LearningLearning

What do we want to What do we want to learn…. learn….

…….and how do we do it?.and how do we do it?

Think about what you’re Think about what you’re going to have to learn on the going to have to learn on the

VTSVTS

Bradford VTS aimsBradford VTS aims Knowledge of clinical Knowledge of clinical

medicinemedicine Understanding of health Understanding of health

care for populationscare for populations Broad understanding of Broad understanding of

medical ethicsmedical ethics Evidence based medicineEvidence based medicine Preventive medicinePreventive medicine Patient centred medicinePatient centred medicine Use time effectivelyUse time effectively Good communication Good communication

skillsskills

Organise an efficient and Organise an efficient and caring practicecaring practice

Work effectively in teamsWork effectively in teams Audit own performanceAudit own performance Able to adapt to changeAble to adapt to change Plan continuing Plan continuing

professional developmentprofessional development Balance demands of Balance demands of

work and personal lifework and personal life Tolerate uncertaintyTolerate uncertainty Value diversityValue diversity

MRCGP: 17 domainsMRCGP: 17 domains

Knowledge: factual, evolving, evidence baseKnowledge: factual, evolving, evidence base Evaluating and using knowledge: critical appraisal, Evaluating and using knowledge: critical appraisal,

application of knowledgeapplication of knowledge Problem solving: general, specificProblem solving: general, specific Personal care for patientsPersonal care for patients Communication: written, spokenCommunication: written, spoken Practice context: practice issues, regulatory frameworkPractice context: practice issues, regulatory framework Broader context: medicopolitical/legal/social, Broader context: medicopolitical/legal/social,

cultural/ethniccultural/ethnic Values/attitudes: ethics, commitment to maintaining Values/attitudes: ethics, commitment to maintaining

standards, self awarenessstandards, self awareness

Think about how you learned Think about how you learned somethingsomething

Experiential learningExperiential learning

ExperienceExperience

Observe and Observe and reflectreflect

Make abstract conceptsMake abstract concepts and generalisationsand generalisations

Test implications Test implications of concepts of concepts

in new situationin new situation

The reflective practitionerThe reflective practitioner

The professional practitioner The professional practitioner reflects on their reflects on their knowledge whilst engaging in activityknowledge whilst engaging in activity. This . This enables them to adapt to the potentially unique enables them to adapt to the potentially unique context or problem with which they are faced context or problem with which they are faced ((SchonSchon, 1983), 1983)

Professional Professional education should provide people education should provide people with the opportunity to reflectwith the opportunity to reflect on their practice on their practice and identify the theories embedded in their and identify the theories embedded in their routine work (Coles, 1994)routine work (Coles, 1994)

Constructivism Constructivism (3 C’s)(3 C’s)

Construction - you build your knowledge Construction - you build your knowledge on what you know alreadyon what you know already

Context - important both in learning and in Context - important both in learning and in applying itapplying it

Collaboration - work together and explore Collaboration - work together and explore each other’s perspectives: “knowledge” each other’s perspectives: “knowledge” varies across contexts and culturesvaries across contexts and cultures

Adult learningAdult learning

Learning what’s important to youLearning what’s important to you Applicable in the real worldApplicable in the real world Learner, not teacher, is responsibleLearner, not teacher, is responsible Learning is self directedLearning is self directed Learning is continuous, adapts to new Learning is continuous, adapts to new

situationssituations

Think about feedbackThink about feedback

Definition of feedbackDefinition of feedback

Information about performance or Information about performance or behaviour which leads to action to affirm behaviour which leads to action to affirm or develop performance or behaviour - i e or develop performance or behaviour - i e

To affirm what you do wellTo affirm what you do well To help you develop in areas you do less To help you develop in areas you do less

wellwell

Useful feedbackUseful feedback

Is well timed (enough time, full attention, Is well timed (enough time, full attention, calm, prepared)calm, prepared)

Involves mutual goodwillInvolves mutual goodwill Is balancedIs balanced Is specificIs specific Is descriptiveIs descriptive Can lead to change (if change required)Can lead to change (if change required)

Receiving feedbackReceiving feedback

May need to askMay need to ask Listen carefullyListen carefully Ask for clarification, examples, alternativesAsk for clarification, examples, alternatives Give it time to sink inGive it time to sink in Think about your relationship with the Think about your relationship with the

givergiver Don’t let small criticisms devastate youDon’t let small criticisms devastate you Don’t be defensiveDon’t be defensive

Giving feedbackGiving feedback

GP trainers value feedbackGP trainers value feedback Be balancedBe balanced Be specificBe specific Make suggestions for changeMake suggestions for change Don’t wait till you’re about to leaveDon’t wait till you’re about to leave

Think about learning from Think about learning from each othereach other

Learning from each otherLearning from each other

FeedbackFeedback Facilitating reflectionFacilitating reflection Sharing knowledgeSharing knowledge Sharing resourcesSharing resources Teaching skillsTeaching skills Different perspectivesDifferent perspectives

Some learning toolsSome learning tools

Problem case analysis - things you know Problem case analysis - things you know you don’t knowyou don’t know

Random case analysis - issues you Random case analysis - issues you haven’t identifiedhaven’t identified

Critical incident analysis - learning from Critical incident analysis - learning from mistakes and near missesmistakes and near misses

PUNs - patient unmet needsPUNs - patient unmet needs DENs - doctor’s educational needsDENs - doctor’s educational needs

SummarySummary

There’s a lot to learnThere’s a lot to learn ‘‘Knowledge’ is only part of itKnowledge’ is only part of it Even ‘knowledge’ isn’t straightforwardEven ‘knowledge’ isn’t straightforward There are many ways to learnThere are many ways to learn Most of your learning will be from Most of your learning will be from

yourselves, each other and your patients, yourselves, each other and your patients, not your teachersnot your teachers

Understanding learning helps you do it Understanding learning helps you do it more effectivelymore effectively

Recording educational Recording educational experience - why?experience - why?

As evidence of learning (for Trainer’s As evidence of learning (for Trainer’s report etc, and for appraisal)report etc, and for appraisal)

To enhance learningTo enhance learning To plan future learningTo plan future learning To reflectTo reflect

Recording educational Recording educational experience - how?experience - how?

Log book with tick boxesLog book with tick boxes Reflective diaryReflective diary Critical incidentsCritical incidents Cases with learning pointsCases with learning points Electronic diaryElectronic diary Email exchange with trainerEmail exchange with trainer

Whatever method you chooseWhatever method you choose

Record it somehowRecord it somehow and choose somethingand choose something (or several things)(or several things) which works for YOUwhich works for YOU