HARROGATE STS INTRODUCTION DAY

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HARROGATE STS INTRODUCTION DAY

• DR RICHARD HALL

11.8.11
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PROGRAMME

• 1215-1300 Lunch
• 1300-1400 Introduction to Harrogate STS
  (Richard Hall)
• 1400-1500 Work Place Based Assessments (Chris
  Walsh)
• 1500-1515 Coffee/tea break
• 1515-1545 Vital facts for ST1s- Dr M Locke
• 1545-1630 Small group work
• 1630-1700 Looking at portfolios-
  introduction

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CONTENT

• Our educational philosophy.
• How to work together and group rules
• Planning your learning
• Assessments
• Communication skills
• E-portfolio
• Some housekeeping matters

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INTRODUCTIONS

• Facilitators Richard Hall and Chris
  Walsh-Harrogate STS
• APD John Hain
• Introductions -all new Harrogate STS trainees
• STS Administrator. Mrs Lisa Adams. Strayside
  Education Centre, Harrogate Hospital. Telephone
  01423 553094. lisa.adams_at_hdft.nhs.uk
• WEBSITE http//www.harrogategpsts.co.uk/

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AIMS

• To consider the statutory educational
  requirements.
• To look at the (hopefully not new to you) concept
  of adult learning.
• Plan your learning-study leave budgets!
• How to engage with the e-portfolio

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Aims - Getting YOU To-

• Start to think about looking after yourself.
• Start to think about the consultation process.
• Consider the organisation of primary care.
• Accelerate learning
• Dealing with uncertainty
• To consider comparisons between primary and
  secondary care.

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PHILOSOPHY

• 3 years isnt long enough to learn all the skills
  and knowledge for a lifetime in practice.
• Some of the stuff you learnt in medical school is
  out of date (most of what I learnt)
• General practice is a lot about rather soft
  knowledge, not so much the hard facts of
  textbooks.

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PHILOSOPHY CONT

• These skills remain constant despite changing
  knowledge and the changes of deckchairs in health
  delivery structures
• A good GP is particularly skilled in higher order
  social skills that revolve around consultation
  and interpersonal skills

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ADULT LEARNING

• The purpose of adult education is to help them
  to learn, not to teach them all they know and
  thus stop them from carrying on learning
• Rogers 1988

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ICE BREAKER

• GETTING TO KNOW YOUR GROUP
• HOPES AND FEARS

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GROUP LEARNING

• Most of the work you will be doing is in small
  groups.
• What skills does this develop?

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Group Rules

• Confidentiality
• Respect
• Listening
• Contributing in a dominant way
• Contributing in a passive way

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Acronym quiz

• AIT
• AKT
• ARCP
• CSA
• WPBA
• DOPS
• COT
• CBD
• NOE

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WHAT IS INVOLVED WITH STS

• REGISTER AIT _at_ RCGP
• GET LOST IN SEA OF ACRONYMS
• ATTEND HDR-80
• KEEP ePORTFOLIO UP TO DATE
• EDUCATIONAL SUPERVISION
• ARCP PANELS
• CONTRACTS
• OOH
• HAVE FUN

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HDR

• Thursday afternoons 2-5pm
• Attendance Mandatory 80 attendance either
  HDH or equivalent approved education.
• If there is no HDR session then you should be in
  practice/ hospital post.
• If you are unable to attend please inform Lisa
  well in advance (as it counts towards your study
  leave)
• Timekeeping/Respect
• Mobile phones Off unless on call.
• Parking

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STUDY LEAVE

• 15 days every 6 months, including HDR.
• Plan ahead and discuss with your trainer /
  clinical supervisor/educational supervisor
• Must be in PDP.
• Must be relevant and local.
• Apply well in advance 4 weeks notice - using
  the forms available from Lisa Adams.
• Remember budget is limited to 400pa-approval TPD
  discretion.

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EDUCATIONAL SUPERVISION

• 1 ES allocated for whole scheme
• Meetings 1 in first 2m
• Then 6 monthly-
• Role of ES
• Guide through WPBA
• Facilitate PDP
• Assess progress to competences
• Report pre ARCP
• Pastoral

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OOH

• 36 hours in 6m
• Book via website-Linda parkinson
  Linda.Parkinson_at_hdft.nhs.uk
• Or Jude Partridge-Judith.Partridge_at_hdft.nhs.uk
• Telephone triage/pcc consults/home visits
• Book sessions early difficult just pre ARCP
• With trainer or approved supervisor or partner of
  practice where work.

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nMRCGP

• Components-
• 1 AKT applied knowledge test
• 2 CSA clinical skills assessment
• 3 WPBA workplace based assessment.

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AKT

• The AKT is designed to test the application of
  knowledge and interpretation of information
• Each question is intended to explore a topic of
  which an ordinary GP could be expected to have a
  working knowledge

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AKT Format

• An evolution from the previous MCQ
• A three hour, 200 item multiple-choice
• Delivered on a computer terminal at an
  invigilated test centre
• Offered initially three times a year Oct/Nov,
  Jan/Feb, April/May
• No limit to the number of attempts
• A pass will be valid for three years only
• Can be attempted at any time during GP specialist
  training (GPST), but most appropriately at end
  ST2-beginning ST3

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Question writing

• Scenarios derived from clinical work
• Practice issues
• Topical
• All questions are referenced and the draft
  questions are then carefully scrutinised by a
  panel of other question writers.
• Remember that all question writers are working
  GPs

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AKT subject content

• Core clinical medicine and its application to
  problem solving in a general practice context
• 80 of items
• Critical appraisal and evidence based clinical
  practice
• 10 of items
• Ethical and legal issues as well as the
  organisational structures that support UK general
  practice
• 10 of items

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AKT Stats May 2011

• Pass mark 69
• Overall pass rate 72.6
• ST2 75 /ST3 81.9 1st time takers
• The mean scores by subject area were
• 'Clinical medicine' 74
• Evidence interpretation 74
• Administration questions 73
• See regular feedback RCGP

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CSA

• Takes place in the NLA Tower in Croydon
• 13 patients all trained simulators of which 12
  scenarios are assessed.
• 10 minute consultations at the end of which
  buzzer will sound 2 minutes then next buzzer
  and new consultation begins
• Patients and assessors come to you
• OK to examine (not intimate examinations!) if
  appropriate. You may be given a card of relevant
  findings

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CSA Continued-

• Bring your own equipment stethoscope, sphyg.,
  patella hammer, auri/ophthalmoscope, PEFR meter/
  mouthpieces etc (typical Drs. Bag and its all on
  the website www.rcgp.org.uk)
• domains assessed data gathering, technical and
  assessments skills, clinical management skills
  and interpersonal skills.
• 4 Grades CP, MP, MF, CF

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CSA Continued-

• Results given via ePortfolios after approximately
  3 weeks as grades of the 12 assessed cases and an
  overall pass or fail.
• 4 sittings per year Feb/May/September and
  November dates on website
• There are periodic Mock CSAs run locally
  either at scheme level or Deanery get your name
  down and have a go!

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Data On CSA-May 2011

• Overall Pass rate 64
• The mean score for the entire cohort was 77.2 out
  of 117
• The pass rate for first time applicants was 77.9
  
• Pass rate 4th time applicants 30
• Pass Rates by Country of Qualification
• UK Graduates 91.6 (AKT-90)
• EEA Graduates 72.0(AKT-65)
• Non EEA Graduates 54.0(AKT-70)

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CSA -marking

• 13 cases
• Each case is marked by a different examiner
• 3 domains-carry equal weight -3 per case
• Data Gathering
• Clinical Management
• Interpersonal Skills
• Total from all 13 cases-no standard-total 117

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CSA-tests the following areas

• Primary Care Management - recognition /management
  of common medical conditions  
• Problem Solving Skills - gathering / using data
  for clinical judgment, choice of examination,
  investigations and their interpretation.
  Demonstration of a structured and flexible
  approach to decision making.
• Comprehensive Approach - proficiency in the
  management of co-morbidity and risk.
•  
• Person-centred Care - communication with patient
  and the use of recognised consultation techniques
  to promote a shared approach to managing
  problems.
•  
• Attitudinal Aspects - practising ethically with
  respect for equality and diversity, with accepted
  professional codes of conduct.
• Clinical Practical Skills - proficiency physical
  examinations and using diagnostic/therapeutic
  instruments

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TOPICS

• ePortfolio
• nMRCGP components
• WPBA/AKT/CSA
• The Curriculum
• HDR
• CONTRACTS
• Educational Supervison
• CSR reports
• ARCP panels-how to prepare
• What is a good log entry
• Consultation skills

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LINKS

• HARROGATE STS WEBSITE-http//www.harrogategpsts.co
  .uk/updates/index.html
• YORKSHIRE AND HUMBER SCHOOL OF PRIMARY
  CARE-http//www.yorksandhumberdeanery.nhs.uk/gener
  al_practice/
• BRADFORD STS-www.bradfordvts.co.uk
• PENNINE STS-www.pennine-gp-training.co.uk

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Finally
Learning Should be fun
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Ideas to cover in small groups

• You will decide !
• Leaders have two roles
• Facilitator Encourage active participation and
  identification of learning needs.
• Expert Experienced GP

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TOPICS

• GP culture v secondary care
• Consultation process
• Difficult consultations
• Role of video
• Adult learning/ Styles
• Hospital jobs
• Half/Day release

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Team building activity

• 40 mins /4 groups
• Design a marketing plan for marketing the
  Harrogate Vocational training scheme.
• Appoint a team leader
• Give a presentation for about 5 mins at end (use
  as many of team as possible-and ensure mix all ST
  groups).
• Target audience FY2s applying for GP Training
• You can use any resources visual aids,leaflets ,
  even song ,dance and humour
• Max points for variety of resources used and
  interest.

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