Supervised practice for medical radiation practice 8 October 2014 Webinar Helen Tierney Policy Officer Medical Radiation Practice Board of Australia 1

Background Supervised practice program Professional capabilities Supervision arrangements Confirming capability Questions MRP Supervised Practice 2

3 Supervised practice - background MRP Board responsible for supervised practice graduates in programs managed by AIR and ANZSNM Past three years – Board consultation on registration standard, guidelines and program for supervised practice Ministerial Council approved SP registration standard Board – through AHPRA – will now manage supervised practice

Supervised practice program Practitioners need to demonstrate their capability in each of the domains relevant to their division of practice. Based on capabilities statements - the supervision plan identifies what a practitioner must demonstrate by the conclusion of their program. Not prescriptive about how/when practice should be organised - recognises each workplace and each practitioner is different. 4

For supervised practitioners: How to participate in the supervised practice program (SPP) 5 Step 1 Apply for provisional registration: six weeks before you will receive your results, complete an online application at Step 2 Find a supervised practice position: confirm your radiation licencing requirements remember you cannot start working until you have graduated and hold provisional registration Step 3 When your provisional registration is confirmed: enrol in the supervised practice program Step 4 You may commence practice when: you are registered with the Board you meet radiation licence requirements, and you are confirmed to be participating in the Board's supervised practice program Step 5 During supervised practice: participate in the SPP in accordance with the program requirements, including assessments Step 6 On completion of supervised practice : apply to the Board for general registration as a medical radiation practitioner

Professional capabilities for MRP 6 Capabilities identify the knowledge, skills and professional attributes needed to safely practise DR, NM and RT Domain 1: professional and ethical conduct Domain 2: professional communication and collaboration Domain 3: evidence based practice and professional learning Domain 4: radiation safety and risk management, and Domain 5: practice in medical radiation science, And5a:practice in diagnostic radiography, OR 5b: practice in nuclear medicine, OR 5c:practice in radiation therapy

7 Supervised practice standard Sets out requirements of supervised practice & applies to:  graduates holding provisional registration  practitioners returning to practice  practitioners with conditions requiring a program of supervised practice Level of supervision provided - appropriate to the skills and experience of the supervised practitioner Acknowledges difficulties in rural and remote areas and for small private practices & allows for workplace flexibility Ensures appropriate supervision & public safety protected Guidelines explain levels & principal supervisors will use professional judgement

Supervision levels Level 1: The supervisor takes direct and principal responsibility for individual patients: Supervisor physically present at the workplace & observing at all times when the supervised practitioner is providing clinical care Supervised practitioner must consult supervisor about patient management before care delivered Telephone supervision (indirect) not permitted 8

Supervision levels Level 2: The supervisor and supervised practitioner share the responsibility for individual patients Supervisor must be physically present at workplace majority of time when supervised practitioner is providing clinical care Supervised practitioner must inform the supervisor at agreed intervals about the management of each patient; this may be after the care has been delivered Supervision is primarily in person (direct); when supervisor is not physically present, must always be accessible by telephone or other means eg videoconference & available to observe and discuss (indirect) 9

Supervision levels Level 3: The supervised practitioner takes primary responsibility for their practice, including individual patients Principal supervisor must ensure mechanisms in place for monitoring if supervised practitioner is practising safely Supervised practitioner permitted to work independently, provided a supervisor is contactable by telephone or other means such as videoconference Supervised practitioner may provide on-call & after hours Where required by supervised practitioner, a supervisor must be able to attend in person, in a timely manner 10

Supervision levels Level 4: The supervised practitioner takes full responsibility for their practice, including individual patients with general oversight provided by a supervisor Principal supervisor oversees practice of supervised practitioner Supervisor must be available for consultation if supervised practitioner requires assistance Principal supervisor must conduct periodic reviews of practice of supervised practitioner Supervised practitioner must not practice as a sole practitioner at any time during the program(ie the only MRP practitioner in the practice, so there is no other MRP to provide supervision, direction or assessment) 11

Principal supervisor Responsible for: developing a detailed quarterly supervision implementation plan to ensure the practitioner receives exposure to and experience across each domain of the capabilities, including: range of instrumentation clinical contexts, and patient/client presentations for each division. (Examples provided in program guide) Ensuring appropriate supervision by self & others Submitting assessments 12

For principal supervisors : How to supervise a practitioner in the supervised practice program (SPP) 13 Step 1 Confirm recruitment of a supervised practitioner: confirm the practitioner holds provisional registration with the Board and meets radiation licencing requirements Step 2 Develop a supervision implementation plan: identify the instrumentation (modalities),clinical settings and patient/client presentations the practitioner will undertake identify the elements of the capabilities that will be assessed using case discussions Step 3 Sign on as a principal supervisor through the AHPRA website: agree to provide supervision in accordance with the Board's supervised practice standard and guidelines Step 4 During supervised practice: discuss the practitioner's progress with other supervisors provide ongoing feedback to the practitioner Step 5 Undertake quarterly assessments and review supervision implementation plan: discuss the practitioner's progress with other supervisors and the practitioner complete the supervision assessment report, including details of any areas where the practitioner is making limited or no progress, and review the supervision implementation plan and document any required changes Step 6 On completion of the practitioner's supervised practice : provide a final assessment report to the Board

Confirming capability Domains 1-5: The practitioner should incorporate this capability into their practice and demonstrate evidence in a range of clinical settings. Occur over the duration of the program Be demonstrated in the context of the medical radiation practice (Domain 5) and division specific capabilities (Domain 5A; 5B or 5C). It may also be appropriate for the practitioner to provide further evidence of their knowledge and understanding through case studies and case discussions between the practitioner and supervisor. 14

Confirming capability The following slides show (page numbers from the Guide) Domain 1 Professional and ethical conduct - p15 Domain 5A: practice in diagnostic radiography - p28 Domain 5B: practice in nuclear medicine - p31 Domain 5C: practice in radiation therapy - p34 Each domain includes a description of what a practitioner must be able to do and evidence of the capability (from the Professional capabilities for MRP practice). Also describes how capability should be assessed at the completion of the program. General advice for domains 1-5 and specific advice for each element in 5A, 5B & 5C 15

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Supervision implementation plan A detailed quarterly supervision implementation plan should be tailored for each practitioner To ensure the practitioner receives exposure to and experience across each domain of the capabilities. The implementation plan should include: the instrumentation (modalities),clinical settings and patient/client presentations the practitioner will undertake during each quarter of the program identify the elements of the capabilities that will be assessed using case discussions Example plans provided to guide development of the plan for each practitioner that can be implemented in the workplace and addresses the practitioners needs - not mandatory to use template or follow the detail of any of the examples. 28

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Assessments Assessments occur at 3, 6, 9 months – progress reposts Final assessment at 12 months (48 weeks) Principal supervisor responsible for consulting with other supervisors, discussing with practitioner and submitting report Reports will be submitted electronically Draft assessment reports follow 33

Supervised practice assessment Context for assessing: End of period one they: usually require direction and extended timeframes to undertake a practice or treatment have demonstrated clinical understanding and knowledge of the domain, but is not able to consistently apply this knowledge and often requires assistance have transitioned from the supervisor initially taking direct and principal responsibility for individual patient/clients; to shared responsibility between the supervisor and supervised practitioner End of period two they: sometimes require direction and extended timeframes to undertake a practice or treatment have demonstrated clinical understanding and knowledge of the domain, sometimes requiring assistance to apply this knowledge practice semi-independently, sharing the responsibility for individual patient/clients with the supervisor 34

Supervised practice assessment End of period three they: rarely require direction and mostly work within expected timeframes for practices or treatments rarely require assistance to apply knowledge of clinical understanding and knowledge of the domain take primary responsibility for their practice, including individual patient/clients End of period four they: always demonstrate capability to standard required for independent practice take full responsibility for their practice, including individual patient/clients within the supervisor’s general oversight consistently demonstrate an understanding of MRP concepts in new or unusual circumstances and/or in contexts that are unfamiliar to them 35

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Supervisor training Teaching on the Run 20 Facilitators – MRP supervisors who are trained to deliver supervisor training to others Recruited mainly from Queensland, NSW and Victoria R&R and metropolitan & public and private Nominations needed – by Friday 10 October Facilitator training – Mon 27 & Tues 28 October 2014 Supervisor training – November, December & February Need support from Directors/Managers for facilitators to attend and deliver training 49

Questions? Send to 50

Program information Program guide – release late October Website updates Direct to supervisors 51

52 Contact details Helen Tierney Policy Officer Medical Radiation Practice Board of Australia supervised practiceMedical Radiation Practice Board of Australia supervised practice