Beyond Mentoring planned proactive pastoral care

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Beyond Mentoring -planned proactive pastoral care

• David Everett, DCT (2003 2008), TMO Unit, SAHS
• Andrea Lloyd, Manager, TMO Unit, SAHS

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Background

• Mentoring schemes often proposed how often
  implemented
• Medical Culture works against problem-based
  mentoring
• Most mentors are unofficial and opportunistic
  relationships
• Usually not under-pinned by organising
  administration system like training activities,
  no organisation no activity
• Reactive systems rarely have a preventative impact

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FMC program since 2005
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FMC program since 2005

• Interviews
• Minimum of 3 interviews for each Intern. Early,
  mid and end year.
• Expectation set at Orientation Program, including
  being non-optional part of their professional
  and personal development.
• Planned, organised and scheduled.
• 100 attendance record over 4 years
• Conducted in private office in TMO unit with DCT
  and MEO/Manager
• 20 mins duration
• Notes taken and kept in Interns confidential
  folder in TMO Unit (not their HR file)

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Proactive pastoral care

• General format is to review Interns perceived
  progress, discuss their mid-term and end-term
  appraisals, discuss reflections re career plans
• Open-ended enquiry re highs/lows best/worst
  invite anecdotes.
• Specific enquiry re difficult or traumatic
  experiences
• Often discussion of their development of
  reflective practice, support systems, team
  experiences, active seeking of appraisal and
  feedback
• Make specific next-step plans for some
• Occasionally results in performance management,
  or major intervention (time off, term change,
  medical board notification etc) but at an early
  stage of the problem

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Examples

• (at Orientation) I know I wont be needing those
  interviews ., others might
• Ive killed a patient ..!
• All good Im fine Its term 2 and I still
  cant sleep ..
• The team? Theyre good, . Except for my
  RMO/Reg/Fellow Intern
• I heard you (TMO Unit) had a complaint about me
  ..
• Its time I tell you that I have a problem .. a
  mental health problem
• (tears ) Im pregnant!
• (IMG) I know the team thinks Im slow and stupid
  do you think I should quit?

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Benefits (taken from their final/exit interview
comments)

• The interviews develop a force-function re
  reflecting on professional life
• Trust - at least you guys care, so, now I know
  I can talk to someone, its a safe experience
• Actively develops aspects of professional growth
• Leads to early-intervention, rather than reacting
  to doctors-in-crisis. Continuing practice with
  specific team support is the general rule.
• Encourages mentoring of others in subsequent
  years. Encourages seeking help as junior
  supervisors in subsequent years
• Helps TMO Unit staff get to know the Interns
  personally

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Program aspects

• 70 20 mins 3 interviews 70 hours minimum (
  2 working weeks)
• For the 0.2 FTE DCT that represents 20 of annual
  time.
• Large number of hours of Admin officer time
  scheduling, reminding, re-booking
• Is it value for time?
• YES, and is one of the pillars of our Intern
  program along with Sim Lab training, lecture
  series, group feed-back sessions, skills
  workshops

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Questions?
Manager
DCT