Report for Reapproval Visit

REPORT FOR REAPPROVAL VISIT

Trainer Visited:

Date:

Visitors:1.

PRACTICE

1. Next registrar MUST engage in OOH. Advised to discuss further with Course Organiser for Leeds in order to implement a local strategy
2. Next registrar MUST actively engage in AUDIT, rather than passively being exposed to practice audits. Advised trainer to look at simple audits for the registrar eg GPAQ feedback from patients, referred to web resource:
3. Outdated large analogue vide recording equipment; advised to invest in a digital camera; Deanery to help with funding.

TRAINER

1. Tutorial:

• Clarifies registrar statements when vague or unclear
• Relaxed style
• Use cases to make the it more experiential

• Video started without the beginning so not able to see aims and objectives and how they were set; NEED to HOOK the GPR
• No commentary available – how did they decide on the methodology?
• Dynamism – try to use a variety of methods: books, handouts, mini-powerpoint, flipchart; engage multiple senses in learning. Too much Q&A type session; comes across as an examination session than a challenging tutorial
• Trainer led questions; ask registrar what they find difficult about the subject and what they would like tackling NEEDS TO BE LEARNER CENTRED
• 70:30 % chat (trainer:GPR, aim for 50:50/60:40)
• Set the GPR some homework; eg cases they have seen in surgeries
• Learn together: Trainer acknowledged his own needs eg breast cancer risk; which is excellent for encouraging the GPR to detail his, but then both could have both looked up this information together (also adding to dynamism)
• Explaining risk – look at process rather than content, eg looking at the various ways of explaining risk: pictograms; how to best portray figures to patients; doing a Google search on “explaining risk”
• not particularly based on evidence
• “We’ve done that to death, shall we call it a draw”: not a motivating statement; better to end on a positive note eg “I hope you found that useful”; summarising statements tend to be positive statements too.
• Always summarise to pull together what has been learned into some sort of framework
• Consider evaluating some sessions to get some feedback on one’s own teaching performance

1. Random Case Analysis:

• Good psychosocial exploration of cases
• Good reassurance of registrar – “do you think I should have done an examination” (abdo pain)
• Registrar looks very comfortable with trainer
• Trainer always ends each case with the registrar: “anything else you want to say about this case”
• Some good scenarios with challenge eg “I always find abx helpful and I am going away this weekend”

• Start off by asking the registrar if there were any difficulties (s)he had; tackle those first
• Consider making notes to help navigate your thoughts; in addition this results in a list you could discuss with your registrar to see what areas (s)he would consider a priority; not necessary to cover everything on the list
• Consider using informal role play “so what exactly would you say to me if I am the patient?”
• Don’t feel you need to exhaust all possible issues on a single consultation, otherwise there is a fear of not picking up more important stuff from other others (through running out of time)
• Use more scenarios to push the registrar: “what do you do if the abdominal pain does not settle and the surgeons discharge her back to your care”; “so the bloods come back as normal, how do you make the link between TATT and psycho social problems”
• Differentiate between methods which identify what he “says” he would do vs what he “actually does”; so, rather than asking him how he would say something, ask him to say it to you as the patient
• You may get this particular registrar to open up a bit more is to ask him how he FELT about that consultation; may result in a shift from a clinical discussion to that based on attitudes/emotions (a deeper level of learning)
• Summarise learning points to help form a framework of what has been covered in today’s tutorial
• Occasional evaluation of tutorials will provide the trainer some feedback on how to do things in the future – you can do this informally or formally

1. CONCERN: Next registrar MUST engage in OOH.

1. CONCERN: Next registrar MUST actively engage in AUDIT, rather than passively being exposed to practice audits.

1. WHAT: Outdated large analogue vide recording equipment

1