Educational Supervision

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Educational Supervision

• ..an overview
• Nicki Williams Nov 2007

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Based on the job description(Task in pairs)

• What skills do the Ed Supervisors need?
• What knowledge do they need use those skills?

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Todays plan

• Overview of curriculum
• How it connects with assessment
• WPBA quick quiz
• 6 month reviews
• ePortfolio
• Annual Review of Competence Progression Panel.

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The RCGP Curriculum

• With thanks to Dr Ben Riley
• Curriculum Development Fellow
• Royal College of General Practitioners
• author of The Condensed Curriculum Guide

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A calibration quiz...

• How many statements are there in the RCGP
  curriculum?A) 10 B) 15 C) 32
• How long did the curriculum take to develop?A) 1
  year B) 3 years C) 5 years
• What wheat-based foodstuff can the curriculum be
  compared to?A) A loaf of bread B) A bowel of
  spaghetti C) A plate of donuts

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What you need to know

• Where the curriculum came from
• The relationship between curriculum domains and
  nMRCGP professional competencies
• How to access and navigate the curriculum

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Being a General Practitioner

• Core statement based on EURACT and GMP

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The RCGP Curriculum

• A competency based document
• 32 statements
• 10 domains
• 6 core competences
• 3 essential application features
• 1 psychomotor skills

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The 32 Statements

• 1. The 'Core Statement' - Being a General
  Practitioner
• 2. The General Practice Consultation
• 3. Personal and Professional responsibilities (7
  statements)
• 4. Management in Primary Care (2 statements)
• 5. Healthy People
• 6. Genetics in Primary Care
• 7. Care of Acutely Ill People
• 8. Care of Children and Young People
• 9. Care of Older Adults
• 10. Gender-specific Health Issues (2 statements)
• 11. Sexual Health
• 12 Care of People with Cancer Palliative Care
• 13 Care of People with Mental Health Problems
• 14. Care of People with Learning Disabilities
• 15. Clinical Management (10 statements)

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10 Curriculum Domains

• Six Core Competences
• 1. Primary Care Management
• 2. Person-centred Care
• 3. Specific Problem-solving Skills
• 4. A Comprehensive Approach
• 5. Community Orientation
• 6. A Holistic Approach
• Three Essential Application Features
• 7. Contextual
• 8. Attitudinal
• 9. Scientific
• 10. Psychomotor Skills

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The Curriculum Donut
The core statement is like a plain donut with 6
bites
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1. Primary Care Management

• Concepts of health, function, quality of life and
  disease
• Preventative health care
• Managing conditions commonly encountered in
  primary care
• An understanding of cost-efficiency
• Working with an extended team of professionals
• Using the diagnostic and treatment resources
• Integrating and communicating with different
  disciplines

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2. Person-centred Care

• Seeing the patient as a unique person in a unique
  context
• Taking into account patient preferences and
  expectations
• A patient-centred consultation
• Sharing the management of problems with the
  patient
• Resolving difficult issues without damaging the
  doctorpatient relationship
• Continuity of the doctor-patient relationship

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3. Specific Problem-solving Skills

• Adopting a problem-based approach
• Relating problems to the context in which they
  are encountered
• Tolerating uncertainty
• Exploring probability
• Marginalising danger
• Use of time as part of the diagnostic process
• Incremental investigation

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4. A Comprehensive Approach

• Addressing multiple complaints and co-morbidity
• Interpreting health issues and prioritising them
  with the patient
• Reducing risk factors
• Promoting self-care and empowering patients
• Considering the patients personality, family,
  daily life, economic circumstances, physical and
  social surroundings
• Providing rehabilitation and palliative care
• Coordinating care provided by other professionals
  and agencies

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5. Community Orientation

• Taking appropriate responsibility for health the
  community
• Understanding the socio-economic and health
  features of the community
• Considering how health and community issues
  interrelate
• Involvement in the rationing decisions applicable
  to healthcare
• Influencing health policy in the community

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6. A Holistic Approach

• Caring for the whole person in the context of the
  persons values, their family beliefs, their
  family system, and their culture
• Considering a range of therapies based on the
  evidence of their benefits and cost
• Integrating physical, psychological and social
  components of health problems in making diagnoses
  and planning management
• Understanding that holistic care can only be
  interpreted in relation to an individuals
  perception of holism
• Understanding the influence and limitations of
  doctors

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The Curriculum Donut
The core statement is like a plain donut with 6
bites
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The 32 statements

• 1. The 'Core Statement' - Being a General
  Practitioner
• 2. The General Practice Consultation
• 3. Personal and Professional responsibilities (7
  statements)
• 4. Management in Primary Care (2 statements)
• 5. Healthy People
• 6. Genetics in Primary Care
• 7. Care of Acutely Ill People
• 8. Care of Children and Young People
• 9. Care of Older Adults
• 10. Gender-specific Health Issues (2 statements)
• 11. Sexual Health
• 12 Care of People with Cancer Palliative Care
• 13 Care of People with Mental Health Problems
• 14. Care of People with Learning Disabilities
• 15. Clinical Management (10 statements)

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The 32 donuts
Each statement is based on the same core
competences (donut ring) but features a different
topic (topping)
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Every statement tastes different
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Three Application Features

• 1. Contextual
• 2. Attitudinal
• 3. Scientific
• These are the factors that determine how a doctor
  applies their expertise in reality

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Three Application Features

• 1. Contextual
• The context of the patient, the family, the
  community and their culture

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Three Application Features

• 2. Attitudinal
• The doctors values, capabilities, and ethics

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Three Application Features

• 3. Scientific
• A critical and research- based approach to
  practice, continuing learning, and quality
  improvement

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Domain 10 Psychomotor skills

• Examination skills
• Use of equipment
• Procedures
• Assessments
• Other skills

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Curriculum ? nMRCGP

• The curriculum describes the knowledge, skills,
  attitudes and expertise of a competent GP
• The nMRCGP assesses those aspects that can be
  reliably assessed (but alone does not represent
  the entirety of general practice)
• WPBA (e-portfolio) evaluates a doctors progress
  against 12 professional competencies that are
  best tested in the workplace

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12 Professional Competencies

• 1. Clinical management
• 2. Working with colleagues and in teams
• 3. Primary care administration and IMT
• 4. Communication consulting skills
• 5. Data gathering and interpretation
• 6. Making a diagnosis/making decisions
• 7. Managing medical complexity
• 8. Community orientation
• 9. Practising holistically
• 10. Maintaining an ethical approach to practice
• 11. Fitness to practise
• 12. Maintaining performance, learning and
  teaching

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Pin the competency on the donkey
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Curriculum and nMRCGP
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Education and Training

• The 32 curriculum statements
• The 10 curriculum domains

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Performance and Assessment

• The 12 professional competencies

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RCGP curriculum resources

• The Curriculum Map
• Website containing the curriculum
• Mapped to signposted educational resources
• Over 850 resources listed so far...
• http//www.rcgp-curriculum.org.uk

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RCGP curriculum resources

• The Condensed Curriculum Guide
• Official RCGP guide to the curriculum
• Summarises the 32 curriculum statements
• Checklist of the key knowledge and skills
• Gives learning resources and tips
• http//www.rcgp.org.uk/acatalog

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Summary

• The curriculum describes the knowledge, skills,
  attitudes and expertise of a competent GP
• The nMRCGP considers those aspects that can be
  reliably assessed (but does not represent the
  entirety of general practice)
• WPBA evaluates a doctors progress against 12
  professional competencies best tested in the
  workplace, derived from the curriculum domains

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WPBA Quiz (Task in pairs)

• What is being assessed in WPBA?
• What is the point of the 6monthly review?
• What is the format of the 6monthly review?
• What does passing WPBA mean?
• Is a trainee with developmental needs in several
  areas failing?
• What happens if you fail a COT or a CbD?

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WPBA Quiz (Task in pairs)

• Why specify certain tools for gathering evidence?
• What happens if a trainee does not post
  sufficient evidence prior to a review?
• Who/what is the Educational Supervisor and what
  skills are needed for this role?
• How do we ensure the reliability of WPBA across
  Deaneries?

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Your job description!

• Gold guide is available on the MMC website
• http//www.mmc.nhs.uk/download/Gold_Guide_290607.d
  oc
• Chapter 7 deals with educational supervision.
• Appendix 4 has one possible form of the Ed Sups
  Report to be agreed.

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Next Step

• .for the nuts and bolts of how to be an
  Educational Supervisor, please refer to the
  latest version of the Oxford Deanery Guidance (
  version 2 in Nov 2007)