Dr Marc DavisonDr Tamsin McAllisterMr Amir Khaki

The Creation of a Foundation Programme Forum

NAMEM September 2011

Introduction

• What is the forum?Dr Marc DavisonAssociate Director FP

• Trainees perspective of the forum

Dr Tamsin McAllisterForum member 2009-10

• The leadership trainingMr Amir KhakiOrganisational Psychologist

Why create a forum?• Qualitative feedback that goes beyond tick boxes

– ‘Gives trainees a voice and management an ear’

• LEP’s must– Ensure that there are systems and processes in place to induct, supervise,

support, train, assess and monitor the progress of foundation doctors– Be responsible for the quality control of the training they deliver– Provide high quality and safe training

UKFPO Reference Guide 2010

• Trainees must have involvement in their own education• There is the requirement for leadership training to be embedded into

curricula at the earliest stageGMC - The new doctor: guidance on foundation training. 2009

UKFPO Curriculum 2010

Why ‘we’ needed a forum?

• Increasing numbers of FP trainees• Poor completion and feedback on

GMC/PMETB survey from trainees• Poor representation of trainees views to

educational management• Little innovation occurring in Bucks FP• Struggling to solve issues in certain specialities

with regard to training opportunities/rotas

Aims of Bucks forum• Representing trainees

– Addressing educational and developmental needs• Feedback to trainees

– Disseminate information to colleagues• Help to

– Improve teaching– Improve supervision– Improve training posts– Enhance learning opportunities

• Create better training for future years

Forum structure• 8 members to constitute forum

– 4 F1: 4 F2 3 F1: 5 F2– Chaired by associate director of foundation programme

• Formal meeting 4x year with agenda/minutes– Standing items – bullying, ed/clin supervisers, rotas– Other items driven by forum members

• Informal contact throughout the year

• Chair empowers and facilitates change by the forum rather than leads it

• Chair provides continuity over the years to avoid repetition

How we selected the forum• Problem: How to select trainees

that no one knows?• Application form (400 words)

– Why do you want to be a forum member?

– What do you think you can contribute to the programme?

– What are you hoping to gain from the programme?

– Tell us about any other skills or experience that you think might be relevant.

• Problem: trainees who are only in trust for 6 months– Unfortunately excluded from

applying

Darwin misses witnessing unnatural selection

What are the costs to the LEP?• 8 half day sessions of leadership training by

external facilitator– To equip forum members with the skills to carry out

role• Leave for forum members to attend meetings &

management training– F1’s no S/L provided normally

• Buy-in from DME/MD– Financial– Willingness to allow change where appropriate– Support to run innovative projects

Role of forum representatives• Identify themselves and represent the views of the FP

trainees to the FP committee• Pass feedback to FP trainees from FP committee• Help find innovative solutions to problems within

Bucks FP training• Identify and run projects to benefit Bucks FP• Attend

– 6/8 management training sessions– Quarterly forum meetings– Post graduate medical education (PGME) board– Deanery forum when set up

The future

• Continue innovation• Fully establish a deanery level forum• Continue publishing papers

Peer led E-Portfolio trainingNACT UKFPO Sharing notable practice - June 2011Dr James Wigley, Dr B Wildblood, Dr C Greszczuk, Dr M Johnston, Dr A Tse and Dr M DavisonThe Development of a Foundation Programme Trainee Forum NACT UKFPO Sharing notable practice - June 2010Dr L Creasy, Dr S Dunkerley, Dr. T McAllister, Dr K Sahota, Dr M Sinczak, Dr S Edmonds, Mr. P Lintott, Dr M Davison

Foundation Medical Leadership Programme

What is it?

• An innovative training programme to give foundation representatives leadership skills in the context of the NHS

• A safe testing ground for practicing new interpersonal skills

• A proven way to empower Junior Doctors to start supporting each other

Components

• A medical leadership competency framework

• Facilitation (medical context)

• Representation from the FY1 & FY2 cohort

• Training modules

• Monitoring & evaluation

Programme structure• 8 half day sessions

– Lectures & interactive workshops– Guest speakers

• Foundation Medical leadership framework – NHS institute of innovation & improvements (2009)– Emotional intelligence (Salovey & Myer 1993)– Leadership & Followership (Lewin 1939)

• Designed specifically for Foundation years training doctors

Program content– The ever evolving NHS & the drivers for change

– Why is it important for doctors to be leaders?

– Defining the key challenges facing doctors now & in coming years & how to address these

– Difference between leaders & managers

– Understanding basic principals of communication

– Using basic leadership skills to enhance effectiveness

Programme overviewModule Key points Content Duration

Module 1 Changes in NHS & GMC Doctors of tomorrow, structure of the NHS 1/2 day

Your trust Buckinghamshire Hospitals NHS Trust

Medical leadership competency framework Intro to course content & structure

Leadership Your default leading style

Module 2 Leaders vs. Managers Understanding your emotions & their effect 1/2 day

Followership Followers preferences

Developing Self awareness Strengths & weaknesses + role of emotion

A day in the life of… GP

Module 3 Communication I Johari Window & transactional Analysis 1/2 day

Managing yourself Controlling the effect of emotions

Relationship with patients Managing patient expectations

Social awareness Empathy vs. sympathy

Benefits– Improving personal effectiveness & providing better

patient care

– Embedding leadership training as part of FY training (GMC – The New Doctor)

– Understanding the NHS business model & be better prepared for the requirements of their future roles

– Enhanced skills in recognising & avoiding conflicts

– Dealing with & understanding emotions & their impact on decision making

Evaluation• Last 2 years data (2009, 2010)• Buckinghamshire Hospitals Trust

2009 2010

Attendance 87% 85%

Punctuality 92% 95%

Survey item Average of 09/10

Was the course interesting? 100%

Were you able to apply it in your role?

80%

Would you recommend the course to peers?

100%

Sound bites

“A fascinating and relevant course which offers junior doctors the competitive edge to differentiate themselves from their peers.”

“I have used questioning skills a lot, mainly to get most from patients when taking history.”

“Recognising my values & beliefs (ideal self) has helped me in my choice of career.”

“… one of the best, most enjoyable & most valuable bits of FY1.”

Long term evaluation• Comparing patient’s perception of doctors;• Within participants ( Pre & Post FMLP) – 2012• Between participants ( FMLP attendees &

equivalent FY2s)• Initial data supports a positive correlation• Small sample • Individual differences

Dr. Tamsin McAllisterCT2 Anaesthetics

The Foundation Programme Forum – A Trainee’s Perspective

Why apply for the forum?• Frustration at lack of structured feedback

mechanisms– All F2s felt we had issues to bring to the forum

• “No point complaining if you’re not going to do anything about it”

• Experience of management and leadership

• Leadership training

Leadership from junior doctors

• The Medical Leadership Competency Framework– built on the concept of shared leadership – Acts of leadership can come from anyone in the

organisation, as appropriate at different timesNHS Institute for Innovation and Improvement

• Foundation Doctors often required to show leadership– In presence of more experienced team members.

Areas of benefit

• Creation of forum

• Leadership and Management training

• Activities and Outcomes from forum

Creating the forum

• Introduced ourselves each to a group of F1/F2s for whom we would act as representative

• Able to get to know a larger proportion of foundation doctors within the trust, improving working relationships, support and handover

• Experience of process

Management and leadership training

• Speakers– Understanding of NHS / Trust Management

structure

– Opportunity to meet Trust managers providing insight into goals and directions

– More able to liaise appropriately with members of management and work together to achieve common goals

Management and leadership training

• Leadership Styles

• Emotional Awareness

• Parent / Child / Adult communication styles

• Listening / Active listening

Achievements 2009/10Outcomes Examples

Opportunities for trainees to voice expectations, experiences and concerns

Development of feedback pathway from forum members to foundation programme committee

Feedback of outcomes to trainees Meeting minutes circulated by email and disseminated by forum members

Improvements in clinical supervision process

Development of trainee feedback survey about supervision process

Achievements 2009/10Outcomes Examples

Enhanced learning opportunities Learning opportunities handbook

Reinforcement to senior team members about protected bleep free teaching

Foundation teaching presentations circulated by email

Funded ALS places for all F2s

Availability of ATLS to F2s

Achievements 2009/10Outcomes Examples

Improvements in induction processes Streamlining induction for trainees who have previously worked in the trust

Improvements in training posts Re-structuring of rotations to ensure all trainees get on call experience.

Ensuring equality in the experience from GP rotations.

Consent Training for F2s in surgical specialties at beginning of post for those expected to take consent

Achievements 2010/11Outcomes Examples

Overhaul in T&O experience for foundation doctors

Increase support available to the juniors Increase educational opportunities Bring greater diversity to the job

Audit and research presentation evening Support increasing demands for participation in clinical governance by peer-reviewed prizes and regional competition.

Achievements 2010/11Outcomes Examples

NHS E-portfolio drop-in sessions Significantly improved trainees understanding of utilisation of e-portfolio.

Foundation trainees clinical guidelines handbook

Consolidating important trust guidelines into one handbook, smoothing transition into clinical practice for new trainees

Any Question

s?