SAS Tutors Development

Developing a safe Learning Environment

The wider Role of the SAS Tutor Yohanna Takwoingi, SAS Tutor Rep, NACT UK Council Liz Spencer, Clinical Tutor, Education Adviser, NACT UK Claire Mallinson, DME, Chair NACT UK 3 October 2014

Objectives

• Identify ways that SAS doctors can influence the culture of the workplace • Ingredients for a learning environment • Define the role of the SAS Tutor moving forward • Engaging with the wider faculty • And what else………?

The journey to becoming a value-based leader starts with self-reflection. If you are not self reflective, how can you know yourself?

If you do not know yourself, how can you lead yourself?

If you can not lead yourself, how can you lead others?

In pairs discuss

• Greatest Achievement this year • What do you want from today

What is the role of SAS Tutor now ? Why did/does the DH give you money ?

SAS Doctors Past

Failed, demoralized, underpaid….

Present

“Hidden heroes of the NHS”, Herculean contribution to patient service

Future

Our role in modern NHS times

You can’t have better tomorrow if you are thinking of yesterday all the time

CPD for all

Options for SAS development

• Clinical – CESR – Subspecialise – Service improvement – Change to new specialty / subspecialty • Non-clinical – Trust Appraiser or mentor – LNC rep, Trust committee, League of Friends – Management role in dept eg induction lead, audit lead – Education – undergrad, Foundation, journal club, teaching – Education / Clinical Supervisor • Go part-time – Set up a business, sheep farm, GMC/BMA role – Medical writing, medico-legal, pharma – Charity work • Do stuff outside work

working on behalf of Your Role in Supporting SAS to Manage their Careers Katharine Hankins

Developing people for health and healthcare

The power of the role model?

Clinical knowledge ?

Think of Examples ?

Team leading Skills ?

Role Model

Practical skills ?

Personality Temper ament ?

Developing people for health and healthcare

working on behalf of

etc

Workplace Learning Culture

Liz Spencer Consultant Anaesthetist Clinical Tutor for Professional Development, Glos Hospitals Education Adviser NACT UK “..the community within which students and novice staff engage in the clinical setting directly influences how students and novices perform their practice, make sense of their knowledge, and contribute to safe and contemporary care.”

(Egan & Jaye 2009).

Outcomes

1. Place patient safety & patient care central in medical training / CPD 2. Your role in creating a safe learning environment 3. Clinical Learning – engagement & opportunity 4. Candour in our relationships with our team

Candour

the quality of being open and honest; frankness.

honesty, candidness, truthfulness, sincerity, forthrightness, directness, lack of restraint, straightforwardness, plain spokenness, plain dealing, plainness, calling a spade a spade, unreservedness, bluffness, bluntness, outspokenness; telling it like it is "he spoke with a degree of candour unusual in political life" antonyms: guardedness, evasiveness, insincerity

2013

• • • Francis Report – Feb 2013 Keogh Report – July 2013 Berwick Report – Aug 2013

Place the quality of patient care, especially patient safety, above all other aims, Engage, empower, and hear patients and carers at all times Foster whole-heartedly the growth and development of staff, including their ability and support to improve the processes in which they work Embrace transparency unequivocally and everywhere, in the service of accountability, trust, and the growth of knowledge

Culture will trump rules, standards and control strategies every single time …… … achieving a vastly safer NHS will depend far more on major cultural change than on a new regulatory regime Berwick 2013

Importance of positive interactions, sharing experiences and learning …culture of learning and improvement Culture – “the ways things are done round here.”

What are we cultivating?

• • What is a good learning environment List 3 essential ingredients for positive learning culture in the workplace • Pairs / small groups 3 minutes

Successful Learning Environments

Inspirational Leadership

Open, trusting, OK to ask & reflect

Effective Management

• Appropriate rota Time for discussion Task focused to Behaviour focused • • • Role-model Professional Knowledge Evidence of proficiency Consistent behaviour Assist staff to integrate induction Released for training Feedback, discussion & support (supervisor)

Positive Partnership

Between healthcare providers & tertiary institutions Clear definition of roles & expectations Multiprofessional team know what is needed & their role to engage with novices HENDERSON A., BRIGGS J., SCHOONBEEK S., & PATERSON K. (2011) A framework to develop a clinical learning culture in health facilities: ideas from the literature. International Nursing Review 58, 196–202

www.nact.org.uk

Faculty Guide

A doctor in both foundation and specialty training should

be a valued member

of their multi-professional team, and

be responsible

carers with whom they interface during the working day. for providing high quality and safe clinical care to the patients, relatives and To maximize the learning from these clinical encounters

all members of the clinical team are involved

encouraging discussion. , both individually and collectively, in observing performance, advising, teaching, giving feedback and The culture within the workplace environment is key to the safe and successful learning of all learners. All doctors, nurses and allied health professionals have a

professional duty

to support and develop colleagues of their own and other professions, particularly students, less experienced staff and those new to the department. This role should be clarified and discussed in annual appraisal for all staff.

It is through doing, and the opportunity to deliberately reflect, that we develop ideas, understanding and learn more about practice

(Higgs & Titchen 2001)

If staff are to feel a sense of comfort and connectedness with the work environment, the work context must be free from bullying and immediate threatening behaviors

(Murray, 2009)

. Equipping staff to recognize bullying and providing them with strategies to address this problem is essential because bullying behaviors undermine learning. Students should be prepared to deal with bullying behaviors

(Levett-Jones & Lathlean, 2009).

Pearson DJ, Lucas BJ. 2011. Engagement and opportunity in clinical learning: Findings from a case study in primary care Medical Teacher;33: e670–e677

Developing a learning culture: twelve tips

1.

2.

3.

4.

5.

6.

7.

8.

Value and recognize the need for lifelong learning Energize active learning amongst students Develop self-awareness Be open to new ideas Make time for learning Teams should provide protected time for learning Develop a shared team, departmental or organizational vision Take time out to build the team 9.

Develop leadership skills 10. Learn from mistakes 11. Think about the wider environment 12.

‘Take time to smell the roses’ Stinsin L, Pearson D, Lucas B. Medical Teacher, Vol. 28, No. 4, 2006, pp. 309–312

“Leaders …..have a crucial role to play in shaping a positive culture…” Berwick August 2013 We all need to work at it all of the time.

Leadership Behaviours

“There are attending physicians who take the time and are prepared to discuss something even in stressful situations and who are willing to accept suggestions from subordinate doctors. There are others, who are relatively dominant, and handle things rather one-sidedly”

Medical Education 2013: 47: 463–475

What are you doing about this?

Articulate expectations Set bar high Consider whole professional Discuss & reflect when standards not met

• • • • What is your role in creating / developing the Learning Culture?

What is your role in the professional development of others……and other members of the MDT developing you?

How often DO you give feedback… to whom? Could you do more?

Is that feedback Task or Behaviour focused? How could you make the shift?

This House believes that SAS doctors have different education and training requirements PreDebate PostDebate

YES

10 12

NO

5 6

Influencing

• Identify those with power and interest • Engage with the multiprofessional Faculty internally • Liaise with external stakeholders – SAS Lead Deanery – LETB • Trust representative • Director of Education & Quality (DEQ) • Be positive, specific & constructive