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					Making GP Training More Interesting and Possibly Better

A work contract is mandatory but in addition you may wish to consider having an educational contract. Advantages include: 1. providing a clear statement what you and the trainee can expect from each other 2. Providing you and your trainee with a common shared vision for the training period 3. A great document to refer to when things start falling apart eg persistently late trainee or lazy trainee who does no preparatory work  refer to the document and revisit what you both agreed Example educational contracts can be found at www.bradfordvts.co.uk  click “tools for training”  click “month 1”. Pick one that you like.

You might want to use some tools to help you identify your trainee’s learning needs so you can focus the training period to deliver on these. Eg TISA (trainee initial self assessment) questionnaire available from www.bradfordvts.co.uk  click “trainer’s toolkit”  click “before starting”

TRAINEEs sitting in with various members of your team or waiting in the reception area observing patients is common training practice. However, some trainees might find this boring and fail to appreciate the learning opportunities these may yield. Therefore, you might wish to consider a more active, dynamic and structured approach by using task sheets. These are sheets where the trainee has to actively find out stuff when sitting in with a specific member of the team eg with the nurse practitioner  what is their qualification called, what their training involved, what they can and cannot do, how are they regulated etc Task sheets available from www.bradfordvts.co.uk  click “trainer’s toolkit”  click “month 1”

CONSULTATION SKILLS – Calgary Cambridge Model
Most of us have heard of Neighbour’s “The Inner Consultation” and it’s a good model. However, I believe there is an even better Consultation Model out there called the Calgary Cambridge Model. The book that tells you more about this is called “Skills for Communicating with Patients” by Silvermann, Kurtz and Draper. Why I Like It?  Traditionally trainers have discussed with their trainees what they consider to be the components of good consulting - often grounded in logic and experience. What this book does is take it further by presenting the evidence.  It lists specific behavioural markers that define a competence  It will help trainers with video analysis tutorials by helping them to identify exactly what defines a particular competence and whether they were displayed or not

Making GP Training More Interesting and Possibly Better
  It gives a variety of phrases the trainee might use to try and achieve a certain competence. It covers all the MRCGP competencies in great depth (which is what trainees always yearn for and what most trainers feel apprehensive about)

Although it lists 72 competencies, please don’t be overwhelmed by this compared to Neighbour’s 5 point model. The following analogy might help place this in perspective: A mechanic may have loads of tools in his/her tool box but that is not to say (s)he will use all of them on a particular job; instead, they will use what is necessary. In the same way, although the Calgary Cambridge model presents a toolbox of 72 competencies, you only use what is appropriate for the particular situation you are dealing with. If you’re an experienced GP, you’ll be familiar with most of them anyway; it’s just some of them have specific names now. Others will be new thus helping you to expand your repertoire of skills that will hopefully prove invaluable in your own consultations.

CONSULTATION SKILLS – The “See-Hear” Method of Viewing Videos
When watching videos, consider asking the trainee to write down competencies they feel were demonstrated by asking them to note what they actually saw or heard at that point. Rather than saying “yes, I think you explored the patients ideas, concerns and expectations there” this method helps define exactly what makes up that competence in terms of verbal and/or non-verbal behaviour.

Visit www.bradfordvts.co.uk
There’s loads of other educational stuff on www.bradfordvts.co.uk that you might find stimulating. Two areas you will find particularly helpful are  “online educational tools”  loads of PowerPoint’s, tutorial plans, consultation and other useful stuff that I’ve collected from trainers throughout the UK  “trainer’s toolkit”  more specifically geared towards the variety of things you can do in training offered with a suggested time line for events. Keep your enthusiasm for training going by developing your skills even further! Take a look now.

It is compulsory that all trainees actually do an audit project on top of their NPMS. Some suggestions:  If your TRAINEE wants to do a clinical audit, choose something which will be relatively easy to do so that one can spend time on teaching the key principles of audit rather than getting bogged down with numbers and statistics. One way of doing this is to choose an area which will have relative few patients eg Epileptics  audit of epilepsy review or last fit recorded in the notes.  Rather than doing a traditional clinically focused audit (eg number of our post MI patients who are on aspirin) consider something more funkier and less clinical eg an audit of patient feedback questionnaires  A helpful website for teaching the theory (and suggesting some funkier audits) is: http://gppro.co.uk/contents.htm  There are loads of written material on the theory behind audit on the Bradford VTS website www.bradfordvts.co.uk  click “online educational resources”  click “audit”

Making GP Training More Interesting and Possibly Better
OOH Workbook
Not sure how to fill this in? Actually, it’s the educational supervisor at the OOH session that should be filling this in. I’ve got a guide for you below. Get your trainee to print out this handy “2 sides of A4” guide. Get them to show it to their OOH educational supervisor BEFORE they start they session and that they ensure the workbook is filled in as per guidance afterwards. I’ve often found that whilst the OOH educational supervisors have filled in the OOH workbook, they’ve done it in a way that doesn’t actually help with the criteria that need ticking off in the OOH workbook. This guide aims to rectify that. For a copy, go to www.bradfordvts.co.uk click on nMRCGP then click on OOH and you’ll find it in the downloads section there.

If you have any other suggestions to add to this document which you think might be of benefit to others, please email me on rameshmehay@googlemail.com

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