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Concerns and performance. Dr Barry Lewis Director GP Education. Defining Clinical and Educational supervision. Generic ‘supervision’ model Normative Environment and ‘tools’ Formative Teaching, coaching, mentoring Assessment Restorative Recognising difficulty and responding remediation. - PowerPoint PPT Presentation
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Concerns and performanceDr Barry LewisDirector GP Education
Defining Clinical and Educational supervision
• Generic ‘supervision’ model– Normative
• Environment and ‘tools’
– Formative• Teaching, coaching, mentoring• Assessment
– Restorative• Recognising difficulty and responding• remediation
Task
• Take the model and agree where the 3 domains fall into the ‘trainer’ roles
• Agree ‘key’ roles for CS and ES
• Allow 15 mins for task
• Summary
Coaching
Clinical Coaching (JACSTAG)
• Demonstration of the full procedure
• talking through the procedure
• trainee talking through the procedure
• trainee undertaking the procedure
GROW• GOAL setting for the session
as well as short and long term
• REALITY checking to explore the current situation
• OPTIONS and alternative strategies or courses of action
• WHAT is to be done, WHEN, by WHOM and the WILL to do it.
Concerns about performance
• Task– Produce a list of performance parameters
that will allow ‘reporting’ of concerns
– e.g – poor punctuality– Include clinical and educational areas
• Allow 20 minutes
National Patient Safety Agency
• Low standard of work, mistakes.
• Inability to cope with work volume
• Unacceptable attitudes– To patients– To colleagues
• Punctuality and absence issues
• Specific skill deficiencies
National Patient Safety Agency
• Lack of awareness of standards required
• Failing to meet agreed objectives
• Acting outside competence limits
• Poor supervision of others when this is required
• Health problems that impact on work
ARCP Flow Chart
Meeting with educational supervisor – Initial PDP
Clinical supervisor appraisal 0, 3 & 6 months
e-portfolio evidence
Meeting with Educational supervisor 6 month appraisal
Satisfactory progress Produce PDP
Some concerns
Significant concerns
Feedback from PD and PCME
Produce PDP for next 6 months – copy to PD
Involve PD to produce PDP for next 6 months
Meeting with ES PD and AD to plan action including PDP
Meeting with Educational supervisor Educational appraisal – review of portfolio. NHS Appraisal Report to ARCP Panel
Satisfactory progress
Development needs – additional supervision or learning within normal training time. Produce provisional PDP
Development needs requiring additional training Produce statement of concerns and competencies to be developed
ARCP Review panel reviews report, portfolio and PDP
Outcome 1 Satisfactory progress PDP accepted or minor changes
Outcome 2 Additional learning or supervision needed No additional time PDP accepted or modified
Outcome 3 Additional training time required Action plan inc. PDP produced
WPBA
Educational and Clinical experience
WPBA Clinical supervisor appraisal 0, 3 & 6 months
e-portfolio evidence
Feedback from PD and PCME
Educational and Clinical experience
Continue as planned
Meet ES or PD to discuss plan
Meet with AD PD ES to implement plan
E-portfolio competence areas
• Communication/consultation skills
• Holistic practice• Data gathering,
interpretation• Making
diagnosis/decisions• Clinical management• Managing complexity
• Primary care admin• Working with
colleagues, teams• Community orientation• Performance, learning
and teaching• Ethical approach• Fitness to practice
Handling concerns – good practice
• Receiving information• Patient safety• Informing the trainee• Supporting the trainee• Dealing with concern
– Informally– ………………………………………….– formally
CS/ES
Examples
• Task– In groups of 3-4 choose a specific example
from experience, summarise it and decide how, in the new training environment, this should be recorded and handled.
– Allow 15-20 min
Handling concerns – good practice
• Gathering further information
• Deciding what to do
• Understanding contributory factors
• Interventions and remediation
• Review
• Aftermath and rehab.
PD >ARCP > AD