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RVTS Supervisor Series. 2013 Planning to learn ? Learning to Plan ? A fresh look at learning plans. Background.
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RVTS Supervisor Series 2013 • Planning to learn? • Learning to Plan? A fresh look at learning plans
Background The learning plans are highly valued by registrars as a log book of learning, a framework of exam progress, a guide book for professional ambitions and a diary of their progress with their Supervisor, Training Advisor and RVTS.
Since LP’s started … • Registrars often sit both College exams • Increasing numbers seek AST / FARGP • Develop sub-specialty interests E.g. skin cancer – not necessarily an AST The current format is not ideal
So… For a new LP?? • Where have you been? • Where are you now? • Where are you going? • How are you going to get there? • How can I help you along the road? • What do you need? • How do we build a plan?
The New LP Well it’ll be different? The focus is about the Registrar defining his/her needs; refining his/her goals and clearly outlining how their Supervisor and T/A will ensure the goals are achieved.
GOALS – mandated or optional MANDATORY • RVTS required • Colleges • Emergency course • AST ? FARGP OPTIONAL • Exambitions • Other interests • Pastoral • Practice
Is it a diary? • The idea is that each month the Registrar and Supervisor build the plan with prescribed input: ie: my stuff; Exam stuff; Clinic stuff: 3 monthly T/A 3-ways to underline this.
Objectives • Develop plan for learning • Objectives • Learning/teaching • Feedback and Assessment • Discuss strategies for implementation • Think about educational history • Address challenges in the clinical setting
Plan • Experiences and activity - planning for a trainee term • Difficulties - workable strategies • Sum up and evaluation
In the new plan… What goes in the plan And what doesn’t…
Learning plans • SMART learning objectives • How are you going to learn it? • How are you going to assess whether you have achieved it?
SMART learning outcomes Specific Measureable Achievable Realistic Timely
Objectives • Specific • Achievable • Measurable • Are they set at the correct level? • Individual learning needs?
Set your own learning outcomes e.g., At the end of this term, I will be able to… - be confident at prescribing oral contraceptives - perform simple skin excisions
Learning plan Be confident at prescribing contraception How? -Attend FPQ course • Discuss with supervisor • CHECK • Meet with pharmacist Measure • Am I confident? Yes or no... • Check with patients, supervisors • Audit
What is your experience with teaching plans? Think about 3-ways you may have had and what they could achieve?
What do we want the Registrars to Achieve? • To gain fellowship • To be good Doctors • To perhaps stay Rural Doctors • To manage professional and family life • And then some …
Teaching/Learning Plan • Objectives • Methods (teaching/learning) • Appraisal with feedback • Assessment
Feedback and Assessment • Competency being defined by observable behaviours • Adequate sampling (multiple events) • Adequate inputs (multiple people) • Timely (remember!)
Miller’s pyramid:Assessing Clinical Competence Miller, 1990
Deliberate Practice • Well defined and important tasks • Opportunity to practice and improve • Motivation and endurance (hanging in there) • Reflection • Good supervision and feedback • Planning to ensure optimal use of time
What are the difficulties with implementing your learning program?
Time… • Good orientation • Effective teaching learning methods (one minute teacher, SNAPPS) • Sharing responsibility • Use of resources as backup
SNAPPS • Summarise the History & Exam • Narrow the differential • Analyze the differential • Probe the teachers about uncertainties • Plan management • Select an issue for self directed learning • Wolpaw, 2003.
Have You Planned For… • Orientation • Learning environment • Range of methods • Resources
Patient Care… • Teach essential skills early • Ensure competency = responsibility • Increase teacher observation • Patients like it
Taking an educational history • Set aside time • Get to know them – family, background, non-medical interests, book they are reading... • Determine • Previous experience • Future plans • Self evaluated strengths and weaknesses • Why this attachment? • What they want to achieve? • Any concerns?
Teaching and learning styles Teacher styles Learner stages Based on Grow, 1991
What Works… • Good orientation • Incorporate learner into active patient care role • Schedule explicit teaching/learning time (Regan-Smith, Acad Med, 2002)
Teacher as Role Model • Teacher - one of the most powerful influences on learning • Role models - attitudes, interest, enthusiasm • Interpersonal relationship has major impact on learning
To Sum Up… • Develop plan for learning • Objectives • Learning/teaching • Appraisal and Assessment • Discuss strategies for implementation • Take an educational history • Address challenges in the clinical setting