Working together-Learning together: Improving workforce readiness Merrilyn Walton  Professor of Medical Education Sydney S...
What does working together- learning together mean?
Deliver patient centred care Active member of multidisciplinary teams  Report and learn from errors Apply evidenced based ...
Being prepared for safe practice
Why  do our professionals graduate unprepared for work?
Some observations about current learning in the workplace
 
How is the NPSEF structured? <ul><li>3 L earning Domains in each Learning Topic   </li></ul>Communicating  effectively Usi...
What preparation should professionals have?
What preparation should professionals have?
Patient  centred learning principles
Patient centred principles
How learners learn safely
The educational conceptual framework Davis & Dixon Usually achieved in well designed programs Much more difficult to achieve
Minimising harm to patients Attitudes Pre-contemplation Adverse events are preventable  Knowledge Contemplation Skill to a...
Preparing health professionals for work  requires:-
We need to:
Resources & Web sites <ul><li>Runciman B, Merry A, Walton M  Safety and Ethics in Health Care :  A Guide to getting it Rig...
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Working together-Learning together: Improving workforce readiness Professor Merrilyn Walton

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  • Read Medical Examination Papers from the early decades of the Medical School.
  • The Framework was published in 2005. It is a 200 page document that describes all the competencies required for health care workers not just health care professionals. From the patient’s perspective the people who deliver the meals are an important part of the team. All health workers are educated to deliver patient- centred care as members of inter-disciplinary teams, using evidence-based and ethical practice, quality improvement approaches and information technology Framework principles Safety is everybody’s business Patient centred Takes into account the consumer perspective Simple, flexible and accessible Generic Progressive levels of knowledge, skills and behaviours Identifiable best practice Outcome based education How was the framework developed Literature review Development of Learning Categories (7) Development of Learning Topics (22) Classification into learning domains Conversion to performance based format What dies the framework do Identifies the key skills, knowledge, behaviours and attitudes related to patient safety for all health care workers provides a simple, flexible framework that acts as a benchmark for training, educating and assessing health care workers in patient safety Ensures all workers in the health system are competent and supported in adopting a patient-centred approach to their work
  • The Framework is built around seven learning areas and 22 learning topics, which have been identified as best practice in the literature and at the coalface. The Framework describes the core competencies that will equip health care workers with an understanding of how patients might suffer harm as a result of their health care. It also provides them with the required knowledge and skills for preventing, managing and learning from adverse events and near misses as well as emphasising the importance of ethical practice. Each topic is supported by a patient narrative, reminding the reader of the importance of their voice in patient safety. A separate extensive bibliography accompanies the Framework to assist development of curricula.
  • The Framework is built around seven learning areas and 22 learning topics, which have been identified as best practice in the literature and at the coalface. The Framework describes the core competencies that will equip health care workers with an understanding of how patients might suffer harm as a result of their health care. It also provides them with the required knowledge and skills for preventing, managing and learning from adverse events and near misses as well as emphasising the importance of ethical practice. Each topic is supported by a patient narrative, reminding the reader of the importance of their voice in patient safety. A separate extensive bibliography accompanies the Framework to assist development of curricula.
  • The Framework is built around seven learning areas and 22 learning topics, which have been identified as best practice in the literature and at the coalface. The Framework describes the core competencies that will equip health care workers with an understanding of how patients might suffer harm as a result of their health care. It also provides them with the required knowledge and skills for preventing, managing and learning from adverse events and near misses as well as emphasising the importance of ethical practice. Each topic is supported by a patient narrative, reminding the reader of the importance of their voice in patient safety. A separate extensive bibliography accompanies the Framework to assist development of curricula.
  • Requirements for disclosure benefits and risks level of experience and training Ethical duty to prevent harm Tension between service delivery and training Learning on patients performance anxiety Impedes completion of multiple tasks. Increased opportunities for medical errors Litigation We know that patients are often not told about the level of training- or done in a perfunctory manner. 88% of patients responding to a survey about attitudes to participating in training stemmed from altruistic reasons.( Lynone N et al informed consent in medial training-patient experiences and motives for participating Med education 32(5) 1998
  • Requirements for disclosure benefits and risks level of experience and training Ethical duty to prevent harm Tension between service delivery and training Learning on patients performance anxiety Impedes completion of multiple tasks. Increased opportunities for medical errors Litigation We know that patients are often not told about the level of training- or done in a perfunctory manner. 88% of patients responding to a survey about attitudes to participating in training stemmed from altruistic reasons.( Lynone N et al informed consent in medial training-patient experiences and motives for participating Med education 32(5) 1998
  • Separate learning from actual patients
  • Naïve to think that knowledge alone changes behaviours. If goal is to improve the patient experience of health care( anaesthesia-care and treatment) need to adopt a more precise way of understanding education. Davis and Dixon have developed a cascade of steps for evaluation of education. Knowledge and attitude precede the learning of new skills These skills must be translated into behaviour if desired outcome is to be seen. When enough people are experiencing the desired outcomes there will be community wide improvement reflected in norms of practice. These stages are Pre-contemplation-person or group has a disposition or attitude toward the potential change that is not receptive Contemplation-person or group is ready to think about the change or issues related to it Preparation-person or group is acquiring what it will take to accomplish the change Maintenance- norms are set up to reinforce and maintain change If we apply this framework to understand the necessary steps of education and change in anesthetic practice we would say the attitude to anesthetic errors are preventable and the knowledge of how to minimise them come first. Then the skills of assessing sources of errors seeing how to change error prone systems and teaching trainees how to use them must be learned. Then the clinicla teachers and hospital accreditation systems need to change on a permanent basis in order to achieve the desired outcome. When all patients have an anaesthetic without mishap we will have achieved a social good.
  • Working together-Learning together: Improving workforce readiness Professor Merrilyn Walton

    1. 1. Working together-Learning together: Improving workforce readiness Merrilyn Walton Professor of Medical Education Sydney School of Public Health
    2. 2. What does working together- learning together mean?
    3. 3. Deliver patient centred care Active member of multidisciplinary teams Report and learn from errors Apply evidenced based health care Ethical practice Use quality improvement approaches Use information technology Competent practitioners New knowledge & skills required Partnerships with patients & carers Teamwork Risk communication Data collection Adverse events Professional responsibility Professional accountability Is professional knowledge enough ?
    4. 4. Being prepared for safe practice
    5. 5. Why do our professionals graduate unprepared for work?
    6. 6. Some observations about current learning in the workplace
    7. 8. How is the NPSEF structured? <ul><li>3 L earning Domains in each Learning Topic </li></ul>Communicating effectively Using evidence Adverse events Working safely Being ethical Teaching & Learning 7 Learning Categories 22 Learning Topics Specific issues Knowledge - Skills - Behaviours Underpinning/applied knowledge – Performance elements
    8. 9. What preparation should professionals have?
    9. 10. What preparation should professionals have?
    10. 11.
    11. 12.
    12. 13. Patient centred learning principles
    13. 14. Patient centred principles
    14. 15. How learners learn safely
    15. 16. The educational conceptual framework Davis & Dixon Usually achieved in well designed programs Much more difficult to achieve
    16. 17. Minimising harm to patients Attitudes Pre-contemplation Adverse events are preventable Knowledge Contemplation Skill to assess errors, how to change practice & systems Health practitioners change their system and implement changes on permanent basis Teaching peers, supervisors, trainees & patients Knowledge about how to prevent mishaps When all patients receive treatment without AEs- Societal Norms/Maintenance Patient experience Outcome of action Behaviour Action Skills Preparation
    17. 18. Preparing health professionals for work requires:-
    18. 19. We need to:
    19. 20. Resources & Web sites <ul><li>Runciman B, Merry A, Walton M Safety and Ethics in Health Care : A Guide to getting it Right , Ashgate , 2007. </li></ul><ul><li>National Patient Safety Education Framework </li></ul><ul><li>http://www.health.gov.au/internet/safety/publishing.nsf/Content/C06811AD746228E9CA2571C600835DBB/$File/framework0705.pdf </li></ul><ul><li>Australian Curriculum Framework for Junior Doctors </li></ul><ul><li>http://www.cpmec.org.au/curriculum/index.cfm </li></ul><ul><li>The Patient Safety Education Project (PSEPTM) ( USA) </li></ul><ul><li>http://www.northwestern.edu/aging/projects.htm#psep </li></ul><ul><li>WHO Patient Safety Curriculum Guide for Medical Schools </li></ul><ul><li>http://www.who.int/patientsafety/activities/technical/medical_curriculum/en </li></ul><ul><li>Health Professionals for a new century: transforming education to strengthen health systems in an interdependent world </li></ul><ul><li>http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673610618545.pdf?id=e16241398b8eb460:3bb166fc:12db655013c:-2841295848133237 </li></ul>
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