cetiscape 5 may 2011

Health Workforce Australia (HWA), as part of the National Partnership Agreement on Hospital and Health Workforce, is funding an Australia-wide program to expand the use of simulated training environments to increase clinical training capacity for medicine, nursing, paramedicine and allied health.

Capital funding of $46 million and $48 million of recurrent funding is available. NSW Health’s share of the capital funding is $14.7 million. This is split between public health ($10.3 million) and private, higher education and non-government organisations ($4.4 million). The commitment to ongoing funding will support sustainability and development. Last month NSW Health requested submissions from local health districts and specialist networks for funding and, with some input from CETI, has provided a simulation capacity building plan to HWA.

NSW is a large state, with areas of both dense and sparse population, and this affects the access that trainees, practising clinicians and undergraduate students have to training facilities. The simulation plan for NSW involves leveraging existing simulation capacity, strengthening and developing partnerships, strategic placement of simulation facilities, use of mobile facilities and equipment, and developing a network of expertise in simulated learning environments. CETI has a keen interest in this effort to build simulation capacity, as it sees simulation playing a key role in education for new starters and

ongoing professional development for clinical staff, particularly in interprofessional learning activities.

Simulation technology today can allow clinicians to undertake full mission rehearsals for critical or rare events in a real clinical environment, or practice advanced surgical techniques many times over so that they can develop a breadth of experience to draw upon when caring for patients. Just as importantly, these environments allow clinical teams to learn and practice together, helping clinicians understand the roles of other team members and how to work as an effective unit, not just as skilled individuals. Numerous studies have shown that effective teamwork is as important in providing quality patient care as the technical skills of each individual team member.

So keep an ear to the ground in your local health district, because an enhanced simulation capacity may well be coming your way.

CLINICAL EDUCATION& TRAINING INSTITUTE

Building 12, Gladesville Hospital, Victoria Road, Gladesville NSW, 2111 Editor: Craig Bingham

Locked Bag 5022, Gladesville NSW 1675 02 9844 6511

p: (02) 9844 6551 f: (02) 9844 6544 e: [email protected] [email protected]


cetiscape Issue 5 May 2011 Promoting excellence in clinical education www.ceti.nsw.gov.au page 1

Money for manikins

Stephanie O’Regan Curriculum Developer, Centre for Learning and Teaching, CETI [email protected]

In this issueMoney for manikins 1

Please tell us: is it working for you? 1

Rural and remote Australia – heart of a healthy nation 2

Coming events 3

HSP Education Strategy Forum 4–5 April 2011 4

Trauma skills and human factors 5

Worth a look: MedEdPortal 5

The CEC Clinical Leadership Program 6

ANZJMOC — is it Croatian for “spirit of cooperation”? 7

Intergenerational health systems 8

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It’s tick box simple, and one lucky contestant will win a packet of TimTams. Thank you — the editor.

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The ability to attend national conferences is limited for our rural and remote workforce, and yet such events have the potential to inform otherwise-isolated professionals of innovative new models of care and service delivery, to establish networking with other like-minded clinicians and to cascade new ideas throughout the state.

The CETI Rural Division provides sponsorship for 26 rural and remote health staff from across New South Wales to attend the biennial National Rural Health Conference, which this year was held in Perth, 13–16 March 2011.

For 24 sponsored delegates, this was their first attendance at a National Rural Health Conference and for many it was their first-ever conference experience. Delegates aimed to meet three new people each day and find out about where they came from and what they did.

Sponsored delegates completed an evaluation of learning outcomes after returning to work. All reported that they had identified at least one take-home message for their clinical workplace that they will share with their team. Some examples included:

Use arts in health to get health messages across.

Make better use of health promotion in planning service delivery.

Think outside the square when staffing rural sites: build partnerships with community and integrate with general practices.

Tap into new and innovative projects instead of trying to invent your own.

Engage the community in planning service delivery so that health is just not provider-driven: overlap partnerships in a “bottom up” approach to create models of care.

For most it was the energy within the conference, the networking opportunities and the learning experience which was motivating and inspiring. As inconsistent staffing in rural areas is a longstanding problem, many commented that they would share some key strategies from plenary sessions to use non-government organisations and build community partnerships to put more sustainable programs in place. Most of the delegates felt challenged to look beyond their own area of isolated practice and understand the big picture: how complex relationships, interactions and influences of the many determinants of health impact on service planning and delivery.

Four CETI Rural Division staff attended the conference and fielded many enquiries at the CETI booth, with two CETI staff ,Jan Dent and Jenny Preece, presenting papers.

Rural and remote Australia – the heart of a healthy nation

11th National Rural Health Conference, Perth 13–16 March 2011

Jenny PreeceRural and Remote Health Project Officer, CETI Rural [email protected]

Twenty-six rural and remote health staff from NSW were sponsored to attend the National Rural Health Conference in Perth by CETI Rural Division.

CETI Rural Division Head Linda Cutler at the CETI booth in the conference exhibition.



Coming events

NSW Prevocational Medical Education Forum Stamford Grand North Ryde 11–12 August 2011

At this year’s forum, educators, directors of training and administrators will share their experience and hear practical advice from leaders in the education of junior doctors.

The Forum will provide a choice of optional workshops, an induction session for new Directors of Prevocational Education and Training, a special interest group meeting for JMO Managers, and a half-day plenary session.

Workshops

Teaching on the Run: We hope to offer all six modules on the day: Clinical teaching | Skills teaching | Feedback and assessment | Supporting trainees | Planning term learning | Effective group teaching.

Online learning: An introductory workshop aimed at education support officers and JMO Managers as much as Directors in Prevocational Training. Introduction to Moodle and simple tools that can be used to help create online learning. Some attention to instructional design principles. Resources and links to further information will be provided.

Building better prevocational trainee assessment: Exposition of current and potential assessment methods

is followed by a workshop to design effective and efficient assessment for prevocational trainees. This is a hands-on workshop aimed at developing better JMO assessment methods for use in NSW.

Building a better registrar: Registrars play a vital role in prevocational training. What makes a good registrar? How should registrars contribute to prevocational training? What should CETI/DPETs/Supervisors do to support registrars and build their skills as leaders and educators?

Prevocational general practice placements program (PGPPP): Hospital DPETs and GP DPETs need to work together to maximise the effectiveness of general practice placements for prevocational trainees. How does it work and what are the issues that need to be considered? This session will be led by GP training providers and hospital DPETs with experience in PGPPP.

Core competencies for prevocational trainees?: The Australian Curriculum Framework for Junior Doctors outlines a comprehensive set of learning outcomes, but is there a set of core competencies that should be specifically taught and assessed in core terms? This is a brainstorming session for people who want to help find the answer.

More information: Craig Bingham (02 9844 6511, [email protected]), or visit the website <www.ceti.nsw.gov.au/prevocational>.

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Fourth Rural Health Research Colloquium Dubbo, 11–13 October 2011

The Colloquium is co-convened by the Australian Rural Health Research Collaboration and CETI’s Rural Division.

The theme for the Colloquium is “Sustaining Rural Health through Research”.

Abstracts are now being received (closing date 13 May 2011). Abstracts should present research with implications for rural health practice, and should demonstrate clarity in regard to the research question, research method, and the analysis of qualitative and/or quantitative data.

Areas of particular interest include Aboriginal health, preventive health and health promotion, community well-being, service delivery and workforce.

For additional information, please see <www.rhrc.com.au>.

Fifth NSW Rural Allied Health Conference The Glasshouse, Port Macquarie, 9–11 November 2011

Rural allied health services bring together a blend of multidisciplinary skills, requiring a flexible approach to cooperation, coordination and collaboration. This conference will provide an opportunity for all allied health staff, managers and education providers to demonstrate how collaborative health partnerships create models of care which achieve positive patient journeys.

This conference is designed to attract rural and remote allied health clinicians from new graduates to senior managers, and those who work in partnership with allied health services.

Abstracts are now being received (closing date 27 June 2011).

Additional information can be obtained from the conference website: <www.hotelnetwork.com.au/conferences/conferences/ruralhealth2011>

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mailto:[email protected]



After the Education Strategy Forum, Hospital Skills Program teams will be busier than ever during the next six months. Several new initiatives are planned to increase participation in the training now available in local health districts, and to roll-out workplace-based assessment in support of HSP learning objectives.

A state-wide orientation manual is being developed to introduce all new participants to the HSP. There will be opportunity for local information to be added to the manual.

CETI is calling for expresssions of interest in a Performance Review, Learning Plan, Portfolio and Assessment (PLPA) Implementation Working Group. This group will work

with local health districts to pilot implementation of HSP assessment (including performance review processes, professional development plans, development of a portfolio and assessment activities using the HSP Assessment Toolbox). The toolbox provides a set of assessment forms (Case-based Discussion, Mini-CEX, Directly Observed Procedural Skills, Multi-source Feedback and Performance Review) with guidelines for their use in workplace-based assessment. Supervisor training in assessment will continue around the State. We plan to collaborate with supervisor training already provided by the colleges and universities, and to use existing resources such as “Teaching on the Run”.

We are also working to improve the visibility and content of the HSP website: <www.ceti.nsw.gov.au/hsp>.

The Education Strategy Forum was attended by directors of training, education support officers, career medical officers, members of the HSP State Council and representatives from CETI and the Australian School of Advanced Medicine.

Professor Kichu Nair, Director of the Hunter New England Centre for Medical Professional Development, presented a workshop on assessment methods. Local health district representatives were given a video resource produced by the Centre, “Assessment in Action”, which demonstrates assessment of history taking and physical examination using the mini-CEX.

Participants were led by Professor Nair in conducting an assessment calibration exercise using the mini-CEX assessment tool and a clinical encounter on the video.

In other sessions, Dr Alan Giles presented an update on the Australasian College of Emergency Medicine Certificate and Diploma in Emergency Medicine and Mr Peter Davy provided an update on HSP module development and the HSP assessment tools.

Small group discussions on Day 2 of the forum laid the foundation stones for new initiatives, informed the CETI HSP Team about local issues and provided for collaboration on strategic solutions.

The next HSP Forum will be held in November 2011.

HSP Education Strategy Forum 4–5 April 2011

Toni VialHSP Program Coordinator, CETI, [email protected]

Highlights:“hearing each network update and sharing educational ideas”

“gathering of the group and open discussions on a variety of issues ... seeing the program ready to form a plan”

“networking and hearing about other districts’ progress”“small group workshops ... discussion with others from other districts at all levels”

The HSP supports the training and professional development of non-specialist doctors working in NSW hospitals. For more information:

www.ceti.nsw.gov.au/hsp

HOSPITAL SKILLS PROGRAM

An enrolment poster will be distributed to hospitals to increase awareness of the HSP. It shows the HSP in action, featuring participants and supervisors from South Eastern Sydney and Illawarra Shoalhaven districts at clinical skills workshops.

Are you a CMO MMO GP VMO

Hospitalist or

SRMO?

Have you enrolled in the Hospital Skills Program?

HSP is a professional development program for doctors who are

not in specialist training and who are working in NSW hospitals.

HSP gives you a career path with diverse opportunities and the

flexibility to accommodate both your personal goals and the needs

of your employer.

You can choose to participate at any level to fulfil a role in

your hospital, to multi-skill, or to work towards a Hospitalist career.

Training modules have been developed for Core Professional Skills,

Emergency Medicine, Mental Health, and Aged Care. Modules

are under development for Hospital Medicine, Children’s Health,

Women’s Health, Alcohol and Other Drugs, Sexual Health,

Indigenous Health and Rural Medicine.

The Medical Board of Australia’s Continuing Professional

Development (CPD) Registration Standard for doctors not on

the specialist register stipulates that you must complete at least

50 hours of CPD per year. The HSP can help you meet this

requirement with training that is relevant, engaging and fulfilling.

Enrol in HSP today!!

www.ceti.nsw.gov.au/hsp

Your LHN HSP Contact:

Phone

Email

HOSPITAL SKILLS PROGRAM

HSP_enrolment2.indd 1

7/04/2011 3:57:44 PM

http://www.ceti.nsw.gov.au/hsp

http://www.ceti.nsw.gov.au/hospitalskills



Trauma skills and human factors On Saturday 2 April, doctors in the Hospital Skills Program from South East Sydney and Illawarra Shoalhaven districts attended a workshop at the Australian School of Advanced Medicine (ASAM), Macquarie University. The school collaborated with Dr Anna Di Marco (Area Director of Hospital Training) to design the course for career medical officers working in emergency departments. “Trauma skills and human factors” is designed to improve team-based care, procedural skills and management of human factors in trauma-care scenarios. The course included an update on fluids and massive transfusions, neurological presentations to the emergency department, managing hypotension, ventiliation problems and ultrasound in trauma. The event was attended by 22 doctors and evaluated by Professor Rufus Clarke (Director of

Medical Education, ASAM). It will run regularly from June 2011. Further information: Mr Graeme Still (Manager of Medical Education, ASAM): [email protected]

(From top:) Dr Samantha Bendall, Professor John Cartmill, Dr Mary Langcake, Dr Andrew Davidson, Ms Marian Casey (actor), Associate Professor Richard Morris.

Photos courtesy Graeme Still.

Worth a lookMedEdPORTAL (www.aamc.org/mededportal) is a free peer-reviewed publication service and repository for medical and oral health teaching materials, assessment tools, and faculty development resources. It is provided by the Association of American Medical Colleges (AAMC) in partnership with the American Dental Education Association (ADEA).

All copyright and patient privacy issues are addressed during the submission process so users around the globe can download and use any and all of the published resources for educational purposes without legal infringements.

You can sign up for a monthly newsletter if you want to stay in touch with new additions to the database.



Our belief in the power of clinical leadership is an essential component of the CEC’s commitment to improving patient safety and clinical quality in our healthcare system. Clinical leaders play a pivotal role in patient safety and clinical quality. We need to harness their full potential to ensure that the health system works better and more safely for staff, patients and their families.

A central premise of the CEC Clinical Leadership Program (CLP) is that leadership occurs at all levels in healthcare and is not dependent on the position to which a person is appointed. In this, the program supports “ordinary personnel” to develop extraordinary leadership practice.

The Clinical Leadership Program is offered at a foundational (statewide CLP) and executive (modular CLP) level. The foundational program is aimed at middle managers and clinicians and is delivered in local health districts by locally employed facilitators, with central coordination provided by the CEC. The executive program is aimed at senior clinicians and managers and is delivered centrally in Sydney over six modules by experts in leadership and change management.

The CLP aims to develop effective clinical leaders who:

demonstrate a high level of clinical mastery

build the capability of clinical teams

advocate for patient safety and integrate system improvement into clinical care

have insights into their own leadership style and its impact on others

work effectively with a range of clinicians and managers

use consensus development and vision to set, align and achieve goals

resolve conflict and balance demands within the larger environment.

The program develops an integrated model of clinical leadership by building on leadership and clinical governance principles, self-awareness, change management,

The Clinical Excellence Commission Clinical Leadership Program

Rachel PrimroseClinical Excellence Commission Directorate Clinical Leadership Development and Training

The theoretical framework of the CLP is adapted from a model by Miller (2003) and outlines key dimensions and related skills that underpin effective clinical leadership. [Miller GV (2003). The Leadership Dimensions Survey. In: Gordon J, editor. Pfeiffer’s Classic Activities for Developing Leaders. (pp. 409–435).]

2010 Executive (Modular) Clinical Leadership Program Graduation on 1 April 2011



interpersonal communication and clinical practice improvement. A key distinction between the CLP and other leadership educational programs is its experiential nature.

Participants are required to undertake a clinical improvement project within the CLP that directly link with the programs goals of improving patient safety and clinical quality. Each year the CEC publishes completed Improvement

Project summaries. The 2009 CPI booklet can be found at <www.cec.health.nsw.gov.au/__data/assets/pdf_file/0004/136588/clp-projects_booklet_09.pdf>.

The CEC will be providing a second Executive Modular Program that will commence in August this year. More information: Rachel Primrose ([email protected], 02 9629 5512).

Western Sydney & Nepean Blue Mountains LHN Statewide Clinical Leadership Program Graduation 2010 – Facilitators Richard Tewson and Johanna Dennis

Actually, ANZJMOC is the Australian and New Zealand Junior Medical Officer Committee — an opportunity for the Chairs of each JMO Forum to discuss issues of national relevance and share ideas across borders. ANZJMOC held its annual face-to-face meeting in Melbourne on Saturday 9 April.

Representatives from all states and territories were there, as well as the JMO representative from New Zealand. The Australasian Prevocational Medical Education Forum will be held this year in Auckland, with the Australasian JMO Forum meeting included on 6 November. The committee heard that preparations are well under way, with a venue chosen and a website soon to be up and running. The scientific committee has shortlisted an exciting group of speakers and the call for abstracts will go out soon.

We heard from Dr Jag Singh, General Manager of the Confederation of Postgraduate Medical Education Councils (CPMEC), regarding developments in internship in Australia. Last year the main focus was on getting national registration up and running. This year the definition of national internship standards is being considered. The increase in graduate numbers continues to be a challenge relevant to NSW JMOs and their supervisors. In 2014 we will have double the numbers from 2006. Expanding capacity for new interns raises issues to do with accreditation of new sites and training terms, and identifying and developing supervisors. The new big issue

which is looming is the potential vocational training bottleneck for PGY2s and PGY3s. Colleges and state and federal health bodies are working to find solutions.

CPMEC is waiting to hear regarding funding to continue work on the Australian Curriculum Framework for Junior Doctors. ANZJMOC supports a renewed federal government commitment to developing, monitoring and assessing this nationally accepted framework of basic knowledge and competencies. With the influx of graduates and the move towards more innovative training placements, ensuring basic skills are achieved is vital in maintaining a high standard of medical officer moving upwards through our health system.

It was helpful to hear about what is going on in other states. Some issues are standard across the board — such as obtaining informed consent, rotation locations and training and education. Others, such as the proposed “activity based funding” (ABF) which has come up in Western Australia, give pause for thought. In essence, ABF asks hospitals to monitor the investigations and procedures each patient has so that they can claim funding from the government. A standard “cost allowance” is in the works so that hospitals may be able to claim (or have to meet) the difference in treating a particular patient/problem. Considered from a JMO perspective, the additional administration required by this funding model might be another

ANZJMOC — is it Klingon for “spirit of cooperation”?

Lucy Cho JMO Forum Chair 2011, PGY2 at Wollongong Hospital (Oceans 11 Training Network) [email protected]

JMO FORUM

NEW SOUTH WALES

http://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0004/136588/clp-projects_booklet_09.pdf

http://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0004/136588/clp-projects_booklet_09.pdf





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Building 12, Gladesville Hospital, Victoria Road, Gladesville NSW, 2111 Editor: Craig Bingham

Locked Bag 5022, Gladesville NSW 1675 02 9844 6511

p: (02) 9844 6551 f: (02) 9844 6544 e: [email protected] [email protected]

duty distancing JMOs from bedside care and learning. The WA JMO Forum has responded with a position statement and will hopefully be involved in planning if this goes ahead.

Royal Darwin Hospital has started a mentoring program for international medical graduates/Australian Medical Council graduates, to be trialled with their June intake, acknowledging the need to provide improved support and representation for this group of junior medical officers.

South Australia is currently undertaking a statewide review of internship and may be looking to adapt a network model similar to NSW in the future.

The Victorian JMO Forum continues to expand its Teaching on the Run sessions with great success. Other works in progress include Rover – a rolling handover template, a paging protocol and guidelines for internship mentoring programs and orientation guidelines. New JMO positions in radiology, pathology and forensic medicine have been developed by the Postgraduate Medical Council of Victoria to accommodate the increasing numbers of graduates.

Tasmania reported an innovative wellbeing project. After wide distribution of a “health and wellbeing guide”, a senior doctor visits from an external hospital one day per week and JMOs are able to discuss issues they are experiencing within their hospital in a confidential environment. Workforce expansion issues will be a big issue in Tasmania due to the large ratio of graduates to available intern positions in that state.

The Queensland JMO Forum is working on assessing uptake of Australian Curriculum Framework for Junior Doctors as a means of identifying learning objectives and shortfalls. They have a number of other projects afoot, including looking at IMG advocacy, JMO wellbeing (including mentoring), buddy systems and involvement in the nationwide Beyond Blue study being undertaken across all health professions.

On behalf of the NSW JMO Forum, I was pleased to present the Education Working Group’s work on a unified lecture series for interns (previously reported in cetiscape 1 and 2). This ongoing project is developing a guide to appropriate topics and content for intern lectures as an aid to the education planning

of directors of training. It is certainly a project capable of application in other jurisdictions, and we are happy to share.

AMZJMOC also discussed progress in the resolutions presented at last year’s Prevocational Medical Education Forum. These will be workshopped and updated before and during the upcoming conference in New Zealand.

All in all, it was an interesting and productive day with many ideas exchanged. I hope some shared projects will be forthcoming. ANZJMOC will continue its work in supporting the education, training and quality of life of junior medical officers in Australia and will be presenting in Auckland this year.

Intergenerational health systems: securing a sustainable future In February, the Intergenerational Health Systems Forum brought together government, education, community and business groups in western Sydney to seek a common direction to address some of the major issues affecting health and community care, focusing on the potential of digital technologies to better coordinate, integrate and improve services (see report in cetiscape no. 2, February).

The forum explored possibilities for partnerships to enhance health, aged and community care services in Western Sydney. One example is the Greater Western Sydney eHealth Consortium which is now working towards the rapid roll out of personally controlled ehealth records (PCEHRs) in the region.

The communiqué from the forum is now available at the Leaders Forums page of the Centre for Health Innovation and Partnership <swahs.elcom.com.au/CHIP/CHIP-Leaders-Forums/default.aspx>.

The communiqué gives the background to the event, presentations of key speakers, a summary of debate and recommendations of the forum.

http://www.ceti.nsw.gov.au/cetiscape

cetiscape 5 may 2011

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