medical education registrars and supervisors: enhancers and barriers to building medical education...
TRANSCRIPT
Medical Education Registrars and Supervisors: enhancers and barriers to building medical
education capacity
Karen Roberts Medical Education Coordinator
HETI NSW Prevocational Medical Education Forum9-10 August 2012
the opportunity
• Registrar – 1.0FTE• 6 or 12 months• Based in their
clinical context• Educational
development experience for appointee
QLD Medical Education Registrar Scholarship: Program Objectives
• Develop an understanding of the role and functions of an educational supervisor for doctors in training
• Gain an insight to educational theory and practice as it pertains to clinical education and training of junior doctors
• Disseminate knowledge and skills in the area of medical education to senior medical staff, registrars and junior doctors
• Undertake formal training to develop clinical education skills • Contribute to medical education scholarship through leading or participating in
an educational or related research project
• Participate in a min. of one clinical session per week for skills maintenance
program players
• Registrar
• Project supervisor
• Educational supports
• Formal education studies• Participate in junior doctor
education activities• Participate in one clinical
session per week (min)• Participate in educational
network sessions• Contribute to medical
education scholarship through leading educational research project
program players
• Registrar
• Project supervisor
• Educational supports
• Has the time and capabilities to provide senior clinician and educational support to Registrar
• Holds a strong interest in education
• In some instances this has required more than one person to supervise
program players
• Registrar
• Project supervisor
• Additional educational support
Medical Education Registrar and Supervisor Seminar (MERSS) - QMET
• Invited presenters• Registrars present project
progress report• MERSS group use ‘step
back consultation method’ to develop project ideas
• Supervisors are encouraged to attend as a valuable professional development opportunity
enhancers - exercise
• position• clinical education in
context• organisation
barriers - exercise
• position• clinical education in
context• organisation
evaluation themes (2009 & 2010)Orientation to rolesRegistrar
• ‘take the time to adjust to a change from the often very structured clinical role … learn how to structure your own time – it can be challenging initially but it was a valuable experience [R09.1]
• ‘it took me a significant part of the year to identify people at a senior level who had an interest in education’ [R09.5]
• ‘adequate…whilst being given enough autonomy to explore and discover avenues on my own [R10.5]
• ‘give the Registrar permission to have 3 months to simply find their feet … they very quickly find themselves with more than enough to do’ [S10.2]
Orientation to rolesSupervisor
• lack of role clarity; lack of knowledge - ‘to determine the degree of supervision, uncertainty about the supervision I could/ was providing …’ [S09.3]
• ‘clarify [the supervisor] role from the outset. Have clear goals for the Registrar and continue to reinforce those goals. Meet regularly and frequently both informally and formally’ [S09.1]
Clinical service – education tension
• ‘when resources are tight the first thing to be sacrificed is education [R09.2]
• ‘completed the year with 2 important insights; the service – education tension and the challenges for educators, the complexity of educational program development and conduct from operational issues of scheduling, rosters and room bookings to [educational design and the importance of] alignment of learning objectives, activities and assessment [R10.5]
Formal educational studies• ‘the studies have deepened my interest and understanding in learning
and education and have been the backbone to my job’ [R09.2]
• ‘the university studies I thought excellently supplemented what I was trying to apply at the coalface’ [R10.1]
• ‘I found the [course] challenging and rewarding however a significant
proportion of semester one was not applicable to education for post-graduate health professionals. It would be interesting to see if other [courses] provided a more clinical focus’ [R10.5]
Registrar – supervisor relationship
• ‘having informal and regular access to my supervisor was important as a means of debrief [and] useful feedback when trying different approaches’ [R09.3]
• [a supervisor who was] ‘enthusiastic, encouraging, available, and involved …and reigned in my enthusiasm’ [R09.4]
• ‘… seeing the amazing things the registrars were capable of doing. I learned so much’ [S10.2]
• ‘lack of time to adequately supervise, ‘invariably the supervisor position is fractional and thus I was pulled in many directions at once’ [S10.2]
what next …
‘I plan to make medical education an integral component of my long term career’ [R09.5],
‘to progress on a vocational pathway but endeavour to continue education, particularly involving simulation’ [R10.1]
enhancers
Factors drawn from their experiences that enhanced the position’s success included:
• orientation to the roles of registrar and supervisor
• early negotiation of the project scope and direction
• the educational studies and opportunity to apply the theory in practice, shared by registrars and supervisors
• registrar – supervisor collaborative working relationship with sufficient time to meet, discuss and problem-solve.
Projects 2009R1 - RCH Paediatrics
Interns, JMOs, undergraduatesPOLIE – Paediatric Online Interactive Education – a modularised learning package
focused on key paediatric presenting complaintsR2 - PAH Emergency Medicine
Junior House officer educationCase based learning, procedural skills training
R3 – RBWH Gastroenterology/ Skills Development Centre Gastroenterology trainees, Networked cased based learning for gastro trainees state-wideCompetency assessment in endoscopy
R4 - RBWH NeonatologyPaediatric trainees and junior medical officersMulti-media resources for neonatology procedures
R5 - Townsville Department of Emergency Medicine (district funded)Undergraduates, junior doctorsFacilitating bedside and tutorial teaching in ED
R6 - RBWH Department of Emergency Medicine (district funded)Vocational traineesProcedural skills program and curriculum
Projects 2010
R1 - Redcliffe-Caboolture – Mental HealthMentoring for junior doctor welfare - Interns, JMOs
R2 - TPCH Emergency MedicineALS simulation training site including Interns, JMOs, and nurses
R3 - RBWH Emergency MedicineJMO educationWorkplace based assessment for Interns
R4 – RBWH Gastroenterology/ Skills Development Centre Gastroenterology trainees, Networked cased based learning for gastro trainees state-wide
R5 - Townsville Department of Emergency Medicine (district funded position)Undergraduates, junior doctorsFacilitating bedside and tutorial teaching in EDResearch support ‘club’ for junior researcher projects
Projects 2011
R1 – Royal Children’s Hospital – Emergency DepartmentDevelopment of 12 e-learning modules in paediatric trauma skills in collaboration with Clinical Skills
Development ServiceDevelopment of 3 e-learning modules for core paediatric skills in collaboration with Toowoomba Medical
Education Unit
R2 – Inner North Brisbane Mental Health Service, Northern TeamIntroducing an Intern education program for mental health; changing an entrenched culture
R3 – Mater Hospital – Adults – Endocrine and Obstetric MedicineDevelopment of content for on-line modules in diabetes care:
insulin pumps - introduction & management in hospitalised patients;diabetic ketoacidosis management protocol;preconception counselling in diabetes
R4 – Toowoomba Hospital – Emergency DepartmentTeam based learning – scenarios for doctors and nurses in the emergency department setting.
take home messages
• The Queensland Health Medical Education Registrar scholarship is structured as a professional development activity within the registrar’s vocational training program
• Medical Education Registrars are part of the solution to expanding supervisory capacity in healthcare, and an important step toward developing a community of medical education leaders
contact
Queensland Health – Hospital Service and Clinical Innovation Division
Queensland Medical Education & Training