“increasing skilled...

The Australian Musculoskeletal Education Collaboration: AMSEC

Bone and Joint Decade 2010 – 2020 Global Alliance for Musculoskeletal Health World

Summit 2014

“Increasing the skilled workforce”

Mellick J ChehadePhD, MBBS, FRACS, FAOrthA,GCert.Online Learning (H.Ed.)

Orthopaedics &Trauma University of Adelaide


Declaration• DoHA funding through AOA Research Foundation• No conflict of interest


Outline

• Principle requirements for a “global” solution• AMSEC project – potential contribution• Future directions / requirements


Objective• Convince you possible (but only) if :

– Common educational framework– IT infrastructure – Collaboration of educators, clinicians and researchers across

disciplines and professions– Networks champions– Shared educational resources (with development templates)

• Evidence based• Adaptable online modules• Clinical / procedural teaching techniques


Clarify terminology / concepts• Competencies• Principle based education


Norm Eizenberg – An@tomedia


Increasing skilled workforce – steps:• Identify competencies• Define them (knowledge/skills/attitudes)• Teach them• Assess/ accredit


Issues• Who are we teaching?• How do we teach? • How do we assess?• Who assesses/accredits? – (Professional boundaries)• Managing prior learning – how to recognise and determine

gaps?• Access to IT resources• Scope for inter/trans professional education with task

substitution/delegation?


www.amsec.org.au


• 29 countries• National / international societies

– SICOT, EFORT, AAOS, ILAR, IOF, etc

• Multidisciplinary– Orthopaedics– Rheumatology– Rehabilitation– Endocrinology

Bottom Draw


Challenges of translation

• Knowledge/Awareness• Ownership• Incentive• Resources• Expertise• Power/Influence


Strategy• Federal government funding• National Approach – outside of universities• Based on International recommendations (BJD)• Involve all stakeholders• Nationally recognised experts (academic and clinical )• Provide content (competency standards) and resources• Allow universities to manage curriculum• Linked to RACGP’s training entry requirements

TOO GOOD/DIFFICULT TO SAY NO!


Stakeholders

• AOA• ARA• ACRM (Rehab)• RACGP’s• RACS• RACP• APA• Endocrinology• ANZBMS• ISFR• OA• Arthritis Foundation• Geriatrics• Paediatrics• Neurology

• Australian Government• Universities (MDANZ)• AMSA (medical students)• AMA (PGMEC)• ACRRM• ACEM• Nursing• Public Health• Allied Health• Musculoskeletal Medicine• Traditional Medicine• Naturopathy• Alternative Medicine• Consumer• Carers• others


AUSTRALIAN GOVERNMENT DEPARTMENT OF HEALTH

AND AGEING

(Project Sponsor)

PROJECT TEAM

(Project Facilitator & Director)

NATIONAL STEETING

COMMITTEE

(Project Custodian)

NATIONAL STAKEHOLDERS

GROUP

RED FLAGEMERGENCIES

STANDARDISED PHYSICAL

EXAMINATION

CLINCIAL SKILLS

BASIC & CLINICAL SCIENCE

SELF-MANAGEMENT & RHABILITATION

PATIENT EDUCATION

National Working Groups (NWG’s)

CORE COMPETENCYASSESSMENT

PROJECT EVALUATION

AMSEC

Project Organisational Structure


“Top-Down” approachDecide on what you ultimately what them to be able to do

(competencies)

Then determine supporting core knowledge, skill and attitude requirements

Good in theory but very difficult in practice – how do you translate that into a modern curriculum integrated with non MSK specific learning?


Competencies cannot sit alone!

Need to sit in a framework that accommodates supporting basic and

clinical science


FrameworkTool/organisational structure that groups elements of

competency (knowledge/skills/attitude) into a manageable order


Demonstration of Framework and “mindmapping”


Levels of Knowledge

• Core– that which is commonly considered necessary for efficient and

effective practice at the prescribed level. It includes, but is not restricted to, that which is “essential” for baseline “safe practice”.

• Advanced– important information in the context of general MSK and related

practice, but not essential for safe, competent practice at intern level

• Specialised– information that is in general in the domain of specialization in

MSK practice.


Levels of Practice (L0-4)Level 0

(Not aware)Highly specialised uncommonly performed procedures

Level 1(knows of)Outlines very general indications for a procedure - not expected to have seen the procedure performed - exhibits a general awareness

Level 2(knows how)Outlines at a basic level the performance of a procedure and its indications, common and important complications and general limitations and has seen the procedure performed either on patients or in a presentation


Levels of PracticeLevel 3

(shows how)Outlines the indications, complications and limitations of the procedures, and has had training using cadavers, models, or patients in performing these procedures though they will not be expected to be able to perform these procedures without supervision

Level 4(does)Performs clinical procedures independently and correctly, knows their associated indications, complications and limitations and recognizes when further consultation or assistance is required


What are its advantages?

• Organisation of Competencies – Includes key knowledge, skills and attitude components– Arranged in hierarchy that allows for

• expansion in detail• horizontal integration with related areas• vertical integration with advancing specialisation and

expertise• educationally rational steps to advance and integrate

components – CRITICAL REASONING


– Identifies duplication of components– Allows prioritisation of components– Provides contextual outline to facilitate and direct self learning– Allows mapping of a existing curricula or syllabi to ensure

adequate coverage and/or identify gaps in content– Facilitates process of review and renewal


Cross professional application

– Common basic principles• evidence based• uniformity of language/terminology • platform for common accreditation processes

– Adaptable and expendable within specific discipline/professional

– Provides process to define and ensure competency for cross discipline/professional task delegation/substitution


EARLY IMPLEMENTATION


Resources • Broad expert input• High quality production

– videos/pictures– Interactive (“storyline/quiz maker”)

• Linked directly to competency framework• On‐line delivery + clinical teaching tools• Integrated assessment processes• Creative Commons License


Future

• International collaboration– Online community of educators– Increased efficiency of development– Cost effective– Attraction of international funding

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