the training log

The Training Log

Experienced Trainers’ Course

2005

Information gathering

• Takes place all day

• Takes place in different contexts

• Comes from multiple sources

• Can be subtle feelings which we must record

WHO ? HOW ?

• Registrar

• Trainer

• Should it be shared document

• Contributions from other team members

• Written or electronic

• NOT in your head !!

GROUP WORK

• BLOCKS

Blocks to recording

• Time

• Last task on the pile

• Too complex and cumbersome

• Not accessible

• What use is it anyway?

• Fear of writing it down

• Not knowing what to put in

Reflective diary- tips

• Must be handy

• Try to write in it most days

• Relections/actions/what am I recording?

• About GPR

• About me

• About the learning environment

• Write down ANY thoughts

Why keep a log?Immediate needs

• To aid and record reflection

• To record learning needs perceived by learner

• To record learning needs perceived by Trainer

• To record negotiated curriculum plans/timetable

Why keep a log? Medium term needs

• To see progress

• To help order your thoughts

• Continued recording of learning needs and curriculum planning

• To share with registrar and show model

• Reassurance

Why keep a log? Long term

• To aid completion of the structured trainer’s report

• Evidence of good or bad performance

• As future teaching resource

• For future reference construction

What are we looking for?

• Expectations at different stages of training

• What is normal development?

• Without a knowledge of normal development impossible to assess accurately

• Normal milestones

Stages of development

• Unconscious incompetence

• Conscious incompetence

• Conscious competence

• Unconscious competence

Group exercise

• Working out the milestones

• What is a normal registrar behaviour

• First few weeks

• At 3/12

• At 6/12

• At 9/12

• At 12/12

6 weeks(1)

• Good time keeping• Enthusiasm• Observe presentation/dress• Lacking in confidence• Worried about learning agenda• Identifying own learning needs topic based• Express some areas of expertise• Share background information• Curiosity

6 weeks(2)

• Needs 30minutes to assess patients• Struggles with consultation task list• Struggles with computer• Hospital-style clinical skills• Makes complex diagnoses• Orders many or no investigations• Huge Dr’s agenda• Surprise at family dynamics• PEPS a bit daunting

6 weeks(3)

• Variable team skills• Observe ability to cope with change• Keen attendance at practice meetings• Social skills at getting on with team• Early feedback from accompanying PHCT• Very keen to sit in• Finds constructing simple management plans

difficult• “I’ll never be able to do this” is normal

At 6/52 priority objectivesGroup Work

PATIENT CARE

• Should feel safe

• Emergency care adequate

• Basic prescribing

• Wants to do own surgeries

• Should be asking

• May be dr centred

At 6/52 Priority ObjectivesGroup Work

COMMUNICATION

• Knows who/how to contact when

• Knows referral systems including OOH

• Will ask for help

• Can talk and listen to patients

• History taking hospital style


ORGANISATION• Can use computer• Knows team/telephone/ alarm• Starting to plan year

PROFESSIONAL VALUES• Punctual• Respect• Probity• Dress code• Confidentiality


PERSONAL/PROFESSIONAL GROWTH

• Ownership of learning contract

• Started Log for PDP

• Still at the FEED ME stage

At 3 months

• Enthusiasm• Chinks beginning to show through• 20minute consultations• Identifying more complex learning needs• Will do PEPS and share results• Comfortable with computer• Able to grasp family dynamics and is curious• Still follows up simple problems• First video

At 3 months (2)

• Struggling with time management• Integrating into team• Still likes to sit in • Has ideas re audit project• Beginning to change consultation style• Able to use open questions• Realising that they have knowledge• Should have dealt with some difficult issues• Keen to take on tricky problems• Will do visits alone

At 3 months (3)

• Responds to feedback in constructive way

• Attitudes and beliefs beginning to show

• Prepares well for tutorials

• Starting to challenge Trainer

• Plans to sit summative assessment mcq

• Can write a good referral letter

At 3/12 Priority ObjectivesGroup work

PATIENT CARE

• Consulting 20min

• Some videos

• Safe in emergencies

• Basics of chronic disease

• Minor ailments understood

• Own home visits


ORGANISATION

• Punctual

• Recording accurately

• Attends VTS

• Keeping log

• Dr,s bag organised has own equipment

• Knows about the formulARY


COMMUNICATION

• Use of computer – notes and presenting

• Video skills

• Record keeping adequate

• Seeking out the team

AT 3/12 Priority ObjectivesGroup Work

PROFESSIONAL VALUES

• Has professional image

• Asking for help comfortably

• Values team work

• Participating in medical meetings



• Helping to run the team

• Reading

At 6 months

• Taking responsibility and initiative• Has completed first audit cycle project• Shows inititiave in day to day work• Shows initiative in Learning• More challenging• Comfortable with video• Worry about mrcgp/video• Has built up own “list”

At 6 months

• Management plans more realistic• 15 minute appointments• Does not follow up simple problems• Integrating well into team• Team will go to him for help• Does on call sessions• Will cover for absent partners willingly• Able to deal with basic admin

At 6/12-priority objectives group work

PATIENT CARE• Good management of emergencies• Preventative medicine skills present• Chronic disease management skills

present• Computer literate• Knows own role in team and contributes• Using video


COMMUNICATION

• 10 minute consultations

ORGANISATION

• Computer literate

• Audit completed

• MRCGP planned


PROFESSIONAL VALUES• On time• Clean/not smelly• Respect for peers• Respect for patientsPERSONAL/PROFESSIONAL GROWTH• Developing good Log/PDP• Summative Assessment/MRCGP

At 9 months

• 10 minute appointments• Managing complex organisational tasks• Time management good• Want to look at wider issues• Formulating own learning plans and thinking

about PDP• Beginning to think more about the future• Showing an interest in finance

/management/employment options• Increased interest in medical politics

9 months (2)

• 2nd audit cycle commenced• Looking for new projects• Master of technology and presentation• Challenging the norm• Would I like this dr as a partner?• Real dr on show – expresses opinions• Ethical dilemmas discussed regularly with insight• Planning future education


PATIENT CARE

• Independent management

• Pro-active

• Involved in patient groups

• Involved in preventive care

• Audit cycle completed


COMMUNICATION

• Teamwork functioning

• Consulting skills developed at practitioner level


ORGANISATION

• Chair meetings

• Management – Understand finance and Tax

• Involved in Staff recruitment

• Involved in Appraisals

• An interest in the running of the PCT


PROFESSIONAL VALUES

• ?least developed

• Involved in Clinical Governance



• Independent self-directed learners

• Have produced log

• Working on PDP

At 12 months

• Do you feel safe to let them go?

• Independent practitioner

• Robust PDP

• Excitement

• Enthusiasm for the job

What to record?

• Much easier when you know what to look for and expect

• Use check lists? or is this too rigid

• Must be personalised

• There are some broad headings

• KEEP IT SIMPLE AND ACHIEVABLE FOR YOU

Section 1

• Timetables/Rotas.

• Practice and Day-Release timetable

• Important dates for GP Registrars

• Reading list/website addresses

Section 2

• Learning needs – an evolving list

• Syllabus and Curriculum plans

Section 3

• Diary – include feedback/learning points

• PUNs DENs

• Weekly – To-do list

Section 4

• Tutorials – List and feedback sheets

• Surgery debrief

• Problem cases Analysis

• Significant Event Analysis

Section 5 Feedback• Staff feedback – formal and informal• Videos• Belbin team styles• Honey & Mumford learning styles• Manchester rating scales• Wolverhampton grid• Kiddy Ring interview• SWOT analysis/exit questionnaire• Referral analysis and feedback• Self assessment questionnaire• Joint surgeries• PEPs• MEQs• Pigeon-hole audits

Section 6

• Audit/project

• MCQ

• MRCGP information

• Working Towards an MSc/CATS PointsFlow chart

• What to do with VTR1/2 etc at end of year

Section 7

• CV

• Contract

• Exams

• Certificates

• Feedback from previous jobs

Section 8

• Structured GP Trainer’s Report

• Out of Hours Information

• Out of Hours Training Workbook

Banbury Training Log

If you would like a copy of this please send

Me your address with a cheque made out to

Horton Postgraduate Centre for £10.Please

Also email me your request in case of

Problems.

My email [email protected]

Telephone: 01295 229314

mailto:[email protected]

the training log

Documents

learning agendaidentifying

learning environmentwrite

complex learning needswill

trainerto record

record reflection

medium term needs

piletoo complex

recordingtimelast task