The Patient Partner Program (P3) recruits patient volunteers from the community for supervised consult-style teaching. P3 aims to equip students for patient-centred care, development and integration of key clinical competencies. In this educational conference poster, we describe transfer of an existing program to a new institution using a program logic framework to adapt the program and manage its implementation. Citation of this poster: Lai MM, Roberts N, Martin J. Translating a multisource feedback educational program for medical students to a new institution. Australian & New Zealand Association for Health Professional Educators (ANZAHPE) conference, QLD, 2014.

1. Translating a Multisource Feedback Program
for Medical Students to a New Institution.
M. Lai, N. Roberts, J. Martin
Eastern Health Clinical School. Monash University and Deakin University
Background
Different
ins*tu*ons
have
similar
aims
to
train
future
workforce
to
provide
pa*ent-­‐centred,
personalised
medicine
and
manage
chronic
illness
in
an
ageing
popula*on.
However,
due
to
ins*tu*ons’
different
educa*onal,
clinical
and
organisa*onal
contexts,
off-­‐the-­‐shelf
programs
may
not
transplant
effec*vely
to
new
environments.
We
describe
transfer
of
an
exis*ng
program
to
a
new
ins*tu*on
using
a
program
logic
framework
to
adapt
the
program
and
manage
its
implementa*on.
The P3 PTA Program
The
Pa*ent
Partner
Program
(P3)
recruits
pa*ent
volunteers
from
the
community
for
supervised
consult-­‐style
teaching.
P3
aims
to
equip
students
for
pa*ent-­‐centred
care,
development
and
integra*on
of
key
clinical
competencies.
P3
was
developed
in
2005
by
the
University
of
Tasmania
Launceston
Clinical
School
(1)
and
translated
to
the
first
clinical
year
at
Eastern
Health
Clinical
School
in
2013.
Key
features
of
P3
are
enthusias*c
pa*ent
teachers,
very
small
groups,
a
safe
environment,
adequate
*me,
and
immediate
mul*-­‐source
feedback
from
pa*ents,
peers
and
tutors.
Tutors
assess
students
using
a
structured
scale
(2)
and
provide
immediate
feedback
during
student-­‐led
consulta*on
prac*ces.
Students
also
receive
verbal
feedback
from
peers
and
pa*ents.
The Evaluation Design
Formal
evalua*on
of
the
first
year
of
P3
PTA
implementa*on
was
undertaken
to
clarify
the
internal
structure
and
the
func*oning
of
the
translated
program.
Logis*c
and
educa*onal
challenges
of
implementa*on
were
explored
through
observa*on,
program
record
analysis
and
obtaining
pa*ent,
tutor
and
student
feedback.
The
resul*ng
program
logic
will
guide
further
implementa*on
to
maximize
the
desired
outcomes
of
the
program.
Educa*onal
research
exploring
the
development
of
the
students’
pa*ent
centred
consulta*on
skills
is
reported
elsewhere.
Ethics
approval
for
the
evalua*on
and
research
was
obtained
from
Monash
HREC.
What Did We Learn?
Successful
implementa*on
highlighted
the
value
of
a
clear
plan,
star*ng
small,
defined
expecta*ons
to
suit
our
learners,
experienced
mentors,
key
staff
with
necessary
skills,
suppor*ve
faculty
and
associates.
Learner
and
teacher
feedback
was
very
posi*ve,
favourably
contras*ng
the
new
learning
environment
to
the
tradi*onal
seXng.
The translation
UTAS P3 EHCS P3 PTA
• Senior students – Year 4&5
• 2 year program
• Progressive skill development and
complexity
• Range of consult styles/settings
• GP tutors
• Patient volunteers from GP
practices
• Multisource feedback
• Video to support feedback and
reflection
• Junior clinical students – Year 3
• One semester (current)
• Focus on patient centred
consultation skills
• GP style consult
• Tutors mainly hospital staff
• Patient volunteers from patient
support groups and advertising
• Multisource feedback
• No video
“much
more
helpful
to
me
than
I
expected”
“excellent
environment,
everything
we
needed
was
there”
“ability
to
prac*ce
history
and
examina*on
in
an
unhurried,
controlled
seXng”
“the
feedback
was
great
,much
beaer
than
I
expected”
The Research
Measurable
improvement
in
pa*ent-­‐centredness
afer
5
sessions.
Posi*ve
benefit
of
wriaen
pa*ent
feedback
The P3 PTA Program Logic
A
program
logic
to
guide
effec*ve
program
planning
and
implementa*on,
clearly
iden*fied
the
enablers
and
barriers
for
success.
This
approach
uncovered
the
implicit
assump*ons
and
understandings
of
P3,
focussed
the
team,
limited
unexpected
situa*ons
and
provided
the
basis
for
analysis
and
sharing
of
outcomes.
“It
made
me
more
confident
talking
about
my
condi*on”
“I
probably
get
as
much
out
of
it
as
the
students”
“Volunteering
helps
me
to
feel
useful,
and
I’m
excited
to
see
these
students
in
their
medical
training.
I
like
being
part
of
their
future.”
“It’s
a
great
thing
for
our
community”
Students
Patients
s
Tutors
“even
more
enjoyable
than
I
expected”
“a
great
opportunity
to
comment
and
help
improve
student
performance
there
and
then
“much
easier
than
teaching
in
General
Prac*ce
where
I
am
more
focused
on
pa*ent
diagnosis
and
management”
“obviously
enjoyable
and
sa*sfying
for
pa*ents”
Relative importance of program features in narrative descriptions
Introduction One year
Key success factors
Ø Robust system for screening, informed consent, and support of patient recruits
Ø Comprehensive database to manage patient, student, tutor data, session
schedule and assessment process
Ø Carefully developed pedagogy, and student assessment tool (Rating
Instrument for Clinical Consultation Skills: RICS)
Ø Mentoring and lifelong learning skills promoted: patients, tutors and students
participate in a ‘community of educational practice’
Ø Support of students, tutors and patients
Ø Planned evaluation
Ø Expect the unexpected!
!
Context!
!
Increased!
burden!of!
chronic!disease!
!
!
!
!
!
!
!
Changing!
consumer!and!
societal!
expectations!of!
doctors!
!
!
!
!
!
Patients!
increasingly!
informed!and!!
willing!to!be!
actively!engaged!
in!own!
healthcare!and!
medical!
education!
!
Changing!learning!
environment!in!
health!services!
! ! ! !
Develop!competence!in;!
=!Consultation!and!communication!skills!
=!Patient=centred!care!!
=!Chronic!disease!management!
Intended!outcomes!
Effective!and!efficient!learning!methods!to!
complement!acute!environment!
Safe!and!paced!learning!environment!
!
Better!tools!for!learning,!teaching,!
assessment!and!feedback!
Inputs!
Learning!theory!based!education!approach!
People!
• Patient!volunteers!(PTAs)!
• Clinical!tutors!
• Educators!
• Students!
• Program!manager!
• Coordinator!
• Administrative!support!staff!
• Steering!group!
Logistics:!
Community!resources!
• PTA!volunteers!
Eastern!Health!Clinical!School!
• Administrative!Staff!
• Equipment!
• Consumables!!
• Funding!
• PTA!and!tutor!recruitment!!
Medicare!Local!
• Venue!
• Facilities!and!equipment!
• Consumables!
• PTA!and!tutor!recruitment!!
Launceston!Clinical!School!
• Database!support!
• P3!intellectual!property!
• Mentoring!and!resources!!
Monash!University!&!Deakin!University!
• Faculty!support!
• Research!funding!
• Research!support!!
External!funding!resources!
Activities!
!
PTA!
• Recruitment!
• Training!
• Management!!
• Feedback!
• Support!
• Database!
Tutor!
• Recruitment!
• Training!
• Management!!
• Support!
Administration!
!Session!
• Structure!
• Management!
!Program!
• Development!
• Management,!logistics!
• Promotion!
!Education!
• Objectives!
• Design!
• Monitoring!
!Collaboration!
• Internal!
• External!
Research!
Short!term!
Student!experience!and!learning!
• Diversity!of!cases!
• Skill!development!
o Consulting!tasks!
o Patient!management!
o Communication!skills!
• Knowledge!development!
o Clinical!content!
o Health!care!system!
o Patient!journey!
o Psycho=social!
o Demographic!diversity!
• Attribute!development!
o Clinical!reasoning!
o Patient=centred!care!
o Professional!identity!!
o Empathy!
o Cultural!competency!
o Reflective!practice!
o Team!work!
Tutors!
o Skill!development!
o Build!capacity!
o Modelling!professionalism!
PTAs!
o Satisfaction!with!experience!
o Development!of!teaching!role!and!
skills!
o Development!of!communication!skills!
o Motivation!
Program!
o Issue!management!
o Viability!
Medium!term!
!
!
!
!
!
!
Student!
• Increased!self=efficacy!
• Retained!knowledge!and!
skills!
• Sustained!reflective!
practice!
• Enhanced!OSCE!
performance!
!
PTAs!
o Diversity!of!cases!
o Identification!with!
team!and!program!
o !
Team!member!role!
development!!
!
Research!achievements!and!
opportunities!
!
Long!term!
!
!
!
!
!
!
Graduate!
• Practice!behaviours!
• Reflective!practice!
Workforce!implications!
Community!engagement!
Program!development!!
o Branding!
o Transferability!to!
other!medical!
education!setting!
Program!sustainability!
o Funding!
o Clinical!School!and!
Faculty!support!
o Demonstrated!
effectiveness!and!
efficiency!
Changing!
teaching!culture!
in!medical!
profession!
! ! ! ! ! Measurement!
Program!delivery!parameters!
• Scheduled!sessions,!reach,!costing!and!resource!use!
• Unplanned/adverse!events!
!
Feedback!
o PTAs!
o Students!
o Tutors!
References:
(1)
Barr
J,
Ogden
K,
Rooney
K
(2009).
Sustainable
involvement
of
real
pa*ents
in
medical
educa*on:
thanks
to
volunteerism
and
rela*onship
management.
Medical
Educa*on
43:
599-­‐600
(2)
Ogden
K,
Barr
J,
Hill
A,
Summers
M,
Mulligan
B,
Rooney
K.
2012.
Valida*ng
a
tool
designed
to
assess
medical
student’s
pa*ent-­‐centred
capabili*es
and
integra*on
of
consulta*on
skills.
Poster
at
Oaawa
Conference,
Kuala
Lumpur.
Acknowledgements:
We
wish
to
express
gra*tude
for
the
generosity
of
Professor
Kim
Rooney,
Dr
Jennifer
Barr
and
Dr
Kathryn
Ogden
from
the
Launceston
Clinical
School
UTas
who
guided
us
in
this
transla*on.
Also,
to
our
wonderful
volunteer
pa*ents!