Template 1: The traditional paradigm
Aims and objectives
- To demonstrate competence in the clinical skills of general practice.
- To make a diagnosis in physical, psychological and social terms.
- To develop consulting skills.
- To make and implement appropriate management plans.
- To understand the use of time in general practice.
- To be able to work independently but also ....
- ....to function as a member of the primary health care team.
- To cope with the basic administration of general practice.
- To demonstrate an understanding of practice management.
- To identify own learning needs and appreciate the need to continue
learning throughout a career.
- To demonstrate an active commitment to the promotion of health in the
patient as well as society.
- To have a public style of living consonant with advice given to
patients.
- To show a sensitivity to emotions and an ability to use personal
awareness of feelings for the therapeutic benefit of the patient.
- To show an understanding of the evaluation of scientific evidence,
research as applied to general practice, and statistics.
- To be aware of the philosophical and ethical issues involved in the care
of patients.
- To be able to recognise stress within oneself and to develop mechanisms
to cope with it. To value medical audit.
- To demonstrate knowledge of the wide range of interventions available
and the appropriate usage of other agencies.
- To demonstrate understanding of how family dynamics can cause illness or
alter its presentation, course and management.
- To safely manage acute problems and emergencies.
- To live with and manage uncertainty.
- To be able to design guidelines.
- To develop an ability to evaluate.
- To develop an ability to delegate.
- To develop evidence-based thinking and practice.
- To take postgraduate exams.
- To pass summative assessment.
- To boldly go .....
- Negotiation of educational contract.
- Curriculum planning.
- Shadow trainer initially then controlled separation.
- Sit in with other partners.
- Meet other members of the primary health care team.
- Explain the vagaries of local hospitals.
- Give practice information pack containing list of useful telephone
numbers, practice leaflet, map of the area, timetable and on-call
arrangements.
- Locate and make friends with the computer.
- Bond!
- Negotiate together the structure for learning and frequency of the
various types of formative assessment used.
- Discuss the shift from trainer to registrar directed learning as the
year progress.
- Outline the assessment methods that will be used to plan future teaching
eg.
- Multiple choice questions
- Modified essay questions
- Project/audit
- Personality profiles
- Consultation observation eg video taping, joint surgeries.
- Hot topics.
- Prescription analysis.
- Local confidence rating scales.
- Manchester rating scales.
- Follow-up slip system.
- Phased evaluation programmes.
- Log book.
- Registrar’s rolling assessment diary.
- Simulated surgeries.
- Attitude questionnaires.
- Random and problem case analysis.
- Discuss the format and frequency of tutorials with specific reference to
the generation of suitable topics. These may arise as a result of
- the registrar’s perceived need
- assessment
- a patient with a problem
- from a previously negotiated list of topics.
- The registrar will be encouraged to investigate in detail areas found
particularly interesting.
- Timetable
- Study leave arrangements
- Library
- Domestic conditions.
- Provide P45, MDU/MPS certificate and proof of full registration.
- Sign a service contract.
- Be punctual.
- Read current literature.
- Do consultations at 15-20 minute lengths initially, building up to 10
minutes when trainee feels comfortable.
- Attend the half-day release course.
- Attend practice meetings.
- Undertake out-of-hours work.
- Keep a list of books read.
- Use the log diary.
- Be registered with a doctor other than the partnership.
- Provide own portable equipment for use whilst home visiting.
- Raise topics/patients where uncertainty arises.
- Call for help if in difficulty with a situation.
- Accept regular assessments and discuss the results, repeating the
assessment if necessary.
- Log out books from library.
- Develop their own clientele.
- Use the course organiser as a mediator in the case of difficulty.
- Be enthusiastic about being videoed!
- Be entitled to 30 days study leave per year and pro rata for shorter
periods.
- Be in residence within a certain area when on-call.
- Hold a valid driving licence.
- The registrar may be asked to complete a health questionnaire and also
give the trainer/course organiser permission to approach the registrar’s GP
for a pre-employment medical.
- Keep consulting room tidy and well stocked.
- Encourage the trainee to sit in with all other partners at least once
during attachment.
- Follow the regional guidelines for training practices.
- Take note of suggestions/recommendations of previous re-approval
visits.
- Do everything possible to welcome the new registrar and make them feel
part of the team.
- Safe environment.
- Adequate cover both on call and in the surgery.
- Protected time for tutorials, reading and learning.
- Regular debriefing after surgery.
- Adequate updated library.
- Study leave.
- Trainee’s own well-equipped consultation room.
- Equipment such as ECG, nebuliser, sonicaid, sphygmomanometer etc.
- Drugs for the bag.
- Support and advice about available courses.
- A weekly timetable which will be negotiated between the trainer and
registrar and reviewed at regular intervals.
- Help with the production of CV.
- References when required.
- Access to all meetings.
- Opportunities to visit other practices.
- Another partner to act as educational supervisor when trainer is
absent.
- A record of all formal assessments.
- The trainer will be available to act in a more personal way as
counsellor should the registrar so wish.
- Attend trainers’ workshop and keep his/her own CME up to date.
What makes a good tutorial?
Traditional
and behavioural models of the tutorial