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
The Australian Musculoskeletal Education Collaboration: AMSEC
Declaration• DoHA funding through AOA Research Foundation• No conflict of interest
The Australian Musculoskeletal Education Collaboration: AMSEC
Outline
• Principle requirements for a “global” solution• AMSEC project – potential contribution• Future directions / requirements
The Australian Musculoskeletal Education Collaboration: AMSEC
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
The Australian Musculoskeletal Education Collaboration: AMSEC
Clarify terminology / concepts• Competencies• Principle based education
The Australian Musculoskeletal Education Collaboration: AMSEC
The Australian Musculoskeletal Education Collaboration: AMSEC
Norm Eizenberg – An@tomedia
The Australian Musculoskeletal Education Collaboration: AMSEC
Increasing skilled workforce – steps:• Identify competencies• Define them (knowledge/skills/attitudes)• Teach them• Assess/ accredit
The Australian Musculoskeletal Education Collaboration: AMSEC
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?
The Australian Musculoskeletal Education Collaboration: AMSEC
www.amsec.org.au
The Australian Musculoskeletal Education Collaboration: AMSEC
• 29 countries• National / international societies
– SICOT, EFORT, AAOS, ILAR, IOF, etc
• Multidisciplinary– Orthopaedics– Rheumatology– Rehabilitation– Endocrinology
Bottom Draw
The Australian Musculoskeletal Education Collaboration: AMSEC
Challenges of translation
• Knowledge/Awareness• Ownership• Incentive• Resources• Expertise• Power/Influence
The Australian Musculoskeletal Education Collaboration: AMSEC
The Australian Musculoskeletal Education Collaboration: AMSEC
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!
The Australian Musculoskeletal Education Collaboration: AMSEC
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
The Australian Musculoskeletal Education Collaboration: AMSEC
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
The Australian Musculoskeletal Education Collaboration: AMSEC
“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?
The Australian Musculoskeletal Education Collaboration: AMSEC
Competencies cannot sit alone!
Need to sit in a framework that accommodates supporting basic and
clinical science
The Australian Musculoskeletal Education Collaboration: AMSEC
FrameworkTool/organisational structure that groups elements of
competency (knowledge/skills/attitude) into a manageable order
The Australian Musculoskeletal Education Collaboration: AMSEC
Demonstration of Framework and “mindmapping”
The Australian Musculoskeletal Education Collaboration: AMSEC
The Australian Musculoskeletal Education Collaboration: AMSEC
The Australian Musculoskeletal Education Collaboration: AMSEC
The Australian Musculoskeletal Education Collaboration: AMSEC
The Australian Musculoskeletal Education Collaboration: AMSEC
The Australian Musculoskeletal Education Collaboration: AMSEC
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.
The Australian Musculoskeletal Education Collaboration: AMSEC
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
The Australian Musculoskeletal Education Collaboration: AMSEC
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
The Australian Musculoskeletal Education Collaboration: AMSEC
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
The Australian Musculoskeletal Education Collaboration: AMSEC
– 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
The Australian Musculoskeletal Education Collaboration: AMSEC
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
The Australian Musculoskeletal Education Collaboration: AMSEC
EARLY IMPLEMENTATION
The Australian Musculoskeletal Education Collaboration: AMSEC
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
The Australian Musculoskeletal Education Collaboration: AMSEC
The Australian Musculoskeletal Education Collaboration: AMSEC
Future
• International collaboration– Online community of educators– Increased efficiency of development– Cost effective– Attraction of international funding