March 20 2012
Joint Workshop & VTS

Entered in order (paragraph each):
Team working with: 
Natalie Settle
Alison Holman
Shahid Shah
Jennifer Needham
Janani Bodhinayake
Sanjay Patel
Hannah Brownhill
Sue Howarth

Questions for Trainees to answer:
What are the most helpful/valuable things a trainer can do?

- Availability – using EMIS/phone
- Approachability/friendliness/feeling well inducted into practice (good organisation)
- Helping work through problems by reflecting the questions back to trainee: developing a way of thinking, not just giving the answer

Overview of career and training
Approachable for help – but not hand-holding throughout year

- Assessing learning needs early on and arranging tutorials/learning needs accordingly
- Regular review of eportfolio
- Supervision with home visits

Timely feedback, positive things, not just negative
Quite encouraging to go from 30 mins down to 20 min appts
Have supervision from other GPs in the practice

- Be approachable and available, while maintaining boundaries
- Assess learning needs at the beginning of job
- ensure other GPs in the practice provide you with support
- be supportive of annual/study leave

Approachable
Perspective
Sympathetic
Constructive feedback
Give impression of more time available
Understanding
Specific learning needs assessment

- Be available 
- Give some freedom to make clinical decisions but be supportive/available
- reflection/debrief sessions
- Reflection among senior GPs in group meetings
- regular teaching sessions

Regular tutorials – opportunity to discuss difficult cases
Opportunity to ask questions
Protected tutorial time
Prompting to keep up with eportfolio
Discuss learning log entries and feedback is valuable

What would you like more of from your trainer?

-More joint surgeries
-More practice management training
-More information about what is expected at our level to help direct our learning and ensure not aiming too high/low (targeting to time frame eg ST1/2)

Joint surgeries – more help with structure and forward planning in consultations

- To sit in more and observe consultations
- To observe our trainer managing common problems more
- More exposure to educational supervisor when in hospital medicine, communication between clinical and educational supervisor

More time for us as trainees – sometimes feel a little ‘extra’ add on – esp as ST1
Joint clinics – trainer sitting in with trainee
OOH commitments – having the trainer observe/listen to your consults/phone

Protected teaching time (weekly at least) which is ideal or arrange teaching with other GPs in the practice

Difficult to find anything
CSA teaching (better feedback)
Quite happy with trainers
Joint surgeries – more of them (COTS)
See difficult consultations
Do COTS on trainers (after 6pm in practice)
Split the morning surgeries up into mini-COTS

More open discussion, perhaps not so centred on the eportfolio

Stories about patients they have seen and difficulties encountered by trainer – boundaries tested
Review of notes occasionally by trainer
Joint surgeries – later on during registrar year, monthly basis, sit in with other members of practice

What tutorials have worked best and why?

-Discussing problem patients after having thought about them
-Having tutorials with more specialised GPs covering their interests (eg other drs in practice)
- Role play can be helpful/useful for CSA

Clinical examples in group tutorials
Going through new guidelines
Short periods

- Discussing cases where mistakes have been made
- presenting a topic and the trainer illustrating this with interesting cases
- Tutorials with trainees at different stages
- Different tutors with different approaches

1:1 tutorials – led by the trainee
Practical skills of examining joints
Smaller the better

Video consultations have limited educational value
Trainee led tutorials
Case based discussions to reflect ‘real life’ practice
Topic in advance to allow reading around
Bringing cases with a positive outcome or what you thought you did well

Role plays and video consultations
Case based tutorials
BMJ tutorials beforehand
Go through cases related to that
Complex cases help learning
Problem solving skills
More of an apprenticeship is a better approach

The more ‘open’ discussions
Perhaps the less didactic ones

Work out gaps in syllabus and organise a tutorial in advance
Focussed on registrar’s needs – ie towards AKT/CSA
Prepare to teach the trainer something
Use for more abstract topics – ie not medical (work life balance, finances, careers: CV/covering letters, interview skills)
Tutorials with other GPs in the practice with specialist interests

Questions for Trainers to answer:
Why do trainers train? What are the good bits?

Enjoy teaching
Keeps you up to date with practice/scrutinise your own practice
Nice to have young drs coming through with new ideas
(Good for the organisation/contributing to the team)
Maintains motivation – very rewarding

Interested in education, improves development as a dr
Integral part of being a dr
Share enthusiasm for general practice
Potential Employee
Variety in the week

- Working with young trainees – helps keep up to date and increases reflection on own practice
- Fresh energy and enthusiasm into practice
- Develop teaching strategies, mix of needs/personalities

Keeps you on you toes, rewarding, good for the practice
New eyes on the scene, enthusiasm of youth is rejuvenating
Keeps you learning newest guidelines
MDT likes the new faces. Good for recruitment – registrars becoming salaried
Re-evaluating own practice

Variety in the working week/takes away isolation of GP
You learn yourself!
Allowed them to reflect on their own practice
Close professional relationship with training dr
Rewarding

Give feedback about the challenging things
Making eportfolio work for both people
Working week (for time for trainees)
Giving skills rather than just knowledge
Passion in the job and importance of teaching

Finds it inspiring
Makes for a better dr as has to justify himself
Keeps the practice ‘energised’
Everybody learns from it

To keep ‘on toes’ upt o date
Pass on skills
Helps in consultation with patients
One to one relationship with trainee – talking through cases
More opportunity and time to reflect on practice
Stimulates

What are the most challenging aspects of training and how can trainees help?

E portfolios filled in on time very helpful
Getting trainees motivated if wanting to just ‘coast’ along
Significant interpersonal differences – important to recognise not trying to create clones of ourselves, ensure trainee independently competent

Eportfolio – how to enter things, being pro-active
OOH – feels difficult
Practicalities of training – being organised and forward planning
Stepping back from always helping

- TIME – not always having time available during clinic, trainees help with admin – useful
- Making trainees develop their own answers to problems rather than telling them what to do

Organising them early
Organisisng – get trainees to be on the ball with CBD/COTS/CEX etc 
THE EPORTFOLIO! & It’s changing landscape: has to be part of routine and a habit
Trainee to know their own learning needs/interests before starting

Educational supervisors report
Eportfolio – not keeping up to date
Being flexible ie with rota

Time issues during surgeries
For trainees to learn how to ‘be a GP’
Teaching empathy (some trainees have difficulty with this)
Trainees help by:
Open and honesty about problems trainees face
Fill in eportfolio without promptine
Trainees help with using IT systems
Keep trainee enthusiasm

Less eportfolio!
Would like more constructive feedback at the time
Unenthusiastic trainees (doesn’t happen often!)

Giving feedback at a useful level to trainee
Assessments – would help for trainee to offer some self-assessment 
Opportunity for feedback as to usefulness of assessments

What are your clinical interests?

‘Generalism’
Education and training x 3
Sports medicine
Management roles: GPs as a business, a well-run practice

Women’s health and paediatrics
Diabetes
Mental health and paediatrics
Management

Diabetes
Respiratory Medicine
Child Protection
End of life care
Joint injections
Care pathways

Paeds
Palliative Care
Diabetes
Womens health
Mental health
Antenatal
Management
Employment
Work for football club
IT
Developing role of HCAs

ENT & dermatology
Everyday general practice
Anti-coagulation
Paediatrics

Educator
Clinical commissioning
Diabetes
Psychiatry

Patient narrative and patient stories
Child health
‘Generalism’
Substance misuse
ENT
Being a GP for families, continuity

General medicine
Men’s health
Paediatrics
Family planning – training
Gynaecology
Dermatology
Minor Surgery
Medical Politics