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North Lincolnshire Vocational Training Scheme


									                  North Lincolnshire Vocational Training Scheme

                                   Trainer workshop

             4th November 2009 at Riverside Surgery Brigg 1pm – 4pm


Pat Webster, Naveen Samuel, A Pillai, Paul Harris, Usma Khan, Laura Bernal-
Gilliver, John Potter, Anne Spalding, Arun Nayyar, Sanjay Chauhan, Rebecca Clark


Jutta Meiwald, Keith Collett, Peter John, Tim Bruning, Julian Clark, Hardik Gandhi,
Salim Modan, T Elangovan.

This was the workshop’s first visit to the Riverside Surgery and those who made the
journey were rewarded with a quite magnificent lunch, I do hope that this becomes a
trend! Parking however is obviously an acquired skill (not possessed by me!), future
visitors would be well advised to head straight for the Tesco car park.

It was apparent that a number of us had had difficulty opening the minutes of the last
meeting. It was resolved that as well as sending the minutes as an attachment they
would also be pasted into the email.

The main business of the workshop was to be the Case Based Discussion and in
particular an attempt to assess our calibration in marking by simultaneously marking a
video of a CBD. Paul Harris had produced a video of his current Registrar who is in
ST1. Unfortunately the registrar was very softly spoken and it was not possible to use
the video for the group task. We then watched a video brought by Sanjay.

There was a discussion around getting the balance between covering the competencies
in enough depth and covering all of the competencies in the training period. Most
trainers appeared to be attempting to cover as many competencies as possible at each
assessment. One way of covering the more difficult competencies (e.g. Fitness to
practise) is to introduce hypothetical scenarios into the discussion, e.g. Supposing
your partner had previously been seeing this patient and the patient mentioned that he
frequently smelled of alcohol when he saw him?

It was also clear that most trainers are spending a lot of time preparing for each
assessment and in some cases that may be more time than the registrar. When
marking one of the trainers said that she puts a patient identifier into the report which
also describes the complexity and degree of difficulty of the particular patient’s case
which helps to ensure that the registrar is not repeatedly bringing very simple cases
for discussion.

We also had a discussion around CBDs and COTs which result in widespread poor
marks, where often the registrar wants the trainer to withhold that assessment from the
ePortfolio and repeat the exercise with another patient in an attempt to ensure only
evidence of good work is retained. It was agreed that we would expect there to be a
progression of development within the ePortfolio and that all evidence should be
included. Obviously in order to identify struggling registrars it is important to have
saved that evidence of poor performance.

Whilst watching Sanjay’s registrar it was clear that he gets the registrar to input
virtually all of the information in the ePortfolio. One benefit of this is that it allows
the trainer to assess a large part of the Primary care and IMT competence!

We then marked the presented tape and achieved good concordance for this particular
registrar, with all markers clustering around the Needs Further
Development/Competent domains.

We were all reminded that the competencies are described in the ePortfolio, one
trainer has printed out the descriptors for each and keeps them with him when he is
marking the assessments. They are of course available within the ePortfolio by
clicking the hyperlink over each competency statement.

This process was felt to be helpful and reassuring for trainers.

There was not enough time to cover the next part of the agenda which was
reaccreditation visits and this was rolled onto the next workshop which is also hoping
to look at the CSR.

The relevant documents for re-approval are available at the deanery website:

There followed a general discussion about training issues and some of the “hot issues”
for trainers.
There was a discussion about the use of the practice library. There is an increasing
consensus that buying and providing books is not good use of resources when most of
us now use the extensive internet resources available.
One trainer had had found that a new registrar although having Medical indemnity
cover had not increased the cover for work in primary care. There is still no robust
way that this is checked by the Deanery and it is, therefore, and important part of the
induction process to check this is in place.

In summary this was a well attended and energetic workshop which helped those
present to calibrate themselves against other trainers in marking CBDs

The next workshop is at Woodford Surgery In the new Freshney Green Primary Care
Centre in Sorrell Road Grimsby, DN34 4GB. Sadly the new postcode does not work
yet for finding the address but hopefully it will work by the time of the next

January 6th 2010 – Woodford surgery - CSR and reapproval Visits
March 3rd 2010 – Cambridge Avenue Scunthorpe

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