Medical Education Fellows: Educators of the future Miss Nikki Kelsall MEF Lead Trauma & Orthopaedic SpR

Original development 2005 Mr James Gilbert & Dr Rosie Lusznat The majority of trainees engage in education Some do more than expected, in their own time This needed formal recognition To support the educators of the future ‘Professionalisation’ of educational interests There is a general expectation and assumption that all trainees will to some extent engage in, and be involved with teaching and education. Some trainees undertake considerably more educational activity than is expected of their level and this is recognised more formally within the Wessex Deanery. This role has been developed to help professionalise educational activities as well as to produce educationally minded professionals who are able to take up Lead Educator positions at the end of training. This role has gained the title of Medical Education Fellow ( MEF) and competition for the title is high.

Who should be a MEF? Full criteria on website Champion of education Trust, speciality, deanery or national level Formal education roles Higher educational qualification Currently at/above SpR, ST3, GP registrar Usually 12-20, 45 have been through the programme A champion of education at Trust, Specialty, Deanery or National Level Involved with organisation of educational events at Trust, Specialty, Deanery or National Level Current Medical Education Associate Tutor within NHS Trust Member of Tomorrow’s Teachers Faculty Engaged in or completed Certificate / Diploma or Masters in Education Member of Deanery Working Groups Strong Educational Portfolio Completed GP Registrar training year Currently at SpR or at ST3 level and above, the appointments we make are trainees who we expect to stay in the region long enough that but the fellow and the Deanery can fully benefit from the appointment. Once you have gained a CCT it is very unlikely that you will be appointed, however fellow's appointed during their training are welcome to remain a fellow for as long as they feel it useful to them and the group. GP's in their first 5 years of practice will be considered for appointment. Currently we are pan specialty (medical, surgical, paeds, EM, ortho, psychiatry, GP) with the group range from ST3 to post CCT consultants and GPs Formal application process Supported by Educational Supervisor / Clinical Tutor Evidence of MEF criteria Formal certificate / contract at deanery level Transferable from Trust to Trust Regular appraisal of educational activity Active input into Institute work as well as own / Trust / Specialty work http://www.wessexdeanery.nhs.uk/medical_education_fellows.aspx

Excellence in educational supervision Leadership Lead educator development programme Further Educational Development Educational supervisor Trust / Specialty lead CCT Higher Degree Access Wessex educational courses Annual conference for MEFs by MEFs Active input into deanery work Access to bursary scheme Facilitated peer group WPP Deanery Induction Certificate / Contract Wessex Medical Education Fellow Entry Education champion Certificate / Diploma / MA in education Other experiences

Benefits & requirements Certificate & contract for portfolio Yearly appraisal Support with personal projects Access to deanery supported projects Continue to develop educational portfolio Attendance at 2 out of 4 yearly meetings Involvement in annual conference Evidence that requirements are met If you are appointed to the role of a MEF you will receive a certificate of acknowledgment for your portfolio. You will also receive a 12 month contract that is intended to formalise the role of MEF, and ensure accountability from the deanery to you and vice versa. The contract will be renewed on an annual basis following an appraisal process during which you will be expected to provide a report of your educational activity with evidence of having met the terms of reference. You will also be expected to demonstrate evidence that you have fulfilled the expectations of your role to the deanery (see below). Current opportunities There are lots of changes happening at both deanery and national levels currently. Our new Dean is keen to work with the MEF's (and other fellow's within the deanery) as his 'think tank' on issues such as reviewing the ARCP/ RITA process, including MEF's on deanery visits, using our expertise to solve quality issues, involve us at ground level with developing a faculty of Wessex Medical Educators (aimed at those who innovate and change education) and to be involved in the project "What does Wessex Deanery do?". In addition we are working on developing the profile of our fellow's and extending our role in the mentorship of more junior medical educators What is expected of our fellows? Although we accept that by definition of your appointment you are already busy the deanery does expect a level of commitment to the role: Give active input to the work of the Wessex Deanery e.g. Trainee representative on working groups, project work, teaching activities, mentoring and facilitation. Continue to develop as an educationalist and professionalise educational interest with academic qualification. Engage in educational research. Undergo a yearly appraisal of educational activity. (downloadable appraisal form) This appraisal is an informal meeting at the deanery with Dr Rosie Lusznat and the MEF Lead. You are expected to complete the activity form above and a copy of your CV a week in advance of the meeting. You do not need to wear a suit or bring a portfolio unless you have some specific project work you wish to share. It is a truly developmental meeting where you have the opportunity to reflect on your educational achievements in the previous year, think about where you want to take these in the next year and receive advice and support on how you might achieve these goals. Attend a minimum of at least 2 MEF meetings per year. Contribute to the organisation of (and attend) the annual education conference for trainees.

Validation Recognition Mentorship Influence Credibility Educational community Career development Exposure to deanery business Education conference planning Haven conference Wessex courses In a recent MEF meeting we discussed what we feel the benefits of our role are: 'It validates what we do' 'Recognition of hard/unpaid work' 'Gives us exposure to the workings and dynamics of deanery business' 'Its a massive career opportunity' 'Gives us access to people and resources' 'Provides peer support' 'Its a community of like minded individuals' 'Mentorship' 'Start of an education based career pathway' 'Career development' 'Gives us influence over training issues' 'Dedicated development days' 'Free conference attendance' 'Conference planning experience' 'Recognition is prospective (helping what you will do as well as what you have done)' 'Access to reduced fees on Wessex courses' 'Access to the Haven Educators forum' 'The most developmental appraisal I have ever had, where the focus was really on me rather than trust based problems' 'It gives us credibility in negotiations' 'Exposure to deanery level education issues/educators/leaders in medical education both present and future'

MEF Structural Framework Academia & Research Tomorrow’s Teachers 1 & 2 Annual MEF Conference Flexible Training Specialty Training Wessex deanery MEF Strategy Group Undergraduate Education GP Training Multi-professional Education Mentorship of junior trainees Strategy Group Remit: Strategic input to PGME within Wessex deanery Promote medical education at training grade level Develop educational activities for trainees

MEF projects –present/ongoing The annual Wessex medical education conference Tomorrow’s Teachers (1, 2, faculty & franchise) Junior trainee development & mentorship Dorset County Hospital education committee Trainee representation on review panel hearings Trainee presence at deanery induction/bmjcareers fair Audit of the MEF programme Educational resources Undergraduate projects Using technology for teaching Faculty members on local & national courses Development of new training opportunities Between us we sit on multiple steering groups including the education conference TT – Paula, Denzil & James (Majority of us on faculty) Mentorship – Lucy, Mark, Will & Nikki (Emma & Kat) DCH – Kat Review panels – Nikki & Emma Auditing the MEF programme – Nikki & Poppy Resources – Paula – CASEcards, Nikki – Extranet, Jo – 1 minute wonder & Peads ED book, Graham Lloyd-Jones – Radiology at a glance Undergraduate projects – Intro to clinical practice – Nikki, Lucy, Will. SSM in teaching – Paula. 3rd year assessments – Andy (exam & assessment committee), multiple other MEF’s Jo, Lucy, Will, final OSCE examiner (Mark), Radiology (Graham LJ) Technology – Elearning for health – Mark & Suzy Coles, Extranets – Nikki, Eassessment @ soton uni – Nikki, Simulation – Kat, Mark, Rich Speciality courses – Richard Jee (now compulsory simulation course), Poppy (MDT Gynae course), Will & Lucy (Geriatric training days), Nikki & Lucy (T&O), Jo (Paeds A&E) Faculty – most of us are faculty on revision courses (MRCS – Nikki & Mark, PACES – Kate Wiles & Lucy, public health – Suzy, FRCA - Emma H, Poppy M, Radiology – Graham LJ), PROMPT (Sarah Cregan), ATLS (Denzil), ALS (Jo), APLS (Jo, Ellen, Emma H), SPEARS(Jo) ACCS SGH (Poppy, Emma H) Development of new Wessex training opportunities' - subspecialty training in paediatric emergency medicine which is starting for the first time in Wessex in March 2012 - Jo Rowlinson Leadership group – Nikki Cohen, Nikki K, James G – during initial stages

MEF projects past Developing the MEF role Studies looking at: Educational supervisor development Trainee perspectives of educational supervision Supporting doctors in difficulty Marker motivation in undergraduate assessments Quality assurance Evaluation of work based learning Validity of the OSCE & simulated patients in the FRCPsych Teaching quality improvement at Salisbury District Hospital Development of speciality specific courses/hand books Shadow school of surgery Selection criteria for core trainees Supporting the leadership fellows MEF development – James G Educational supervisor development – Poppy. My project was a study looking at the professional development of educational supervisors. I researched current views and practices of educational supervisors in different specialties and hospitals in the Wessex region. I also researched the provision for professional development of educational supervisors in other regions in the UK. This has helped to inform the professional development programme in the Wessex region. I also identified support for specialty specific educational supervisor refresher courses in some specialties and we ran the first anaesthetic specific refresher course last May, with plans for a second one soon. Trainee perspectives of Educational supervision – Kate Wiles Doctors in difficulty – Sarah Beaney - which made a major contribution to our strategy and processes for the PSU Marker motivation – Andy QA – Mark Work based learning – Adetokunbo Osunrinade Validity of the OSCE & simulated patients in the FRCPsych - Toks Service development – Ellen Taylor Speciality courses – Richard Jee (now compulsory simulation course), Poppy (MDT Gynae course), Will & Lucy (Geriatric training days), Nikki & Lucy (T&O), Jo (Paeds A&E) Selection - Nikki Leadership group – Nikki Cohen, Nikki K, James G – during initial stages

The next steps Publicity, recruitment and appointment to role Identifying projects (deanery, speciality & trust) Ensuring accountability & regulation Encouraging MEF’s personal professional educational development MEFs beyond training Evaluating the RITA/ARCP process Deanery visits James G is trying to help develop a similar role in Oxford but they seem to lack of understanding that this is about developing education leads of the future.

Tomorrow's Teachers co-directors Lucy Sykes & Mark Szymankiewicz Paula Hunt & Denzil May Tomorrow's Teachers co-directors Lucy Sykes & Mark Szymankiewicz Junior trainee mentorship co-developers

Tomorrow’s Teachers: New Horizons Denzil May Paula Hunt

Educator Training – Needed by the profession? GMC’s “Good Medical Practice”, 2001.   - Teaching, training, appraising and assessing doctors and students are important for the care of patients now and in the future. You should be willing to contribute to these activities. - If you are involved in teaching you must develop the skills, attitudes and practices of a competent teacher. - You must make sure that all staff, for whom you are responsible, including locums and students, are properly supervised. - You must be honest and objective when appraising or assessing the performance of colleagues, including locums and students. Patients will be put at risk if you describe as competent someone who has not reached or maintained a satisfactory standard of practice. The GMC publication Good Medical Practice published in 2001 makes it explicit that doctors should engage in teaching, training, appraising and assessing doctors and students. From the literature it is clear that training institutions have better outcomes that service institutions. There is a recognition that a lack of teacher education leads to problems with teaching methods. However there is no compulsory formal training or educational programmes for doctors. ‘Tomorrows Teachers’ was developed in the Wessex Deanery with the aim of addressing some of the basic skills necessary to enable junior doctors to provide education in the workplace. Educational and clinical supervision is addressed in other courses offered within the Deanery.

Tomorrow’s Teachers – The Advantage to Wessex Deanery? Wessex Trainees have access to a teaching course. Cheap for trainees, cost neutral for the Deanery Objective evidence that teacher training is occurring Enthusing work place education Platform for Lead Educator Development Faculty development MEF appointment & other educational projects Most courses are commercially run by companies. Expensive ranging from about £350 up to £750 for a 2 day course. Advantage of TT is that it is offered to Wessex trainee’s at cost price, so does not unduly dig into limited study budgets and that money taken is recycled within the Deanery and is not lost to profit making companies.

Tomorrow’s Teachers: The Past Established over 12 years ago Number of delegates so far – approx 1450 BMJ Careers Diplomatosis 3rd September 2008 – “It increased my enthusiasm and has motivated me to pursue medical education training further. I would certainly recommend it for anyone who wants to improve their teaching skills.” Tomorrows Teachers was established approximately 12 years ago. We have had over 1450 trainee’s attend the course Year on year the course has expanded. For the last few years RITA and ARCP panels have been advising trainee’s to attend Tomorrows Teachers In 2008 a freelance reporter, a trainee from Severn Deanery attended TT and wrote a glowing article in the BMJ diplomatosis, and we had a sudden increase in demand.

Tomorrow’s Teachers: The Present Increased to 12 courses per year, 18 delegates per course (24 soon). Currently registered interest to do TT - >100 Target audience FY2 to ST5 Dedicated well trained faculty Currently 14 members of faculty Since 2008 we have had massively increased demand. We have expanded from 6 courses per year to 12 – 14 courses per year, and we are increasing number of delegates on each course from 18 to 24. Our main limiting factor has been limited by the number of faculty that we have. An important aspect for us is to the quality of the course, and we have introduced criteria for faculty selection and ongoing development, The course is more suitable for junior trainee’s. We think that providing training in educator development from an early stage allows for development of teaching skills in the work place.

Tomorrow’s Teachers: Franchising Numerous enquiries from outside of Wessex Appointed Project Coordinator for TT Franchise Raising profile of education within Wessex Potential for revenue generation We have numerous enquiries about TT from trainees outside of Wessex from all over the country and there is clearly demand for the course outside of Wessex. This has formed the basis for Franchising the course to other Deaneries. The primary aim for franchising is that offering TT to other Deaneries it will raise the profile of Wessex as a Deanery, it may help attract higher calibre doctors, which invariably will improve quality of care. Secondarily it may generate income, which can be used for the educational benefit of our trainees

Wessex Educator Development TRAINED DOCTOR Work & Training ESDP TALICS We found from analysing feedback from TT that it was less suitable for more senior trainee’s, and that when trainee’s had completed TT there were no other teaching related courses to attend and no further potential development, unless embarking on a formal education qualification. What we wanted to achieve was a programme for educator development from start to end of training, and taking inspiration from the Wessex Professional Programme, we wanted to provide early middle and later years courses for educational development. Our professional programme is often annotated as a pyramid with development and talent moving upwards. I prefer to think of trainee’s as a fertile seed planted at the beginning of training, and as that trainee grows and develops, each branch denotes acquirement of a skill, attitude, or aptitude in their development as an effective workplace educator. TT2 was therefore developed to help fill a void. TT will be our early years course, TT2 middle years, and possibly TALICS for later years. TT TT2

Tomorrow’s Teachers 2 Demand for further teaching course Development funded by Tomorrow’s Teachers Aimed at more senior trainee’s (ST3 to peri- CCT) Focused on facilitation skills Focused on facilitation skills Managing and getting the best from a group of people, perhaps from those you have not met before, how to establish rapport, how to use a group to meet your educational outcomes of the session, and how to facilitate learning. Also consider how to use your team in the workplace to educate others, eg an SpR can utilise their core trainee, foundation doctor etc to teach others.

Summary Tomorrow’s Teachers popular and successful Franchising Delegate development Professional development for faculty Franchising Funds reinvested into Wessex Trainees Educator development from start to end of training Tomorrow’s Teachers 2

Thank You “If you are unable to explain something simply enough then it is unlikely that you understand it well enough” Albert Einstein

Developing Trainee Educators: Wessex MEF Project Mr Mark Szymankiewicz, Dr Lucy Sykes Deanery Supervisor: Dr Rosie Lusznat

Developing Trainee Educators Cultivate trainees’ med. ed. experience Aimed at pre-ST3 level Structured pathway Informal mentorship programme

Structured pathway Web-based guidance on how to broaden / enhance medical educational experience Available to all NOT a list of requirements / competencies

Sample Teaching material Who to contact Hello and welcome to the Wessex Deanery Medical Education Fellows’ guide on how to develop your interest in Medical Education. This resource is aimed at anyone who wants to expand their horizons in Medical Education. As trainees with a passion for education and training, we know how difficult and daunting it can be to start building up experience in this arena and even to know exactly what falls under ‘the umbrella’ of Medical Education. Having all pioneered a way through it ourselves, here are our combined ideas about how to put your enthusiasm to work, develop opportunities and broaden your horizons in this area. Have fun! Deanery structure Explained Mentorship programme Sample Teaching material Who to contact Educational Journals & Further Reading Project ideas Setting up a teaching programme Recommended courses Higher qualifications 25

Mentorship programme Recognisable but informal programme Complement & support Ed. Supervisors Named MEF for each trainee / mentee, preferably in same trust Discussion, guidance, goal-setting

Mentorship programme NOT based on ‘competency’ or appraisal NOT for support of struggling trainees MEFs involved receive mentorship training

Future outcomes Formalise & develop trainees’ ed. skills Increase MEF numbers, experience & expertise Stronger links with Ed. Supervisors Continue strong Deanery ed. focus Regular pathway / programme evaluation

What happens next? Wessex DMEs – Oct 2011 Wessex Ed. Conf – Nov 2011 8 trainees already registered interest Formal written enrolment underway 8 MEF mentors undergoing training Review of progress Aug 2012

Aspiring to Excellence Wessex Medical Education Conference http://www.wessexdeanery.nhs.uk/medical_education_fellows.aspx Aspiring to Excellence Seventh Annual Wessex Medical Education Conference November 8th 2012