The Training Log

1. The Training Log Experienced Trainers’ Course 2005

2. Information gathering • Takes place all day • Takes place in different contexts • Comes from multiple sources • Can be subtle feelings which we must record

3. WHO ? HOW ? • Registrar • Trainer • Should it be shared document • Contributions from other team members • Written or electronic • NOT in your head !!

4. GROUP WORK • BLOCKS

5. Blocks to recording • Time • Last task on the pile • Too complex and cumbersome • Not accessible • What use is it anyway? • Fear of writing it down • Not knowing what to put in

6. Reflective diary- tips • Must be handy • Try to write in it most days • Relections/actions/what am I recording? • About GPR • About me • About the learning environment • Write down ANY thoughts

7. Why keep a log?Immediate needs • To aid and record reflection • To record learning needs perceived by learner • To record learning needs perceived by Trainer • To record negotiated curriculum plans/timetable

8. Why keep a log? Medium term needs • To see progress • To help order your thoughts • Continued recording of learning needs and curriculum planning • To share with registrar and show model • Reassurance

9. Why keep a log? Long term • To aid completion of the structured trainer’s report • Evidence of good or bad performance • As future teaching resource • For future reference construction

10. What are we looking for? • Expectations at different stages of training • What is normal development? • Without a knowledge of normal development impossible to assess accurately • Normal milestones

11. Stages of development • Unconscious incompetence • Conscious incompetence • Conscious competence • Unconscious competence

12. Group exercise • Working out the milestones • What is a normal registrar behaviour • First few weeks • At 3/12 • At 6/12 • At 9/12 • At 12/12

13. 6 weeks(1) • Good time keeping • Enthusiasm • Observe presentation/dress • Lacking in confidence • Worried about learning agenda • Identifying own learning needs topic based • Express some areas of expertise • Share background information • Curiosity

14. 6 weeks(2) • Needs 30minutes to assess patients • Struggles with consultation task list • Struggles with computer • Hospital-style clinical skills • Makes complex diagnoses • Orders many or no investigations • Huge Dr’s agenda • Surprise at family dynamics • PEPS a bit daunting

15. 6 weeks(3) • Variable team skills • Observe ability to cope with change • Keen attendance at practice meetings • Social skills at getting on with team • Early feedback from accompanying PHCT • Very keen to sit in • Finds constructing simple management plans difficult • “I’ll never be able to do this” is normal

16. At 6/52 priority objectivesGroup Work PATIENT CARE • Should feel safe • Emergency care adequate • Basic prescribing • Wants to do own surgeries • Should be asking • May be dr centred

17. At 6/52 Priority ObjectivesGroup Work COMMUNICATION • Knows who/how to contact when • Knows referral systems including OOH • Will ask for help • Can talk and listen to patients • History taking hospital style

18. At 6/52 Priority ObjectivesGroup Work ORGANISATION • Can use computer • Knows team/telephone/ alarm • Starting to plan year PROFESSIONAL VALUES • Punctual • Respect • Probity • Dress code • Confidentiality

19. At 6/52 Priority ObjectivesGroup Work PERSONAL/PROFESSIONAL GROWTH • Ownership of learning contract • Started Log for PDP • Still at the FEED ME stage

20. At 3 months • Enthusiasm • Chinks beginning to show through • 20minute consultations • Identifying more complex learning needs • Will do PEPS and share results • Comfortable with computer • Able to grasp family dynamics and is curious • Still follows up simple problems • First video

21. At 3 months (2) • Struggling with time management • Integrating into team • Still likes to sit in • Has ideas re audit project • Beginning to change consultation style • Able to use open questions • Realising that they have knowledge • Should have dealt with some difficult issues • Keen to take on tricky problems • Will do visits alone

22. At 3 months (3) • Responds to feedback in constructive way • Attitudes and beliefs beginning to show • Prepares well for tutorials • Starting to challenge Trainer • Plans to sit summative assessment mcq • Can write a good referral letter

23. At 3/12 Priority ObjectivesGroup work PATIENT CARE • Consulting 20min • Some videos • Safe in emergencies • Basics of chronic disease • Minor ailments understood • Own home visits

24. At 3/12 Priority ObjectivesGroup Work ORGANISATION • Punctual • Recording accurately • Attends VTS • Keeping log • Dr,s bag organised has own equipment • Knows about the formulARY

25. At 3/12 Priority ObjectivesGroup Work COMMUNICATION • Use of computer – notes and presenting • Video skills • Record keeping adequate • Seeking out the team

26. AT 3/12 Priority ObjectivesGroup Work PROFESSIONAL VALUES • Has professional image • Asking for help comfortably • Values team work • Participating in medical meetings

27. AT 3/12 Priority ObjectivesGroup Work PERSONAL/PROFESSIONAL GROWTH • Helping to run the team • Reading

28. At 6 months • Taking responsibility and initiative • Has completed first audit cycle project • Shows inititiave in day to day work • Shows initiative in Learning • More challenging • Comfortable with video • Worry about mrcgp/video • Has built up own “list”

29. At 6 months • Management plans more realistic • 15 minute appointments • Does not follow up simple problems • Integrating well into team • Team will go to him for help • Does on call sessions • Will cover for absent partners willingly • Able to deal with basic admin

30. At 6/12-priority objectives group work PATIENT CARE • Good management of emergencies • Preventative medicine skills present • Chronic disease management skills present • Computer literate • Knows own role in team and contributes • Using video

31. At 6/12 Priority ObjectivesGroup work COMMUNICATION • 10 minute consultations ORGANISATION • Computer literate • Audit completed • MRCGP planned

32. At 6/12 Priority ObjectivesGroup Work PROFESSIONAL VALUES • On time • Clean/not smelly • Respect for peers • Respect for patients PERSONAL/PROFESSIONAL GROWTH • Developing good Log/PDP • Summative Assessment/MRCGP

33. At 9 months • 10 minute appointments • Managing complex organisational tasks • Time management good • Want to look at wider issues • Formulating own learning plans and thinking about PDP • Beginning to think more about the future • Showing an interest in finance /management/employment options • Increased interest in medical politics

34. 9 months (2) • 2nd audit cycle commenced • Looking for new projects • Master of technology and presentation • Challenging the norm • Would I like this dr as a partner? • Real dr on show – expresses opinions • Ethical dilemmas discussed regularly with insight • Planning future education

35. At 9/12 Priority ObjectivesGroup work PATIENT CARE • Independent management • Pro-active • Involved in patient groups • Involved in preventive care • Audit cycle completed

36. At 9/12 Priority ObjectivesGroup work COMMUNICATION • Teamwork functioning • Consulting skills developed at practitioner level

37. At 9/12 Priority ObjectivesGroup Work ORGANISATION • Chair meetings • Management – Understand finance and Tax • Involved in Staff recruitment • Involved in Appraisals • An interest in the running of the PCT

38. AT 9/12 Priority ObjectivesGroup Work PROFESSIONAL VALUES • ?least developed • Involved in Clinical Governance

39. At 9/12 Priority ObjectivesGroup Work PERSONAL/PROFESSIONAL GROWTH • Independent self-directed learners • Have produced log • Working on PDP

40. At 12 months • Do you feel safe to let them go? • Independent practitioner • Robust PDP • Excitement • Enthusiasm for the job

41. What to record? • Much easier when you know what to look for and expect • Use check lists? or is this too rigid • Must be personalised • There are some broad headings • KEEP IT SIMPLE AND ACHIEVABLE FOR YOU

42. Section 1 • Timetables/Rotas. • Practice and Day-Release timetable • Important dates for GP Registrars • Reading list/website addresses

43. Section 2 • Learning needs – an evolving list • Syllabus and Curriculum plans

44. Section 3 • Diary – include feedback/learning points • PUNs DENs • Weekly – To-do list

45. Section 4 • Tutorials – List and feedback sheets • Surgery debrief • Problem cases Analysis • Significant Event Analysis

46. Section 5 Feedback • Staff feedback – formal and informal • Videos • Belbin team styles • Honey & Mumford learning styles • Manchester rating scales • Wolverhampton grid • Kiddy Ring interview • SWOT analysis/exit questionnaire • Referral analysis and feedback • Self assessment questionnaire • Joint surgeries • PEPs • MEQs • Pigeon-hole audits

47. Section 6 • Audit/project • MCQ • MRCGP information • Working Towards an MSc/CATS PointsFlow chart • What to do with VTR1/2 etc at end of year

48. Section 7 • CV • Contract • Exams • Certificates • Feedback from previous jobs

49. Section 8 • Structured GP Trainer’s Report • Out of Hours Information • Out of Hours Training Workbook

50. Banbury Training Log If you would like a copy of this please send Me your address with a cheque made out to Horton Postgraduate Centre for £10.Please Also email me your request in case of Problems. My email Horton.PGTutors@orh.nhs.uk Telephone: 01295 229314