Welcome ST1s in General Practice Tameside 2013

Aims and Intended Learning Outcomes (ILOs) AIM - to feel comfortable with and understand - each other, the tutor and the course ILOs - We shall be able to enjoy and make the most of the diversity of backgrounds of folk who come into GP We will be able to start to think about and do some self directed learning We will have some ideas for making the most of hospital jobs We will know where the curriculum is and have some ideas for how to use it

What we are doing this morning Interview your partner and prepare to present your partner to the group Who are you? Names, where from, where trained? What brought you to GP? What special medical knowledge and skills do you have? What hobbies, interests and unusual skills do you have? Name a FEELING you have about being a GP

What we are going to do this year What do you WANT to achieve? (Hopes) What do you NEED to achieve? (Any fears) What would your trainers (educational supervisors) like you to achieve? (What do you need help with) What would I like us to achieve? HOW?!?!?!

Enjoying The ST1 Year What is an ideal GP? What is the opposite of an ideal GP? The curriculum What is self-directed learning? How to cope with hospital jobs? What do we need to do?

The GP Curriculum COMPETENCIES Primary care management (clinical management, teams, IM&T) Person-centred care (consultation skills) Specific problem solving skills (data gathering,making diagnosis/decisions) A comprehensive approach (medical complexity) Community orientation A holistic approach ESSENTIAL FEATURES Contextual Attitudes (ethics and fitness to practice) Scientific (maintaining performance, learning and teaching)

Self directed learning What is it?

What is Self Regulated Learning? An active process whereby learners set goals for their learning and monitor, regulate and control their cognition, motivation and behaviour. (Pintrich 2002)

Performance Phase Self-Control Imagery Self-instruction Attention focussing Task strategies Self-Observation Self-recording Self-experimentation Self-Reflection Phase Self-Judgment Self-evaluation Causal attribution Self-Reaction Self-satisfaction/affect Adaptive/defensive Forethought Phase Task Analysis Goal setting Strategic planning Self-Motivation Beliefs Self-efficacy Outcome expectations Intrinsic interest/value Learning goal orientation

Classes of self-regulated learners Self-regulatory phasesNaïve self-regulatorsSkillful self-regulators ForethoughtNonspecific distal goals Performance goal orientation Low self-efficacy Disinterested Specific hierarchical goals Learning goal orientation High self-efficacy Intrinsically interested Performance/ Volitional control Unfocused plan Self-handicapping strategies Outcome self-monitoring Focused on performance Self-instruction/imagery Process self-monitoring Self-reflectionAvoid self-evaluation Ability attributions Negative self-reactions Nonadaptive Seek self-evaluation Strategy/practice attributions Positive self-reactions Adaptive

IN MY LEARNING I CAN GENERALLY: Set my own learning goals Set my own process goals (i.e. determine what tasks/methods are required to achieve my goals) Identify strategies for achieving my goals Revise goals when necessary Am motivated to learn Can articulate what is expected of me Document the processes I use when working on tasks Monitor my progress towards achieving goals Adjust my actions on my own to achieve goals Modify or adapt strategies that are unsuccessful Give constructive feedback to my peers Constructively use feedback from my clinical supervisors Constructively use feedback from the course facilitators Constructively use feedback from my peers Revise versions of my work to improve them Reflect on my process of achieving my goals Evaluate my own work Know how I am being evaluated Attribute my success to my efforts Work well with other students Have a learning goal orientation

Metacognitive ComponentTypeTerminology Cognitive knowledge Knowledge about oneself as a learner and factors affecting cognition Person and task knowledge Self-appraisal Epistemological understanding Declarative knowledge Awareness and management of cognition, including knowledge about strategies Procedural knowledge Strategy knowledge Knowledge about why and when to use a given strategy Conditional knowledge Cognitive regulation Identification and selection of appropriate strategies and allocation of resources Planning Attending to and being aware of comprehension and task performance Monitoring or regulating Cognitive experiences Assessing the processes and products of one’s learning, and revisiting and revising learning goals Evaluating METACOGNITION Typology of Metacognitive Components

Features of Self Regulated Learning(SRL) It is not a generic competency or a fixed ability It is not about learning in isolation All of us use self regulatory processes in our learning Skills of SRL can be learned and taught It is a context specific process

On our team You are GPs now...

You are our spies.... observers and participants observe their behaviour level of participation and reflection our ethos - where to find this?

Anthropological Study How do the other species behave? What animals could represent physicians, surgeons, paediatricians, psychiatrists, A and E, O and G,

Discipline and Learning Environment RULES OF ENGAGEMENT Phones? Eating? Being late? Wondering in and out? Openness and honesty? Respect and value all perspectives? Support and constructive criticism? Confidentiality? Anonymised or absolute? Preparation and commitment? Enjoyment? Expressing emotion? Attendance? Mandatory - need to Sam!!!

The course Have basic knowledge of subject of the month (NICE) Two Thursday mornings per month - one with expert and clinical focus and one with ST3 and actors for communication focus Start 9am. Half hour catch up time 9.30am Expert presentation on clinical subject in GP Including case discussion Lots of interaction!!!