Teaching and Learning in the New Curriculum Dr Gareth Holsgrove Medical Education Adviser Annual Med

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Teaching and Learning in the New Curriculum Dr
Gareth HolsgroveMedical Education Adviser
Annual Medical Education and Training
ConferenceSeptember 2005
Royal College of Psychiatrists
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Royal College of Psychiatrists

• Background
• PMETB will be the single statutory authority
• Most current postgraduate medical curricula are
  not actually curricula
• Methods and outcomes of PGME are changing
• Working practices are changing

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Royal College of Psychiatrists

• PMETB Standards for Curricula
• Must describe
• Training structure
• Methods of learning, feedback and supervision
• What the learner will achieve

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Royal College of Psychiatrists

• PMETB Standards for Curricula
• Must describe
• Nature, content and methods of assessment
• Assessment is determined by and set out in the
  curriculum
• Assessment must meet PMETB Principles

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Royal College of Psychiatrists

• PMETB Principles of Assessment
• Assessment must be fit for purpose
• Content based on curricula and Good Medical
  Practice, and blueprinted
• Methods must be valid, reliable, psychometrically
  supported and in the public domain

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Royal College of Psychiatrists

• PMETB Principles of Assessment
• Transparent standard setting
• Relevant feedback must be given
• Assessors/Examiners recruited against specific
  criteria, competent and trained

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Royal College of Psychiatrists

• PMETB Principles of Assessment
• Lay input in assessment
• Standardised documentation, accessible nationally
• Adequately resourced

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Royal College of Psychiatrists

• PMETB require that
• Curricula, blueprinting, exam psychometrics etc
  must all be in the public domain

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Royal College of Psychiatrists

• PMETB Standards for Curricula
• Must map to Good Medical Practice

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Royal College of Psychiatrists

• Good Medical Practice
• competency/performance headings
• Good clinical care
• Working with colleagues
• Probity
• Health

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Royal College of Psychiatrists

• Good clinical care
• Providing a good standard of practice and care
• Decisions about access to medical care
• Treatment in emergencies
• Maintaining good medical practice
• Maintaining your performance
• Teaching, training, appraising and assessing
• Relationships with patients
• Dealing with problems in professional practice

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Royal College of Psychiatrists

• 2. Working with colleagues
• Treating colleagues fairly
• Working in teams
• Leading teams
• Arranging cover
• Taking up appointments
• Sharing information with colleagues
• Delegation and referral

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Royal College of Psychiatrists

• 3. Probity
• Providing information about your services
• Writing reports, giving evidence and signing
  documents
• Research
• Financial and commercial dealings
• Conflicts of interest
• Financial interests in hospitals, nursing homes
  and other medical organizations

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Royal College of Psychiatrists

• 4. Health
• A. If your health may put others at risk

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Royal College of Psychiatrists

• PMETB Standards for Curricula
• Rational
• Content of learning
• Model of learning
• Learning experiences
• Supervision and feedback
• Curriculum review and updating
• Equality and diversity

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Royal College of Psychiatrists

• PMETB Standards for Curricula
• Rational
• Content of learning
• Model of learning
• Learning experiences
• Supervision and feedback
• Curriculum review and updating
• Equality and diversity

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Royal College of Psychiatrists

• Curriculum content
• Set out under GMP headings
• Competency based and patient centred
• Competencies set out
• in 3 levels
• in 3 domains
• Developing performance indicated
• Under supervision
• Competent
• Mastery

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Royal College of Psychiatrists

• Curriculum content
• Possible additions
• Stage of training indicated (using colour)
• Importance indicated (using bold and italic)

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Royal College of Psychiatrists

• Performance indicated
• Under supervision
• Competent
• Mastery
• Competent standard for a new consultant
  (from PMETB Standards for Entry to the Specialist
  Register)

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Royal College of Psychiatrists

• Competencies the 3 levels
• Major competencies identified under each GMP
  heading
• Aspects of each major competency identified
• Supporting competencies for each aspect identified

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Royal College of Psychiatrists

• Competencies the 3 domains
• Knowledge
• Skills
• Attitudes

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Royal College of Psychiatrists

• Eg Good Clinical Care
• Major competencies
• Undertake clinical assessments of patients with
  mental health problems
• Use the results of the clinical assessment to
  ensure effective patient management
• Managing emergencies
• Managing chronic illness

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Royal College of Psychiatrists

• Eg Good Clinical Care
• Major competencies
• Undertake clinical assessments of patients with
  mental health problems
• Use the results of the clinical assessment to
  ensure effective patient management
• Managing emergencies
• Managing chronic illness

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Royal College of Psychiatrists

• Major competency
• Undertake clinical assessments of
• patients with mental health problems
• Aspects
• Consultation
• Patient examination
• Patient evaluation and record keeping

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Royal College of Psychiatrists
Major Competency Undertake clinical assessment
of patients with mental health problems
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Royal College of Psychiatrists
Major Competency Undertake clinical assessment
of patients with mental health problems
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Royal College of Psychiatrists

• Aspect Patient examination
• Developing Performance
• Under Supervision
• Assess mental and physical state in patients
  with common conditions

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Royal College of Psychiatrists

• Aspect Patient examination
• Developing Performance
• Competent
• By the completion of their training,
  psychiatrists will be able to perform a
  comprehensive psychiatric assessment in people of
  all ages with mental health problems and mental
  illness

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Royal College of Psychiatrists

• Aspect Patient examination
• Developing Performance
• Mastery
• Assess and diagnose patients with multiple
  complicated pathologies

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Royal College of Psychiatrists
Major Competency Undertake clinical assessment
of patients with mental health problems
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Royal College of Psychiatrists

• Aspect Consultation
• Supporting competencies
• Knowledge (eg apply knowledge of specific
  consultation techniques)
• Skills (eg listen to and understand patients and
  carers)
• Attitudes (eg respect the patient, taking
  cultural, ethical, and economic background and
  its impact into account)

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Royal College of Psychiatrists

• Teaching, learning and assessment
• Will all be predominantly workplace based
• Trainees will be primarily responsible for their
  own learning and assessment
• Will become much better integrated

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Royal College of Psychiatrists

• Teaching, learning and assessment
• Focus will be on 3 key points
• PERFORMANCE
• EVIDENCE
• TRIANGULATION

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Royal College of Psychiatrists

• Performance
• What the Doctor does, daily, in the workplace

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Royal College of Psychiatrists

• Evidence
• Evidence that the Doctor is (or is not)
  performing competently

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Royal College of Psychiatrists

• Triangulation
• Evidence provided
• by more than one person
• (usually) on more than one occasion
• if possible, using different methods

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Royal College of Psychiatrists

• Also
• The distinction between formative (how am I
  doing?) and summative (pass/fail) assessment will
  become less significant
• Evidence will be used for multiple purposes

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Royal College of Psychiatrists

• Evidence will be used for
• Planning progress through the curriculum
• Action plans to support specific needs
• CCT
• Royal College Membership etc

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Royal College of Psychiatrists

• Teaching and learning methods
• observation and modelling
• working as a member of a team that includes
  healthcare professionals, patients, carers and
  other individuals and groups as appropriate
• supervised clinical practice
• case conferences

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Royal College of Psychiatrists

• Teaching and learning methods
• evidence-based review
• significant event review
• participation and presentation at team meetings

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Royal College of Psychiatrists

• Teaching and learning methods
• supervised completion of care plans
• multi-professional case conferences and workshops
• meetings with supervisors

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Royal College of Psychiatrists

• Teaching and learning methods
• attendance at specific courses and workshops
• attendance at professional conferences
• production of poster presentations and
  publications
• guided reading
• internet-based learning

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Royal College of Psychiatrists

• Assessment methods/sources of evidence
• validated self-assessment
• 360 assessment (mini-PAT)
• clinical supervision
• direct observation (mini-CEX and DOPS)
• peer review
• clinical logbook
• clinical audit

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Royal College of Psychiatrists

• Assessment methods/sources of evidence
• significant event review
• case presentations
• review of case notes and other records
• chart-stimulated recall (case based discussion
  CbD)
• video-stimulated recall
• conference and poster presentations, articles,
  broadcasts etc
• papers accepted by peer-reviewed journals

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Royal College of Psychiatrists

• Sumary
• PMETB will be the single UK statutory authority
• PMETB will be responsible for all postgraduate
  medical education standards and QA
• All curricula, assessments and training
  programmes must be PMETB approved

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Royal College of Psychiatrists

• Sumary
• Learning and assessment will become increasingly
  workplace based
• Trainers will be increasingly responsible for
  training and assessment
• Training and assessment will become more
  integrated

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Royal College of Psychiatrists

• Thank you