Cetiscape 7 Oct 2011


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Cetiscape is the newsletter of the Clinical Education and Training Institute.It is published around 4 times a year.

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Cetiscape 7 Oct 2011

  1. 1. cetiscape newsletter of the Clinical Education and Training Institute  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 1 Renovation, innovation, inspirationNSW Prevocational Medical Education Forum10-11 August 2011 Stamford Grand North RydeThis year’s Forum was attended by more than 150 CETI Awards for 2010participants, including directors of training, JMO managers, were presented at theand representatives from general practice training providers, plenary session of theuniversities, specialist colleges, the Clinical Excellence NSW PrevocationalCommission and the NSW Department of Health. Interstate Medical Educationrepresentatives came from Queensland, South Australia and Forum.the Australian Capital Territory. Dr Steve May won the 2010 NSW Geoff Marel Award and Dr Matt Stanowski won the NSWPart of the objective this year was to give people more actual JMO of the Year Award.hands-on training, so Teaching on the Run training sessions The Awards were announced last year. “We had to wait untilwere held for 50 people and an online learning workshop for 78. now to find a suitably august audience to give the award winnersThe online learning workshop featured eight demonstration the applause they deserve” said Dr Ros Crampton, Chair of thestations where participants were introduced to a range of Prevocational Training Council, at the awards ceremony. In 2011,technologies and e-learning options. Kate Jurd, our special CETI has added a new JMO Manager of the Year Award.guest from Toowoomba Hospital, impressed the audiencewith her highly polished demonstrations of interactive learning Look inside to see the 2011 CETI Awardmodules developed in Moodle using tools such as Articulate Winners! (page 2)and Code Baby. “You have to escape from read-and-clickonline presentations if you are going to create resources thatpeople really engage with and learn from,” Kate said. In this issue (... continued page 3)  Renovation, innovation, inspiration 1  General practice is the new black 1  2011 CETI Awards 2General practice is the new black  Simulation clinical lead appointed to CETI 4Why you need it in your prevocational program  Surgical wetlabs are fun! 4  eHealth: a future reality or a fantastic vision? 5CETI is focused on ensuring that a wide range of high qualitytraining experiences are available to prevocational medical  Surgical Sciences Course accredited by RACS 6trainees. The Prevocational General Practice Placements  Serious gaming? 6Program (PGPPP) is proving to be a significant success in  Interprofessional student unit 7this area, providing JMOs with wide and varied experiences in  Bureau profiles demand in NSW hospitals 7primary health care in a supportive learning environment.  research continues to grow Rural 8PGPPP is relatively new to NSW. Almost 50 new general  National Stroke Awareness Week in rural NSW 9practices came on board last year, due in part to a new andstreamlined accreditation process piloted by CETI.  and remote scholarship program Rural 10CETI is receiving exceptionally positive feedback from  Risky Business website The 10trainees. The key message from both an online survey  Preparation for the FRACP exam 11and telephone interviews was that the trainees found the  Clinical Ethics Resource website The 11placement challenging, but that they felt very well supported  Device wise 12by the supervision provided in the practices. All the traineessurveyed in Term 1 reported that they would recommend the  Harvard course for simulation instructors 13placement to colleagues. Two thirds said that their skills and  Telling it like it is supervisor forum 15confidence as a doctor were “significantly improved”.  Master of Education (Health Professional Education) 16A full report on Term 1 is available on our website.  beginning: Daniel Stewart The 17Further information: Program Coordinator Sharyn Brown:  SimHealth 2011 18sbrown@ceti.nsw.gov.au; 02 9844 6525.  or HETI? CETI 18
  2. 2. 2011 CETI Awards New Award!NSW Geoff Marel Award 2011 NSW JMO Manager of the Year 2011awarded to Associate Professor awarded to Ms Judy MullerMichael Agrez CETI is delighted to announce that Associate Professor Michael Agrez is Judy Muller, JMO Manager at Hornsby highly regarded for his work on behalf of Hospital, is the inaugural winner of junior medical officers and in particular this award. It is long overdue that his passion and commitment to high there be an award for JMO Managers, quality and relevant education programs, who in NSW play a vital role in his concern for the needs and safety of supporting the education and training individual junior doctors and his advocacy of junior doctors. Judy was nominated for the junior medical workforce. for the award by several of her current cohort of JMOs.Michael is a colorectal surgeon with a professional interest Judy has been passionate about the welfare of juniorin cancer research. He is involved in prevocational training doctors for 20 years as a JMO Manager at Westmead andnationally as a member of ACF Project working groups, at Hornsby Hospitals. She has been an active participant ina state level with the Prevocational Training Council and improving the working conditions of JMOs, ensuring safethe Prevocational Accreditation Committee, at a district working hours, adequate orientation, protected teachinglevel as head of the education subcommittee of the HNE times and a variety of clinical experiences, all while ensuringprevocational network, and as a Director of Prevocational adequate balance of service to the hospital.Education and Training in John Hunter Hospital. He has arare flair for systematic approaches to medical education Judy has a huge reputation with several generations ofresearch, and presents findings at the Australasian JMOs as being tough but fair — a rock in uncertain seas.Prevocational Medical Education Forum every year. Judy is a leader among her peers. For many years, JudyMichael recently climbed Mount Kilimanjaro as a charitable coordinated statewide meetings of JMO Managersfundraiser for the Care Foundation, raising money for cancer which contributed to their professional development andresearch. promoted their collaboration across the system. Judy has aCETI is grateful to Michael for the work he has done with us legendary reputation as a straight shooter, and her forthrightover many years. He was nominated for this award by a large advice has been keenly sought and widely appreciatedcohort of the prevocational trainees in his network, which by clinicians and managers at all levels in CETI and NSWspoke volumes for his qualities as an educator and mentor. Health.NSW Junior Doctor of the Year Award 2011awarded to Dr Lucy Cho Dr Lucy Cho, Chair of the NSW JMO Improvement Branch to promote an improved shift handover Forum, is an example of a JMO who process for all junior doctors. She led the JMO Forum in goes way beyond what is required in the conducting an audit of handover across NSW which formed course of duty. Dr Cho works tirelessly in the basis of the Departmental evaluation of the reforms. her local Resident Medical Officer (RMO) Dr Cho has been an active member of the NSW Association and as a representative at Prevocational Training Council and has contributed to General Clinical Training Committtee several other NSW health committees and working groups,meetings, where she achieved local adoption of the Unified such as the Acute Care Taskforce and the Intern SummitLecture Series for JMOs developed by the JMO Forum on expanded settings for training. Her presentation to theeducation group. Lucy is also a member of the AMA NSW summit was a lucid highlight of the day, the product of herDoctors in Training Forum. personal consultation with JMOs across the state.As a member of the JMO Forum handover working group,Lucy collaborated with Health Services Performance cetiscape  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 2
  3. 3. ... Renovation, innovation, inspiration — NSW workplace-based assessments and a more explicit criterion-Prevocational Medical Education Forum (continued based assessment form. The core competencies workshopfrom page 1) reached a good consensus on some essential competencies for JMOs to be developed and assessed in specific training terms.David Peterson, from the South Australian Institute of MedicalEducation and Training, spoke on narrative strategies for A meeting with JMO Managers led to proposals for a neweffective online learning. Tam Hennessy, from online learning JMO Manager guidebook. CETI representatives at the meetingprovider PrimEd, outlined strategic choices of technologies were pleased to commit to supporting this project. The JMOand emphasised the importance of adopting and applying a managers also wanted to re-establish a regular forum wherestandards-based approach to content development. they can provide support and share expertise within the group.Trevor McKinnon, CETI’s Director of Learning Innovation and At the plenary session, Professor Peter Procopis, a memberFuture Technology, offered a vision of a health system re- of the Medical Board of Australia, outlined the new proposedenabled by adopting social media and Web 2 technologies. The national internship standard. Audience members wererisks this might pose to patient confidentiality and information concerned about the new emergency medical care trainingcontrol raised protests from some participants, but Trevor made requirement, which represented a dilution of the standardthe point that social media was in use “right here, right now” currently prevailing in NSW. Others expressed doubts about theby clinicians, managers, patients and the community, and that new standard’s openness to internships completed in traininghealthcare managers need to consider how to engage with the sites outside Australia.technology to reap its benefits and reduce its risks. Dr Ros Crampton, Chair of the Prevocational Training Council,Jay Jacinto, CETI Program Coordinator in vocational training, launched a consultation draft of new terms of reference forbrought along a Nintendo Wii and encouraged people to network committees of prevocational training. The new terms ofhave a go at playing surgeon. It wasn’t all fun and games -- reference are more explicit about the level of coordination andJay and his co-presenter, Conjoint Professor Jane Conway cooperation required in training networks. They propose that(University of Newcastle), raised issues of entertainment the committee needs to negotiate explicit agreements betweenversus education, and asked participants to consider just network partners covering aspects of trainee management thatwhat it would really take to engage the gaming generation in have been contentious in some networks. The Prevocationale-learning. Training Council is encouraging network committees to consider and comment on these new terms of reference, with the hope Jay Jacinto (standing) that they may be adopted for the 2012 clinical year. demonstrates the Nintendo This year’s conference included a large contingent of general course in surgery -- not practice educators from the GP regional providers. The really, but how do we create Prevocational General Practice Placements Program (PGPPP) compelling online learning for is relatively new in NSW (see page 1 story). The GP directors of the Web 2 generation? training brought a valuable new perspective to the conference, For one possible answer, see with fresh insights into how to train and supervise junior doctors. page 4. Supervision is just one area where the GP experience may have lessons for hospital-based prevocational training. Another workshop at the conference explored the roleToni Vial, Coordinator of CETI’s Hospital Skills Program, of vocational trainees in the supervision and training ofshowed just how easy it is to record lectures and prevocational trainees. Recommendations arising from thispresentations using Camtasia, and Sharyn Brown (CETI workshop included adapting CETI’s Superguide for theProgram Coordinator, PGPPP) demonstrated an interactive vocational trainee audience and developing specific supervisorcase study created in Moodle. training for this group of doctors. CETI has now established a“Our aim is to show examples that might inspire you to build working group to take this concept further.online learning that works” explained Craig Bingham, convenor The Forum achieved its twin goals of providing professionalof the workshop. “Too much of what is done in this space fails development to the clinicians and administrators who deliverto engage learners. Online learning is more than connecting prevocational training in NSW and setting the developmenta learner to a computer. It is about connecting learners to agenda for the forthcoming year. CETI thanks all the participantslearners and learners to teachers, surmounting barriers of and presenters who helped make the event a success.space and time to create learning environments that are Craig Binghaminteresting and thought-provoking.” Prevocational Program CoordinatorIn other workshops on assessment and core competenciesfor prevocational trainees, participants helped map out new Save the datedirections for education in the prevocational program. CETI isinvestigating practical methods for improving the assessment NSW Prevocational Medical Education Forum 2012of prevocational trainees, exploring the possibility of specific Thursday 9 August – Friday 10 August 2012 cetiscape  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 3
  4. 4. Simulation clinical lead appointed to CETICETI is pleased to announce the appointment Rino currently chairs the Paediatric and Neonatalof Dr Marino Festa as the Clinical Chair for Special Interest Group of the Australian SocietySimulated Learning Environments (SLE). Rino for Simulation in Healthcare (ASSH), is a NSWwill chair the Simulation Advisory Committee and representative on the Health Workforce Australiaprovide professional leadership for the strategic Simulated Learning Environments Expert Referencedirection, statewide coordination and standards Group and a member of the Clinical Excellenceof simulated learning environments for NSW Commission Between the Flags SteeringHealth. Committee and DETECT Junior Workshop Advisory Committee.Rino is a well-respected member of the simulationcommunity, both nationally and internationally. He CETI welcomes Rino to the team and looks forwardis a paediatric intensive care specialist and clinical lead of to his contribution to the simulation learning environmentsthe simulation program at the Children’s Hospital Westmead. project.Surgical wetlabs are fun!Andrew KempEducation Support OfficerEastern & Greater Southern Surgical Training NetworkThe trainees who come together on a Saturday morningfor a surgical wetlab are so interested in surgery thatit’s a real pleasure to help them gain some skills. Asan education support officer (ESO), my role is to co-ordinate the different people who will come togetherto teach and learn. The collaboration of consultants,fellows, registrars, industry representatives and traineesis truly impressive and inspiring. Good education programs bring together a number of elements for trainees. The opportunity to reflect on a problem, to collaborate with peers and instructors and to incorporate new skills are three essential elements to help cement knowledge for later use. Surgical wetlabs (in which trainees practise surgical skills on prepared animal specimens) are perfect for all these three elements to combine, providing a great learning experience for all surgical trainees. When I see them working on their anastomoses, chest drains, sutures or knots, the look on their faces is priceless. They are absorbed in a way I rarely see elsewhere. I know they are learning and thankful for the surgical training program. I also think the wetlabs inspire them to visualise themselves performing these skills independently with real patients in the future. Like the other surgical skills networks in NSW, we offer more places than we have surgical skills trainees. This allows trainees from other networks to attend. It also makes room for prevocational trainees, who can get a headstart on skills that will enable them to perform better in theatre when the time comes. More information: Andrew Kemp, (02) 8382-2563, akemp@stvincents.com.au cetiscape  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 4
  5. 5. eHealth: a future reality or a fantastic vision? Professor Steven people, it’s about high touch. When things go wrong it’s usually Boyages because of a failure of people and process, not machinery. Chief Executive of the Clinical Secondly, investment in health information technology is Education and Training just that, an investment, but too often we see it as a magical Institute (CETI) of NSW solution. Because of the electronic wizardry of health IT Recently I attended the something amazing is assumed will happen to health care Health Support Services delivery without doing the hard work. Expo in Sydney. As with all Unfortunately, this is not the case in health or in any other these events, it was large and industry where information technology has been rapidly diverse. This year’s theme adopted. Information technology is an accelerator of bestwas on ehealth and a series of speakers, including myself, practice workflow and is not a substitute for redesigningdebated its virtues and vices. The discussion was frank and processes and systems of delivery.robust as we deliberated the merits of a personally controlledelectronic health record (PCEHR). We heard about curated Too often the introduction of a new IT system without requisiteelectronic records, national identifiers, electronic blue books, redesign can lead to a worsening of workflows. My thesis isand the need to make certain the community was on side. that we will never fully realise the investment in health IT until we understand how we do our work, Other industries term thisThe discussion wasn’t necessarily new; I chaired the State’s workflow or logistics or business process mapping. Informationfirst EHR committee in the year 2000. What is different on technology systems should emulate and support clinical andthis occasion is the momentum and scale of some of the pilot corporate processes.studies that are being proposed by the National ElectronicHealth Transition Authority (NEHTA). The flipside of all this is As I sat back on the panel, it reminded me of those earlythe risk of not realising expectations, clinicians and patients not pioneers in any industry who advocated for a new way of doingparticipating and another waste of taxpayers’ dollars. I did get things. Passion and persuasion will not be enough to get healtha sense that the audience was not entirely persuaded and was IT systems across the line. We are only at the beginning of athinking: sounds good, but we will believe it when we see it. it long journey of discovery that will require an understanding of engineering and redesign principles and how these apply toAs I prepared for the panel, I was scrolling through the healthcare delivery.latest LinkedIn news. There was a report that the UK PublicAccounts Committee was about to recommend to review The greatest value from health IT will be realised when thesewhether the NHS program on IT should be continued. systems reduce duplication, avoid clinical error, improve patient safety and improve health care worker experience. TheseThe Rt Hon Margaret Hodge MP, Chair of the Committee of benefits will not be derived without investing time and dollarsPublic Accounts, was quoted: “The Department of Health is not in streamlining and, where appropriate, standardising clinicalgoing to achieve its original aim of a fully integrated care records workflow.system across the NHS. Trying to create a one-size-fits-allsystem in the NHS was a massive risk and has proven to beunworkable. The Department has been unable to demonstratewhat benefits have been delivered from the £2.7 billion spent onthe project so far.”<www.parliament.uk/business/committees/ Social media surveycommittees-a-z/commons-select/public-accounts-committee/news/nhs-it-report-/>. You are invited to participate in a survey of the use of social media byThis report was not a good omen. I sat back and reflected that Australian healthcare professionals. Itthere was no other topic in health that generated so much heat will take no more than 10 minutes toand passion. Further, there is no other strategy in health that has complete.promised so much and delivered so little. Why is this so? This survey is being conducted by the NSW ClinicalIs it because of a false belief that in healthcare we are a Excellence Commission to gather information about wheretechnologically advanced industry which is at the cutting and how often healthcare professionals access the internet,edge of science and therefore we are able to integrate these and if they use social media sites such as Facebook, Twittersophisticated IT tools just as easily as we introduce new clinical and LinkedIn for professional purposes. The informationtechnology? Or is it because we over-sold the promise of health collected will be used for publications.IT to our funders and are now reaping a poor harvest? The survey is open to any registered health professionalThe reality is probably somewhere in between. Firstly, health is practising in the Australian healthcare system.not a high tech industry. It uses a lot of high tech equipment andrelies on high tech procedures; but, the health industry is about Do the survey at: www.asr2.com/cec/anon/146.aspx cetiscape  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 5
  6. 6. CETI Surgical Sciences Course accredited by RACSIn 2010 CETI worked with the University of Western Sydneyto pilot a Surgical Sciences Course. The course was designedas an intensive method of teaching anatomy, physiology andpathology to surgical sciences trainees over two weeks – analternative to weekend courses for which attendance hadbecome quite variable.The pilot was repeated this year, with 66 hours of anatomy,physiology, pathology, pharmacology and radiology teachingbeing covered over 10 teaching days. Attendees alsocompleted 8 hours of trial examinations, anatomy spottests and assessments. The course required 15 anatomydemonstrators, 5 physiology lecturers, 7 pathology lecturers, aradiology lecturer and a pharmacology lecturer. Examinations Professor Fiona Stewart, University of New England, takes on thewere conducted on entry and exit. skeleton during the Surgical Sciences Course.The course is the brainchild of Professor Robert Rae who hasworked tirelessly to bring this course to where it is today — onethat meets the curriculum requirements for surgical science as determined byRACS.The course will run again in 2012 from Monday 23 January to Friday 3February and enrolment applications are now open – you need to be quickbecause places are filling fast and numbers are limited to 30.More information on the course, the 2012 timetable and applicationform: www.ceti.nsw.gov.au/surgicalSerious gaming? Go to: investigate.med.unsw.edu.auLearning by doing can be very effective, but no one working are presented with relevant information about their use andin the health system wants to make significant errors while interpretation from the RCPA Manual.learning. On the other hand, every learner wants feedback A running tally of the estimated cost of all tests is provided,from an expert about their learning. based on the Medicare Benefits schedule. After reviewingiNvestigate is an interactive website which can help junior the results, you may select further investigations, for up to adoctors learn about the rational use of investigations. It maximum of 4 test-ordering encounters. Feedback is thenprovides a simulation environment in which you can learn by provided, which allows comparison of cost, time to definitivedoing, but errors do not have serious consequences and you diagnosis, and overall diagnostic strategy relative to an expert.have an opportunity to compare what you did with what an iNvestigate might be described as a game — and hopefullyexpert regarded as appropriate. doctors will find it fun and interesting — but its purpose isThe cases in iNvestigate were selected in discussion with absolutely serious! To check it out, go to investigate.med.advanced physician trainees and specialists. There are 22 unsw.edu.au and self-register via the link at top right.case studies planned that are relevant to PGY1 and PGY2 iNvestigate has been developed with funding from the Qualitydoctors, of which 17 are already complete. Use of Pathology Program of the Commonwealth DepartmentFor each case study, you review the clinical information, of Health. The project is a collaboration between UNSW andprioritise differential diagnoses and then select appropriate the RCPA. It is led by Prof Rakesh Kumar of the Departmentinitial investigations. When ordering pathology tests, you of Pathology at UNSW. cetiscape  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 6
  7. 7. Interprofessional student unitThe Royal Rehabilitation Centre Sydney, in partnershipwith the University of Sydney, has delivered a series ofinterprofessional clinical placements in 2011.The final placement for the year is currently underway, andincludes nurses, a physiotherapist, occupational therapists,speech pathologists, and a dietitian. These students worktogether to deliver community-based health care to RoyalRehab clients.The placement responds to the latest research, which shows Beth Causa (centre) and Annie Roman (on Beth’s left) withthat health professionals benefit from learning with, from, and students on placement, hearing one of the students give anabout each other on clinical placement. Students attend tutorials interprofessional tutorial delivered on a cognitive assessmenttogether, set rehab goals together, and practice collaboratively technique.with clients. Students learn to deliver client-centred care, anddiscover the benefits of teamwork for improved client outcomes. mobile phone, and mobile internet. These tools are used to planInterprofessional placements are complex to organise, requiring and deliver client care as well as to augment traditional clinicallots of flexibility to ensure that each student’s placement education techniques. We look forward to evaluating the Mobilerequirements are met. However, it has been worthwhile to Learning Stations and sharing our findings in the future.hear the positive feedback from students regarding the unique More info: Beth Causa, Project Manager, Community Basedopportunity to collaborate with their student peers. Multidisciplinary Student Clinical Training Program RoyalAs a point of innovation, students are trialing Mobile Learning Rehabilitation Centre Sydney ,PO Box 6, Ryde NSW 1680;Stations. Each student is provided with a laptop, webcam, beth.causa@royalrehab.com.auBureau profiles demand in NSWhospitalsThe Bureau of Health Information’s latest Hospital Quarterly “The highest rise was for non-urgent elective surgery withprofiles demand in NSW public hospitals in the April to June, 92% of patients seen within the recommended 365 days.2011 quarter — showing a shift in the types of pressure That compares to 85% one year ago and 90% two yearsbeing felt in NSW emergency departments. ago,” she said.Emergency department attendances from April to June In NSW public hospitals, there were over 412,000 admittedexceeded 512,000 — up by more than 16,000 or 3% from patient episodes, 12,000 or 3% more than a year ago andone year ago but down 23,000 from the two-year peak that 28,000 or 7% more than two years ago.occurred during the Christmas quarter last year. In this latest Hospital Quarterly, the Bureau reports on“This represents a decline in the number of people going to emergency department attendances while it considersemergency departments since the 2010 Christmas peak, but new ways to report wait-time performance. The Bureau willmore patients are being admitted from emergency departments resume reporting of emergency department wait times in itsto hospital,” Bureau Chief Executive Dr Diane Watson said. next Hospital Quarterly due out in December.“Emergency admissions of 120,000 represent an increase “We’ve seen some differences in how hospitals recordof more than 1000 since the 2010 Christmas peak, almost emergency department information and from what the8000 or 7% since one year ago and 10,000 or 9% since two Bureau has seen so far, the varied recording methods canyears ago.” be clinically reasonable but make it difficult to fairly compareThere were 52,000 elective surgery procedures performed in hospitals. The Bureau expects to change the way it reportsNSW public hospitals. on emergency departments,” Dr Watson said.“What we see is more elective surgery procedures being The report and supplements can be downloaded from thecompleted than two years ago but also more patients being Bureau website:seen on time,” Dr Watson said. www.bhi.nsw.gov.au cetiscape  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 7
  8. 8. Rural research continues to grow2011 Rural Research Capacity Building Program (RRCBP)Twenty research-ready rural healthworkers commenced the RRCBP thisyear, attending the first face-to-faceworkshop in Sydney in September. Thisbrings the total number of candidatesaccepted into the RRCBP to 124. TheResearch Methods Short Course andProject Development Retreat provedan excellent introduction to researchmethods, conducted by academics fromthe University Centre for Rural Health(Lismore) and the University Departmentof Rural Health (Broken Hill) who are The 2011 candidates for the Rural Research Capacity Building Program at theirpassionate about building research workshop in Sydney in September.capacity in rural health workers.The highlight of the week was “researchspeed dating,” which involved each Successful candidates 2011 Expert mentors 2011candidate spending 45 minutes with an Julie Adamson (HNELHD) Frances Boreland (Broken Hill UDRH)expert mentor to discuss their research Patrina Byng (MLHD) David Lyle (Broken Hill UDRH)proposals and refine and explore Atosha Clancy (NNSWLHD) Sarah Dennis (University of NSW)alternative study designs. Special Rae Conway (NNSWLHD) Amanda Rosso-Buckton (University ofthanks go to the 18 expert mentors who Emma Davies (Ambulance) Sydney)shared their collective brain power and Tracey Drabsch (WNSWLHD) Jenni Devine (SNSWLHD) Kim Edwards (SNDSLHD) Tod Adams (SESILHD)enthusiasm for research with the 20 James Ward (University of NSW)candidates! Julie Hilditch (ISLHD) Tony Lower (Australian Centre for Anne Hills (HNELHD) Agricultural Health and Safety) Deborah Hoban (WNSWLHD)Newsflash — Have you Bronwyn Leon (NNSWLHD) Megan Passey (UCRH) Lesley Barclay (UCRH)heard? Katherine McQuillan (WNSWLHD) Jo Longman (UCRH)Forty-one candidates have completed Monica Murray (WNSWLHD) Tina Navin (NSW Health Bio-statisticstheir research reports. These can be Dean Phelps (NNSWLHD) program)downloaded from our website: Kim Riley (HNELHD) Dona Powell (NNSWLHD)www.ruralceti.health.nsw.gov.au/ Belinda Robinson (HNELHD) Stuart Garland (NNSWLHD)initiatives/building_rural_research_ Matthew Simpson (Ambulance) Catherine Hawke (University of Sydney,capacity/2007 Debra Tabor (SNSWLHD) School of Rural Health, Orange Bridget Thompson (SNSWLHD) Campus) Barbara Turner (FWLHD) Buck Reed (Ambulance Service of NSW) Pauline Chiarelli (University ofThe Rural Research Capacity Newcastle)Building Program is a two-year Therese Jones (WNSWLHD)program conducted by CETIRural Directorate. Applicationsare called for annually in June Save the date: 7–8 March 2012(available on our website from Training & Support Unit for Aboriginal Mothers, Babies & Children (TSU)April). Check the website for State-Wide Forum, ‘Strengthening Connections’more information, eligibility This forum will focus on raising the awareness of current Aboriginal health initiatives and services. Staff working in Aboriginal Maternal Infant Health Services (AMIHS), Building Strongcriteria and contact details. Foundations for Aboriginal Children, Families and Communities (BSF) programs, and thoseFor further information please working in close partnership with these services, will be able ‘Strengthen Connections’ andcontact Emma Webster or David build professional networks across NSW.Schmidt, CETI Rural Directorate. For more details, contact the TSU, Orange, 02 6360 7847. cetiscape  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 8
  9. 9. 2011 National Stroke Awareness Week across rural NSWJenny PreeceCETI Rural DirectorateStroke affects about 53,000 Australians each year, week. There were also media releases and televisionand is the third largest cause of death and the interviews with the local neurologist and two stroke survivors.leading cause of disability in Australia. Orange/Bathurst: Fiona Ryan coordinated media releases in the local papers and an afternoon tea for the hospital staff.In 2007, following an evaluation of rural stroke services, the Interviews with stroke survivors were played on the radioRural Stroke Coordinator Network was established to providea statewide coordinated approach to evidence-based care during the week and the Orange Stroke Recovery Groupfor rural people with stroke. Evaluation revealed that stroke held a stall in shopping centre to sell ribbons. A healthycare in rural hospitals had a low level of compliance with the afternoon tea was also held at Orange and Bathurst hospitalsNational Stroke Guidelines and 94% of rural health facilities to promote the message for staff.had no dedicated or organised stroke services. Port Macquarie: Kim Parrey continued the awarenessKnow your stroke risk was the community awareness message with a bright board outlining risk factors and waysmessage promoted by the Rural Stroke Coordinator Network to manage them. Staff were encouraged to attend with fruitacross NSW during this year’s National Stroke Week (12–18 salad cups for morning tea, a quiz and a thickened fluidsSeptember 2011). challenge to try and identify which fluid was thickened and which they liked the best? Surprisingly most staff selectedArmidale: Melissa Gill promoted stroke week with a media the thickened fluid as their preferred taste. Staff were alsorelease from a local stroke survivor. At the hospital, there was encouraged to complete the National Stroke Foundationa focus on staff with morning tea, stroke promotion and a know your stroke risk factors and the local paper publishedtrivia quiz on stroke knowledge and risk factors. an article on stroke risk factors with a story from one of theTamworth and Narrabri: Rachel Peake coordinated local general practitioners, a recent stroke survivor.a community stroke forum with a largeparticipation by the Aboriginal Community.An afternoon tea and information standswere held for the nursing and allied healthstaff at the hospitals. Tamworth also hadmedia releases and editorials in the localnewspapers. Armidale, Tamworth and PortMacquarie also had the stroke message as arolling banner on the staff intranetWagga Wagga: Katherine Mohr had aninformation stand at the local RSL clubstaffed by the stroke unit staff throughout Narrabri: Rachel Peake, Rural Stroke Coordinator, Renee Watmore (student nurse) and Bill Toomey (stroke survivor). Tamworth: Staff afternoon tea at Tamworth Base Hospital.the cetiscape  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 9
  10. 10. Rural and remote scholarship program – a year in reviewJenny Preece and Karyn ShermanRural and Remote Health Projects, CETI Scholarships AHS/LHD awarded GSAHS Workshop 11The Rural and Remote Scholarship Program provides National conference 2financial assistance for rural and remote health servicestaff to attend state, national or international conferences, State conference 1workshops / seminars, and to assist in writing up Total GSAHS (incorporating MLHD and SLHD) 14research. The program began in January 2009 to addressgaps identified in an audit undertaken in 2008. GWAHS Workshop/seminar 11 International conference 3Providing scholarships is one means by which CETI’sRural Directorate supports a sustainable workforce and National conference 5promotes excellence in rural and remote health services. State conference 4Since the inception of the program, 229 scholarships Total GWAHS (incorporating WLHD and FWLHD) 23have been awarded, totalling $262,568. This has enabled HNEAHS Workshop/seminar 14rural and remote health service staff to attend a widevariety of educational forums, increasing exposure to National conference 7best practice and new ideas, improving skills, providing State conference 6opportunities to showcase achievements, strengthening Total HNEAHS 27professional networks and earning valuable continuingprofessional development (CPD) points. International conference 1 NCAHS State conference 8Scholarship applications are predominantly forfinancial assistance to meet registration, travel and Workshop 7accommodation expenses, which can be prohibitive torural staff accessing educational opportunities. Total NCAHS (incorporating NLHD and MNCLHD) 16In 2010/11, 84 scholarships totalling $89,316 and four SESIAHS State conference 1applications for discipline-specific group educational National conference 1activities totalling $45,729 were awarded. Of these, 18 Workshop 2recipients had abstracts accepted for presentation atinternational or national conferences. Total SESIAHS (incorporating ISLHD) 4The Table gives a summary of scholarships by local health 84 Total 2010/11 scholarshipsdistrict for 2010/11 ($89,316)To date all evaluations received have indicated thatindividual learning objectives were met, with clinicians impact on decreasing the length and frequency of clinicalreporting the application of new skills and knowledge in the sessions needed to successfully treat clients, while outcomesworkplace and the sharing of outcomes with colleagues. for others have been more in reflective practice, reducingSeveral recipients have reported that new skills acquired feelings of professional isolation and increasing networkingthrough attendance at workshops/courses have had direct and peer support opportunities. Worth a look The Risky Business website is non- profit collaborative venture between:  NHS Institute for Innovation and Improvement The  Ormond Street Hospital for Children NHS Trust Great  British Medical Journal The  Children’s Hospital of Boston  Cincinnati Children’s Medical Center The site provides a range of fascinating talks on themes related  Children’s Hospital of Philadelphia to risks, errors and the measures we can take to reduce costly  National Patient Safety Agency (United Kingdom) mistakes in patient care. There is plenty here to inspire discussion  Clinical Human Factors Group The and local initiatives for patient safety. www.risky-business.com cetiscape  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 10
  11. 11. Preparation for the FRACP exam ? ? ?Muh Geot Wong ?Director of Physician Training RNSH ? ?Emma McCahonState Chair Paediatric Training, Clinical Lead Leadership Programs, CETIIn preparation for the FRACP exam which of the We asked questions such as:following is the key to success? 1 When learning something new do Ia) Sitting in a room on your own in the small hours of the a) prefer to talk through my thoughts as they come to me morning memorising Harrisons and the last five years of ? and try out new ideas straight away ? NEJM articles. b) take time to myself to work through the ideas, read aboutb) Working with your study group through strict 18 month them and reflect. timetable of topic summaries. 2 I do my best learning with teachers whoc) Doing endless past exam questions until you can recite them in your sleep. a) organise the material in logical systems, use a cool and objective approach, and give feedback that shows what Id) Going to the pub after a long day on the ward and do and don’t accomplish debriefing about the patients you saw. b. focus on relationships with the learners, foster ae) All of the above. harmonious learning environment, and give feedback thatThis year a group of first-year basic physician trainees from shows appreciation of me as a person.the Northern Sydney Central Coast Training Network, a And finally we felt confident to answer our first multiplepaediatrician and a director of physician training spent some choice question:time thinking about the answer to this question. e) All of the above.To find out more about ourselves as learners we used theMyers Briggs Personality Type Indicator (MBTI). The MBTI We concluded that we all learn differently, we all haveidentifies preferences for where we focus our energy, how we different learning preferences and that the real key totake in and process new information, how we make decisions success is to understand our own learning preferences.and how we order our lives. Junior doctors are expected to learn and apply vast amountsWe used the MBTI to look at our learning preferences, of knowledge both in their everyday work and also inincluding learning environment, interactions with teachers preparing for college assessments. However, learning is notand other learners, how we look for new information, plan and just the realm of the junior doctor — we all need to be goodorganise our studies, and our keys to motivated learning. learners. Worth a look The Clinical Ethics Resource provides an extensive range of sources addressing the ethical and legal issues experienced by those working in clinical environments. The website was developed by the University of Sydney and is funded by NSW Health. http://clinicalethics.info/ cetiscape  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 11
  12. 12. Device wise clinical equipment user manual library April 04, 2011 MakesGeorge KoningBioClinical Services library Librarygeorge.koning@bioclinicalservices.com.au help Select a make: Get Devices search (by make/device) F FindIn 2009 the NSW Department of Health document request Frigitronicsentered into an infusion device contract which log out Frigitronics :: Cryosurgical System Fisher & Paykel Healthcareresulted in the worlds largest roll-out and hence Fisher & Paykel Healthcare :: CPAPstandardisation of its kind. In the background, System Fisher & Paykel Healthcare ::NSW Health Support Services web portal, CiAP Humidifiers(www.ciap.health.nsw.gov.au), was also quietly Fisher & Paykel Healthcare :: Infant Resuscitationmaking history with the world’s first and largest Fisher & Paykel Healthcare :: Infantstandardisation of device instruction manuals, Warmingincluding the Frasenuis Kabi Injectomat and Fisher & Paykel Healthcare :: Peripheral Nerve StimulatorVolumat pump instructions manuals. Library | Help | Document Request | Terms Of Use | Privacy Statement Flaem Nuova SpAThis information system means that throughout Clinical Equipment User Manual Library in CiAP: search by make.NSW Health, clinicians can access manufacturer-supplied information on medical devices at thepoint–of-care. clinical equipment user manual libraryThis standardisation has many benefits for patient April 04, 2011 Makes » Fisher & Paykel Healthcare » Humidifierssafety, developing user competence, managingconsumables and accessories and reducing library Humidifiers Documentstotal costs of ownership. However, the medical help Current Documentsequipment world is supplied by thousands of name description document request Airvo Series Humidifier Hospital Use Operating Manual Hospital Use Operating Manualsmall manufacturers, with many innovations, Bubble CPAP System Quick Guide Quick Guidetransfers of ownership and changes of branding, log out HC100 Respiratory Humidifier Operating Manual Rev 1 HC150 Respiratory Instruction Sheet Operating Manual Instruction Sheetso keeping device instruction manuals up-to-date HC500 Respiratory Humidifier Operating Manual Operating Manual MR410 Respiratory Humidifier Operating Manual Operating Manualis a perpetual challenge. MR480 Respiratory Humidifier Operating Manual Operating Manual MR630 Dual Mode Respiratory Humidifier Operating Manual Operating ManualIt’s quite common to compare safety in healthcare MR700 720 730 Respiratory Humidifier Operating Manual Operating Manualto the commercial airline industry, but with MR810 Respiratory Humidifier Instructions Sheet Rev C MR850 Respiratory Humidifier Instructions Sheet Rev D Instruction Sheet Instruction Sheetrespect to measuring and monitoring equipment, MR880 Respiratory Humidifier Instructions Sheet Rev C Instruction Sheet OXYFLO Oxygen Therapy RT 308 Guide GuideBOEING and AIRBUS operate on the basis thatsuppliers need to customise their products and Library | Help | Document Request | Terms Of Use | Privacy Statementservices for them — which is extremely unlikelyever to be the case in healthcare.The NSW Clinical Equipment User Manual Library in CiAP: selecting a user manual.infusion pump contract management could onlyselect from a pre-existing range with very limited User Manual Library is a proactive step to support tech-savvyoptions to customise. clinicians and help them to develop skills which are irreplaceablePropriety features built into the devices by manufacturers place when things go wrong, when questions need answers instantly,more responsibility on the user to know the equipment by make when you don’t get a second chance.and model. Having a good working knowledge of the general Food for thoughtprinciples of devices will allow most people to get by undernormal circumstances, but with compromised patients, time  Inquest into the death of Oliver Steven McVey. www. courts.qld.gov.au/ [Search for “McVey”] (limited make andconstraints and pressure of work, technical competence needs model experience [pp 10 & 27] may have contributed to ato stepped up a notch. death).The Clinical Equipment User Manual Library, accessible via the  Story of Bethany Bowen. www.risky-business.com/talk-CiAP Web Portal ( under Clinical Tools) gives clinicians precise 18-story-of-bethany-bowen-2.html?channel_id=5 (a case ofguidance to devices by make and model. not following the manufacturer instructions – using a deviceNursing staff are the custodians of medical equipment in without training).hospitals. They are ultimately responsible for its readiness and  a routine operation. www.risky-business.com/talk-89- Justspend more time in front of it than any other discipline. Rather just-a-routine-operation.html (nursing staff stepping up to thethan wait for a crisis, CiAP’s access to the Clinical Equipment plate with respect to “readiness”). cetiscape  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 12
  13. 13. Preparing future leaders in health professional education Master of Education (Health Professional Education) Koshila Kumar, Sydney Medical School, koshila.kumar@sydney.edu.au Christopher Gordon, Sydney Nursing School, christopher.gordon@sydney.edu.au Christopher Roberts, Sydney Medical School, christopher.roberts@sydney.edu.au Richard Walker, Faculty of Education and Social Work, richard.walker@sydney.edu.au Victoria Neville, Faculty of Health Sciences, victoria.neville@sydney.edu.au A new postgraduate degree in health professional education The MEd (HPE) is based on an interdisciplinary framework in has been introduced at the University of Sydney. The Master two ways:   of Education (Health Professional Education) is a bold  recognises the importance of students from across It approach to preparing future educators across the health   the health professions learning together. Students are professions. health professionals engaged in developing and delivering The program aims to equip health professionals with   education in a range of health-related settings including a deeper understanding of contemporary educational hospitals, clinics, professional organisations, staff pedagogies and practices that underpin health professional development centres, and higher education institutions. teaching and learning. Core content includes clinical Current students include clinical nurses, nurse educators, teaching, clinical reasoning, assessment, simulation- medical staff specialists, surgeons, physiotherapists, based learning, and the scholarship of teaching in health orthopists, and health lecturers. professional education.  is collaboratively managed by staff across multiple It disciplines. The degree is coordinated by the Faculty of Education and Social Work and draws on teaching expertise and resources from Sydney Medical School, Sydney Nursing School, and the Faculty of Health Sciences at the University of Sydney. The program is underpinned by adult learning principles, in that learners are considered proactive participants in constructing their own learning, and students’ prior knowledge and experience informs   what and how they learn. The MEd  (HPE) curriculum is aligned with students’  educational needs in   classroom or clinical  settings. The program   is delivered in a   blended mode and includes both face-   to-face and online learning. More details about the MEd (HPE) program     are available at   sydney.edu.au/education_social_work/future_students/ postgraduate/med/health_professional_education.shtml   cetiscape  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 16  
  14. 14. In practiceThe beginningDaniel StewartIntern, Network 1, based at DubboThe patient’s headache remained as severe as it hadbeen when I first introduced myself. Simple analgesia,Nurofen and Panadol, might as well have been distilledwater for all the good they had done. Poor girl, she’d hada lumbar puncture a week earlier and the small change inpressure had likely precipitated the worst headache she’dever known. Apparently ‘LP’ headaches are particularly reviewed the previous notes, I checked the blood results as they camepainful and so far I’d seen nothing to suggest otherwise. In an effort to in and cast an eye over the brain CT from the week before. There wasestablish some control of the pain I’d ascended the analgesia ladder nothing to find, but at least I was looking.and prescribed some intravenous morphine to be given alongside IVfluids. It’s not much, checking to see if a patient’s pain had subsided to a more manageable level, offering what I could, then reviewing theAnd here I was, sitting behind the desk, staring across the floor at background history. I’d done it dozens of times before for dozens ofthe patient with the damp towel across her head, wondering if the other patients, but none of them were mine, and that’s what made itmorphine and fluids were starting to work. They should work, if not special. No doubt some of my contemporaries will scoff at how I laudto extinguish the pain entirely then certainly to bring it down a notch the experience, but there will be others, some junior and some senior,or two. At the moment the patient would be happy with a single who will remember forever the moment they actually became a Doctornotch, she could barely open her eyes and nausea frustrated all her too. The moment when you no longer have someone to check andattempts to eat and drink. How she managed to answer my questions correct, the moment when you assume the identity that comes withat all intrigued me; she must have possessed some measure of inner the role; the moment when “the patient” becomes “my patient”.strength hard to perceive from a casual glance, or perhaps she felt I’dbe the one to make the pain go away. The pain did eventually get better, as a consequence of good painkillers, fluids and time; but I wasn’t around to see. My shift hadThus my train of thought continued, as I sat in the office chair that finished and I’d gone home. I had wished my patient farewell upon myswivels while she reclined on the mattress that sags, both of us departure and reassured myself she was at least a little better as afocused on the same entity, her pain. By now, if the “morph” were consequence of my bumbling care, then left.going to work, it would have done so. “Somebody should checkand see if it has,” I thought. And then, in a decidedly underwhelming Medical school finished months ago and since then my friends andmanner, that which could not or had not been taught during four years family have delighted in giving me the moniker “Dr Dan”. Hardlyof medical school came to me like a cut-out pass to the unmarked original, certainly catchy, and the appeal seems to lie predominatelywinger; it was my job to go and check on the patient, because she in the alliteration. I didn’t mind and smiled politely whenever it waswasn’t just a patient, she was my patient. thrown my way, but I didn’t believe it. I’d earned it by virtue of passing a few tests and spending a few years living and studying off the publicOnly death or dementia will wrest that moment from my mind’s grasp. purse, but the prefix “Dr” means so much more to the communityThe moment when the role and the responsibility intertwine, daring than a passing mark, and so I’d refrained from using the term for nome to accept the new paradigm, questioning my readiness. Doctor particular reason other than I felt something was missing.in name but not yet in nature, still with a misplaced sense of comfortthat “someone else” would take responsibility, still maintaining the In a very small way a part of what was missing emerged the day I rosedistance. We’d spent so much time at medical school learning what from my swivel chair and closed the distance. I may be an Intern, andnot to do, courtesy of a professional development curriculum written I may be just a Junior Doctor, but I’m still a Doctor and that meansby a lawyer, that “the distance” was something that kept me safe. something.Naturally the distance had to go, and so it did.I rose, and asked how the pain was.I was now at the centre of a relationship I’d never been in before,where the half-closed squinting eyes simultaneously pleaded with Thanks Daniel — Editor.me to help and thanked me for what little I’d done so far. It was nowincredibly important that we, the patient and I, get on top of this pain We’d like to invite all clinicians to send usand “win”. The pain was a little better, but that didn’t mean much as stories from their experience for our “Inthe drip had only just been connected and needed some time before practice” column.we could establish its effectiveness. In the meantime I went back and cetiscape  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 17
  15. 15. SimHealth 2011 CETI or HETI?CETI was a gold sponsor for SimHealth 2011, the annual As we go to press, the Clinical Education andconference of the Australian Society for Simulation in Training Institute is on the verge of a change ofHealthcare, held at the Sydney Hilton Hotel last month. name and about to become the Health EducationMore than 300 keen educators, policy developers, clinicians and Training Institute.and researchers gathered to explore the theme of “patient-centred simulation,” with keynote addresses from expert The planned change was announced by theinternational and national speakers including patient safety Minister for Health, the Honourable Jillianexpert Dr Amatai Ziv. CETI’s Chief Executive Professor Skinner, some time ago, but it has yet to beSteven Boyages spoke on the final day about creating amodern flexible health professional workforce. made official. It reflects a planned extension in the responsibilities of the current organisationThis conference is an interesting blend of hands-onworkshops, free papers, plenary sessions, roundtable to include education and training for all NSWdiscussions and poster presentations. One of the highlights Health workforce, non-clinicians as well as itsincluded a moulage workshop which allowed the participants clinicians.to make and take home reusable wounds for use in theirmanikin-based simulations. SimWars, in which teams The next issue of our newsletter will includecompeted in their management of simulated emergency more information about the change and the newroom clinical situations was again very popular, with our own programs of work that HETI will be undertaking.Stephanie O’Regan playing a key role in this event. A minor casuality will be the name of this newsletter. While “cetiscape” was fun, “hetiscape” doesn’t have the same ring to it. We will have to think of something new. If you have any suggestions for a new name, or comments to make on the newsletter, please let me know. Meanwhile, be assured that [the newsletter] still needs your contributions and will continue to appear. Thank you, CETI’s simulation learning and teaching coordinator, Stephanie O’Regan, lends a hand during SimWars at SimHealth 2011. Craig Bingham Editor, cetiscape Program ManagerSimHealth will be held again in Sydney next September. General Medical Training UnitDetails, including a call for abstracts and photos from this CETIyear’s conference, can be found at www.simhealth.com.au cbingham@ceti.nsw.gov.au Contributing to [the newsletter] The submission deadline for each issue is the middle of This newsletter is published by email and online: the month. Articles can be submitted as Word documents. www.ceti.nsw.gov.au/cetiscape Pictures and logos should be sent separately, using the best We invite contributions on all aspects of clinical education available file. For logos, this is often an EPS file. Picture files and training, in particular: should be sent at the highest resolution available.   Short news stories: achievements, launches, events. Articles are subject to editing (proofs are shown to the (100 to 300 words, photos and illustrations desirable) 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 cetiscape  Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 18