty, uniqueness and value-conflict. • Experienced practitioners seem to know what to do - ‘knowing-in-action’. • When something happens, the practitioner is thinking about how to reshape the activity - ‘reflection-in-action’ • Translate these actions into learning where the experienced practitioner who, acts as a mentor and educator: • models ‘reflection-in-action’ • Conducts a ‘reflective conversation’.

15. Reflective Practice Outcomes (Russell, 2005) • Recognise new ways of perceiving or thinking about the professional situation of practice; • Stimulate a novel course of action; and • Provide evidence for deciding if the new perspective and associated new actions deserved to be included in future professional practice. References • Schon D. The reflective practitioner. How professionals think in action. New York. Basic Books, 1983. • Schon D. Educating the reflective practitioner. San Francisco: Jossey-Bass, 1988. • Kottkamp RB. Means for facilitating reflection. Education and Urban Society 1990; 22(2): 182-203. • Russell, T. Can reflective practice be taught? Reflective Practice May 2005;6(2), 199–204.

16. Supervision • When and where? • Set a formal and regular supervision time • Document this as part of the Learning Agreement and Ongoing Supervision and Assessment (both available on the Website) • What to cover • Use the Learning Agreement as basis for discussion. This will incorporate; • Personal and professional development of the student • Progress of key activities and tasks • Informal assessment and feedback on student learning • Expectations for future practice and performance • Any issues or concerns

17. Supervision • Difficulties between student and Supervisor • Follow guidelines in Handbook (page 7) • Personal reflection and counselling • Emotional reaction to a placement event or interaction • Formal debrief as part of supervision meeting • Supervisor should not enter the role of personal counsellor • Direct student to student support services listed in the handbook

18. Orientation Learning Agreement Faculty visit Ongoing assessment Final CPP assessment Final Report Debrief Placement parameters Attendance • Minimum of 78 hours over 12-weeks • See placement dates (Appendix J) • Reported on Supervisors Final Assessment Absence and illness • Students are asked to contact you as soon as possible if they are unable to attend • Absence should be reported to the CPP Coordinator ASAP • Supporting documentation must be provided where minimum hours are not met

19. Orientation Learning Agreement Faculty visit Ongoing assessment Final CPP assessment Final Report Debrief Placement parameters Use of private or agency vehicles • Students must not transport clients under any circumstance • Not expected that students will use agency vehicles • Students may use their own vehicle to undertake visits Agency Policy • Students sign a Consent Form acknowledging that agency policy and procedure applies while on placement

20. Orientation Learning Agreement Faculty visit Ongoing assessment Final term assessment Final Report Debrief Student orientation – Week 1 • Understanding ‘duty of care’ • Understanding confidentiality and privacy • Mandatory reporting • Professional behaviour • Outline your expectations; • Presentation of Police Check • Working within agency policy • Start to discuss learning goals

21. Orientation Learning Agreement Faculty visit Ongoing assessment Final CPP assessment Final Report Debrief The Learning Agreement –CPP Day 3 Purpose • Plan for the next 12-weeks placed online • Practical and concise working document Responsibility • Close consultation between student and Supervisor • When the supervisor is happy with the content, student to submit online (in the case where the on-line system is not working, a note will be put up on the Website) • They will receive online feedback from Faculty • Due end of the week of Day 3

22. Orientation Learning Agreement Faculty visit Ongoing assessment Final CPP assessment Final Report Debrief The Learning Agreement – Contd. Key elements • Three learning goals • Personal and professional development of the student • Supervisor’s goal – what do you want the student to take away from this experience? • Student contribution to the service / community • Activities / tasks relating to each goal • Timeline for completing activities / tasks

23. Orientation Learning Agreement Faculty visit Ongoing assessment Final CPP assessment Final Report Debrief The Learning Agreement • Sample Learning Agreement • Review • Use during supervision sessions to track students progress • Change / amend as required

24. Orientation Learning Agreement Faculty visit Ongoing assessment Final CPP assessment Final Report Debrief The Faculty Field Liaison visit – Days 5-7 • Purpose • To provide onsite guidance and support to students and Supervisors • Identify / assist in the resolution of any difficulties • Responsibility • The FFLO will contact you to arrange a suitable time around Day 4 (22nd August) • Format of meeting • Supervisor; student; Supervisor and student

25. Orientation Learning Agreement Faculty visit Ongoing assessment Final CPP assessment Final Report Debrief The Faculty Field Liaison visit • Feedback • An evaluation form is submitted following the visit • CPP Coordinator will follow up on any identified issues • Used as part of overall program evaluation • Provided to Agency Coordinators

26. Orientation Learning Agreement Faculty visit Ongoing assessment Final CPP assessment Final Report Debrief Completing Ongoing Assessment, Supervision and Feedback • Purpose • Discussion of activities • Debriefing student at the end of the day • Planning for the next CPP day or mini-block placement • Review student progress • Evidence • Field Educator’s Monitoring and Assessment of Student Form • Incorporate changes to the Learning Agreement

27. Orientation Learning Agreement Faculty visit Ongoing assessment Final CPP assessment Final Report Debrief …and final term assessment – Day 11/12 • Purpose • Final review of student performance and learning • Completion of placement hours • Providing an overall recommendation on the successful completion of the placement • Evidence • Learning Agreement and Supervisor / staff / feedback • Field Educator’s monitoring and assessment of student

28. Orientation Learning Agreement Faculty visit Ongoing assessment Final CPP assessment Final Report Debrief The Final Placement Report – due week 13 • Purpose • Capture placement experiences, initiatives, outcomes • Capture impact on personal and professional development of the student • Showcase any physical materials; such as a brochure or presentation • Student should work on the report independently outside of placement hours (see Page 19 in Handbook for greater detail)

29. Orientation Learning Agreement Faculty visit Ongoing assessment Final CPP assessment Final Report Debrief Debrief • Student Debrief • Integration lecture • Lecture discussion during week 14 • Complete a program evaluation • Supervisors feedback session • You will be invited to participate in a focus group session at the end of the year and provide feedback to the faculty on the program

30. Process for managing difficulties • Regular supervision session • Provision for a private discussion • Outline the specific concern • Specify your expectations • Identify, negotiate strategies to manage issue • Specify a date for review • Document agreement and provide a copy to the student • Notify CPP Coordinator

31. Managing difficulties • First review meeting • Have the expectations been met? • If not, contact the CPP Coordinator • Second review meeting • Meeting with CPP Faculty, student and Field Educator • Discussion on issues of concern • Review and agree an appropriate course of action • Set a date for review • CPP Faculty will document meeting and provide copies to Student and Field Educator • Agency Coordinator will be informed

32. Managing difficulties • Final review meeting • CPP Faculty will meet again with the student and Field Educator to discuss progress • If expectations have not been met; • Issues regarding Student performance will be referred to the Associate Dean • Issues regarding the ability of the placement/Field Educator to meet expectations will be referred to the Agency Coordinator

33. Withdrawal from the placement • Should the student / field educator / CPP faculty recommend withdrawal from the placement; • A meeting will be held to discuss the reasons for requesting withdrawal. If parties cannot agree on a pathway for resolving issues the student will be withdrawn • Student will be required to repeat CPP, or if completing in semester 4, repeat Year 2!

34. Summary of Roles and Responsibilities • Field Educator • Provide an orientation to the agency • Work with the student to complete the Learning Agreement • Identify and assign tasks which will; • Be of benefit to the agency; staff; clients; community • Allow student to address learning goals • Facilitate regular supervision sessions • Complete a ongoing and final CPP assessment of each student • Meet with the Faculty liaison officer to discuss the progress of the placement • Report any difficulties to the CPP Coordinator / FFLO as soon as possible

35. Summary of Roles and Responsibilities • Student • Take initiative! • Demonstrate professional attitudes and behaviour • Follow the guidance and direction of Supervisor • Complete a minimum of 78-hours on placement over 12-weeks • Complete all assessment tasks and checklist items listed • Meet with the Faculty liaison officer • Work with the Field Educator, FFLO and/or faculty staff to resolve any placement difficulties in a timely manner

36. Summary of Roles and Responsibilities • Faculty Field Liaison Officer • Discuss learning goals with the Field Educator and student • Outline criteria for acceptable performance • Assess the progress of the placement • Complete a placement evaluation • Identify any difficulties and report these to the CPP Coordinator for follow up.

37. Summary of Roles and Responsibilities • CPP Academic Convenor • Academic leadership for the program • Managing academic progress and serious placement difficulties • CPP Coordinator • Overall coordination of program • Managing communication between all key stakeholders • Providing support and guidance to all key stakeholders • CPP Adviser • Providing guidance on student difficulties • Input into program development and implementation

38. CPP Evaluation • FFLO Evaluation • Final CPP Field Educator Evaluation of the program • Completed during focus group at end-of-year • Student Evaluation • Completed following final debriefing session

39. Positive Outcomes • Developed ability to engage with various target populations (elderly, kids, youth, etc); • Improved communication skills; • Increased knowledge and awareness of social justice issues; • Better understanding of a range of issues; • Appreciation of varying value systems and beliefs – including own; • Increased awareness of personal values and the need to be non-judgemental as a professional.

40. “Personally I was lucky and had a great placement – for the future, I believe most placements should somewhat model on this one to maximise the potential of CPP and embrace student enjoyment. It offers interaction with clients, as well as an understanding, not just computer interaction!” “On reflection, many of my experiences and encounters have transformed my impressions of patient treatment and what it means to be a doctor when treating patients with sensitive and challenging social circumstances. It became increasingly evident that “treating” a patient spanned far beyond the provision of medications and procedures. Many in society aren’t afforded the same opportunities, therefore it seems fundamental to patient treatment that doctors have a firm understanding of the issues their patients are facing. The skills developed at my placement will hopefully benefit my outlook on medical practice for years to come.”

41. Indicators of success for CPP • Increased numbers of partnerships between Monash University and the community – From 4 in 2003 to over 30 in 2006. • Mutually agreed upon CPP goal and objectives, operating principles, expectations • Clarity in communication, leadership, power sharing, decision-making • Sharing of roles – community-based educators, co-learners, Faculty Field Liaisons role in community • Sustained commitment, willingness to learn together and collaborate for long-term • Evaluation responsiveness to all constituents -- the community, faculty, students, and partnership itself. • Validation by Faculty and Partners including supervisors the merits and value of evaluation, that provides the evidence of action and results to be accepted. • Selected for the VCs Teaching in Excellence Showcase -2005.