Orthopaedic Competence Assessment Project

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OrthopaedicCompetenceAssessmentProject

• Using the tools
• David Pitts
• d.pitts_at_rcsed.ac.uk

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OCAP Mission

• Improve the quality of HST in orthopaedics
  through the introduction of a competence based
  portfolio of coaching and assessment tools

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This Presentation

• Overview of system tools
• Trainer profile
• Learning Agreement
• Procedure Based Assessments
• Records
• Coaching

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Coaching, Assessment Recording Tools
Knowledge
Assessment
Trainer Profile
Learning Agreement
Evidence
Procedures
Coaching
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Features
Knowledge
Trainer Profile
Procedures
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Features
Knowledge
Trainer Profile
Procedures
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Features
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Overview
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Coaching, Assessment Recording Tools
Knowledge
Assessment
Trainer Profile
Learning Agreement
Evidence
Procedures
Coaching
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Meeting 3
Completed PBAs
Consolidation Sheet
PBA
Meeting 2

• Only 3 pieces of paperwork
• All will become electronic in time

PBA
Meeting 1
Entire process driven by trainee
Learning Agreement
Trainer Profile
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Developing a Trainer Profile
Knowledge
Trainer Profile
Procedures
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What I do (Procedures)
In collaboration with Trainee
What you need to know about what I
do (Knowledge)
Supported by Templates
One time only!
What you need to know about me (CV)
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Trainer Profile 1Procedures
Tools in detail

• Procedures map
• Based on e-logbook
• Template on CDROM
• Add your name
• Delete inapplicable
• Add whatevers missing
• Comprehensive?
• Willing to teach?
• Save as new file

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Trainer Profile 2Knowledge
Tools in detail

• Knowledge map
• BOA syllabus
• Template on CDROM
• Add your name
• Delete inapplicable
• Delete rows, backspace!
• Add anything missing
• Develop over time!

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Trainer Profile 3 Mini-CV
Tools in detail

• CV (brief)
• Build relationship
• Communicate expectations of Trainees
  performance, behaviour, attitude
• Samples on CDROM
• Add your name
• Add photograph
• Cut paste
• Save as new file

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Using a Trainer Profile
Knowledge
Trainer Profile
Procedures
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1. Using the CV

• Build relationship
• Communicate expectations
• Performance
• Behaviour / conduct
• Attitude
• Being a surgeon is more than doing surgery

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2. Using the Procedures profile
1st year trainee
4th year trainee
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3. Using the Knowledge profile

• 1 Knows of
• 2 Knows basic concepts
• 3 Knows generally
• 4 Knows specifically broadly
• BOA syllabus
• Not the exam!
• To help trainee make progress
• Guide reading/study

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This Presentation

• Overview of system tools
• Trainer profile
• Learning Agreement
• Procedure Based Assessments
• Records
• Coaching

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Meeting 3
Learning Agreement
PBA
End of attachment summary
Meeting 2
PBA
Progress Review
Meeting 1
Agenda Setting
Each meeting 20 minutes?
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Meeting 1

• Review materials completed by trainee beforehand
• Tick boxes
• Sign form
• Length/depth of discussion how much you write
  is up to you

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Meeting 2

• Provide feedback to trainee
• Review feedback already given in theatre or
  assessments
• Tick boxes
• Agree actions
• Sign form

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Meeting 3

• Trainee completes reflection beforehand (detail
  up to you)
• Trainer trainee agree progress
• Tick boxes
• Sign form

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This Presentation

• Overview of system tools
• Trainer profile
• Learning Agreement
• Procedure Based Assessments
• Records
• Coaching

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Results entered onto PBA summary sheet
Meeting 3
PBA
Individual sheets signed and kept in portfolio
Meeting 2
PBA
Triggered by Trainee or trainer
Meeting 1
Agree which ones (all or part) at first meeting
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Current PBAs (01 03 05)
Tools in detail

• Mini-PBA (DOPS)
• Closed mgt of
• Clinic activity in TO
• Debridement of wound
• Hand
• Carpal tunnel decompression
• Digital and palmar fasciectomy
• Knee
• Diagnostic arthroscopy simple arthroscopic
  procedures
• Total knee replacement
• Foot
• 1st ray surgery
• Hip
• Total hip replacement
• Spine
• Lumbar discectomy

• Generic
• template
• Trauma
• Compression hip screw intertrochanteric fracture
  neck of femur
• Hemiarthroplasty intra capsular fracture neck of
  femur
• Application of limb external fixator
• Operative fixation Weber B ankle fracture
• Fixation by tension band wiring, olecranon
  patella
• Intramedullary nailing femoral or tibial shaft
• Tendon repair
• In development
• Upper limb
• Paediatric

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Performance Based Assessments
Tools in detail

• Triggered
• Trainee or trainer
• Objective
• Passed / To be improved
• Indicative
• Formative individually
• Summative as whole collection

• Common format
• Consent
• Preoperative planning
• Preoperative preparation
• Exposure closure
• Intra operative technique
• Post operative mgt

Users Guide on website
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Example THR

• Trainee has forms beforehand (no surprises)
• Trainer agrees to the PBA (patient, trainee etc)
• Trainee conducts procedure observed by trainer
• Usually scrubbed
• Trainee verbalises, explains what intentions are
• Trainer steps in as/where necessary
• Forms completed and feedback given immediately
  after procedure

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This Presentation

• Overview of system tools
• Trainer profile
• Learning Agreement
• Procedure Based Assessments
• Records
• Coaching

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Learning Agreement
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PBA Consolidation sheet
Tools in detail

• For discussion at RITA
• Must be presented on request
• Compares scores across PBAs
• Evidence of Learning
• Trainee updates as attachment progresses
• Brings to meeting 2 3

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Final summary PBA Consolidation sheet(2 sides)
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Portfolio Checklist

• Weekly timetable for attachment SAC
• Details of on call rota
• Trainer CV (from trainer portfolio)
• Procedures Profile (original, signed)
• Knowledge Profile (original, signed)
• Learning Agreement agendas (original, signed)
• All individual assessments completed (original,
  signed)
• In-house educational programme (with note of
  sessions attended)
• Evidence of activity on audit/research project
• Details of significant events (to include
  clinical and professional incidents (and
  outcomes))
• Details of absences from training post

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This Presentation

• Overview of system tools
• Trainer profile
• Learning Agreement
• Procedure Based Assessments
• Records
• Coaching

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Personal Effectiveness

• Mindmap
• Viewer software free via website

• Positive negative behaviours
• Facilitates feedback

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This Presentation

• Overview of system tools
• Trainer profile
• Learning Agreement
• Procedure Based Assessments
• Records
• Coaching

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Overview