Symposia Stream A
Wednesday 27 August 2008 11:00am
THE INTEGRATED TEACHING GENERAL PRACTICE MODEL PRACTICE OR BLUEPRINT FOR DISASTER?
Dr Peter Stevens
Gippsland Education and Training for General Practice (getGP)
With the expansion of the number of medical graduates in Australia and mounting evidence that extended general practice is an ideal teaching and learning site for students and pre-vocational doctors there is an increasing expectation that we should be developing integrated teaching practices.
These practices would be our existing experienced GP training sites also taking medical students on extended clinical placements, interns or other pre-vocational doctors on rotation, perhaps international medical graduates (IMGs) and eventually the hoped for increased numbers of GP registrars to fill the both the existing deficit and the places now occupied by mature incumbents in the GP workforce
We will look at a small rural teaching practice that is among the pioneers and examine:
- why and how
- what works what doesn’t and why
- then where to from here.
A ROLE FOR INTERNATIONAL MEDICAL GRADUATE REGISTRARS AS TEACHERS AND SUPERVISORS IN AUSTRALIA
Professor Louis Pilotto 1, Ms Bernadette Kelly 1, Ms Jane Anderson-Wurf 1, Dr Geraldine Duncan 1, Dr Samantha Egan 2
1University of New South Wales, 2The Australian National University
The expansion of medical education in Australia has seen the establishment of new medical training programs and a subsequent increase in the number of medical students.
This increase in the number of undergraduate medical students and medical registrars will lead to heightened demands for trained supervisors and teachers to oversee their training needs.
Vertical integration provides opportunities to include international medical graduate (IMG) registrars as teachers of other registrars and, also, as teachers of medical students.
Literature has identified important themes for effective supervision and teaching in clinical practice settings: quality of the relationship, availability, structure, content, time, feedback, and input by the trainee. The relationship between teacher and student contains an inherent power dynamic so there is a need to be conscious of issues arising within a multicultural workforce.
Given the changing demographics of our rural workforce, a greater opportunity exists for IMG registrars to teach medical students. All teachers need support and training and ways of providing effective support need to be investigated.
This presentation will explore the progression of IMG registrars into a teaching role and identify if any particular challenges may arise for this cohort and how they can be best supported.
REGISTRARS AS TEACHERS - THE FUTURE OF MEDICAL EDUCATION?
Dr Jennifer Lonergan 1, Dr Kate Beardmore 1
1 Sydney Institute of General Practice Education and Training Ltd (SIGPET)
With the current increase in medical students in Australia there is an imminent need for an expanded GP registrar medical educator workforce. The practice of employing registrars as medical educators is becoming increasingly adopted by regional training providers (RTPs). It is therefore a critical time to evaluate the successes and limitations of the registrar medical educator role and whether it is likely to provide a larger medical educator workforce.
SIGPET has employed registrars as medical educators since 2005. We have had seven registrars who have worked at SIGPET on a part time basis (5-10 hours/week) since that time.Their roles in education have included:
- Registrar support/ pastoral care
- Running workshops (including our very popular pre-exam series)
- Facilitating small groups
- Training Advisory contacts
- Curriculum development
- Educational planning
- Research projects
SIGPET has attempted to critically evaluate the successes and limitations of the registrar medical educator role in 2008. In particular we have focused on:
- Succession planning: how many of our registrar medical educators have subsequently become medical educators? How has it affected their career plans?
- The successes and limitations of the role: How acceptable are registrars as medical educators to their fellow registrars? We have attempted to quantify this by surveying our current registrars and our past and present registrar medical educators. A review of our qualitative feedback confirms a high level of satisfaction amongst registrars for registrar medical educator presentations.
- Professional benefit: How has the role been of benefit to the registrar?
LEARNERS AS TEACHERS IN GENERAL PRACTICE EDUCATION
Dr Hung Nguyen
Northern Territory General Practice Education (NTGPE)
Context
NTGPE is encouraging vertical integration of medical education. General practice registrars (GPRs) are increasingly likely to teach medical students and junior doctors within the practices where they work.
At NTGPE, medical students (RUSC program), junior doctors (PGPPP) and GPRs are educated and trained using the vertical integration model. There are many opportunities for GPRs and junior doctors to contribute to the organisation whilst developing professional skills in teaching and learning through engagement in one or all of these programs. Programs deliver general practice teaching, cultural and medical orientation, clinical education, rural and remote practice and Indigenous health training. The delivery methods include lectures, seminars, workshops, procedural skills training, mentoring, assessment, remediation and curriculum design.
Objectives
- To describe role of learners as teachers in NTGPE programs
- To describe the ‘Learners as Teachers’, and extended skills post offered at NTGPE
- To explore a model of a salaried GPR as a trainer in general practice
Key messages
Learners have shown an intense enthusiasm to be involved in the development and delivery of teaching to their peers and junior colleagues.
Regional training providers (RTPs) are instrumental in providing a safe and encouraging environment to nurture future GP educators as well as encouraging teaching as a skill in general practice.
Programs should provide flexibility in the engagement of learners as teachers, such as time, payment options, curricula involvement based on interest, professional development, mentoring and supervision.
Conclusions
Learners want to teach and they will play a key role in enhancing training capacity of RTPs.
GENERAL PRACTICE REGISTRARS AS MEDICAL EDUCATORS
Dr Manisha Fernando, Dr Don Cameron, Dr Lisa Cutfield, Dr Katherine Dent, Dr Rachel Lee, Dr Angela Nguyen, Dr Louise Sterling
General Practice Registrars Australia (GPRA)
Teaching and educating are integral to general practice on a many levels. As part of our daily work GP registrars are involved in a process of education for ourselves, our patients, our communities and our colleagues. In addition we are increasingly included in the formal educating process though involvement in the education of junior GP registrars, pre-vocational registrars and medical students.
This paper outlines the current role of GP registrars in education across the Australian GP training landscape. It also provides a practical framework for acquiring skills in education and teaching throughout GP training and is in keeping with the RACGP curriculum statement on ‘GPs as teachers and mentors’. The framework acknowledges that while all GP registrars require some training and experience in educating and teaching, others may elect to further develop these skills though options such as special skills posts in teaching and educating and/or formal qualifications such as a post graduate certificate in clinical education.
Issues requiring further development include definition of roles and responsibilities, support, mentoring and supervision, remuneration, training, assessment and legal responsibilities.
While a philosophy of nurturing GP registrar interest and ability in medical education is the basis for this framework we also acknowledge that an increased need for quality educators in the general practice setting is required to embrace future increases in medical student and GP registrar numbers. Thus a GPRA national framework for GP registrar medical educators will formally contribute to addressing this issue.
Symposia Stream A
Wednesday 27 August 2008 01:30pm
TRENDS IN MARKETING AND RECRUITMENT IN GENERAL PRACTICE TRAINING IN VICTORIA
Mrs Pauline Ingham 1, Dr John Togno 2, Mr Rod Wellard 3, Mr Mark Rowe 4, Ms Nicki Melville 5, Mr Greg McMeel 6
1Rural workforce Agency Victoria (RWAV), 2Victoria Felix Medical Education, 3Gippsland Education and Training for General Practice Ltd (getGP), 4Victorian Metropolitan Alliance (VMA), 5 Bogong Regional Training Network, 6 Greater Green Triangle GP Education and Training (GGT GPET)
Since 2005 Victorian regional training providers (RTPs), have participated in a marketing collaboration to maximise the number of Australian General Practice Training (AGPT) applicants each year across Victoria. An important part of VicNet has been continual evaluation and research into its effectiveness. The research was designed to
- better understand the range of influences on career decisions to undertake the AGPT program
- measure the effectiveness of VicNet Marketing Activities in 2005, 2006 and 2007
Data has been collected over three years from two sources:
1. Successful Victorian AGPT candidates, and
2. Attendees of VicNet Hospital seminars promoting the AGPT program in Victoria including both medical students and prevocational junior doctors (PGY1-7)
The survey findings highlighted the importance of friends, family and colleagues in the decision making process. Major influences included the desire for a work/life balance, a real interest in general practice and the type and variety of work, the flexible career that general practice offers and the flexibility of the AGPT program.
Results indicated that attendance at promotional events had influenced their decision to enter the training program. Interestingly, approximately 80% of all hospital seminar attendees rated the content as new to them.
With respect to timing of career decision-making, 32% of respondents indicated that the decision to become a GP was made over time. Key factors influencing the choice of RTP choice included proximity to Melbourne, staying near family and friends and an interest in the geographic area.
The differences between rural and urban based doctors in terms of factors affecting their decision making were explored.
This research concludes that to influence potential AGPT applicants it is important to (a) inform them about work/life and general practice career opportunities; (b) take the message to them in their work environment; and (c) promote general practice at every stage of a doctor’s training.
CLAIMING THE PREVOCATIONAL YEARS FOR GENERAL PRACTICE
A/Prof Jennifer Thomson 1, Dr Katrina Anderson 1
1 Australian National University (ANU) Medical School
This paper will present the steps in a change management process used to engage GPs in ACT and SE NSW in the teaching of prevocational junior doctors. It will describe how a targeted research process can assist in change management.
The prevocational years are known to be key years in choosing career pathways and until recently general practice has not been part of the prevocational experience.
In 2007 the ACT and Southern NSW Local Training Group of CoastCityCountry Training embarked on a plan to get junior hospital doctors rotating from the Canberra Hospital to GP training practices in the region as part of the Prevocational General Practice Placement Program (PGPPP). A research project was initiated to look at the feasibility of such a plan with key stakeholder interviews and a GP supervisor survey being the methods used in the research. This engendered interest in the PGPPP by all parties and an interest group was set up to develop a PGPPP funding proposal. At the same time GP supervisors were kept informed of results of their research participation at a major GP supervisor workshop and this discussion further informed the development of a PGPPP in the region. Using a well known GP as a champion for the process to address peers was also part of the strategy.
INTERNS IN GENERAL PRACTICE: 'RECRUITMENT FOR THE FUTURE'.
Dr Ian McCombe
Sturt Fleurieu
Objective:
To give a summary of General Practice recruitment from interns rotating through Sturt Fleurieu Prevocational General Practice Placements Program (PGPPP) and a perspective as to the role of a regional training provider (RTP) in the PGPPP intern training program. It will describe the close links and understanding that an RTP has with general practices, and outline the support given to practices and interns by Sturt Fleurieu.
Design:
The talk will summarise three years (2005 to 2007) of RTP input to intern PGPPP rotations in South Australia, with a special focus on recruitment to general practice. More than 80 individual interns have experienced a GP rotation through Sturt Fleurieu in this time.
Results:
Although the program is in its infancy, it appears that well structured rotations in general practice in junior doctor years are a positive influence on choosing GP as a vocation. More than 30% of applicants to Sturt Fleurieu for general practice training in 2007, had previously done an intern placement with Sturt Fleurieu.
Conclusions:
The high level of support, excellent teaching and numerous learning opportunities in general practices is an excellent resource in junior doctor training. With continued funding and support for practices, intern rotations in general practice will continue to provide a positive experience for junior doctors in areas of workforce need. RTP’s are ideally placed to develop these rotations and act as a support for the private practices, interns and tertiary hospitals. Well run intern placements are an excellent recruitment ground for future general practice registrars.
PARTNER PERCEPTIONS OF BARRIERS TO LIVING IN A RURAL COMMUNITY
Dr Stacey Panozzo, Dr Caroline Laurence
Adelaide to Outback GP Training Program
There is limited research and understanding of the perceived barriers and concerns of the spouse/partner of GP registrars toward living and working in rural communities prior to the GP registrars rural placement remains limited. This study sought to identify the perceived barriers concerns from the spouse/partner perspective of GP registrars in South Australia (SA) who were due to undertake their rural placements in 2008.
Two focus groups were conducted with 12 spouses/partners of both rural and general pathway GP registrars from each of the three SA regional training providers (RTPs).
The findings revealed barriers to include limited spouse/partner employment opportunities, a lack of facilities, amenities and entertainment available, a lack of education opportunities for children, and GP registrar workload. Other aspects of concern included the community size and the view that ‘everyone knows who you are’, and the distance from urban centres. Suggestions for improvement were also made by participants and included: provision of community information and services available; and community orientation.
The results of this study can be used by RTPs to develop strategies to address partner concerns with and improve the experience of a rural placement for the family of registrars.
RURAL POST GRADUATE PRE VOCATIONAL PLACEMENTS (PGPPP) IN WESTERN AUSTRALIA NEW DATA ON UPTAKE OF POSTS AND QUALITATIVE EXPERIENCES
Dr Lesley Skinner 1, Dr Denese Playford 1, Ms Rosemary Ingham 2
1 Rural Clinical School Of Western Australia (RCSWA), 2 School of Primary, Aboriginal and Rural Health Care (SPARHC)
Introduction
As rural GP training develops nationally it is important to provide descriptions of current programs and factors associated with their success.
Prevocational General Practice Placements Program (PGPPP) is a Commonwealth funded initiative that provides pre-vocational junior doctors with general practice experience across a range of medical and procedural disciplines. It is recognized by both of the Australian GP colleges. In 2006, management of the Western Australian programme was transferred from the urban Postgraduate Medical Council to the RCSWA within SPARHC, allowing us to assess the impact of a rurally- focused organization on PGPPPP experience and uptake.
Method
PGPPP Registrars were surveyed pre and post placement to obtain qualitative data on their experiences. The number of junior doctors, RCSWA and non-RCSWA, who chose PGPPP rotations as part of their graduate training was used as a proxy for the quantitative impact of the programme.
Findings
Junior doctors report that PGPPP enhances their development of a broad range of clinical and consulting skills. As a result of their PGPPP experience, junior doctors clearly identify positive features of rural practice. They consider the PGPPP placement as positively impacting both their career development and their intention to work rurally in the future.
Quantitatively, there is a relatively small but stable recruitment into the programme. 34 placements were completed over the three years, 2006-2008. A clear trend associated with management by RCSWA was the sharp increase in RCSWA graduates recruited into the PGPPP scheme, from 17% in 2006 to 46% in 2008.
Conclusion
Undergraduate and prevocational educations are being linked in Western Australia through joint management of the RCS and PGPPP programmes. Sustainability of rural residencies is likely to depend on this kind of vertical integration in medical education.
PIPE DREAM - FROM MEDICAL STUDENT TO GP REGISTRAR: HOW VERTICAL INTEGRATION EDUCATION MODEL IMPROVES GP WORKFORCE IN THE NORTHERN TERITORY
Mrs Nicole Lamb, Mrs Margaret Vigants
Northern Territory General Practice Education Ltd(NTGPE)
NTGPE is one of a few regional training providers (RTPs) that use the vertical integration model to effect change in the GP workforce in its region. NTGPE manages medical student education and placement through its Rural Undergraduate Support and Coordination (RUSC) program, junior doctors through the Prevocational General Practice Placements Program (PGPPP), vocational doctors through GP training program and international medical graduates (IMGs) through its IMG Education and Support Program.
We have kept statistics on the number of medical students that have returned to the NT to do a prevocational placement and then returned again to join the GP training program.
This abstract will outline the number of medical students who have returned to do a PGPPP placement and then joined GP training in the NT. We will also show the numbers of GP registrars that have become medical educators with NTGPE. These figures prove that providing program participants with a well rounded/supported placement will assist with the long term recruitment of general practitioners in the NT.
Since the PGPPP commenced in 2005, our figures show that a high percentage of junior doctors have previously done a medical student placement in the NT and over 70% of the junior doctors who have done a PGPPP placement in the past three years have come back to join our GP training program.
We will outline what makes NTGPE different, how we support our participants to give them the best possible experience during their placement and how successful vertical integration is, also how we can better improve our programs with ongoing funding for accommodation, consulting space and supervisor support.
VERTICAL INTEGRATION SNAKES & LADDERS
Dr Eldon Lyon
Greater Green Triangle GP Education and Training (GGT GPET)
The small rural clinic in which I work began the training year in a more complex fashion than usual. Employing one full-time and two part-time general practitioners, we had elected to accept Prevocational General Practice Placements Program (PGPPP) interns as well as our usual basic term registrar. In addition we were still employing the previous years registrar, now in subsequent term, and for the first five weeks a medical student joined us for her elective.
The manpower teaching problem was exacerbated by the departure on holiday, for the month of February, of the married partners, full-time GP and one of the part-time GPs.
Vertical integration was stretched to the limit and some innovative methods of teaching were employed. This was aided by good preparation in devising time-tables for the student and intern which made much use of the local hospital and paramedical facilities. Combinations of different trainees were taught together and choices of topics and methods carefully considered in order that each level could benefit.
A considerable amount was learnt about the benefits and drawbacks of vertically integrating medical personnel at differing stages of their education.
I would seek to utilise what was learnt in a workshop format. Projecting a giant snakes & ladders board opposing teams of up to fifteen competitors would play the game. Captions on squares eg. “student and intern visit audiologist” (up ladder) or “registrar disinclined to teach” (down snake) would act as talking points. The workshop would provide a light-hearted look at in-practice vertical integration.
PEER-TO-PEER PROMOTION: THE SUCCESS STORY OF THE GPSN
Mr Joe-Anthony Rotella
Chair, General Practice Students Network (GPSN)
In 2007, the General Practice Students Network (GPSN) emerged onto the national GP stage with a new take on an old problem- not enough GPs! For the first time in Australia, a student-run organisation for medical students was created that sought to address the problem of recruitment in general practice from within. Since then, the GPSN has expanded at a rapid rate to now include 17 local clubs at almost every medical school as well as a three member National Executive. GPSN Chair and Founder, Joe-Anthony Rotella will talk about how the GPSN came into being and why it will continue to serve as a beacon for the future of general practice.
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Symposia Stream A
Thursday 28 August 2008 11:00am
FUTURE GENERAL PRACTITIONERS WITH A SOCIAL CONSCIENCE!
Dr Katrina Anderson
Australian National University Medical School/Coast-City-Country Training
The Australian National University Medical School in conjunction with Coast-City-Country Training has set up a number of special skills posts in Refugee Health, Youth Health and Prison Health to offer registrars experience in diverse areas of primary care with marginalised people. The aim of these posts is to provide registrars with a very supportive experience in an area of patient care that can be difficult and daunting at times even for very experienced doctors. We hope to give registrars the expertise, confidence and desire to continue to do this sort work in the future and have an interest in social medicine.
This paper will present qualitative data from interviews with registrars who have been involved in working in these posts over the last few years and will look at how their experience of training within these posts has affected their attitudes and their career paths since completing training. These posts can be quite challenging to the doctor for a variety of reasons and this paper will also look at what specific sort of support is required to enable registrars to feel competent and to deal with the challenging issues of working with detainees, refugees and youth. Three out of five doctors who have undertaken these posts have stayed on working in these areas and have continued to combine this with mainstream general practice work after Fellowship. For our local region this has been a very successful outcome as it can be difficult to recruit doctors to work in these environments because of the stressful nature of the work and the low remuneration.
TARGETED TRAINING IN REMOTE MEDICINE: THE "VISIBLE PATHWAY" TO VOCATIONAL REGISTRATION AND ANTARCTIC MEDICAL PRACTICE
Dr Edi Albert 1, Dr Jeff Ayton 2
1 General Practice Training Tasmania, 2 Australian Antarctic Division
The Polar Medicine Unit provides health and medical care to personnel participating in Australia’s Antarctic Program. Antarctic medical practitioners require a unique combination of skills in remote medicine that include emergency medicine, surgery, anaesthetics, public health and occupational health.
In common with many remote areas of Australia, the Polar Medicine Unit has had increasing difficulty recruiting appropriately trained doctors. It has been observed that some doctors have applied for posts either towards the end of, or after completion of vocational training, but do not have an appropriate skill set.
We therefore devised a training pathway that could be marketed to medical students, interns and resident medical officers (RMOs). and utilised by any regional training provider (RTP) or remote vocational training shceme (RVTS) that would allow registrars to undertake training that would prepare them for both Antarctic medical practice and vocational registration.
This presentation will describe how this new pathway may be implemented and adapted to suit individual registrars’ interests.
WHAT DOES IT COST TO TEACH IN A COMMUNITY GENERAL PRACTICE SETTING?: RESULTS OF THE ADELAIDE TO OUTBACK GP TRAINING PROGRAM STUDY
Dr Caroline Laurence
Adelaide to Outback GP Training Program
Objectives
With the increase in medical students and graduates over the next five years, there will be increasing pressure on institutions providing medical education. While some of this increase may be accommodated within teaching hospitals, a significant proportion is likely to be accommodated within general practice (GP) in the community. GP has shown that it can successfully teach medical students, junior doctors and registrars, making it an attractive option. This study aims to identify the costs associated with teaching in community based general practice.
Methods
The study is a survey of all teaching practices within Adelaide to Outback GP Training region (70 practices) involved in teaching medical students, junior doctors and/or GP registrars. Data collection is based on a questionnaire, with additional information collected through a focus group with practice managers. The survey content includes attitudes to teaching, current teaching load, capacity to expand teaching and costs of teaching.
Results/principal findings
Preliminary findings from the survey will be presented and will include data on teaching load, activities undertaken by practice staff as well as other educational activities such as up skilling and supervision of international medical graduates (IMGs). Costs will be identified with each of these activities.
Discussion
The study will describe the current teaching load in general practice across all levels using Adelaide to Outback as a case study. It will also identify the direct and indirect cost associated with teaching and the benefits to GPs and practices.Implications for policy or practice
This study provides evidence to inform the provision of appropriate support strategies for teaching in general practice in the future.
PRACTICAL SKILLS OF DOCTORS ENTERING THE WAGPET PROGRAM. WHAT HAVE THEY DONE BY THE END OF THEIR 1ST GP TERM?
Dr Michael Eaton
Western Australian General Practice Education and Training (WAGPET)
Introduction
Hospital based doctors in training face decreasing access to practical skills. Both ACRRM and RACGP have defined the range of skills that general practice registrars need to acquire for baseline general practice competence. What are their learning needs?
Method
A auestionnaire listing 38 practical skills usually performed in consulting rooms or a minor theatre [local anaesthetics, joint injections/aspirations, simple minor surgery and some complex minor surgery] was given to each attendee at a procedural skills workshop run centrally at the beginning of their 2nd [advanced] term in general practice over one year. The registrars were asked to identify which of the 38 skills they had performed even once. The results were collated and analysed.
Findings
- 6% had performed only six skills or less
- 88% had performed less than 50% (19) of the range of skills
- Highest 12% had performed only two thirds (24-26) of the skills.
- There was a wide range of exposure to particular skills
- Some skills had not been performed by any of the registrars.
Conclusions
General practice registrars are increasingly unlikely to gain minor procedural skills in the hospital setting. Systematic planning to provide practical skills teaching at central, regional, local and practice level is needed for any progress to be made in improving the level of GP practical skills. BRIDGING THE CULTURAL DIVIDE
Mrs Tanya Honeychurch
Bogong Regional Training Network
ESL …. Self Evaluation …. Team Work…. Support
Bogong Regional Training Network now offers an holistic approach to English language support and cultural exchange with our overseas trained doctor cohort (66% of our current intake).
Initiated by our new entrants weekend ‘ROADS’ (Recognising Obstacles and Developing Solutions) activity series, overseas doctors demonstrate that the activities enable them, in a supported way, to be able to self evaluate their need for enhanced English language skills.
Our voluntarily attended monthly group workshops are based on themes such as ‘Aussie Slang’ the art of eliciting information, cultural awareness, explanation language, grief and loss language, and how to manage difficult relationships.
Workshops are co-facilitated by our ESL (English as a Second Language) teacher and a medical educator. Registrars are personally coached through topical articles, grammar activities, texts and CDs to achieve their personal best through team work!
Symposia Stream A
Thursday 28 August 2008 01:30pm
THE EVOLUTION OF A SUPPORT PROGRAM FOR INTERNATIONAL MEDICAL GRADUATES: 6 YEARS OF EXPERIENCE FROM ADELAIDE TO OUTBACK
Ms Vanesssa Ryan, Ms Taryn Elliot, Mr Lucien Sankey
Adelaide to Outback GP Training Program
International medical graduates (IMGs) represent a significant proportion of the rural general practice workforce. They often work as solo practitioners in areas that are under resourced and geographically isolated. Arrival in Australia for IMG's requires adjustment to cultural, clinical, language and health system differences.
At the same time, IMGs are often managing a busy clinical schedule and preparing for the Fellowship exams.
In recognition of these real issues for IMG’s, funding was made available through the Rural Doctors Workforce Agency in 2002 to the Adelaide to Outback GP Training Program (A2O). Since this time, A2O has provided IMGs working in the Spencer Gulf region of South Australia, with access to educational support.
The IMG Fellowship Support Program has grown since its inception in 2002.
Beginning with 19 IMG’s and a small budget, the program provided resources and support to attend external workshops. Over time, the program has developed in response to identified needs, a growing body of evidence, lessons learnt and experience. The IMG Fellowship Support Program has become a comprehensive educational program tailored to the unique needs of IMGs.
This presentation will discuss how the support program has evolved over time. It will look at how building the evidence, enhanced budget support and experience has shaped and developed a supportive educational program for IMGs.
WORKING WITH REGISTRARS WHO EXPERIENCE DIFFICULTIES WITH ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH TRAINING
Dr Jennifer Reath 1, Dr Peter O'Mara 2, Dr Wendy Thornthwaite 2
1 General Practice Educatin and Training Ltd (GPET), 2 GPET Aboriginal and Torres Strait Islander Health Training Reference Group
While most registrars enthusiastically engage in learning about Aboriginal and Torres Strait Islander health, some do not accept the requirement for this training, fail to understand historical and cultural issues impacting on health, or have difficulty demonstrating evidence of cultural awareness such as appropriate communication skills.
A recent project undertaken on behalf of the GPET Aboriginal and Torres Strait Islander Health Training Reference Group used feedback from regional training providers, information from medical and cultural educators and a literature review to describe common learning difficulties and propose training strategies to assist in addressing these difficulties. This paper presents key findings of the report including reference to GPET’s Performance, Assessment, Monitoring and Intervention Framework which provides an overall context.
Strategies include those found useful in preventing difficulties from occurring, in early diagnosis of difficulties, and with registrars experiencing difficulty completing requirements of the Aboriginal and Torres Strait Islander health curriculae. The involvement of cultural educators and mentors in diagnosis of difficulties as well as in planning and implementation of remediation activities is essential.
There is a dearth of literature documenting common learning difficulties and effective teaching strategies in this area. The experience of Regional Training Provider educators many of whom have been training for over ten years provides valuable and evidence based information for those with less experience in this area of training.
BOGONG'S ROADS TO GENERAL PRACTICE
Dr Mark Burgemeister
Bogong Regional Training Network
ROADS (Recognising Obstracles and Developing Solutions) is a registrar evaluation session developed by Bogong Regional Training Network for new basic term registrars during their introductory weekend workshop. Registrars individually move through a series of stations related to training and working in general practice, highlighting some of the differences they will encounter moving from hospital-based to general practice.
The activities include; a consultation with a patient (actor), a clinical scenario, a learning styles activity and critical review of a general practice consultation (video). Each station is manned by a medical educator and the consultation is observed by an ESL (English as a Second Language) specialist.
The objectives of each activity are to provide an initial evaluation of the registrar’s skills and attitudes, but mostly to allow discussion between the registrar and medical education team on focused areas of learning.
ROADS allows training advisors to work with each registrar to tailor their individualised learning plan and enter it into GPRime at their first workshop. This introduction to adult learning at Bogong occurs in December prior to first term so that the registrar has an understanding of their learning needs and a familiarity with their own learning plan and GPRime, well in advance of starting community General Practice.
ROADS is a session which requires considerable teamwork throughout the RTP –all aimed at individual excellence for each registrar.
SAFEGUARDING MEDICAL STUDENT EXPERIENCES OF PLACEMENT IN NORTHERN TERRITORY INDIGENOUS COMMUNITIES - PRELIMINARY REPORT
Dr Ameeta Patel, Dr Hung Nguyen, Ms Margaret Vigants
Northern Territory General Practice Education (NTGPE)
A positive community placement is crucial in fostering an interest in Aboriginal health and in encouraging medical students to return to the NT to pursue rural/remote general practice as a career. NTGPE as a regional training provider has a responsibility to provide safe, effective and positive learning experiences for medical students, as well as a responsibility to the host clinic and community, during student placements to remote Aboriginal communities. A retrospective analysis of students’ experience of placement, and analysis of critical incidents, is the basis of the study; ethics approval has been sought. There appear to be a significant number of critical incidents involving medical students, estimated at 10% of placements. These vary widely and include non-clinical (e.g. 4WD motor vehicle accidents, physical assault) and clinical (e.g. inadequate supervision, near-misses, errors in clinical care) events. Contributory factors are myriad and may include the age and gender of medical students, supervision by non-doctor clinic staff, and pre-placement preparation. The findings will be implemented by making additional recommendations to existing NTGPE policies for risk management /prevention. The findings could also be extrapolated to prevocational junior doctor placement programs, registrar training and allied health trainees in remote Aboriginal health settings. Whilst the majority of placements are very successful, negative placement experiences may have long term impacts on student wellbeing and career choices.
SUPPORTING INDIGENOUS REGISTRARS
Dr Aleeta Fejo
This Presentation will introduce the subject of support for Indigenous GP Registrars. It will highlight the need for such a group so that GPET will recognize the unique challenges and assets that IGPR’s are able to contribute to General Practice within Australia.
Some issue’s include:
- Social and Professional Isolation
- Having to face and deal with health and social implications of political decisions
- Having to find the balance between maintaining ones cultural identity and role, and the GP’s role.
Some contributions include:
- Providing information to GPRA on issues relevant to IGPR
- Provide personal support, advice and information to IGPR
Support for IGPR’s is very important because if Australia is going to value the contributions that IGPR’s make to improving Indigenous Health, Australia must recognize, value and encourage the maintenance and development of ATSI Cultural Identity.
This support group can have an impact on the role that GP’s play not only in Indigenous Health, but potentially across Australia, through influencing and making aware issues that affect all registrars and their patients.
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