cetiscape                          CLINICAL EDUCATION                          & TRAINING INSTITUTE     Issue 3  Februar...
cetiscape                             February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  ...
cetiscape                            February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  p...
cetiscape                             February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  ...
cetiscape                             February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  ...
cetiscape                             February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  ...
cetiscape                            February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  p...
cetiscape                             February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  ...
cetiscape                            February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  p...
cetiscape                             February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  ...
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Cetiscape 3 February 2011

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Cetiscape is the newsletter of the NSW Health Clinical Education and Training Institute

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Cetiscape 3 February 2011

  1. 1. cetiscape CLINICAL EDUCATION & TRAINING INSTITUTE  Issue 3  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 1 Intergenerational health systems: securing a sustainable futureThursday 10 February 2011, John Loewenthal Auditorium, Westmead Hospital“The world has changed; we are living longer and the burdenof chronic illness is rising. A revolution in health systems Future thinkers at the forumtechnology and delivery may be our only hope for future  Centre for Health Innovation and Partnership (CHIP)generations.” — so read the banner at the Intergenerational  Clinical Education and Training Institute (CETI)Health Systems Forum, an unprecedented gathering ofgovernment, education, community and business groups in  Regional Development Australia-Sydneywestern Sydney.  NSW Government Education and TrainingThe forum sought a common set of directions to address  Western Sydney Institute of Technical and Furthersome of the major issues affecting health and community Educationcare, focusing on the potential of digital technologies to  College of Health Sciences, University of Westernbetter coordinate, integrate and improve services. SydneyIn his opening remarks, Professor Glen Maberly, Director  Penrith Business Allianceof the Centre for Health Innovation and Partnership,  Western Sydney Community Forumreminded everyone that demographic change presented  Western Sydney Local Hospital Networkhuge challenges for public budgets, as health care costs  Nepean Blue Mountains Local Hospital Network(already 28% of the NSW state budget) threatened to growunsustainably. Smarter health care was the alternative. digital devices like the iPhone — and what we need to do is“I will be happy when we stop talking about technology take relatively simple steps to connect health workers to theand start talking about smart systems,” Professor Steven information potentially available to them.”Boyages, CETI Chief Executive, said in his address to theforum. “The technical means for improved health care don’t Professor Branko Celler, Dean of the College of Healthhave to be invented — they are ubiquitous, on the internet, on Sciences at University of Western Sydney, described the In this issue  Safety with injectable medicines 6  Intergenerational health systems: securing a sustainable  Nursing grand rounds via videoconference 7 future 1  Emergency department demand increases 7  Postgraduate clinical placements 2  making a difference HSP 8  Above and beyond 3  Survey of General Practitioner Procedural Training  Scholarships for doctors in rural training 3 Program 8  Improving care for patients with osteoporosis 4  Diploma of Rehabilitation 9  Coming: 5th NSW Rural Allied Health Conference 5  Karma – a prevocational general practice placement  Coming: NSW Prevocational Medical Education Forum 5 experience 10  Sepsis kills 6 Building 12, Gladesville Hospital, Victoria Road, Gladesville NSW, 2111 Editor: Craig Bingham Locked Bag 5022, Gladesville NSW 1675 02 9844 6511 CLINICAL EDUCATION & TRAINING INSTITUTE p: (02) 9844 6551 f: (02) 9844 6544 e: info@ceti.nsw.gov.au cbingham@ceti.nsw.gov.au
  2. 2. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 2  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTEpotential of telehealth to empower patients to manage their the future as an opportunity for the development of a stronger,health from homes with the aid of clinicians connected by smarter health care industry in Sydney’s west.phone. He hopes to see a Cooperative Research Centre The forum initiated a wideranging discussion about thein Telehealth established at UWS to drive evidence-based possibilities for cooperative action to realise smarter healthadoption of this aid to effective and efficient patient care. systems, which many participants saw as resting on “powerMr Paul Brennan of the Penrith Business Alliance drew to the people” — more information for health care consumers,attention to the health-care corridor that runs from Westmead and more engagement of consumers in managing theirHospital to Nepean Hospital, Penrith, taking in UWS and the health. The positive benefits and potential pitfalls of a patientwestern clinical school of Sydney University. This is Sydney’s controlled electronic health record were debated at length.demographic centre and an area populated with skilled workers A communiqué issued by the forum will be available soon.who need local employment. Mr Brennan saw the challenges of The destiny of our demography: from pyramid to ... coffin? A future with more elderly in the population, and a smaller proportion of workers: demographics cited by Glen Maberly from a Productivity Commission report.Postgraduate clinical placementsWhen the NSW Health Care Advisory Council met on general practice, community settings, specialist and privateThursday 9 December 2010, CETI Chief Executive Professor practice and private hospitals.Steven Boyages and Dr Marie Louise Stokes presented a Several initiatives have already been implemented. Up to 50report on the increasing numbers of medical graduates in prevocational general practice training places in NSW will beNSW requiring placement for clinical training as the new funded by the Commonwealth from 2011, based mainly inmedical schools produce their first graduates. rural and regional areas. CETI has developed a streamlinedProvided clinical training opportunities are expanded, there is accreditation process for general practices and regional training providers wishing to offer clinical placements for junior doctors.an opportunity for the increase in medical graduate numbers toaddress workforce shortages in rural and regional areas, and CETI’s Rural Division will centrally coordinate the NSW Ruralin disciplines such as general practice, emergency medicine, General Practitioner Procedural Training Program to supportpsychiatry, geriatrics and palliative care. Strategies under the rural GP procedural workforce.consideration to increase postgraduate clinical placements The Health Care Advisory Council reiterated the importanceinclude shift rostering, new models of service, increasing the of developing effective strategies to retain the medicalnumber of facilities offering placements, and expanding the graduate workforce in rural areas, and to invest in paediatricsrange of alternative training settings, which could include and general practice.
  3. 3. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 3  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTEAbove and beyond“I will go to any lengths looking for a cure More information about Cure Cancer Australiafor cancer – I’m even prepared to climb can be found at <http://www.cure.org.au>.mountains!” says Associate Professor Michael is a longstanding member ofMichael Agrez, a colorectal surgeon at John CETI’s Prevocational Training Council,Hunter Hospital, and one of Australia’s and has recently joined the Prevocationalmost dedicated Directors of Prevocational Accreditation Committee. At John HunterEducation and Training. Hospital, he was an early adopter of theIn July, Michael is climbing Kilimanjaro Australian Curriculum Framework for Junior(Africa’s tallest mountain) to raise money for Doctors, piloting implementation of thethe Cure Cancer Foundation. framework in new term descriptions andYou can sponsor Michael by visiting reflective portfolios for trainees, and gathering<https://www.gofundraise.com.au/AgrezM>. new data about the experiences that trainees gain (or sometimes do not gain) in their coreCure Cancer Australia commenced in 1967 training terms.and is an independent Foundation for cancerresearch with its own Medical Grants Advisory Michael Agrez, shown here Michael’s ambitious climb to conquer cancerCommittee to select projects with the greatest training for the assault on is typical of his energy and community spirit,potential that have been submitted by young Kilimanjaro in his mountain and CETI will be cheering him on all the way.post-doctoral researchers. climbing kit.Scholarships for doctors in rural training CETI : you be working in two or more rural terms this year? Are you Will The Clinical Education in a CETI network training program? and Training Institute you can answer yes to both questions then you may be entitled If (CETI)EDUCATION CLINICAL is a statutory health & TRAINING INSTITUTE to apply for a rural scholarship of up to $6,000, depending on corporation established your level of training. by the NSW governmentThe Rural Scholarship Fund supports medical trainees committed to training to promote excellenceand providing patient care in rural locations in NSW. in clinical education and training.Prevocational (PGY1 or 2), basic physician, paediatric physician, emergencymedicine (new for 2011), pre-specialist surgical and psychiatry (basic and CETI collaborates withadvanced) trainees can apply. universities, colleges,Applicants must complete a minimum number of regional and/or remote clinicalINSTITUTE leaders, hospitals, CLINICAL EDUCATION & TRAININGterms in NSW Health facilities in the 2011 clinical year as follows: health services and the Prevocational trainees — 2 terms community to achieve better health through Basic trainees — 2 3-month terms education, training and Advanced trainees — a full clinical year. development of a clinicalTrainees who will complete the minimum number of terms and are in a workforce that meets theCETI networked training program can apply for a rural scholarship. If their healthcare needs of theapplication is successful they will receive payments of: people of NSW.  $1500 for prevocational trainees CETI innovates to improve $5000 for basic trainees communication, capacity $6000 for advanced trainees. and competency in health CLINICAL EDUCATION & TRAINING INSTITUTEApplications for the Rural Scholarship Fund open at the end of February and care by promoting blendedclose on 15 April 2011. learning approaches, including face-to-faceFor more information, follow the links on the CETI website or contact Andrea teaching, simulation andRoss (02 9844 6530) or Kirsten Campbell (02 9844 6536) at CETI. e-learning.
  4. 4. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 4  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTEImproving care for patients with osteoporosisCETI is working with the Agency for Clinical Innovation (ACI)to help bring potentially life-saving preventive care to elderlypatients with brittle bone injuries or fractures. Although therisk increases with advancing age, the largest impact on thecommunity is in relation to the relatively young old.This month ACI and its Musculoskeletal Network launched anew model of care to prevent the risk of repeat fractures inpatients with osteoporosis.The bones of people with osteoporosis are fragile and brittle,with a significantly higher likelihood of fracture from evenminimal impact or injury.It is estimated that 2.2 million Australians have osteoporosis, Pictured left to right: Professor Markus Seibel, Professor Lynwhich affects half of all women aged over 60 and one in three March, Robyn Speerin (Network Manager of ACI’s Musculoskeletalolder men. The economic cost was estimated in 2007 at Network), The Hon. Carmel Tebbutt BEc MP, Minister for Health$7 billion, including more than $1.5 billion in direct health costs. and Deputy Premier, and Professor John Eisman. Photo: ACI.About half of all patients who have one osteoporotic bonefracture will have another. support for junior doctors at the front line to identify,In NSW, 35% of patients who were admitted to hospital with investigate and treat patients with osteoporosis.a minimal trauma fracture between 2002 and 2008 were A working group has been convened to develop a curriculumsubsequently admitted to the same hospital with a refracture. under the leadership of Orthopaedic Surgeon Dr KerinThis accounted for 16,225 admissions, with an average Fielding, with representation from endocrinology, rheumatology,length of stay of 22 days. These data do not include patients gerontology, falls prevention, curriculum development andadmitted with a refracture to a different hospital. information technology. The web-based curriculum is close toMany people who have multiple osteoporotic fractures have completion and will be available to NSW Health staff online.ongoing pain and disability, reduced quality of life and die Users will be able to work their way through topics at their ownprematurely. pace and at any time of the day or night.While the increased risk of refracture is well known and The Chief Executive of ACI, Dr Hunter Watt, said the newevidence-based guidelines highlight the need to intervene at model of care addressed one of the biggest health issues forthe time of the first fracture, in far too many cases it is simply elderly people in NSW.not happening. “This is a huge issue. People who suffer osteoporotic fracturesNational audits have repeatedly shown that only 20%–30% often are faced with chronic pain, are less able to manageof female patients, and even fewer male patients, are being activities of daily living, and risk losing their independence andidentified at first fracture for preventive care. This means developing other chronic conditions because of immobility. Theirthat more than four out of five people presenting at health risk of premature death also is very real.”services with an osteoporotic fracture are being denied the “ACI funded this model-of-care project and thehealth benefits of effective fracture prevention. Musculoskeletal Network worked with medical, nursing andThe NSW Model of Care for Osteoporotic Refracture allied health clinicians and consumers from across the State,Prevention is an easy-to-use guide to best practice care for as well as stakeholder groups such as Arthritis NSW anddoctors, nurses, other health professionals and managers Osteoporosis NSW, to make it happen.”across the NSW health system. It aims to ensure that all “The challenge now is implementation and we are delightedpatients presenting with brittle bone fracture are assessed and that CETI is working so closely with us on the need tooffered advice and treatment to prevent further fractures. This educate front-line clinicians.”may include bone density scanning, measurement of vitaminD levels, assessment of calcium intake and thyroid function, Professor Lyn March, a senior rheumatologist from Royaldisease management advice and self management support. North Shore Hospital and one of the authors of the guide, said it was designed to address a very real area ofHigh quality services already are in place at Concord, St underperformance in the health system.Vincent’s, Royal Prince Alfred, Royal Newcastle Centre andthe Mid North Coast Local Health Network. “It is not acceptable that when the markers are so clear and so much can be done to prevent refracture, so many peopleCETI is working with ACI to address one of the keys to with osteoporosis continue to miss out.”implementation of the model of care — education and
  5. 5. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 5  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTE“That is condemning many thousands of people to a future of families. Why wouldn’t you do it? I am delighted that we arepain, inability to perform normal activities of daily living, loss now at the implementation stage.”of independence, developing other chronic diseases and “Early identification of people in NSW who have osteoporosisdying prematurely.” is a critical component of the new model of care because it“It also means that Australians continue to pay billions of will enable early treatment, which can reduce further fracturesdollars in health care costs and loss of productivity for issues by up to 50%.”that can be prevented.”“This model of care has been shown in many trials, including inAustralia, to reduce medical complications, reduce readmissionsto hospital and reduce the number of premature deaths. It alsohas been shown to improve quality of life of individuals and theirComing events îStrong foundations in shifting sands 5th NSW Rural Allied Health Conference The Glasshouse, Port Macquarie, 9–11 November 2011îPrinciples and practiceNSW Prevocational Medical Education Forum Proudly presented by CETI’s Rural Division Rural allied health services bring together a blend of11–12 August 2011 multidisciplinary skills requiring a flexible approach toAt this year’s prevocational forum, medical educators, cooperation, coordination and collaboration. Interdisciplinarydirectors of training and administrators will share their rural health partnerships have become strong foundationsexperience, workshop the issues that matter and hear which will continue to sustain quality care in shifting sands,practical advice from leaders in JMO education. the transitional period of the current national health reform.In 2010, CETI commissioned an external review of the This conference will provide an opportunity for all allied healthprevocational training networks. In November, the review staff, managers and educationteam reported that it “found an extra-ordinary level of providers to demonstratecommitment of individuals and institutions at all levels to how collaborative healthprevocational training across the NSW health system.” partnerships create models of care which achieve positiveThe team delivered inspiring recommendations for renovation patient journeys.of prevocational training that it hoped would multiply the This conference is designedeffectiveness of this commitment. During 2011, CETI is working to attract rural and remotewith its partners in the local health networks to unlock the allied health clinicians from new graduates to seniorpotential identified in the review. managers, and those who work in partnership with allied health services.On the agenda learning model in prevocational training: who learns The Pre-conference workshops what, when, how. There will be a choice of pre-conference workshops to attend Tuning the networks for smoother performance on Tuesday 8 and Wednesday 9 November. Come along, Workable methods of assessing trainees and evaluating share experiences and take home some practical information programs: building better feedback to put straight into practice with your team. Maximising the benefit of general practice training terms Call for abstracts in March Innovations in training and education. In March authors will be invited to submit an abstract relevantFor more information, please contact Craig Bingham to the theme Strong Foundations in Shifting Sands, using(02 9844 6511, cbingham@ceti.nsw.gov.au) or visit the examples of established rural collaborative partnershipswebsite <www.ceti.nsw.gov.au/prevocational>. which achieve positive patient outcomes. First time presenters welcome. For more information please contact Jenny Preece (02 6692 7716, jenny.preece@ncahs.health.nsw.gov.au) or visit the website <www.ircst.health.nsw.gov.au>.
  6. 6. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 6  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTESepsis killsACI and CEC joint project to improve the recognition andmanagement of severe infection and sepsisAppropriate and timely recognition and management of A pilot study using the draftpatients with sepsis is a significant problem in healthcare. sepsis pathway and a staffSepsis is associated with high morbidity and mortality; severe education program has beensepsis and septic shock have a mortality of around 25%.1 In undertaken in emergencyanother study, the mortality rate for patients with septic shock departments at John Hunter,increased by 7.6% for every hour of delay in commencing Liverpool, Concord and Princeantibiotic therapy.2 of Wales Hospitals. Preliminary audit results have been very encouraging, with a markedSepsis has been identified by the NSW Root Cause Analysis reduction in time to administration of intravenous antibioticsReview Committee as a recurrent emerging problem. The and heightened staff awareness of sepsis and the need forClinical Excellence Commission Clinical Focus Report on the prompt treatment. There has been wide consultation withRecognition and Management of Sepsis3 found significant rural clinical groups and the pilot study is being extended to adeficits in a range of clinical settings, with a higher proportion rural site. Staff feedback from the pilot study and audit resultsof problems being reported in the emergency department. are informing the finalisation of the draft sepsis pathway,Key clinicians and other experts have identified improving education resources and project support for the state-widerecognition and management of sepsis as a high priority implementation in May 2011.for local health networks. In response, the Agency for For more information please contact Dr Tony Burrell, DirectorClinical Innovation and Clinical Excellence Commission Patient Safety (02 9269 5550, tony.burrell@cec.health.nsw.are collaborating with the newly-formed Emergency gov.au) or Mary Fullick, Project Manager (02 9269 5542,Care Institute on a joint initiative. The project will enable mary.fullick@cec.health.nsw.gov.au).a consensus approach to improving the recognition andmanagement of sepsis at a state level. 1 The Australasian Resuscitation in Sepsis Evaluation (ARISE) Investigators and the Australian and New Zealand Intensive Care Society (ANZICS) AdultThe goals for the project are to reduce preventable harm to Patient Database (APD) Management Committee. The outcome of patients with sepsis and septic shock presenting to emergency departments inpatients through early recognition of sepsis, appropriate fluid Australia and New Zealand. Critical Care and Resuscitation 2007; 9: 8-18.resuscitation and reduced time to administration of antibiotics. 2 Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiationPhase 1 of the project will focus on emergency departments of effective antimicrobial therapy is the critical determinant of survival inand Phase 2 will focus on improving the recognition and human septic shock. Critical Care Medicine 2006; 34: 1589-1596.management of sepsis for inpatients. Education for junior staff 3 Clinical Excellence Commission, 2009.will be a key component of the project.A generic adult sepsis pathway has been developedfollowing wide clinical consultation. The pathway aimsto support recognition of severe infection and sepsis inthe emergency setting and to give clear guidelines fornotification, escalation and initial management. The sepsis Safety with injectable medicinespathway promotes: New National Recommendations for User-applied Labelling flagging of severe infection and sepsis at triage early of Injectable Medicines, Fluids and Lines propose standards involvement of senior clinicians in diagnosis and for handling injectable medicines to ensure that patients management are never inadvertently injected with the wrong medicine or appropriate and timely fluid resuscitation injected by the wrong route. prompt administration of antibiotics (goal is within one The recommendations and support materials can be found hour of triage) at <http://www.health.gov.au/internet/safety/publishing.nsf/ serum lactate monitoring to assist diagnosis and ongoing Content/PriorityProgram-06_UaLIMFL> monitoring CETI supports this initiative and is consulting with its partners referral of care to appropriate clinical teams, including in the NSW health system to ensure that clinical training has retrieval if appropriate. embraced the labelling standards.
  7. 7. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 7  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTENursing grand rounds via videoconferenceJenny PreeceRural and Remote Health Project Officer, CETI Rural Division, Dorrigo Multi-Purpose ServiceIn 2008, NSW Health Nursing Office, in collaboration with Evaluation of NCAHS nursing grand rounds at 18 months hasthe NSW Institute of Rural Clinical Services and Teaching found that networking with peers, nurses educating nurses and(IRCST, now the CETI Rural Division) identified mentoring sharing experiences in the management of actual cases hasand supervision of rural and remote nursing staff from been a very practical approach to focusing on best practice.smaller facilities across NSW as an area to be addressed, Reflection on team and individual clinical practice and identifyingparticularly where triaging and initial emergency management lessons learned from each episode of care has often influencedof patients is frequently undertaken in the absence of a change in clinical processes. The regular communicationmedical officer. between sites has created an accepted form of peer review. Isolated rural nurses feel more comfortable sharing andIn 2009, IRCST introduced rural and remote nursing grandrounds via videoconference linking nurses from eight analysing experiences with professionally isolated colleaguesisolated health facilities in North Coast Area Health Service and comment they now feel part of an extended team.(NCAHS) for generalist case presentations and discussion of Over time, the operational framework developed in NCAHSinteresting or challenging patient journeys of relevance to the was consolidated into an implementation toolkit to enable therural setting. Nurses are rostered monthly to present a patient spread of nursing grand rounds across NSW.journey for discussion, with guest speakers presenting acase-based inservice at regular intervals as an educational Rural and remote nursing grand rounds via videoconferencecomponent. Presentations can involve the use of PowerPoint have now expanded to include smaller sites across theor simply tell the patient story. Keeping the sessions case- former Greater Western Area Health and Greater Southernoriented — a rural patient’s story told by rural nurses — Area Health Services, with Hunter New England proposing toensures that discussions are relevant and meaningful. implement the program in 2011.Emergency departmentdemand increasesThe recent “Christmas rush” in NSW public hospital There is typically less elective surgery performed in publicemergency departments was intense, with the number of hospitals towards the end of each year and this held true inpatients seen eclipsing those treated at the height of the 2010. The proportion of patients receiving elective surgery2009 swine flu pandemic. on time remained stable and there has been a decrease since last quarter in the time patients wait for non-urgentMore than half a million patients attended NSW emergency surgery. Wait times for urgent and semi-urgent electivedepartments from October to December 2010, according to surgery have remained relatively unchanged.Hospital Quarterly, Issue 3, the most recent report from theBureau of Health Information. This is nearly 30,000 more than The report and related materials, including performance profilesin the previous quarter, nearly 21,000 more than the same time for individual hospitals, are available at <www.bhi.nsw.gov.au>.last year, and nearly 18,000 more than in July to September2009, when the swine flu pandemic was at its peak.Bureau Chief Executive Dr Diane Watson said attendancesduring the quarter were at a two-year high, with increasednumbers generally seen across October and November UM Need the advice, support or creative FORas well as a Christmas holiday spike. In the face of extra JMO thinking of a representative grouppressure, emergency departments generally held their NEW SOUTH WALES of junior doctors?performance. Patients were seen within recommended timeframes for all triage categories, except triage category 3 Contact the JMO Forum via CETI’s Prevocational(patients with a potentially life threatening condition). Program Coordinator: Craig Bingham (cbingham@ceti.nsw.gov.au, 9844 6511).
  8. 8. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 8  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTEHSP making a difference Dr Simon Leslie, Medical Director at He now feels much Shellharbour Hospital and Chair of the less threatened and Hospital Skills Program State Training HOSPITAL SKILLS PROGRAM understands that he Council, reports. is being supported to Three hundred and fifteen medical One of our CMOs thanked me yesterday, improve and will not be officers are now enrolled in enthused about the Hospital Skills Program unfairly judged. He feels CETI’s Hospital Skills Program (HSP) and the benefits to him. He had just part of a group that is and are enjoying the benefits attended a half day in theatres re-skilling in learning and improving of more training opportunities, airway management and could not speak highly together. He has greater better recognition and an improved career pathway. Forenough of the experience and the benefits to him. He was also enthusiasm for work and more information, speak to Actingfull of praise for the education day last week at Wollongong continuing professional Program Coordinator AlpanaUniversity and also for the simulation course he was sent to development, he has Singh (02 9844 6551, asingh@attend at Royal North Shore Hospital last year. His face was engaged with other ceti.nsw.gov.au) or visit <www.beaming and he was obviously very excited. team members and ceti.nsw.gov.au/hospitalskills>.This was a doctor who before the HSP had worked solely become willing to workon weekends, feeling isolated and even somewhat paranoid at any time of the week.because his only contact with “administration” in the past This is just one example of how the Hospital Skills Program iswas with regard to complaints about him. His habit was to making a difference for our doctors.avoid any oversight or scrutiny and his resultant negativeattitude affected his relationship with other staff.Survey of General Practitioner Procedural Training ProgramThe GP Procedural Training Program is being evaluated Feedback gained from the survey will inform the future growththrough a survey of participants. and development of the program, enhancing its contribution to a sustainable rural GP procedural workforce.The program, now coordinated through the CETI RuralDivision, has had 285 participants since 2003. It provides Ms Linda Cutler is the Executive Director of the programGPs and GP registrars with experience in procedural general which was transferred to the Rural and Remote Divisionpractice to equip them to practise in rural NSW. Participants of CETI in December 2010. Many will recall that Linda is the former Executive Director of the NSW Institute of Ruraltrain on a full time, part-time or flexible basis in rural training Clinical Services & Teaching (IRCST), which has now beenhospitals in one or more of the following five specialties: brought under the CETI umbrella. Anaesthetics For more information about the survey or the GP Procedural Emergency Medicine Training Program, contact: Margaret Starr, Program Obstetrics Coordinator, CETI (02 9844 6548, mstarr@ceti.nsw.gov.au). Surgery Mental Health.The survey of participants who have completed their trainingwill be conducted by the NSW Health Department’s trainedtelephone interviewers. The survey asks about: trainee’s experience of the program and the extent to the which they are currently using the skills gained though the training the program has contributed to the GP procedural how workforce in NSW the program has contributed to participants’ career how 16th Australasian decisions Prevocational Medical Education Forum 6-9 November 2011 Auckland, New Zealand suggestions for improving the program.
  9. 9. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 9  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTENew Diploma of RehabilitationSue Steele-SmithEducation Consultant and Manager, Royal Rehabilitation CollegeRoyal Rehabilitation Centre SydneyThe Royal Rehabilitation College The diploma also provides anhas developed a unique, nationally opportunity for specialised training ofrecognised Diploma of Rehabilitation. allied health assistants to meet theThe diploma provides a practical, increasing demand for rehabilitationmultidisciplinary, flexible, accessible services due to the ageing andand relevant program for those growing population.seeking an accredited qualification in The Royal Rehabilitation Collegerehabilitation. is a health-industry-based privateThe Royal Rehabilitation College was registered training organisation thatable to gain national accreditation for is part of the Royal Rehabilitationthis course because an equivalent Centre Sydney. The collegemultidisciplinary course did not exist specialises in the training andwithin Australia. assessment of the Certificate IV in Allied Health Assistance, withThe diploma is a self-paced course over 200 participants nationally.offered by distance education, This experience with clinicianswhich provides the greatest flexibility throughout NSW and Australia hasaround participant needs. The highlighted the need for specificcourse content was developed by practical training in rehabilitation.experienced rehabilitation clinicians The concept, development andworking at the Royal Rehabilitation accreditation of the Diploma ofCentre Sydney. Core units provide Rehab in action. Rehabilitation is the result of thisthe foundation for working in a experience.rehabilitation environment, whilethere are elective options in spinal The Royal Rehabilitation Centreinjury, neurology, cardiopulmonary, Sydney provides specialistorthopaedics, oncology, community, rehabilitation and disability servicesmental health and aged care. There for people with complex and longare also units on goal-directed care, term health care needs, traumatichealth promotion and prevention and brain injury and spinal cord injury.research skills. Royal Rehab engages in extensive education and research to improveThe diploma provides an opportunity the rehabilitation outcomes for itsto refresh and enhance skills or clients and, as a teaching hospital,to retrain. It provides professional Royal Rehab has strong partnershipsdevelopment with a practical with the University of Sydney’srehabilitation focus and a chance academic units.to enhance skills and knowledge ofnew areas of rehabilitation within an Registrations for the Diploma ofinterdisciplinary learning environment. Rehabilitation are now open forSupport for this distance course 2011. For further information onhas come from clinicians working this fantastic learning opportunityin rehabilitation who are interested contact Royal Rehabilitation Collegein validating their skills or who are (02 9808 9626, enquiries@returning to the workforce after royalrehab.com.au) or seeextended leave, and from others <www.royalrehab.com.au/college/interested in moving into rehabilitation courses.html>.from another speciality. Spinal rehabilitation.
  10. 10. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 10  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTEKarma — a prevocational general practice placement experience Stella Tang was a Resident Medical complex care that demands medical prioritisation of their Officer at Westmead Hospital when chronic conditions. How can someone learn this without the she did a term in general practice. She exposure and the appropriate guidance? is now a general practice registrar in My time at TMC provided broad-based teaching and insight Westnet network. into how our health care system works. It encompassed more The first day of my PGPPP term I dedicated one-on-one teaching by passionate mentors on a found myself wondering if I had made vast range of medical subspecialties than any other medical a HUGE mistake in choosing a general terms I have experienced. This was surrounded by a familial practice rotation. The last two years of environment of comradeship and up-to-date medical practice in my hospital training had disciplined me weekly clinical “grand-round” meetings of case presentations, in into an efficient and effective discharging addition to access to quality nursing and allied health services machine moulded by the likings of on site (diabetic educator, podiatrist, psychotherapist, mentalconsultants and their specialities. The words “follow up with health nurse). This was a term that developed my confidenceyour GP”, “that’s something your GP can look into”, “discuss in patient management and also fine-tuned my clinical andthat with your GP, it’s not an emergency problem”, “Your interpersonal skills in diagnosing, interpreting and managingGP can refer you”, flashed before my eyes, and I began to common medical problems.wonder if this was Karma. I found it rewarding to see the outcome of my decisionsAs inconceivable as it may be to some, I found myself being through continued and ongoing patient care, but my termdrawn into the complexities and value of community-based in general practice also emphasised the importance ofteaching in my placement at Toormina Medical Centre (TMC). establishing a good work and life balance. The freedom itNow I wonder why general practice isn’t a core rotation, as it is provided with organising my own patient load, having devotedthe only “speciality” that treats the patient as a whole, not just lunch breaks and the regularity of working “normal” officein bits. General practice is the integral hub that interacts with all hours was a stupendous luxury after the last two years ofthese specialities (the ‘bits’). It’s the speciality that witnesses a unrostered overtimes. All in all, I cannot fault this rotation andpatient’s journey from birth to death and the speciality that has regardless of what “specialist” training you are endeavouringthe privilege to treat all the generations of a family at one time. to strive towards “holistic” patient care such as I was learning and practising at TMC is what good medicine is about, andOur core population in healthcare is ageing day by day as our good medicine is what good doctors practice.advances in medical intervention continue. This means thatour patients not only have multiple morbidities, but require After all, there’s Karma … cetiscape is published monthly by email and online: The submission deadline for each issue is the middle of www.ceti.nsw.gov.au/cetiscape the month. Articles can be submitted as Word documents. Pictures and logos should be sent separately, using the best available file. For logos, this is often an EPS file. Contributions: cetiscape invites contributions on all Picture files should be sent at the highest resolution aspects of clinical education and training, in particular: available.  Short news stories: achievements, launches, events. Articles submitted to cetiscape are subject to editing (100 to 300 words, photos and illustrations desirable) (proofs are shown to the authors).  Reviews or editorials commenting upon issues related to health workforce education, training and development To subscribe or unsubscribe: (300 to 1000 words, photos and illustrations desirable). email cbingham@ceti.nsw.gov.au Building 12, Gladesville Hospital, Victoria Road, Gladesville NSW, 2111 Editor: Craig Bingham Locked Bag 5022, Gladesville NSW 1675 02 9844 6511 CLINICAL EDUCATION & TRAINING INSTITUTE p: (02) 9844 6551 f: (02) 9844 6544 e: info@ceti.nsw.gov.au cbingham@ceti.nsw.gov.au

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