Transcript Year 3-5 Clinical Teacher Induction Training 2012/13

Welcome to
Clinical Teacher
Induction Training
YEARS 3 - 5
2012/2013
Outcomes of the Session
UNDERSTANDING THE CURRICULUM
To have achieved an understanding of how to:
• assess students’ clinical reasoning skills
• facilitate CLINICAL FEEDBACK sessions
• facilitate PATIENT BASED PRESENTATIONS
• assess students’ IN-VIVO CLINICAL SKILLS
• assess students’ PATIENT ORIENTATED
INTEGRATED STRUCTURED EXAMINATIONS
• assess students’ PROFESSIONALISM
OVERVIEW OF THE
COURSE
Overall Curriculum Design
Years 1 and 2
Years 3 and 4
Year 5
Plymouth
Plymouth
Plymouth
Exeter
Exeter
Torbay
Truro
Exeter
Barnstaple
Clinical
Learning
Clinical
Care
Clinical
Practice
F1
programme
(PRHO)
Year 6
Student Numbers
2012/13
YEAR
EXETER
PLYMOUTH
TRURO
TOTAL
1
102
113
X
215
2
115
103
X
218
3
76
77
65
218
4
74
81
66
221
5
54
47
204
TOTAL
421
178
1076
49
54
Plymouth
Torbay
477
Curriculum Overview
Clinical Learning
Year 1
Year 2
Clinical Care
Year 3
Clinical Practice
Year 4
Year 5
Life Sciences
Clinical Skills
Public Health
Human Sciences
PPD
SSU
SSU
SSU
SSU
Elective
Year 1: Human Life Cycle
Normality
F1
Doctor
Life Cycle
Pathways
Clinical Skills
Clinical Skills
Clinical Skills
Clinical Skills
Community
Community
Community
Community
Clinical Blocks
Clinical Skills
Curriculum Overview
Clinical Learning
Year 1
Year 2
Clinical Care
Year 3
Clinical Practice
Year 4
Year 5
Life Sciences
Clinical Skills
Public Health
Human Sciences
PPD
SSU
SSU
SSU
SSU
Elective
Year 2: Human Life Cycle
Pathology
Life Cycle
F1
Doctor
Pathways
Clinical Skills
Clinical Skills
Clinical Skills
Clinical Skills
Community
Community
Community
Community
Clinical Blocks
Clinical Skills
Curriculum Overview
Clinical Learning
Year 1
Clinical Care
Year 2
Year 3
Clinical Practice
Year 4
Year 5
Life Sciences
Clinical Skills
Public Health
Human Sciences
PPD
SSU
SSU
SSU
SSU
Elective
Year 3: Pathways
F1
Doctor
Acute Care 1
Ward Care
Integrated Ambulatory Care
Life Cycle
Pathways
Clinical Skills
Clinical Skills
Clinical Skills
Clinical Skills
Community
Community
Community
Community
Clinical Blocks
Clinical Skills
Curriculum Overview
Clinical Learning
Year 1
Year 2
Clinical Care
Year 3
Clinical Practice
Year 4
Year 5
Life Sciences
Clinical Skills
Public Health
Human Sciences
PPD
SSU
SSU
SSU
SSU
Elective
Year 4: Pathways
Acute Care 2
Continuing Care
Oncology & Palliative Care
Life Cycle
Pathways
Clinical Skills
Clinical Skills
Clinical Skills
Clinical Skills
Community
Community
Community
Community
Clinical Blocks
Clinical Skills
F1
Doctor
Curriculum Overview
Clinical Learning
Year 1
Year 2
Clinical Care
Year 3
Clinical Practice
Year 4
Year 5
Life Sciences
Clinical Skills
Public Health
Human Sciences
PPD
SSU
SSU
SSU
SSU
Elective
Year 5: Clinical
Blocks
Immediate Care
Medicine
Surgery
Community
Specialty
Life Cycle
Pathways
Clinical Skills
Clinical Skills
Clinical Skills
Clinical Skills
Community
Community
Community
Community
Clinical Blocks
Clinical Skills
F1
Doctor
YEAR 1
• Placements 2 hours x 10 per year in pairs
• Placements help students to take a wide
view of society, people with health
problems and healthcare delivery in the
community
• Problem Based Learning
• Small Group Learning
• Special Study Units
YEAR 2
•
•
•
•
6 x one day placements in pairs
Same GP Practice
2 x Professionalism Judgements
4 x clinical competencies:
•
•
•
•
Observed History
Gastrointestinal Examination
Respiratory System Examination
Cardiovascular System Examination
YEARS 3 & 4
• Developing clinical skills with
underpinning science
• Learning in clinical environments
• Clinical sciences, pathology and
therapeutics are key syllabus areas
• Academic Day
(Year 3 – Monday, Year 4 – Friday)
Structure of Years 3&4
Pathways of Care
Year 3
Acute
Care 1
SSU
9 weeks
Ward
Care
SSU
9 weeks
Integrated
Ambulatory
Care
SSU
9 weeks
Year 4
SSU
Acute
Care 2
9 weeks
SSU
Oncology /
Palliative
Care
9 weeks
SSU
Continuing
Care
9 weeks
Acute Care 1
Year
3
Chest pain
Palpitations
Shortness of breath 1
Abdominal pain 1
Abdominal pain 2
The confused drinker
Thirst
Right-sided weakness
Acute Care 2
Year
4
The sick child
The collapsed infant
The sick adult
Stridor
Abdominal pain 3
Multiple injuries
Shortness of breath 2
Acute severe headache
Ward Care
Perioperative collapse
on the ward
Elective major surgery
Fever in the
postoperative patient
Broken leg
Collapse, falls & funny
turns
Confusion
Deafness
HIV/AIDS/STD
Oncology /
Palliative Care
Lumps and bumps
Haemoptysis & weight
loss
Dysphagia
Haemorrhagic tendency
Breast cancer & wobbly
legs
Abdominal swelling
Agitation, fear &
aggression
The last few weeks
Integrated
Ambulatory Care
Psychoses
Depression
Substance misuse &
self-harm
Pregnancy & labour 1
Pregnancy & labour 2
Day surgery
New baby
The worrying child
Continuing Care
Adult with chronic
disability
Child with special
needs
Joint pain
Non-specific symptoms
Visual disturbance
Raised blood pressure
Rash
Chronic SOB
Monday
Tuesday
Wednesday
Thursday
Friday
Academic Day
Exemplar Clinical Week Year 3
SDL
CPC/SSL
Clinical
Placement
Clinical
Placement
Clinical
Placement
SPORT
SDL
Feedback
Assessments
• AMK
• Clinical skills:
– In-Vivo Competencies
– In-Vitro Competencies
– ISCE
– Clinical Reasoning
• Professionalism - PAs +PPD Judgements
COPY IN PACK
Eligibility to sign PMS Assessments
Aim: To bring uniformity to the grade of staff performing assessments across three localities
Eligibility to sign PMS Assessments
Aim: To bring uniformity to the grade
staff
Yearof
3&
4 performing assessments across three localities
Year 5
Professionalism
Judgements
AHP
x
F1 AHP
x
F2 F1
x
F2
ST1
x
ST1
ST2
x
ST2
Fellow
*
Fellow
ST3
Clinical
In Vivo
ISCE Examiner Professionalism Patient-based
POISE
Practical Skills
Year 3 &
4
Year 5
Reasoning
Competencies
(Year 2&4)
Judgements
Presentations
Competencies
Professionalism
Clinical
In Vivo
ISCE Examiner Professionalism Patient-based
POISE
Practical Skills
Feedback
Judgements x Reasoning
Competencies
Judgements
Presentations
Competencies
Obs and Gynae x(Year 2&4)
x
x
x
Feedback
only
2
1
Obs
x
x x
x
x
xx
x and Gynae x x
x
x
only
2
1
1
x
xx
x x
x x
x
x
xx
x
x
1
1
x
x
x
x
x
x
x
x
x
x
x
x
x
1
1
x
x
x
x
x
x
x
x
x
x
x
x
x
1
1
x
x
x
x
x
x
x
x
x
1
1 see notes
1
3
3
3
x3
x
*
1 x see notes
x
x
ST3
x
ST4
x
ST5
x
ST4
ST5
x
x
Staff
Staff
Grade
Grade
Associate
Associate
Specialist
Specialist
Consultant
Consultant
/ GP
/ GP
11
22
33
4
4
x
x
NOTES
3
x
3
x
**see
notes
see notes
3
**see
notes
see notes
3
3
3
x
3
x
3
3
3
3
x
x
x
3
3
x
x
x3
x3
x
1
1
x
x
x
1
3
x
3
x
x
3
3
1
3
1
1
1
11
44
4 4
4
4
4
4
4
4
4
4
1
1
11
44
4 4
4
4
4
4
4
4
4
4
1
1
11
44
4 4
4
4
4
4
4
4
4
4
1
1
Eligible to
to sign
if personally
competent
to undertake
the procedure
themselves
Eligible
sign off
offthese
theseassessments,
assessments,
if personally
competent
to undertake
the procedure
themselves
Eligible to
to sign
if PMS
trained
and and
personally
competent
to undertake
the procedure
themselves
Eligible
sign off
offthese
theseassessments,
assessments,
if PMS
trained
personally
competent
to undertake
the procedure
themselves
Specialist
Trainees:
required to required
attend PMS
trainingPMS
to betraining
eligible to
off these
ST4
and above
or equivalent:
to attend
to sign
be eligible
toassessments
sign off these assessments
Consultants, Associate Specialists and Staff Grades: required to attend PMS training to be eligible to sign off these assessments
Consultants, Associate Specialists and Staff Grades: required to attend PMS training to be eligible to sign off these assessments
Ineligible to sign these assessments
Ineligible to sign these assessments
NOTES
1.*Fellows, ST4 and ST5 doctors must only be used for Clinical Reasoning feedback sessions in an emergency, up to a maximum of twice per year, per
1.*Fellows,
ST4 and above or equivalent doctors must only be used for Clinical Reasoning feedback sessions in an emergency, up to a maximum of
pathway week.
twice
year, per
pathway
week. or fail grade the repeat attempt must be undertaken by a permanent member of staff
2. Ifper
a student
receives
a borderline
2. If
receives
a borderline
or must
fail grade
the repeatbyattempt
3. a
Allstudent
assessments
in General
Practice
be undertaken
a GP must be undertaken by a permanent member of staff
4. Training
is not essential
for Year
3&4 must
Professionalism
Judgements,
3. All
assessments
in General
Practice
be undertaken
by a GPhowever Year 5 Professionalism Judgements require that the assessor be Year
5 trained. is not essential for Year 3&4 Professionalism Judgements, however Year 5 Professionalism Judgements require that the assessor be Year
4. Training
5. From September 2010 assessments which require that the assessor is trained will be deemed invalid if the assessor has not undertaken the required
5 trained.
training.
5. From
September 2010 assessments which require that the assessor is trained will be deemed invalid if the assessor has not undertaken the required
training.
Summative & Formative
Assessment
• Understanding the need and the difference
• Summative means a ‘marked assessment’ –
pass or fail
• Formative assessment is a learning
opportunity after delivering a judgement on
the quality of the behaviour
• All summative assessments should contain an
element of formative / learning in the clinical
setting
• Summative assessments go towards the
student’s final score
Applied Medical Knowledge (AMK) –
The Progress Test
(from PCMD assessment unit)
Clinical Skills
• In vivo Clinical Competencies x 12
per year – formative in year 3 and
summative in year 4
• Summative ISCE at end of year 4
• Clinical Reasoning – “Feedback”
SEE PINK FORMS IN PACK
In Vivo Competencies
Years 3 & 4
In vivo Competencies
•
•
•
•
12 competency assessments per year in yrs 3&4
ALL 12 must be completed
Observed process
15 minutes per student
– 8-10 for intro & examination
– 5-7 for explanation of findings & differential
• Ideally timetabled during a defined pathway week
• ST4 doctors & above to assess (exception: O&G
midwife)
In vivo Competencies
• Paperwork is student’s responsibility
• Written feedback on the form is essential
• From 2010/11 Form includes Professional
Judgement (year 4)
“Global judgement of the observed professional
behaviour demonstrated by student.”
• First attempt, remediation then second attempt
must be undertaken by relevant PCMD staff
(Benchmarking later today)
The Systems
•
•
•
•
•
•
CVS
GI
Respiratory
Musculoskeletal
Neuro – cranials
Neuro - periph
•
•
•
•
•
•
General / skin
Swelling / mass
Assessment of child
Pregnant woman
Mental State Exam
Observed History
See handouts for which departments assess in each year
Year 3
• Formative
• Feedback only
• Learning experience
Year 4
• Summative
• Have 2 attempts only
Problems
• Student misses the week
• Extenuating Circumstance (EC) does NOT cancel
the competency out. Student must complete this.
• Assessor away
• Undertaken by other trained assessors within
department
• Rearrange
• Clinical Skills Co-ordinator (last resort)
• Student loses paperwork
• Their problem!
Why?
Progression
• Formative • Summative • POISE
• Mini CEX
• MRCP etc …
Year 3
Year 4
Year 5
F1 / F2
In Vivo Clinical Competency
Benchmarking
http://eres.pcmd.ac.uk/elsg/benchmarking/in-vivo
Clinical Placements
and Feedback
• Clinical placements / seeing patients
• Case presentation and feedback
2 hours
ETHOS
LEARNING AROUND PATIENTS !
‘Sitting and watching…..is a lot less
useful than ‘doing’ and receiving
feedback on performance’
Bligh 2002
SEE BLUE FORMS IN PACK
The Clinical Feedback Session
• A two hour session at the end of each
week
• Protected time with 2 or 3 students
• Develop clinical reasoning skills via
– Case presentations
– Feedback and assessment
• Identify learning needs for students
Preparation / Attendance
• Failing to attend/prepare for the session is
a professionalism issue
• Please report non-attendance (without EC)
or failure to prepare for the session to the
Undergraduate Office
What are your experiences
of Students’ Presentations?
Clinical Reasoning
‘Encourage students to think about the data
they collect during history taking and relate
it to understanding the patient’s problem’
Nendaz. M.R., & Bordage, G., (2002) Medical Education, 36, 760-766
Promoting Diagnosis Reasoning
• Commit to working diagnosis early
• Co-select: gather data with working diagnosis in
mind
• Focus on the discriminating features
• Summarize the big picture: build an abstracted
problem representation
• Encourage students to express uncertainties:
disclosure without blame
THE MECHANICS
What would YOU want to
hear first when a patient is
presented ?
Clinical Method
‘The student should practice the
art of presenting the leading
features in a few sentences’
Hunter, D. & Bomford, R.R., (1968), Hutchinsons Clinical
Methods, p1., London, Bailliere Tindall & Cassell
Clinical Reasoning Assessment
•
•
•
•
•
•
•
•
•
•
•
•
Summarising statements
Differential diagnosis
History & Examination
Demonstration of relevant clinical skills
Understanding of investigations
Areas of uncertainty
Patient centred issues
Behaviour consistent with Good Medical Practice
Management Plan and treatments
Links to prior learning
Identification of Learning Needs
Attendance & engagement with clinical learning process
Clinical Reasoning Assessment
• As from September 2011 will be formative
for both years 3 & 4
• Formative nature of the session
• Detailed written feedback on the form
– Areas of good practice
– Areas for improvement/development
– Agreed action plan
• No grades given
Year 3 & 4 Good Practice
• Ideas from QA visits of Clinical Reasoning
sessions:
• Linking presentation to basic sciences
• Highlighting patient centred/social/ethical
issues
• Appropriate learning environment
• Reviewing patients when possible
Why have Professionalism
Judgements?
• Conforms to GMC Good Medical Practice
• Encourages students to develop appropriate
•
•
•
professional behaviour
Monitors actual behaviour in the clinical
environment
Identifies students who need additional help
and remediation
Provides a structure for constructive feedback
SEE CREAM FORMS IN PACK
Professionalism in Years 3 & 4
•
•
•
•
•
•
•
By GP supervisors x 3 per year
SSU supervisors x 4 per year
Small Groups x 2 per year
Clinical Skills x 2 per year
One from each Pathway x 3 per year (not GP)
Portfolio analysis x 2 per year
Elective Advisor after elective proposal
Summary of Year 3 & 4
Professionalism Judgements
Year of Study
No. of Summative
Judgements
Assessed by:
4 x SSU Providers
3
12
2 x Small Group Providers
3 x GP Week Provider
3 x Clinical Week Providers
4 x SSU Providers
2 x Small Group Providers
4
30
3 x GP Week Provider
3 x Clinical Week Providers
12 x In vivo Competency Assessors
6 x ISCE Station Assessors
Professionalism Judgements
• Provide feedback about student behaviour
– At regular intervals
– In a variety of settings
– By multiple observers
• However
– Students may perform for the assessment
– We hear of other examples of poor or very
good behaviour
– We need to document these in order to
provide feedback or take action where
necessary
On-the-Spot Feedback
An opportunity to identify exceptional
behaviour and provide feedback to
students and the School
The aim of on-the-spot feedback
• To encourage good professional
behaviour and modify poor professional
behaviour
• To record exceptional behaviours
• Provide timely feedback about this to
students
• Develop a process for dealing with this,
where necessary, as a School
Process for this
• Forms to be available in locality offices
• When exceptional student behaviour is
identified feedback will ideally be given
directly to student
• Form to be completed and returned to
locality office
• Associate Dean to decide appropriate
action
On-the-Spot Feedback
• In order to capture this information each student
will now be allocated an extra Professionalism
Judgement based on this feedback and awarded
by an expert Panel of the Associate Deans and
Lead for Professionalism.
• If no On-the-Spot feedback has been awarded a
student will automatically be awarded a
“satisfactory” but in the light of the On-the-Spot
feedback the Panel may award “excellent”,
“borderline” or “unsatisfactory”. The same rules of
progression will apply to the module.
Student Selected Component (SSC)
• 30% of the course
(GMC Tomorrow’s Doctor)
• Consists of regular Special Study
Units (SSU)
• Elective in year 5
Special Study Units (SSUs)
• Special Environment – 3 of them
during years 3 & 4 (3 weeks each)
• Doctors as Service Planners and
Managers Year 3 (2 weeks)
• Working together for patients Year
3 (2 weeks)
Longitudinal SSUs
•
•
•
•
•
•
Year 4 – 3 of them run across the year
Doctors as Teachers
Medicine an Art? – “humanities”
Research in Action
Total of 6 weeks
One day conferences for Doctors as
Teachers and Medicine an Art? - April
Year 5 SSC – The Elective
• At the beginning of year 5
• 8 weeks duration
• Planned during year 4 – with
assessment to ensure appropriate
and safe
• Mostly taken abroad
• Elective write up by student, report
from “host” organisation assessed
YEAR 5
Year 5
• 5 clinical blocks of 6 weeks
– Immediate Care
– Community
– Specialties
– Medicine
– Surgery
Clinical Component
Year 5
Peninsula Medical School – Year 5
Intensive clinical
experience
Medicine
Surgery
Immediate
Care
Community
Specialties
Clinical Impact
• Funding covers 30% reduction in
patients seen
• Time required for POISE, PBP and
microteaching
Working with Clinical Team
•
•
•
•
•
•
Ward Round
Admissions
Outpatients
Ward/GP Work
Theatres
Multi Disciplinary Team Meetings
Teaching Clinical Placement
•
•
•
•
“Same concept/impact” as years 3 & 4
Ward Round
Outpatients
Specific GP Surgery
Peninsula Medical School – Year 5
Culminating in a week
“Professional Practice”
Medicine
Surgery
Immediate
Care
Community
Specialties
Student Assistantship/
Professional Practice Week
• Follows on from the 5 weeks of the
Clinical Block i.e. a sixth week
• “Acting up” under supervision
• An explicit change of role for the
student – PMS version of
“shadowing”
• Practice “doing the job”
• Demonstrate Good Medical Practice
(professionalism)
Student Assistantship/
Professional Practice Week
• Students should particularly use this
week to document clinical skills
performed and list the activities they
have performed as a member of the
team (this will be communicated to
students)
• Evaluation of this week is ongoing
Peninsula Medical School – Year 5
Supporting Academic
Programme
Medicine
Surgery
Immediate
Care
Community
Specialties
Discipline Overview
Small Group
Therapeutics
Clinical Skills
Public Health
Pathology/Radiology
Supporting Academic Programme
• Wednesday am during Clinical Blocks
• An integrated programme
• “Master-classes” in pathology, radiology,
public health, therapeutics, medicine/
surgery etc overview, clinical skills
• Block specific i.e. medical topics whilst in
the medicine block
Small Group Learning
•
•
•
•
All students
Every year
Facilitated groups of 8-11 students
Explore students development and
professional growth
• Specific topics – e.g. ethics, public health
Medicine
Supporting
Academic
Programme
for the
Medicine
Block
Week 1
Clinical Skills
Small Group
Small Group
Clinical Skills
Week 2
Pathology/Radiology
Medicine Overview
Week 3
Public Health
Small Group
Week 4
Week 5
Therapeutics
Clinical Skills
Clinical Skills
Therapeutics
Medicine Overview
Therapeutics
Peninsula Medical School – Year 5
With rigorous, authentic
assessment of clinical capability
Surgery
2x
POISE
2x
Patient
based
Immediate
Care
2x
POISE
2x
Patient
based
Community
2x
POISE
2x
Patient
based
Specialties
2x
POISE
2x
Patient
based
Discipline Overview
Small Group
Therapeutics
Clinical Skills
Public Health
BLS and ALS competencies
2x
Patient
based
In vivo practical skills competencies
Medicine
2x
POISE
Pathology/Radiology
Assessment Overview – Year 5
• 4 Progress Tests (Applied Medical Knowledge)
• 8 summative Patient Based Presentations– like a
Foundation Programme “Case Based Discussion (CbD)”
• 8 POISE assessments (summative) – like a “Mini CEX”
• Practical Skills Log – evidence of competencies required
in Tomorrow’s Doctors
• 5 Professionalism Judgments (with multi-professional
feedback)
• 5 “progress reviews” by the Academic Tutor (AT) with a
summative portfolio analysis at the end of block 4
• Assessment of the student’s elective report
• Maintain a Clinical Log of all significant patient
encounters – monitored by AT via ATLAS
• No finals! – award board after block 4
SEE BLUE FORM IN PACK
Patient Based Presentations (PBPs)
• One session per week
• Multi-source feedback – peers, clinical
teacher
• In week one of the first clinical block only
practice assessment occurs
• Then 2 summative assessments per
student during the remainder of the block
Patient Based Presentation
(Structured Clinical Session)
How it Works in the Medical Block
•
•
•
•
•
Week 1 Cardiology
Week 2 Respiratory
Week 3 Endocrinology
Week 4 Gastroenterology
Week 5 Renal
Exemplar Cardiology Patient Based
Presentation
Clinical Teacher
Cardiology Consultant
Cardiology Student
He/She is the “Organising student”
and finds patients, collates feedback,
organises sessions – runs the show!
Does not present.
Respiratory Student
Clerks Mr A who has cardiac failure
Endocrinology Student
Clerks Miss B who has had an MI
Gastroenterology Student
Clerks Mr C who has an arrythmia
Renal Student
Clerks Mrs D who has aortic stenosis
Patient Presentations
•
•
•
•
Clinical Teacher selects which patients to visit
Visit at least 3 patients
Student presentations
Demonstrate clinical reasoning, clinical skills
and “behaviour consistent with Good Medical
Practice”
• Patient based discussion – at the bedside if
appropriate
• Student provides assessment forms and
hands in.
SEE PINK FORM IN PACK
Patient Orientated Integrated
Structured Exam (POISE)
• Builds on years 3 & 4 “in vivo” competencies and
links to F1 assessments – the mini CEX
• CVS, Resp, GI and Neuro are core with 8 others
available of which 4 must be assessed
• Assessors must have attended this or similar
training session (see forms in pack)
• 2 POISEs (1st attempt) per block and 2 by any
single assessor during the year
• Students to perform 8 POISEs by the end of the
fourth block
Key Issues in PBP & POISE
•
•
•
•
•
•
See BMBS Assessment Summary Booklet (in pack)
POISE only by PMS trained assessors (ST4 + above)
PBP’s only by PMS trained Consultants
Satisfactory grade = Competence of new F1
2 x Unsatisfactory/Borderline = Fail
2nd attempts must be in same system (POISE) /
department (PBP) and undertaken at least 1 week
later, following remediation
FORM IN PACK
Practical Skills Competencies
• An ongoing assessment of “in vivo”
competencies – building on years 3 & 4
• Assessed by any competent practitioner
• Competencies include cannulae, PEFR,
ABGs, drug dose calculation, catheterisation
• Checked during “Progress Review” with
Academic Tutor
• New for 2010/11 – 18 skills all assessed
once.
SEE CREAM FORMS IN PACK
Year 5 Professionalism
Judgements
• 1 per block i.e. 5
• Summative judgement by clinician at end of
professional practice week
• Supported by 360 degree formative feedback
from the clinical team - end of week 3
• “Do they have the professionalism to be an
F1?” - yes/no/maybe
Year 5 Professionalism
Judgements
• These are of a different quality to other judgements
and will now carry more weight than a normal
Judgement.
• A “maybe” and “no” will lead to 2nd level remediation
by the Associate Dean or representative and will carry
the same consequences as an “unsatisfactory”
judgement in the module.
• If a student is given a “maybe” or a “no” in 2 of the 5
blocks this will result in failure of the module and may
prevent the successful completion of the year.
Summary of Year 5
Professionalism Judgements
No. of Summative Judgements
Assessed by:
5 x Block Leads
17
8 x POISE
2 x Small Group Providers
2 x Clinical Skills Staff
POISE (added to the form for 2010/11):
“Global judgement of the observed professional behaviour
demonstrated by student”
Unsatisfactory / Borderline / Satisfactory / Excellent
Year 5 Exemplar Week –
Secondary Care
AM
PM
Monday
Tuesday
Wednesday
Thursday
Friday
Working
with Clinical
Team
Patient
Based
Presentation
Supporting
Academic
Programme
Teaching
Clinical
Placement
Working
with Clinical
Team
Working
with Clinical
Team
Working
with Clinical
Team
MDT
Meeting
Working
with Clinical
Team
SPORT
Working
with Clinical
Team
Year 5 Exemplar Week –
Primary Care
Monday
AM
PM
Tuesday
Wednesday
Thursday
Friday
Surgery
Community
Hospital
Pharmacy
Supporting
Academic
Programme
Diabetes
Clinic /
Visits /
Chronic
Patients
Surgery /
Joint
Surgery
Surgery
Follow up
patients in
and out of
Hospital
SPORT
Surgery
Audit /
Tutorial
Parallel Surgery
Time
Doctor
Student
Time
Doctor
Student
0900
Patient A
Patient B
0930
Patient D
Patient E
0910
Patient C
0940
Patient F
0920
Discuss Patient
B
0950
Discuss Patient
E
Together
Together
Learning Outcomes for the
Community Block
• Working with the team, seeing patients
• Follow patient pathways through
episodes of hospital care
• Assessment of clinical skills and
professionalism
• Participate in chronic disease
management
• Video consultation (FLIP)
ALL YEARS
Clinical Log
Significant Cases
Indicative Presentations
•
•
•
•
185 presentations
Single page, unified format
Points students towards “ideal” presentations
Forms the backbone of the Year 5 learning
materials
• Gives “alternatives” to Year 3 and 4 trigger
presentations
• Electronic links to prior learning
Educational Support Academic Tutors
• One Academic Tutor per student who
changes each year
• They oversee academic progress
• Assess portfolios and in year 5 the
elective report
• Refer students to the “learning support
team” if a student is struggling/failing
Some Key Points on Remediation
• Patient safety concerns: contact Clinical
Sub-Dean
• 1 x Unsatisfactory or Borderline grade student to discuss with Academic tutor
• 2 x U/B - either Director Clinical Skills
or Locality Clinical Skills Coordinator
• Remediation team
Pastoral Support
• Pastoral tutors – a team at each locality
with “informal” access by students
• “Signposting” of students with more
complex issues to support agencies
• Counsellor available in all localities who
is a university appointee and accessed
by appointment
Electronic Resources
• Managed learning environment (EMILY)
• Electronic support for the trigger presentations and
clinical learning
– Images (clinical, radiological, pathological, etc)
– CD ROMs, DVDs
– Powerpoint presentations
– Downloadable handouts
– Interactive sites
– Useful weblinks
– Structured feedback
If you would like access/training please contact Hannah Poole
https://emily-pcmd.plymouth.ac.uk
Discussion/Questions