Abstracts are displayed in order of program and excluding Symposium Abstracts.
Concurrent Sessions 2B –2F
SUSTAINING AGPT - IT'S NOT ALL MEDICAL EDUCATION!
Mrs Kimberley Martinsen1, Ms Lynette Safranek2, Ms Amanda McCabe3, Ms Sharon Butler4
1Sturt Fleurieu, 2 GPlogic, 3 CSQTC, 4 VMA
Aim:
The AGPT program is administered within RTP’s by well trained and knowledgeable staff. Admin staff are like the roots and stems of plants, they hold the program up and support it. In order for the AGPT program to grow and for the passion in gp training to remain, the administration network must also be nurtured. However there is no formal forum for these people to meet and network ideas. This workshop aims to provide a formal setting in which to discuss and share ideas relating to key elements of the AGPT program. Any recommendations produced as a result of collaboration can be taken back and presented to RTP boards as required.
Intro:
The presenters have a combined GP training program knowledge of 33 + years. Their combined knowledge and passion for the GP training program is a valuable resource for other RTP administrators to learn from and with, in a collaborative process.
Learning Objectives:
To establish a formal setting to share and document administrative issues
To sustain the enthusiasm of GP training amongst RTP staff
To create a collegiate (esprit de corp) amongst RTP staff
To fosterthe cross-pollination of ideas
Format:
Small groups to discuss key administration elements of the AGPT program including:
The Registrar GP Placement Process – how to sustain regionalisation
Full time/Part Time Training – how fiscally sustainable is training flexibility
Management of ADF Registrars/ Hospital Registrars - ????
IRIS/ Data Quality/ New IRIS/ database Issues – are we heading into a new environment
Registrar Transfers – are they managed adequately FACRRM and FARGP – Fellowships other than FRACGP
Each topic will be discussed within the small group for 20 minutes with a summarised report back to the group. Recommendations from the workshop can be presented back to RTP boards for consideration. Written ideas/recommendations/suggestions will be collated and distributed as part of the GPET Convention CD.
THE MEDICAL EDUCATOR AS A PROFESSIONAL
Dr John Buckley 1, Dr Cathy Regan 2, Dr Simon Morgan 2, Dr Patrick Kinsella 3, Dr Rod Wellard 3
1 Central & Southern Qld Training Consortium, 2 General Practice Training - Valley to Coast, 3GetGP - Gippsland Education and Training for General Practice
This workshop will demonstrate one component of the newly developed resource, a Train-the-trainer induction package for new Medical Educators. This project was funded by GPET and was a collaboration of experienced Medical Educators from across Australia. Details will be available at the workshop about the full package.
Target Group New Medical Educators and those who support and teach new Medical Educators
Approach and Content This workshop will be an active demonstration of the Professionalism module, rather than a talk about the module and its use. The session is constructed around two scenarios which a new Medical Educator might face. While clinical and organisational knowledge and skills are needed, the focus of the workshop is on specific professional and ethical competencies.
Using the scenarios as triggers, participants will explore the professional and ethical challenges inherent in the Medical Educator role, particularly where various ‘duties of care’ (to patients, Registrars, practices and Supervisors, colleagues and organisations and the community) might come into conflict.
Learning Objectives The participants will come away with heightened awareness of the issues, dilemmas and potential conflicts in the role, and with increased knowledge and skills to manage difficult situations. Senior educators will be better equipped for the induction and support of new Medical Educators.
LIGHTS. CAMERA. ACTION!
Dr Michal Wozniak 1, Ms Collette Lancaster-Lockwood 2
1 Sturt Fleurieu, 2 Bioskills SA, School of Medical Sciences, Adelaide
Medicine is spoken of as an art …. there are few opportunities for its practitioners to exercise their individual creativity. Clinical simulation offers creativity and education neatly rolled into the one experience.‘Lights, camera, action’ refers to simulation in the role of a theatrical event. Preparation includes the rehearsals, setting the stage, costuming, scriptwriting, moulage, then actors, directors and at the finish, producing, and then the reviews.
The aim of the workshop is to introduce participants to simulation as a creative outcome based teaching tool.
The workshop will provide participants with simple and practical methods of delivering clinical education using a range of simulation techniques within their own clinical practice.
INDIGENOUS CONSULTATIONS IN GENERAL PRACTICE
Dr Hung The Nguyen, Ms Ada Parry, Mr Kevin Parriman
NTGPE
Context
There is a lack of quality video consultations involving Indigenous patients in general practice. Although, live simulated patient sessions offer potential benefits in education and training of learners in Indigenous health there are significant barriers and limitations both logistically and from a cultural safety perspective.
NTGPE with funding from ACRRM, have produced a DVD of Indigenous consultations in general practice with an accompanying booklet. This resource can be used in a number of ways, by employing multiple educational methodology that best fit local and educational objectives.
Objectives To discuss the limitations and advantage of employing live simulated patient scenarios.
To demonstrate the potential uses of this resources by involving participants as learners.
Key messages Potential use of this resource is in the appraisal of skills, knowledge and attitudes of learners, communication issues in an Indigenous context and as a springboard for discussion of common Indigenous health topics.
Conclusions
This resource is a valuable in addition to training providers’ current list of resources in Indigenous health education and training.
WHAT WOULD THE CORONER THINK?: ISSUES FOR SUPERVISORS AND REGISTRARS IN RURAL GP TRAINING
Dr Genevieve Yates
CSQTC
How well are the issues facing registrars moving to a rural term addressed? How are new supervisors, especially in rural locations, supported?
Structure:
This workshop uses a short film “What Would the Coroner Think?” to trigger discussion around key areas needed for preparation of both supervisors and registrars involved in rural placements. The DVD (20mins) will be shown at the start of the session and be followed by facilitator led discussion on a range of topics prompted by the story. Initially discussion will be in groups of 4-5, then continued in the larger group.
Content: The film tells the fictional story of registrar Anna Morris, who starts her GP term 1 in a small country town under first time supervisor, Kate Reid. Anna’s term gets off to a flying start. However, three weeks in, two unfortunate incidents occur within a week of each other. Neither is terribly uncommon nor catastrophic, but circumstances are not in Anna’s favour. Exaggerated stories of her mishaps spread along the small town grapevine and her professional reputation suffers. It becomes too much for Anna – she wants out. Kate, too, is feeling out of her depth. Will Anna stay and complete her term?
The Key Learning Objectives (for an Educator target audience) are:
Facilitation of training for helping registrars and supervisors in:
1) Management of difficult situations.
2) Preparing supervisors and registrars for rural placements.
3) Critical incident debriefing.
Paper Presentation Session 2G
VIRTUAL EDUCATION VISITS IN PGPPP: REAPING REWARDS
Ms Alison Marrinan 1, Dr Tim Kelly 2, Dr Peter Donohoe 1, Dr Helen Mullner 1
1 Adelaide To Outback GP Training Program, 2 Crystal Brook Medical Practice
This pilot study examines the feasibility of innovative virtual Education Practice Visits by Medical Educators with junior doctors on PGPPP placements in general practice. The pioneering virtual visits involved testing several dynamic broadband video link-up technologies as an alternative to on-site Practice Visits by the Medical Educators.
Medical Educator Practice Visits each term are a core component of training in general practice. The visit provides review of trainee satisfaction and progress; observation and feedback on consulting skills; and discussions with the supervisor(s) and practice staff on current and future arrangements. However, the visits are also costly in terms of Medical Educator time and travel.
The dynamic digital technology enabled valuable virtual Practice Visits that effectively addressed the educational and program aims of the visits, in association with significant time and travel cost savings. The technology also allowed for cost-effective brief follow-up virtual visits when required for specific needs.
This pilot study adds to our experience of applications for dynamic broadband video link-up to enhance junior doctor training in general practice. It showcases junior doctors gaining from valuable multi-sour observation, appraisal and feedback to enhance learning, via technology appropriate to Y-generation learning styles. It offers a solution to reduce costs without compromising the quality of training and allows a greater number of visits.
These findings could also relate to enhancing the in-practice training of GP Registrars.
DYNAMIC DIGITAL INNOVATIONS LINKING SPECIALISTS & PGPPP
Ms Alison Marrinan 1, Dr Tim Kelly 2, Dr Simon Burnet 3, Dr Peter Donohoe 1, Dr Victoria Wade 4
1 Adelaide To Outback GP Training Program, 2 Crystal Brook Medical Practice, 3 Consultant Rheumatologist, Adelaide, 4 Discipline of Public Health, University of Adelaide.
This pilot study examines the feasibility of interns on PGPPP placements facilitating specialist services to rural areas via an innovative e-health approach. The project was designed to enhance educational opportunities for junior doctor training, as well as increase rural access to specialist services, while providing optimal patient care.
The study involved interns at a rural general practice performing follow-up rheumatology consultations in collaboration with a metropolitan based specialist via videophone broadband link-up. The process replaces the rheumatologist’s usual follow-up consultations.
We found multiple benefits from this novel approach including:
Interns gaining improved rheumatology clinical skills and communication skills;
Enhanced understanding between general practice and other specialties;
Interns and consultants working together in this way provides a high level of service otherwise not possible; and
Reduced travel time and cost savings for both patients and consultants.
Experience in this pilot study indicates potentially unlimited applications for dynamic broadband video link-up to enhance junior doctor training with specialists in general practice. It showcases junior doctors gaining valuable high-level learning via technology appropriate to Y-generation learning styles. It offers a solution to overcome rural geographic isolation from specialist care. It could also be extended to GP Registrar training.
THE TYRANNY OF DISTANCE! HELPING RURAL REGISTRARS PREPARE FOR THE EXAM
Dr Rashmi Sharma 1, 2, Dr Katrina Anderson 1,2
1 Australian National University Medical School, 2 Coast City Country Training
The tyranny of distance is often a barrier for many registrars trying to prepare for the RACGP exam. In our region rural registrars can be separated by up to 6 hours of driving and so connecting them in study groups and face to face exam preparation is problematic. This paper will look at innovations that have been developed over the last three years to address the problem of exam preparation for rural registrars in our region.
All rural registrars in the SENSW and ACT Local Training Group of Coast City Country Training are situated in vertically integrated teaching practices and so have access to IT facilities of the School of General Practice, Rural and Indigenous Health, Australian National University Medical School. They are therefore able to connect in weekly study groups via “Breeze/Adobe Connect” a web based collaborative teaching tool of the medical school that allows a powerpoint presentation, pictures, role plays, discussion and visual cues to be in front of each registrar on their computer. The session is also recorded so that registrars who run late or miss out because of hospital commitments can revisit the session at a later date. The sessions are facilitated by a medical educator who also organises 2 half day mock exam practices for candidates face to face.
This presentation will outline practical ideas and strategies to use this type of web teaching effectively and to make it as interactive as possible. Ideas for including and supporting supervisors are key to making this form of teaching successful as they can also feel isolated.
This method of teaching has been well received with high attendance achieved using readily available technology and causing minimal disruption to registrars and supervisors at little cost.
PGPPP: OUR GLASS IS MORE THAN HALF FULL!
Ms Alison Marrinan, Dr Peter Donohoe
Adelaide To Outback GP Training Program
South Australia has been at the forefront in taking advantage of the PGPPP opportunity. This paper will outline five years of PGPPP experience at Adelaide to Outback GP Training Program (AOGP) in terms of meeting the main aims of the program:
Well-supervised placements that provide positive and confidence building experiences.
Our evaluative research indicates that the junior doctors value their training in PGPPP terms, well complementing their markedly different training in hospital terms.
Enhance understanding of integration between primary and secondary health care.
As frequently reported by our PGPPP trainees, feeder hospitals, and others, the GP terms are successful in bridging the interface between primary and secondary care. These benefits have important potential ramifications in overall outcomes in health-care systems and delivery.
Encourage general practice as a career choice.
Recruitment to general practice from PGPPP has gained momentum at AOGP over the past five years. Impressively, AOGP’s 2009 GP Training cohort comprises 54% of the 28 places being filled by PGPPP junior doctors.
Conclusion
Our experience provides substantial evidence of the value of the PGPPP for high quality junior doctor training in the general practice setting, as well as for recruitment of junior doctors to GP Training.
Our results strongly support arguments for sustaining current PGPPP training as well as expanding the program throughout Australia.
DIAGNOSING DEFICITS: USING BLOOM'S TAXONOMY TO DETECT AND MANAGE CLINICAL REASONING ISSUES WITH REGISTRARS
Dr Louise Stone
It is not uncommon for registrars to have difficulties in clinical reasoning. As educators, though, it is often difficult to pin down the problem. Are they having difficulty finding the relevant clinical information from the patient or are they having trouble interpreting it? Are there gaps in their knowledge base? Do they know how to weigh up the likelihood of different possibilities (post-viral cough vs asthma, eczema vs psoriasis)?
In order to drill down into the reasoning process, it is helpful to use an adapted form of Bloom’s taxonomy. Benjamin Bloom developed a classification of levels of intellectual behaviour important in learning. Bloom identified six levels within the cognitive domain, from the simple recall or recognition of facts, as the lowest level, through increasingly more complex and abstract mental levels, to the highest order which is classified as evaluation.(http://www.officeport.com/edu/blooms.htm)
In this session, we will be looking at a method of utilising Bloom’s taxonomy as it applies to the cognitive tasks required to perform a GP’s work. We will also be looking at the application of this method in different curriculum domains. Clinical reasoning capacity is context specific: just because a registrar can reason through a complex case of cardiac failure does not mean he or she can perform at the same level for dermatology.
At the end of the session, participants should be able to apply this assessment tool in their own teaching environment.
THE CRYSTAL BALL IN GENERAL PRACTICE TRAINING: PREDICTING AGPT PROGRAM REGISTRARS’ SUCCESS IN THE RACGP EXAMINATION
Dr William CW Wong 1,2, Dr Heather McGarry 1,2, Dr Doris Young 1,2
1 VMA; 2 University Of Melbourne
In 2008, GPET commissioned an analysis to understand which factors influence AGPT registrars’ success in the RACGP examination to assist with ongoing provision of evidence-based quality training and education.
Data relating to 1320 AGPT registrars who sat the RACGP examination between 2006 and 2008 were analysed. Initial analysis focused predominantly on registrar factors (sex, age, previous examination sittings, place of graduation) with an overview of performance of registrars from the different pathways and regional training providers. The main independent predictors of RACGP examination success identified included gender, age and place of graduation.
This paper provides the initial results of the analysis, including limitations affecting interpretation of results, future directions for ongoing analysis and practical application.
