Developing a Fit for Purpose Practice Induction

1. Developing a Fit for Purpose Practice Induction 7 key points from a Trainers’ workshop Ramesh Mehay, Programme Director (Bradford), 2011

2. Point 1 – Welcome them When trainees move from hospital to GP land, they can feel rather isolated and alone. They miss their ‘mates’ who are also their colleagues with whom they collaborate, share experiences and ideas. Therefore, welcome them – really make them feel welcomed! Make them feel valued. Make them feel that they’re not in it alone and that you are there to hold their hand. Good beginnings are important – they result in solid foundations on which other things can be built.

3. Some ideas • Go out for a meal • Get them to sit in surgeries with all the docs (not just a select few). • Get them to sit in with a variety of other PHCT members (including reception). • Give them their own room and permission to personalise it (within reason). • Give them a proper name plate – like the rest of you have (not a scrappy piece of paper). • Photo of them on the staff wall/website • Welcome card and chocolates on their on their first day.

4. Point 2 – flexibility An induction system needs to be build around the needs of the trainee. Different trainees will have different needs and priorities. Therefore, simply furnishing a trainee with an ‘induction pack’ will meet the needs of some but will not hit the mark for many others. It’s time to move away from traditional rigid and prescriptive induction programmes that vary little from year to year. What is needed is a flexible set of induction tools. The one’s you pick depend on what information you have shared with each other.

5. Sharing perspectives • The trainee’s educational journey • Why they have chosen a career in GP • Their views about GPand GP training • The practice’s ethos behind training • Why the trainer wants to train • Using the whole team to train

6. Flexible tools • Do you need to find out more about the trainee as a person? Perhaps their life journey? • Do you need to explore the differences between hospital and GP life? • Do you need to explore the difficulties present in their current life. • Do you need to spend time building a relationship/trust? • Do you need to focus on what their learning needs are? • Do they have heavy clinical deficiencies – hence needing to use something like a TISA questionnaire. • How much perceptual capacity do they have? • What are their core values? • Do you need to spend time developing a shared vision?

7. Point 3 – control information Bombarding trainees with a vast array of new procedures, protocols and systems in General Practice is likely to result in nothing but apprehension and confusion. Therefore, be selective. Not everything has to be covered here and now. Some things are best tackled in context.

8. Point 4 – some bits are essential However, some induction elements are essential. Things like: • What is expected of them and what they can expect of us (educational contract, work contract) • Some regulations – Fire & Safety, Confidentiality, Emergency equipment • Computer training.

9. Point 5 – ‘sit and swap’ surgeries Sitting in with different docs is a good way of exposing the trainee to the variety of consulting styles during induction. But why does it stop there? Regular ‘Sit and Swap’ surgeries are powerful ways of helping trainees continuously re-examine and fine-tune their personal (developing) consultation style in reference to others. Scheduled monthly ‘Sit and Swap’ surgeries are therefore recommended for all GP posts (high educational impact with low impact on service-provision).

10. Point 6 – early review Make time to review matters early on in order to pick out those trainees who need that extra bit of help. Help at an early stage is instrumental to their progression and enjoyment of the post. Use your eyes and ears and listen to your gut feelings about the trainee. Talk to others informally, like admin, nurses, other docs. Or perhaps even formally say after 1 month?

11. Point 7 – a good PM A practice who has a Practice Manager who is as hooked into GP training as the Trainer is likely to deliver high educational standards. A good PM will share the same ethos towards training as the Trainer and training practice – i.e. wanting to help young new seedlings to flower. That means that they need to be trainee-centred rather than seeing what the practice gets in return. GP training and induction requires intricate planning – another reason why a good PM is instrumental, but don’t forget to get PMs involved in the educational side of things too. Things like leadership, communication skills, team working, organisation. Professional competency areas like Primary Care Admin and IT, Working with Colleagues, Community Orientation and even Fitness to Practice.