The supervision during the formative moments: a continuous formation f or practitioners in Italy.

1. The supervision during the formative moments: a continuous formation for practitioners in Italy. 2nd annual meeting of GP/FM teachers in Europe -Assessment in FP/GP Kranjska Gora 23-24 September 2005 Carmela Zotta MD and Diego Sabbi MD Family Physicians - AIMEF ( Italian Association of Family Physicians) Italy

2. The supervision during the formative moments: a continuous formation for practitioners in Italy. In Italy the continuous formation postgraduate of medicine family’s phisicians is obligatory for law; nevertheless precise rules don't exist for the disbursement of the contents. Historically, until the operativeness bylow about ContinuousEducation in Medicine (ECM-2002), the assignement to organize courses of scientific updating and professional formation has been developed by the Medical Societies. __________________________________________________________ The fragmentation of various Scientific Societes didn’t permit to formulate objectives and shared didactic methodologies.

3. The supervision during the formative moments: a continuous formation for practitioners in Italy. They are still currently the Scientific Societies, with private and public provider, to organize the formative appointments, that after recording on special form internet of the Health’s Ministery, is appraised, with the attribution of a score (ECM credits), by 3 referees divided for the various medical specialties. The score estimates the methodologies of teaching, the hours used in classroom and the availability of didactic materials etc. __________________________________________________________ The weight of the pharmaceutical industry is notable and this makes unbalanced the formative offer toward sectors that the business marketing makes more desirable.

4. The supervision during the formative moments: a continuous formation for practitioners in Italy. The physicians are forced, as by law enacted, to reach a number of annual credits, for now thirty and subsequently fifty. __________________________________________________________ All the costs of professional formation burden on the physician.,because are not anticipated for contract abstentions from the job for updating

5. The supervision during the formative moments: a continuous formation for practitioners in Italy. In the courses of the family’s medicine one or more facilitator (GPs graduated in the various Scientific Societies ) manage the event with the contribution of experts of the medical specialties dealt. The didactic materials areoften "formative packets"self madein the respect of the active pedagogy. __________________________________________________________ Not always the formation meets the interest of all sharers : indeed an ample knapsack of colleagues without motivation is interested only in the attainment of the credits necessary.

6. The supervision during the formative moments: a continuous formation for practitioners in Italy. The experience of formation that AIMEF has developed in the last years has brought to the elaboration of a new figure: The Supervisor __________________________________________________________ It derives from the necessity to transfer also methodological contained to experts of the medical specialties devoid of didactics and to check in progress the activity of the facilitators of our scientific society.

7. The supervision during the formative moments: a continuous formation for practitioners in Italy. The supervisor is an experienced GP of didactics and formation who observes ,without directly participating, a formative event. Using special evaluation’s grates he expresses a judgment and he writes possible suggestions for the improvement of the following events.

8. The supervision during the formative moments: a continuous formation for practitioners in Italy. The grates appraise the logistic organization, the teachers and the classroom. The judgment so formulated allows to check the event in its entirety with a considered, repeatable and comparable system.

9. The supervision during the formative moments: a continuous formation for practitioners in Italy. Example of supervision (La Thuile, february 2003)

10. Evaluation about Score 0 Score 1 Score 2 Score 3 Score 4 Introduction nothing not much partially very much fully Si presenta ai discenti  Favorisce la comunicazione tra i discenti  Crea un atmosfera adeguata  Illustra i metodi e le tecniche didattiche  Forma i gruppi di lavoro  Raccoglie aspettativa ed esigenze dei discenti Lesson Inquadra la lezione all’interno del corso Utilizza un linguaggio pertinente chiaro e preciso Descrive logicamente le fasi del modello formativo Sceglie le tecniche educative ed adegua il linguaggio tenendo conto del contesto Mantiene lucidità e disponibilità nonostante le interruzioni  Utilizza la mimica e la gestualità per mettersi in contatto con i discenti Model Descrive i materiali in modo esauriente Illustra adeguatamente le manovre da compiere Organizza esercitazioni di gruppo Esegue una valutazione sui singoli stimolandoli a far meglio Mantiene un atteggiamento paritetico con il discente durante la spiegazione Ripone i materiali al termine della simulazione Before: score 012345 The teacher appears quite Then: score 012345 When the lesson is completed the teacher gives bibliographic guidelines of concern and updating He offer to participants He encourages the message among the participants He creates a confortable atmosphere He shows the educational metods ed tecniques He consitutes the work’s groups He gets in prospects and demands of participants He frames the lesson into the course He uses a properly and intelligible language He describes logically the steps of formative example He choose the educational techniques and adjusts the language esteeming the framework He is mindful and receptive although the breakings He uses the pantomime and motions to network the participants He describes the materials in exhaustive way He shows propery the handlings to observe He organizes the group’s exercises He accomplishes an evaluation about singles exciting them to make better He keeps an equal attitude toward the participant through the lesson He puts back the materials after the model

11. The supervision during the formative moments: a continuous formation for practitioners in Italy. As regards to the experts of the medical specialties this has allowed the Scientific Society to understand better personal motivations, didactic ability and knowledges of the single professionals and to begin to word a list of the most suitable colleagues to intervene in our formative moments.

12. The supervision during the formative moments: a continuous formation for practitioners in Italy. I thank for your attention and let you work