© boa 160707 trauma and orthopaedic specialty induction ocap induction t+o curriculum ocap and iscp...

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Trauma and OrthopaedicSpecialty Induction

OCAP Induction

T+O curriculumOCAP and ISCPeLogbook

Mike Reed MD FRCS(T+O)

Deputy Programme Director

(Early Years)

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Orthopaedic Competence Assessment Project

A Competency Based Curriculum in Trauma and Orthopaedics

Accepted PMETB: September 2006

Authors: David Pitts, David Rowley, Clare Marx, Lester Sher, Tony Banks, Alastair Murray on behalf of the BOA and the Orthopaedic SAC

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What is a Curriculum? (adapted from PMETB definition)

• Aims and objectives• Content

– Experiences– Outcomes– Processes– generic professional– specialty specific

• Training structure– entry requirements– Length of programme

• Organisation of programme– flexibilities– assessment methods – learning, teaching,

feedback and supervision

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How much is existing OCAP used

• Survey conducted during February & March 2008

• All UK trainees with locatable email address contacted by email

• Web based survey

• Over 800 participants

• 715 trainees completed the whole survey

David Boardman – Orthopaedic SpR South West Thames

Aware of OCAP 99%OCAP in portfolio 93%Cons. profile 11-42%Learning agreement 75%PBAs 4 in 6 months

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T&O curriculum – facilitating good practice

Evidence for

Accrediting bodies

Clear Aims & Objectives

Open, high quality, structured

feedback

PBA& other tools

Knowledge

ProceduresMini CV

PBA summaryLogbookLearning agreements

Reportsin various formats

Formative WPB Assessments

Learning

Agreement

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T & O CurriculumCT1-ST8

Trainer Profile

Learning Agreemen

t

Curriculum Vitae

Procedures Coaching

Assessment

Evidence

Applied Clinical knowledge

Applied Clinical skills

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© BOA 160707OCAP Induction 1.Curriculum overview

© BOA 160707OCAP Induction 1.Curriculum overview

Please note that this area of the curriculum is an ongoing development

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For further information

• Go to the OCAP website (www.ocap.org.uk)

• Look on the induction CDROM• Check the details of the

curriculum• Contact admin@ocap.org.uk

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Later Years 3-8

Early Years 1-2

Foundation

Where do PBA’s fit in with other assessment tools?

Mini-PAT

Mini-CEX

DOPS

CBD

PBA

Mini-PAT

CBD

DOPS

Mini-CEX

PBA

mini-PAT

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What do I do as an ST1 and ST2?• Register with ISCP

– Programme directors• ST1 Stefan Plusa

• ST2 Mike Reed

• Do ISCP but use T+O curriculum for guidance

• DOPS, MiniCex, CBD on ISCP

• Do 360 – mini-PAT in this deanery

• Use elogbook.org for logbook

• New agreement Aug 2008 – work in progress

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What do I do as an ST3?

• Register with ISCP

• Use OCAPonline

• Use PBAs and mini-PAT (one per post)

OCAP Induction 4.Using PBA’s

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Introduction to

David PittsAssociate Director, RCSED Leadership & Educational

Development

Andrew LambDirector of Web Services, RCSEd

Mike Reed Clinical Lead, OCAPonline

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Overview

• How OCAP works at present

• HOW TO:– create a Trainer Profile– form a Learning Agreement– do assessments

• ARCP / RITA reports

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Meeting1

Meeting2

Meeting3

LearningAgreement

ConsolidationSheet

CompletedPBA’s

How OCAP works at present

TrainerProfile

PBA

PBA

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Meeting1

Meeting2

Meeting3

How it will work now

TrainerProfile

LearningAgreement

CompletedPBA’s

ConsolidationSheet

PBA

PBA

Via paper if you wish

ElectronicARCP

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Creating an online Trainer Profile

(even if you are a trainee)

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Log in as usual – www.elogbook.org

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Go to Training area

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Choose element of profile you want to create

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Cut & paste from your existing cv

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Choose another profile element

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Created from historical logbook data.Add or remove procedures as you wish

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The new “Trainee Profile”

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Trainees make their own trainee profile

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Creating a Learning Agreement:

Before the first meeting

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Trainee adds details of hospital attachment and reviews trainer profile – “whats on offer”

OCAP IS TRAINEE LED

OCAP IS TRAINEE LED

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Checklist for Learning Agreement meeting 1

• Trainee– Agree date

– Set up the attachment

– Review Trainers Profile• Mini cv• Procedures

– Review own profile and set targets

• Trainer• Agree date

– (Set up all profile elements)

– Choose technology for meeting

• Paper• online

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Creating a Learning Agreement:

The first meeting

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Do it online, put it straight onto your logbook

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Or do it on paper, transfer it at leisure, and send validation request

to trainer

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On paper - A practicalities area

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Online - A practicalities area

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Top screen

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Bottomscreen

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Filling out the form

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The electronic

form guides

you through

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Trainee can fill in the form,send to trainer,trainer

validates

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Validated form is

“locked”

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Using Assessments

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Select “assessments” in the training area

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TRAINER

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Automatic update of PBA and the summary sheet for trainee

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PBA rules

• Trainer or trainee triggers PBA

• NB Trainer agrees to the PBA

• Trainee conducts agreed parts of procedure observed by trainer

• Trainer usually scrubbed

• Trainee verbalises, explains what intentions are

• Trainer steps in as/where necessary

• Forms completed and feedback given immediately after procedure

• Trainee includes all forms in portfolio, notes in logbook PBA summary sheet

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What does a completed PBA mean?

• NOT a license to operate unsupervised!

• DOES give trainer confidence to allow trainee greater responsibility

• “Completed set demonstrates competence to learn procedures and perform to set protocol and standard”

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Email validation – no log in

PBA, miniCEX, DOP, CBDMini-CVProcedures ProfileOperations

360 appraisalsMSF-TAB and mini-PAT

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Early years assessment tools are available

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ARCP / RITA report

Automatically generated from all information in portfolio – paper / pdf

OCAPeLogbookResearch and auditStudy Leaveetc

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The eLogbook

OVERVIEWOVERVIEW

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Contents

• Background

• The role of the eLogbook

• Who should use it

• How it works

• National data analysis

• Future developments

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Background

• Conceived in 1998

• Collaborative venture between: – BOA– BOTA– Orthopaedic SAC– RCS Ed

• Compulsory for trainees since 2003

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Intended Users

Medical studentsFoundation yrs

ST 1 - 8

T&O Consultants

SpR

Career grade T&O surgeons

Surgical assistants etc

All grades of medically and non-medically trained personnel

involved with orthopaedic surgery are encouraged to use the eLogbook

Career progression

Users in ST years 1 & 2 Users in ST years 1 & 2 can enter data even while working in other

specialties. Supervisors = Trainers. All years of T&O Specialty training will be

analysed

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Users

• >5000 users of pan-speciality eLogbook

• > 5 million procedures logged

• Medical students to Consultants

• Surgical assistants

• Overseas surgeons

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Creating an account

Access the eLogbook at….

www.eLogbook.orwww.eLogbook.orgg

To create an account click here

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Creating an account

Enter grade and specialty

Info needed to proceed: Name and address Training region Email address Completion date (for StR/SpRs – can be estimate)

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User basics

Access via www.elogbook.orgwww.elogbook.org

OrDownload software, input data onto personal hard drive & synchronise with

main server later

Hospital terminal / home PC

Main server at RCSEd

Backup servers

Home computer

PDA / palm

All synchronised data is held on a secure server at the RCSEd

with 2 back-up servers

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National training data

• Peer comparison data – for trainees / RITAs / programme directors

• Regional & chronological data– for programme directors / SAC

• Presentations at Meetings

• Peer reviewed journal articles– Influencing the national training agenda. The UK and Ireland

orthopaedic eLogbook. Sher et al. JBJS (Br) 2005;87(9):1182-86

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© BOA 160707OCAP Induction 1.Curriculum overview

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Example of training analysis

National data analysed for hip

joint replacement based on SpR

year in training….

This provides reliable data on the expected

experience of a trainee for a specific

procedure at a particular time in their

training, based on national data

Mean number of procedures performed

by trainees with upper range figure

…. and level of supervision

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Index Procedures

TraumaTrauma Hemiarthroplasty Compression hip screw Ankle ORIF IMN femur / tibia TBW patella / olecranon Tendon repair External fixation

ElectiveElective THR TKR Arthroscopy 1st ray surgery CTD Palmar fasciectomy Lumbar discectomy

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Users can create Consolidation Reports Consolidation Reports based on their operative log, which can be used

for RITAs, job interviews, evidence of training, and

revalidation

Number of procedures performed, with a

breakdown of level of supervision

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Portfolio

Choose the appropriate

field…

Under ‘PortfolioPortfolio’ heading

.. add the details…

… then build your CV

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Data control

PLEASE NOTE:

An individual must register with the Information Commissioner if he or she keeps patient-identifiable data for the purposes of research, private practice or as part of a logbook (the Data Protection Act 1998).*

It is MANDATORYMANDATORY for eLogbook users to register as a ‘data controller’. The user will then ‘own’ their own data and can do with it as they choose.

There is an annual fee of £35. For more information and registration visit:

www.ico.gov.uk www.ico.gov.uk

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Thank you