NHS Health Education East Midlands

NHS Health Education East Midlands

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Your Training - Our Philosophy

1. Principles
2. Aims of the Educational Program
3. The School of Medicine
4. Minimum Standards of Education within Trusts
5. Curriculum co-ordination and facillitation of Education
6. Administrative, I.T. and other support
7. Academic Medicine
8. Acute Medicine
9. Induction
10. Use of the Trent Simulation & Clinical Skills Centre

The implementation of Modernising Medical Careers gives us a unique opportunity to formulate a region-wide educational program for the Core Medical Training (CMT) grade and to review and incorporate current areas of best practice. The development of a new program allows us to re-emphasise the importance of education as the core component of CMT training, and to elaborate the principles underlying the delivery of education within the Trent region.

1. Principles.

We believe that the following three principles should underpin the educational component of our program;

1.1 Education is the key component of the CMT program. Although there can be a tension between the educational and service components of a post, investment in education is likely to improve the service by enabling the recruitment of high-calibre candidates, maintaining their motivation and producing well informed doctors.

1.2 By offering an educational program that delivers over and above the requirements of Post Graduate Medical Education Training Board (PMETB), and provides more than other Deaneries, we will aid the recruitment of high-calibre trainees to the region.

1.3 We will take a didactic approach to ensuring a uniformly high standard of education throughout the region.

2. Aims of the Educational Program.

Obviously, the primary aim of any program will be to enable trainees to meet the requirements of the PMETB. However, we will be more ambitious in its educational remit. The following are the aims of our program:

2.1 To meet the requirements of the PMETB.

2.2 To foster the motivation of trainees.

2.3 To encourage the personal and professional development of trainees.

2.4 To develop the academic potential of all trainees, so that they may take advantage of academic opportunities during the program or later in their careers.

2.5 To continually assess the success of the program by a robust competency-based system of assessment for trainees, and feedback from trainees on the program.

2.6 To encourage the development of high-calibre clinicians.

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3. The School of Medicine.

We will:

3.1 Ensure at least a minimum standard of education throughout the region.

3.2 Highlight areas of good practice.

3.3 Facilitate the provision of education.

3.4 Coordinate curriculum delivery.

3.5 Provide and facilitate the provision of administrative, IT and financial support.

3.6 Aid in the dissemination of information from national bodies.

3.7 Continue to provide training for educators.

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4. Minimum Standards of Education Within Trusts

Weekly hour long firm based tutorials are held in all hospitals

We will provide the following within each trust:

4.1 A formal educational contract to be signed by all trainees.

4.2 Guaranteed weekly three-hour bleep-free formal teaching.

4.3 Formal teaching to include a mix of interactive, peer-led and trainer-led teaching.

4.4 A minimum of thirty minutes per week teaching per firm for trainees within that firm. This opportunity will be used to ensure that specialty- relevant core competencies have been covered.

4.5 Each trust to provide at least three hours of PACES teaching per week in the four weeks prior to the PACES examination.

4.6 The development of educationally focussed job descriptions to form the basis of firm based appraisals. In particular, job descriptions should include

experience of multidisciplinary teamwork and professions allied to medicine and attendance at sub-specialty clinics.

4.7 Strong encouragement to provide teaching for the MRCP Part 1 examination with at least one hour per week in the run-up to the examination.

4.8 A mandatory clinical skills session held within the first four months of starting the program and provided by each trust.

4.9 We will give each trainee the opportunity to undertake one two-week elective period per year. This will allow the trainee to explore an area of medicine outside their program.

4.10 We will have systems in place for monitoring attendance at teaching sessions. Trainees would be expected to attend a minimum of 80% of all teaching sessions that they could attend, allowing for take and leave.

4.11 All trainees should be expected to undertake at least one audit during their program and all trusts should facilitate this by providing suitable audit projects and audit support.

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 5. Curriculum Co-ordination and Facilitation of Education

We will facilitate the provision of education by coordinating syllabus delivery, providing central teaching and coordinating facilities. We will ensure that:

5.1 Half-day teaching will happen at the same time in each trust.

5.2 The curriculum will be delivered as a two-year rolling program. This will be divided into four-month blocks with each trust responsible for providing curriculum-based teaching for the relevant block.

5.3 It is emphasised that covering the curriculum is only a small part of CMT formal education. Teaching sessions should cover issues over and above the curriculum, designed to inspire and motivate trainees and enhance their personal and professional development.

5.4 There will be a four-monthly trainee- led CPC. All trainees in the region would attend the CPC of the specialty they were currently working in. This would replace the half-day teaching that week. We will facilitate attendance by consultants outside the specialty, e.g. pathologists and radiologists.

5.5 In addition to CPCs there will be a small number (1-3) of central teaching sessions per year. These will be whole day sessions. It is appreciated that this would potentially leave certain specialties short of CMTs. However these sessions will be held on different weeks for year one and year two trainees, therefore only involving half the trainees at any time. The increased number of F2s on the ward will enable additional cover to be provided during these days and it is not felt unreasonable that on three days a year Higher Specialist Trainees could provide cover.

5.6 The highly successful MRCP Master Class series will be continued.

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6. Administrative, IT and Other Support.

The smooth running of any teaching program is dependent on a large amount of technical support. We will develop the following:

6.1 An internet based learning resource specific to Mid-Trent. This will be similar to the University of Nottingham 's Network learning resource. This network will contain teaching material, interactive case histories and an area for discussion of clinical and ethical issues.

6.2 A database of teaching facilities within the Trent Region.

6 .3 Funding for inviting outside speakers to the region.

6.4 Internet-based monitoring of teaching attendance. This would be used to monitor cancellation rates of teaching sessions as well as trainee attendance.

The Simulator Control Room systems

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7. Academic Medicine

One of the aims of the program is to develop the academic potentials of all trainees to allow them to take advantage of academic opportunities during their careers. This involves exposing trainees to academic medicine and providing routes/guidance that will allow them to develop an academic interest should they wish.

7.1 All trainees will have access to an academic mentor.

7.2 Formal teaching programs in Derby and Nottingham will include sessions devoted to academic medicine. This will include topics such as epidemiology, clinical trials, recent advances, designing research studies and introductions to the biological sciences.

7.3 Whole-day teaching will include at least one academic session (1 hour) of relevance to the topic being discussed.

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8. Acute Medicine

One of the strengths of the Trent region is the busy nature of its component hospitals. This provides a huge resource of learning material. Arrangements for covering the take vary across trusts and it is not possible to lay down didactic rules as to how teaching should be delivered.

8.1 An acute physician within each trust will be given overall responsibility for the provision of emergency medicine education for the CMT grade within that trust.

8.2 An emergency medicine course for all first-year trainees will be held at the beginning of the program.

8.3 Each trust will organise trainee-led morbidity and mortality meetings.

8.4 Provision will be made during the bleep-free teaching sessions for at least one hour per month at which trainees are required to present cases that they admitted and comment on their post-admission management.

8.5 A primer of emergency cases on CD-Rom will be distributed to new trainees before induction. This should be used to confirm basic knowledge and help plan their learning needs in acute medicine.

8.6 There should be regular trainee feedback on the take experience. Associate college tutors will collect this feedback.

In addition, current areas of good practice that should be highlighted are;

8.7 Trainees attending radiology hot reporting sessions.

8.8 Feedback from consultants on ward rounds.

8.9 Consultant review of patients outside ward rounds.

8.10 Short formal teaching sessions on the admissions unit.

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9. Induction

As well as trust-based induction, an induction will be held for the Trent CMT program. As well as introducing trainees to the program, this will also have the benefit of encouraging a group dynamic amongst the trainees.

9.1 One of the full day teaching sessions (for first years) will be held within the first four weeks of the program and that this will include a short induction to the CMT program.

9.2 This induction will include an outline of the aims of the program, the overall structure of teaching, special options such as electives, appraisal and assessment, mentoring and academic mentors and sources of help for trainees in difficulty.

9.3 An induction CD, or link to induction website, will be given to trainees in advance of starting the program.

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10. Use of the Trent Simulation and Clinical Skills Centre

The Trent Simulation and Clinical Skills Centre is a major asset that can be used to enhance to educational experience of the CMT program.

10.1 All CMT trainees will undertake at least one whole-day mandatory training session per year at the simulation centre.

  • The trainees will be based at a mixture of trusts.
  • The Simulation Centre training days will be additional to, and hence enhance the effectiveness of, the overall educational program being delivered to trainees.
  • The first year session will focus on emergency medicine and the management of common emergency scenarios. Ideally this should be held within 2-3 months of completion of the emergency medicine course.
  • The second year session will focus on leadership skills, risk management and ethical issues.
  • The Trent induction session (9.1) will include an introduction to the simulator, with an outline of the learning objectives.
  • The opportunity for reflection will be provided by the use of personal learning plans for all trainees attending the training days. In addition trainees will be issued DVDs of their involvement that can be viewed and discussed with their educational supervisor, or other nominated individual. Each trust will nominate a consultant to attend at least simulator training day so that they will be more able to give constructive feedback. Issuing of DVDs would require participants to consent and agree to a confidentiality statement.
  • The ultimate aim will be to develop this training on a multi professional basis
  • Consultants nominated to give feedback will, if possible, attend a faculty development day organised by the simulator centre. The Simulation Centre would strongly encourage educational supervisors and consultants with an interest in education to become involved in the delivery of these days.