SAS Tutors Development The SAS Tutor as a Resource Yohanna Takwoingi, SAS Tutor Rep, NACT UK Council Liz Spencer, Anaesthetist & Professional Educator, Education Adviser, NACT UK. Doctorstraining.com Mandy King, Leadership Trainer & Coach, SAS Team, Gloucestershire Hospitals 30 September 2016

Objectives Consider the diverse roles that you have as a Tutor Define yourself as a leader & mentor Principles of giving & receiving feedback Opportunity to learn & share from other Tutors

YOUR ROLE Leading Managing Educating What do we mean by Leadership? How does it differ from management? Why is it important right now? What does it mean in your role?

Role of the Tutor When a SAS doctor comes to you with a problem about workload, being stressed, uncertain where there career is going, being bullied or undermined by consultant what do you do? MAKE TIME TO SIT DOWN, TALK & SUPPORT MENTOR, ACTION PLAN. REVIEW CONSIDER YOUR ROLE AS A SIGNPOST TO OTHER RESOURCES

What’s New? National & Regional current issues Liz Spencer

Educators Individuals with a role in teaching, training, assessing and supervising learners. This includes Individuals in a recognized and approved trainer role Other doctors or healthcare professionals involved in education and training in the course of their daily clinical or medical practice Academic staff from a range of disciplines with a role in education and training

Educators Individuals with a role in teaching, training, assessing and supervising learners. This includes Individuals in a recognized and approved trainer role Other doctors or healthcare professionals involved in education and training in the course of their daily clinical or medical practice Academic staff from a range of disciplines with a role in education and training

Educators are responsible for engaging positively with training, support and appraisal relating to their role and are accountable for the resources they receive to support education and training. They must act in line with professional guidance for all doctors – they must be positive role models demonstrating good medical practice. They are expected to maintain and continue to develop knowledge and skills on an ongoing basis through continuing professional development. Educators are involved in and contribute to the learning environment and culture.

1 – professional values & behaviours

Generic Professional Capabilities Framework – 10 domains Professional values and behaviours Professional skills – practical & clinical Professional knowledge Communication capabilities Capabilities in leadership & teamworking Capabilities in patient safety & quality improvement Capabilities in dealing with complexity & uncertainty Capabilities in safeguarding vulnerable groups Capabilities in education and training Capabilities in research

New Junior Doctor Contract Work schedules inform doctors of the range and pattern of duties expected during a placement, as well as intended learning outcomes. This is later personalised to the individual needs. Exception reports are a formalised way for doctors to raise issues when they feel that their work schedule, either in terms of service or training, does not reflect the reality of their post.

“Educational supervisor will respond to any exception reports, conduct work schedule reviews and will also have joint responsibility with the doctor for personalising their work schedule. While accountability remains with the educational supervisor, completing certain tasks can, and often needs to be, formally reassigned.”

Education & Clinical Supervisor Recognition- July 31st 2016 Hospitals should use the seven areas to show how they identify, train and appraise trainers a. ensuring safe and effective patient care through training b. establishing and maintaining an environment for learning c. teaching and facilitating learning d. enhancing learning through assessment e. supporting and monitoring educational progress f. guiding personal and professional development g. continuing professional development as an educator. Academy of Medical Educators

Appraisal of Supervisors & Tutors Supporting information Personal record of activity Feedback on performance Discussion & reflection www.nact.org.uk

Recent NACT UK documents

Factors Affecting Doctors’ Performance Performance affected by complex mix of issues1 Behavioural and personal factors significant in majority of performance problems – attitude to work Work context & environment needs full exploration e.g. workload, sleep, bullying, harassment Post and programme – selectio,n induction and supervision all contribute Educational factors pre & post qualification impact on trainees’ performance2 Social factors – include family pressures Health – Under diagnosed & poorly managed! stress & depression requires understanding from educationalists & managers Understanding Doctors' Performance. Oxford: Radcliffe Publishing, 2006: 38–47. 9. Paice E, Orton V, Appleyard J. Knights & Kennedy 2006 Dysfunctional tendencies in medical students Performance at University and attitude to work are strong predictors of behaviours exhibited later on in career – Knights and Kennedy 2006 ‘ Dysfunctional tendencies in medical students’ 3/4 over confident, ¼ indecisive, 1/3 over diligent and 1/10 aggressive

The Trainee in Difficulty Clinical performance (knowledge, skills, communication) Personal and behavioural issues (professionalism. motivation) Sickness/ill health (personal/family stress, career frustrations, financial) Environmental issues (organisational, workload, bullying and harassment) These are the key aspects to explore. Refer to the NACT UK Guidelines. Give Guidelines as a handout / put them on postgrad website. NACT UK 2007

Communication Feedback

Purpose of feedback Recognise and build on strengths Identify limitations & structure development needs Encourage self awareness & insight Set clear goals to improve performance and assist in career development BECAUSE YOU CARE

Constructive adjective: constructive having or intended to have a useful or beneficial purpose. "constructive advice” Synonyms: positive, useful, of use, helpful, encouraging helping to improve; promoting further development or advancement (opposed to destructive ): constructive criticism.

Principles of Giving Feedback Describes behaviour and its impact – non-judgmental Specific, Sensitive & Timely Confidential FREQUENT – all the time! Involves the receiver – conversation – manage the airtime >50% theirs Relevant to the curriculum / stage of training - prioritised Against known expectations – don’t move goal post Confronts important or difficult issues Balanced – positive & negative Is understood and accepted by the receiver Method of delivery flexed according to receiver Is given by someone who genuinely wants to help Suitable venue – away from patients – clarify timeframe & agenda

Receiving Feedback In private? Agenda stated so am prepared. Confidential. Am respected as a person & doctor, treated as an adult From someone who cares & who I trust / respect Direct, honest, frequent Empowered to discuss / Time for discussion I make action plan with guidance, may need time to reflect I will listen & be open to comments / suggestions Understand formative nature My opinion invited & I am listened to Taylored to seniority & builds on existing knowledge Treat it as a gift 

Doctor must feel positive Confident, optimistic, resilient & able to cope with work pressures Enables self exploration and self assessment Motivated to make changes MASLOW

Developing Mentoring & Supporting Skills Be positive – we CAN do this – together Listen intently Don’t be “Mr Fix-it” Ask and probe to develop insight & encourage self-determination Time-lined action plan – how can you help? Document & Review

GOOD COMMUNICATION Core Skills Building Rapport Different Levels of Listening Giving supportive feedback Core Skills Asking Questions Using Intuition

Practice Method: Consider a current issue Groups of 3 - 10 mins each each person to mentor be mentored observe & feedback Observe Single open questions? Give advice?? – not to be encouraged! Picking up emotions / “hidden” issues Practice in groups of 3

The SAS Tutor as a Resource Outcomes Consider your role in current climate Define yourself as a leader & mentor Principles of giving & receiving feedback Learn & share from other Tutors

Closure Personal Reflection Evaluation of course What have you learnt What are you going to do / change? What are your development needs Evaluation of course Certificate will be emailed Share one Take Home message