induction

If Richard Branson was PGDME he might say……..

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A thought for all those preparing to welcome our new doctors in August. Train them so well that they want to stay here or come back as a consultant. It’s no small task and we are not an airline, but there is truth in those words. As DME it’s pretty clear to me that although there is clearly a link between workload and satisfaction there is a also a strong association between satisfaction and being valued. We need our trainees to feel part of a team, to feel valued and to feel they are learning here in a hospital with fantastic developmental opportunities.

One to think about in the last few weeks before the biggest induction of the year.

Look after your staff and they will look after your customers (patients)

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S

JOINING OUR TRUST IN AUGUST?

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The Postgrad team is looking forward to welcoming you to our Trust in a few weeks if you are one of our new starters. Thank you for choosing us to work with. Its a great place to work and train and, if you are returning to us having been here before, a warm welcome back. Whether you are in a training post or one of our valued ‘Trust’ grade members of staff, the Postgrad team is responsible for making sure you are given all the training and information that you need to start work effectively and safely.

Take a look at our personal welcome to you here:

Emails are going out at the moment inviting you to induction, so keep an eye on your in-box.  Induction is vital to patient safety and we take it very seriously at CMFT.

We are introducing an Induction WebPortal this August for you to access everything you need to know about your first days and how to hit the ground running. We hope you find it useful and will be asking you how we can make it even better once you get here. We’ll send you details on how to access the website in our email to you.

Induction can be considered as comprising two main areas.

Firstly, there are elements that extend across the entire Trust. All new members of the hospital need to be familiarised with how we work. This includes how we work as an organisation (corporate induction) and specific information for clinical groups (clinical induction).

1. You can find the link to the e-learning modules on corporate and clinical induction http://www.elearning.cmft.nhs.uk/. We will be sending you your user name and password shortly

Secondly, all new starters need to be introduced into their local areas. Local induction is essential to safely welcome new starters into the Trust, orientating them to how things are done here so that they can work safely and efficiently from day one.

Local induction will usually be co-ordinated by a consultant in the department where you will be working. You should complete local induction as soon as possible after you start, and we’ll direct you to the right place after you have attended the Welcome Session (details in your forthcoming email).

Your Division and the Postgraduate department will task you to fill in a self-declaration form during your first month to let us know that you have completed all elements of your induction. You’ll be able to do this quickly and easily on the WebPortal.

Finally, we will be giving you a phone call in the days leading up to you starting here to say hello and make sure you are happy that you have all the information you need to get started on your first day.

Take a look here for an overview of what we stand for here at CMFT, our values and how we put our hearts into what we do.

You’ll see many of these faces on the shop floor when you get here!

We look forward to meeting you.

Local induction guidance is now out

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Screenshot 2014-07-08 09.08.27We are working hard to improve local induction. Medicine is perhaps a strange profession in that our juniors are often expected to turn up and work almost immediately with little preparation or planning. Historically as DME and as foundation lead I have seen docs fall into difficulties as a result of a lack of an effective local induction. We really need to make sure that our new starters are safe to practice for the benefit of our teams, our trust and most importantly for our patients.

So, with a few weeks to go it’s time to think hard about how you are going to make this year’s induction the best that it has ever been.

Click on the link below to look at our guide for local induction and do the best that you can for our new starters. Welcome them into the trust, train them, help them and welcome them.

Local Induction Leaflet

At CMFT we have an induction lead for the trust in John Bright (Acute Medicine Consultant) who can be contacted for further information and help.

vb

S

 

Should we theme supervision and supervisors? CMFT

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Different by http://www.flickr.com/photos/metulsky/

A short story about our attempts at making life easier for Dr X…..

Dr X has been a clinical supervisor for many years…., more than he cares to remember to be honest and he’s pretty good at it. The trainees like him and he likes the trainees, he’s had a few awards for teaching and he is secretly rather proud of this. In summary he really enjoys teaching and interacting with trainees, loves sharing what he has learned and especially enjoys teaching at the bedside with real patients. This is how Dr X grew up as a doctor and he does it well, but in recent years some aspects of teaching have become burdensome….

In the old days trainees came and went, and sure if there was a problem with one of them Dr X would not sign them off at the end of the rotation and/or have words with the hospital dean, but lately this holistic approach has been replaced by the introduction of the portfolio system, a series of meetings, assessments, checks, balances and development plans that each trainee is required to complete. It’s a significant task for trainee and trainer alike, and while Dr X knows that this is something we are all having to get used to there is one issue that really irritates him…

WHY ARE ALL THESE PORTFOLIOS DIFFERENT?

It’s a good question to be honest, but they are. They all reflect how their particular college and the GMC like to set things out and although there has been a call for more standardisation it seems that we are some way off this. In practice this means that in a speciality such as medicine a department may have a whole range of different trainee types, all with their own particular ‘package’ aimed at supporting their learning and supervision.

As a trainer this can become really confusing as the requirements of junior docs in the same workspace may be very different. A doc working towards GPVTS has different learning needs and a very different portfolio that of a doctor on the same rota embarking on a career in general medicine. The e-portfolios are quite different. They have different logins, passwords, different tutors and different curricula and assessment modes. It’s just too much to keep track of and it leads to poor quality supervision and the possibility of ARCP failure for the trainee.

So, whilst Dr X would like all these e-portfolios to disappear (not going to happen), how can we make life easier for him and the many other consultants in the same position?

THEMATIC SUPERVISION IS THE SOLUTION

In my opinion it is now almost impossible to maintain a good working knowledge of more than one type of trainee portfolio. Some consultants can, but I find it tricky to really understand the detail and specific  requirements needed for all the grades and types of staff we get in a place like the ED for example. So, we have moved to the idea of thematic supervision where consultants oversee a group of trainees at the same level/type.

For example, GPVTS trainees on their EM rotation are supervised by me. I’m now much more familiar with their training needs, the GPVTS e-portfolio and the assessments that they need. It has also allowed me to develop contacts with GP trainers in the community. My colleagues in the ED do the same, with themes for foundation, CT1-2, ACCS, SpR, Clinical Fellows etc. so that we all develop expertise and familiarity with our group. We do this for a few years and then have the option to move to a different group (for variety).

This is such an easy thing to do, yet it has a real effect on the quality of educational supervision.

So what of Dr X?

We really want him to continue. We really want him to train all the doctors on the ward, that’s his clinical supervisor role and we are delighted that he will continue. We also know that in his educational supervisor role we need him to reduce any unnecessary repetition and to develop expertise in a group of docs so that he does not have to learn an entirely new portfolio system every 4 months. So Dr X has agreed to look after 3 of the foundation docs on the firm as an Educational Supervisor. He is becoming proficient in the use of HORUS (the e-portfolio for foundation) and is on first name terms with the foundation team.

There is still paperwork, and the process is a bit more onerous than it used to be….., but with thematic supervision it’s at least a little easier, and the trainees do seem to like it when he spends the first 30 minutes of their meetings talking to them rather than trying a series of passwords whilst trying to log on to one of 7 different portfolio systems….

vb

Simon Carley

Consultant in Emergency Medicine

NB: Dr X is largely based on me and my past efforts at juggling different trainees on different rotations at different times of the year. Life is so much better now that I just look after the GPVTS docs. I might rotate to a different group in a few years, but for now this is SO much better than it was.

New Foundation docs: Linnet Clough 2013

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IMG_1644 We are delighted to welcome the new foundation dos to CMFT. Forty-Eight new starters across the trust who will be integral to patient care here for years to come. First impressions are that we’ve attracted a bright bunch of enthusiastic and engaging trainees which is fantastic, and having completed 2 weeks of shadowing they are up and running as of this week.

Let’s not forget that the foundation years can be tough though. The first rung of the medical career ladder represents one of the biggest changes to a doctor (the other being the step up to Consultant), and it’s vital that our trainees have great support. Whilst the trust can and will support trainees there is no doubt that your peers in the same grade are really important.

So, to help speed up the bonding process, to learn some leadership skills, to find out more about each other and the foundation teams we spent a day in the Peaks training, running, climbing, paddling and swimming.

Did it work?

In the view of the instructors – absolutely! At the start of the day the 8 teams – well they weren’t really working as teams….. We saw groups working as individuals, but by the end of the day they were clearly working together, supporting each other and achieving their goals. All this will be important in the workplace and especially during those first on calls.

The activities were

  • Orienteering
  • Raft Building
  • High ropes
  • Low ropes
  • Plus, getting there, on time, not getting lost, looking after an egg for the entire day (Ed- Why the egg????)

So, here are a selection of photos from the day. If you want more then get in touch. As you can see…..some rafts were better than others!!!

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Low ropes course – team tasks
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No prizes for rafting on land!!!!
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Confidence before floatation
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Errr………not sure that’s what you were hoping for.
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Swim for it!
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Is she floating???
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A fab bunch – we’re lucky to have them with us.
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The teams developed a strong sense of self……, this led to some cheating😉
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Hmmm, I’d write your own caption for this one….
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One of these rafts worked slightly better than the other. Can you tell which?

I’d like to personally thank all the trainees who showed willing to take part and get stuck in, but especially to the instructors and organisers of what turned out to be a fantastic day.

Sharon Gibbs gets top marks for once again organising the day beautifully.

vb

S

AoMRC and NHS Employers on ensuring safe induction

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August from: Très Riches Heures du duc de Berry. Wikipedia Commons
August from: Très Riches Heures du duc de Berry.
Wikipedia Commons

Summer has (sort of) arrived in Manchester. The pattern of work has changed in some departments (Paeds ED is all trauma rather than the winter D&V) and most of our staff are settled into their roles. August will soon be upon us, and in postgrad that means that minds are turning towards induction.

There is a great deal of work to do to ensure that new starters are safe to practice. In foundation training we have the luxury of a 2 week shadowing period to bring our new starters up to speed, but at other grades there are frequently difficulties in balancing the need to complete all aspects of induction alongside delivering an effective and safe service. As a supervisor I often feel the paradox of needing to ensure that the department is staffed (for patient safety reasons) whilst also inducting the new docs (for patient safety reasons). Whilst this will remain a challenge, (particularly in the acute specialities), a new document from NHS Employers and the Academy of Medical Royal Colleges places an emphasis on the delivery of training to ensure our junior docs are safe.

You can download the guidance here. safe-trainee-changeover, but in summary the document identifies 4 themes to facilitate trainee changeover.

  • 1. Consultants must be appropriately available
  • 2. Flexible and intelligent rota design
  • 3. High quality clinical induction at all units
  • 4. Reduction of elective work at changeover times

To some extent this is stating the obvious. However, the suggested mechanisms for rota changes are perhaps interesting enough to deserve a read. The implication of not putting trainees on out of hours rotas when they first start will be a challenge to many and indeed impossible for some. In that case we must look to new and innovative ways to deliver induction content (such as e-learning packages).

I was also interested to see that work is being done to stagger changeover for trainees to avoid the ‘all change at once’ situation currently faced by some specialities. This would in my opinion be a great step forward and with a report from AoMRC/CoPMeD due any day we should be looking out for this soon.

So, as the Summer wanes (as far as I can make out it started and ended last week) it is time to think about how we deliver induction this year. June is a great month to dust off last years plans and to ask ourselves whether they are still fit for purpose, but if you did not manage it then, July will do just fine.

vb

S