organising rotations in higher surgical training; mapping the job to the curriculum steve bale...
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Organising rotations in higher surgical training; mapping the
job to the curriculum
Steve BaleProgramme Director T & O
Lancashire Teaching HospitalsNHS Foundation Trust
Regional Representatives MeetingRCS June 2010
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Regional Representatives Meeting RCS June 2010
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Present
• A competency based curriculum
• Trainees are sent to a hospital
• Hopefully given the training they need
• How do we know it’s the best place?
Regional Representatives Meeting RCS June 2010
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Why?
• Loss of SAC visits• Ballooning Consultant numbers• Amalgamation of units• Stagnation of some units• RITA/ARCP feedback• PMETB standards• Deanery Q & A
Regional Representatives Meeting RCS June 2010
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Hospital Visits
• Visited all training hospitals• Team• Informal• Trainees not involved• 3 separate periods to cover all hospitals• Information requested• Trainees questioned separately
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Feedback
• Reports to each STC member
• Visitors findings
• Trainees assessment
Regional Representatives Meeting RCS June 2010
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Mr. M. Aqeel Bhutta
Orthopaedic Registrar
STC Trainee Representative
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Driving Force
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Sources
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The Survey BACKGROUNDVery simple Feedback questionnaire with traffic light system from 2005.The updated survey has been collected from 2007 to date for each 6 month placement.Anonymous when presented to STC.
QUESTION SCORING-Graded from strongly disagree to strongly agree, and weighted 1 to 5.-Questions created/phrased to allow scoring to be correctly weighted when assessing scores. A score of 3 (neither agree or disagree) was a negative sign.
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THE SURVEY
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THE UNIT Direct question about the unit. Specific indicators
- Are all consultants satisfactory trainers?- Are there Regular trauma/audit and journal
meetings?- Is there a adequately equipped registrar
room?- Is the Job Plan variable/service provision?
8 questions: max score of 40
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THE TRAINER Sub-speciality of orthopaedics that ‘trainer’ believes is
provided. TRAINER 4 questions
Approachable/supportive/interested in training/adapted to your training needs
Surgical supervision:- Trauma & Elective :- 4 Q’s Out-patient supervision :- 3 Q’s Mini-logbook. Based on OCAP index procedures. Number procedures as primary surgeon
Total number of procedures with trainer
OCAP compliance Research and Audit support.
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TRAINEE SUMMARY Trainee selects what the placement
delivers in terms of sub-speciality training. Appropriate trainee level for the placement. Mini-logbook for the entire attachment Placement recommended to a colleague
(they got on with!!!) Open comments of how to get the most out
of the attachment FEEDBACK ON THE SURVEY
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<24 POOR UNIT24-<32 BORDERLINE/POOR UNIT =>32 ACCEPTABLE/GOOD UNIT
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Trainer surgical clinical1 19 19 8.5
2 12 12 9
3 16.5 16 7
4 14 12 9
Trainer surgical clinical1 19.5 18.5 14.5
2 16 16 15
3 20 20 14
4 20 16 12
5 20 16 12
6 18 20 13
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The Future
STC
Initial TrainingSlots Data
Post Training Slots Allocation
Trainers
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Next phase
• Ask Trusts whether they want remain as training Trusts
• Ask individual Trainers whether they want to remain as Trainers
• Ask what training can be offered• Invite bids from pairs of Trainers for training
opportunities from ST3 – ST8
Regional Representatives Meeting RCS June 2010
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Results
• Bid quality varied hugely
• Bids assessed by same committee
• Trainees intimately involved
• Excess bids over slotsRegional Representatives Meeting RCS June
2010
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Next phase
• Year 1 – Hip 1, Knee 1• Year 2 – Shoulder & Elbow, Foot & Ankle• Year 3 – Hip 2, Knee 2• Year 4 – Hands, Paeds, Spines*• Year 5 - Subspeciality • Year 6 - Subspeciality
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Each programme, and every trainer, will wish toretain a degree of individuality, whether of
organisation (4, 6 or 8 month attachments) orspecialty selection. It is intended that the curriculumdesign will be able to recognise this, whilst providing
a consistency of standard and outcome.
Regional Representatives Meeting RCS June 2010
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Outcome
• Successful allocation of bids to slots
• Gains by some Trusts
• Losses by others
• Trainees very happy - 4 year programme of specific Trainee/Trainer contracts
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Deanery permission / finance
• Dean to ratify
• Chief Executives
• Financial implications
• Tight for August 2010
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On-going Q & A
• Reassessment
• Waiting in the wings
• New Consultant Trainers
• Review every 2 -3 years
Regional Representatives Meeting RCS June 2010