Abstracts are displayed in order of program and excluding Symposium Abstracts.
Concurrent Sessions 5A –5F
OLD DOGS, NEW TRICKS – A WORKSHOP FOR GP SUPERVISORS ON TEACHING CHRONIC DISEASE MANAGEMENT IN GENERAL PRACTICE
Dr Patrick Byrnes, Dr John Buckley
Central & Southern Qld Training Consortium
A challenge for GP Training is to be teaching for the General Practice of the future, not General Practice as it is or has been. The key growth area for General Practice is Chronic Disease Management. Effective management involves the use of guidelines and audit and a practice-wide systems approach. It is a challenge to introduce these concepts and systems into practice and even more so to teach Registrars.
This workshop will review key guidelines and the use of clinical audit in teaching. It will guide participants through ideas about practice systems. Then the focus will be on the seven steps to Registrar implementation of Chronic Disease Management:
Enthuse
Introduce
Immerse
Support
Contribute to development or refinement of CDM
Opportunistic clinical teaching
Exit strategy for taking skills to next practice.
Setting up practices for teaching will also benefit practice performance and efficiency and can enhance the ‘bottom line’.
Target Group GP Supervisors
Learning Objectives and outcomes
Participants will have a hands –on exposure to key education tools and will be equipped with resources
Participants will be given a framework to aid Registrar implementation of Chronic Disease Management
Participants will be equipped to enhance Chronic Disease Management systems in their own practice
THE REFRACTIVE PRACTITIONER: TRANSLATING ‘EBM’ INTO GENERAL PRACTICE AS INSPIRED BY THE ROSETTA STONE.
Dr Mark Burgemeister
Bogong Regional Training Network
Bogong’s surveys of new general practice registrars indicate strong associations between the terms ‘Evidence Based Medicine’ and ‘statistics, p-values, scientific studies and medical journals’. Our approach from the start of training is to provide learning opportunities focused on translating and communicating the science of medicine to patients of all types – integrating ‘scientific training’ with our other themes of ‘communication’ and ‘patient-based care’.
We highlight the potential barriers new GPs can face, by focussing on everyday-GP-based scenarios and questions which can be answered at the end of the session by the registrars ‘role-playing’ discussing the findings with ‘a patient’. We concentrate on GPs effectively using the short time they have available to evaluate the evidence upon which they base their decisions. The aim is to communicate complex science by translating it to a patient appropriate level to increase the patient’s understanding. We strive to combine the science of medicine with the art of patient communication in general practice; addressing the barrier to EBM of ‘professional to patient interaction’.
We use this approach from the commencement of a General Practitioner’s training, to demonstrate, model and utilise practices so the registrar’s may obtain quick, practical results with their patients.
Just as the Rosetta Stone gives us understanding of the sacred Egyptian hieroglyphs, so too does the General Practitioner break open the mysteries of science for their patients.
THE ART OF SMALL GROUP TEACHING SKILLS. A PRACTICAL AND INTERACTIVE WORKSHOP ON DEALING WITH THE DIFFICULT GROUP PROCESS
Dr Peter Bratuskins, Dr Cath Beasley
VMA
AUDIENCE
Medical Educators
GP Supervisors
Registrars with current teaching commitments or teaching interests
RTP representatives with an interest in Professional Development
INTRODUCTION:
This highly interactive session gives participants a practical approach to small group teaching skills, focusing on dealing with the difficult group process. Participants will be either involved in role play scenarios or able to observe and contribute. Small group teaching is a very common method of teaching in GP Vocational Training. The objective of this session is to improve the skills of participants and facilitate cross-fertilisation of skills and ideas. More effective teaching skills will enhance small group dynamics and ultimately lead to a better teaching and learning process.
SESSION STRUCTURE: The session focuses around three short group teaching episodes to be role played by participants. One volunteer participant will take the tutor role and five other participants will be students, with volunteer participants changing between episodes.
Students will be given specific roles and the tutor will run the teaching episode and be expected to address the issue that arises. Discussion of cases following each scenario will allow sharing of ideas, introduction of theory and practical tips from presenters.
For participants’ ongoing development, readings and summary of the discussion outcome will be emailed after the session.
NOT THE JANE AUSTEN BOOK CLUB – USING (NON-MEDICAL) LITERATURE IN GENERAL PRACTICE TRAINING
Dr Simon Morgan
GP Training Valley To Coast
Background
There is an increasing interest in using the arts and humanities in medical education. Paralleling this educational trend, ‘book clubs’ are an increasingly popular social gathering, based around the reading and discussion of a novel or work of non-fiction.
Objectives This workshop will explore the role of non-medical literature in medical education, using the model of a ‘book club’. Participants are required to read a novel (TBA) in advance of the session. The novel will be discussed, with a specific link to better understanding patient-centred medicine, the clinician-patient relationship and reflective practice. Participants will gain a greater understanding of the role of literature and other humanities in health education. Practical tips on planning and delivering education sessions of this nature will be covered.
Discussion The arts and humanities provide a powerful medium for clinicians to improve their appreciation of the patient experience of illness. There is evidence that the use of literature in health professional education enhances the depth and strength of relationships with patients. Using literature as a teaching method highlights the narrative nature of human lives, and can provide interesting ethical issues for learners to explore. Furthermore, literature-based teaching encourages doctors to better reflect on their own practice and experiences.
The use of literature in medical education facilitates the development of otherwise difficult to teach competencies, including compassion, patient-centredness and empathy. As a teaching method, it helps to reinforce the importance of the sometimes overlooked ‘art of medicine’.
SKINNY DIPS– FUN WAYS TO APPROACH DERMATOLOGY TEACHING
Dr Peter McKain
CSQTC
Workshop design
This workshop will expose you directly to some fun learning activities taken from our dermatology workshop for registrars. This is a hands-on session. For the first hour dip in and get your toes wet - play ‘Celebrity Skinheads’ and do the interactive quiz and yes, even role plays in dermatology along with fellow conference attendees. Then we will discuss how these educational approaches are used and how they have enhanced our sessions and facilitate a discussion on fun, yet effective teaching. Live interactive evaluation included!
Target audience The session is primarily designed to help Medical Educators to experience and share fun, effective teaching ideas. However, all with an interest in teaching and learning are welcome
Learning Objectives To experience some fun interactive learning To consider your own approaches to teaching dermatology To consider your general approaches to engaging learners in all sessions
Paper Presentation Session 5G
READY, SET, GO... DEVELOPING A READINESS FOR GENERAL PRACTICE
Dr Kishan Pandithage, Dr Nada Andric
NTGPE
Background General practice placements for pre vocational doctors are an essential part of the vertical integration model. Most junior doctors undertaking remote general practice placements in the Northern Territory (NT) have had limited general practice exposure in an indigenous context. The Learning Needs Appraisal (LNA) model was developed to identify the “general practice readiness” of pre vocational doctors. The LNA is comprised of an objective structured examination, based on the Australian Curriculum Framework for Junior Doctors (ACFJD). The LNA model was piloted in 2008.
Aim
To determine whether the LNA model improves performance of pre vocational doctors in communication, clinical management and professional skills- the domains of the ACFJD.
Method Pre vocational doctors undertaking placements in rural and remote locations in the NT underwent a LNA during their orientation. The structured examination focused on the three above mentioned domains. Performance in each of the three domains was scored out of five. Group level feedback was provided immediately via group discussions, while further individual feedback was provided in writing. An equivalent structured examination was applied on completion of their placements.
Discussion Quantitatively, there was a modest improvement in the performance of the pre vocational doctors who underwent a LNA. However, qualitatively, this model received positive feedback from the participants for identifying individual learning areas in need of improvement. The LNA model is feasible, and further evaluation is required to determine its utility in addressing junior doctor learning needs.
LEARNING SCRIPTS: AN APPROACH TO ASSESSING LEARNING NEEDS AND PRESCRIBING EDUCATION
Dr Louise Stone
GPSynergy
General practice is a diverse discipline with a formidable range. GP registrars come to general practice with an equally diverse set of skills and competencies and learn their craft in practices that differ significantly with respect to patient population, morbidity profile and services offered. Reconciling a static curriculum with a dynamic, ever-changing “on the job” learning experience has always been a difficult task.
Traditionally, we have approached this dilemma using registrar-driven learning plans. However, as experienced educators are well aware, reception to the idea of learning plans is usually lukewarm at best.
At GPSynergy, we have approached this dilemma by designing “Learning SCRIPTs”. Based on the “lifescripts” model, we have developed a series of assessment tools based on the RACGP curriculum. These learning assessments ask registrars to rate their perceived competence against a series of objectives based on the RACGP curriculum in each key learning area.
However, the innovative element of this approach is the use of indicators; statements that ground the objectives in practice. These indicators answer the question “how will you know if you have met this objective? What behaviour will be observed?”
The partners to these assessments are learning SCRIPTs. Each SCRIPT includes a series of educational activities that can be selected and initiated by the registrar, based on their particular learning assessment.
In this session, we will be discussing the application of these tools and presenting preliminary data around their use in GPSynergy.
OUT WITH REMEDIATION, IN WITH PREVENTION: THE 3-STEP PROGRAM
Dr Taryn Elliott
Adelaide to Outback GP Training
Adelaide To Outback GP Training Program General practice training aims to develop competent and confident General Practitioners. This requires good clinical and communication skills and knowledge and the ability to apply these in the consultation. When this aim is not achieved remediation is required, which places strain on both the Registrars and Training Providers. At AOGP we consider prevention is a better strategy. We have developed a 3-step preventative model which includes:
1) Identification of need
2) Customised training
3) Monitoring progress
Need is identified through a comprehensive learning needs analysis (LNA), which occurs early in training. Customised training, taking in to account identified needs, is then incorporated into inpractice and out-of-practice training. Using a modular format, training can be tailored to the individual. Specific modules have been developed based on areas of common need to assist Supervisors/Trainers to focus training in clinical, communication, and ethical /legal areas. Specialised communication, language and written language programs have also been developed. Monitoring occurs throughout training via a range of formative assessment processes. For example, a follow-up LNA, which assesses that learning needs identified early in training have been addressed, is implemented in GPT3. Following this there is still the option for additional assistance if required. By implementing this 3-step model we have been able to create a positive feedback and planning culture and reduce Registrars’ stress associated with “just-in-time” remediation. By planning and structuring training over time, this 3-step program has also assisted us to improve the sustainability of our teaching.
Why? Registrars:Well-being
Program: Cost Resources/planning
How and when? LNA
Focussed training
In-practice-Trainers Supervisors /online modules
Out-of practice- Com skills program
Has it worked??
"CLOSING THE GAP":THE ROLE OF AN RTP
Ms Vanessa Ryan, Ms Kali Haywood
Adelaide To Outback GP Training Program
It is widely acknowledged in Australia, that Aboriginal people suffer poorer health compared to non-Aboriginal people. The causes and consequences of this health divide are multiple and complex. The lower standard of health in the majority of Aboriginal people can be largely attributed to historical, cultural, social and environmental factors.
In acknowledgement of these complexities, Adelaide to Outback GP Training Program (AOGP) has taken an innovative approach to teaching Aboriginal health. The approach is aimed at exposing GP Registrars to as many of the factors that impact on Aboriginal people’s health through a process of immersion. The objective is to assist GP Registrars to develop a comprehensive framework to deal with the complexities of Aboriginal health. The underlying principles of the program are based on building capacity, awareness, collaboration and understanding.
The program is developed and delivered in collaboration with Aboriginal people, communities, GPs working in Aboriginal Health Services and Medical and Academic staff who have experience in, and a passion for, Aboriginal health. The content is delivered over two days in a rural Aboriginal community and associated Aboriginal health and wellbeing services. Participation is extended beyond GP registrars to include Medical Educators, GP Supervisors and AOGP Education team staff.
This presentation will explore how this innovative approach to teaching Aboriginal health is working to build capacity in Aboriginal communities, develop a holistic approach to managing complex Aboriginal health issues and encouraging an organisational approach to cultural awareness.
LOGBOOK – DO WE NEED 150 HOURS OF DRIVING TO COMPLETE IT?
(COMPLETION OF THE ACRRM CORE COMPETENCIES PROCEDURAL LOGBOOK BY REMOTE DOCTORS)
Dr Louise Baker, Dr Trudi Cullinan, Dr Susan Wearne, Dr Pat Giddings, Ms Jeanette Mclaren
Remote Vocational Training Scheme
“ACRRM has developed a suite of assessment tools that together provide a comprehensive evaluation of the candidate’s knowledge, skills and attitudes. The ACRRM Logbook is one component of this and provides an assessment of the candidate’s key psychomotor procedural skills and the level of competency required for independent rural and remote practice.”
The challenge for RVTS was to find a way for registrars to meet the logbook sign off requirements in a remotely supervised setting. The solution was to develop a skills training workshop that allowed registrars to achieve sign off for procedural skills in a simulated setting.
RVTS reviewed RACGP and ACRRM’s procedural skills log books and Curricula and designed an online procedural skills audit.
The results provided a framework for a procedural skills training workshop designed by RVTS and held at The Royal Australasian College of Surgeons Melbourne in November 2008. RVTS developed train the trainer resources for Supervisors (who helped in providing the procedural skills training) and provided take home procedural skills resources for Registrars and Supervisors.
The workshop was evaluated by Registrars, Supervisors, Medical educators and staff. The procedural skills audit proved a useful tool for identifying individual registrar’s procedural skills training needs and the workshop provided an opportunity to trial the hard copy of the ACRRM log book, allowing the Registrars to complete part of the ACRRM logbook for supervised and simulated procedures.
This paper will articulate the positive and negative outcomes of this process.
THE 'APPRENTICESHIP MODEL' OF GP TRAINING IN 2009
Dr Susan Wearne 1, Dr Patrick Giddings 1
1 Remote Vocational Training Scheme, 2 Remote Vocational Training Scheme
The Australian General Practice Training Program follows an 'apprenticeship model'. The Remote Vocational Training Scheme has adapted this model to train general practitioners in remote, isolated or solo general practice. The presenters are both conducting research on this adaptation: Pat Giddings is evaluating the program and assessing its potential application to other specialties and Susan Wearne is studying the relationship between the registrar and their remote supervisor.
Both research projects require a clear understanding of what is meant by the apprenticeship model. Initial research of the literature shows that the phrase 'the apprenticeship model' is used and a definition assumed, rather than articulated clearly. This paper will present the results of a comprehensive literature review on general practice training models and propose a definition of the apprenticeship model of general practice training.
