1. Supporting Excellence In Medical Education B asics for L eadership I n M edical E ducation Day 2 BLIME Leadership ManagementEducation

2. Supporting Excellence In Medical Education Roles Deanery v Trust

3. Supporting Excellence In Medical Education  Trainers must provide a level of supervision appropriate to the competence and experience of the trainee  Trainers must be involved in, and contribute to, the learning culture in which patient care occurs  Trainers must be supported in their role by a postgraduate medical education team and have a suitable job plan with an appropriate workload and sufficient time to train, supervise, assess and provide feedback to develop trainees  Trainers must understand the structure and purpose of, and their role in, the training programme of their designated trainees. 3 GMC Standards for Trainers listed in Domain 6 of “The Trainee Doctor”

4. Supporting Excellence In Medical Education GMC now requires all LEPs to use these seven areas to show how they identify, train and appraise trainers:  Ensuring safe and effective patient care through training  Establishing and maintaining an environment for learning  Teaching and facilitating learning  Enhancing learning through assessment  Supporting and monitoring educational progress*  Guiding personal and professional development*  Continuing professional development as an educator *2 areas in italics apply to ES not CS 4 Academy of Medical Educators Professional Framework

5. Supporting Excellence In Medical Education What is Your Role ? In groups – 5 mins What are you expected to do What support do you want? from whom? GMC Trust Deanery / TPD / School Depts

6. Supporting Excellence In Medical Education Specialty Tutor Director of Medical Education Training Programme Director Trainees Trainers Clinical Tutor

7. Director of Medical Education Foundation Programme Director (s) Specialty Tutor Learning culture in dept Support Supervisors & Trainers Quality Control of training delivered Dept faculty group SUPPORT & PROFESSIONAL DEVELOPMENT Management of Doctors in Training HR Dept & Medical Personnel EDUCATION, TRAINING & PROGRESSION CLINICAL GOVERNANCE PERFORMANCE & EMPLOYMENT Medical Director Hospital Tutors Careers and counselling Faculty development Doctors in difficulty Generic Skills Educational Supervisor Clinical Supervisor Trainee Learning Occupational Health Medical Education Manager & team Clinical Director Multi-professional Team clinical supervision Accountable Consultant Trainee Working Learning Environment Postgraduate / Foundation Schools Training Programme Director DEANERY Postgraduate Dean

8. Supporting Excellence In Medical Education  Leader for PGME in dept  Support, develop education supervisors  Advise on trainees in difficulty  Link to School and to PGME  Responsible for Quality Control  CULTURE  SAS doctors ? Role of Specialty / College tutor take final responsibility for the delivery, organisation & quality of training in their dept

10. Managing Services Managing Performance  Uses management information to monitor service delivery against national / local targets and plans  Counsels colleagues whose actions have been associated with poor performance, taking appropriate action, including disciplinary action, where necessary  Ensures that progress against targets and plans is widely communicated to encourage colleagues to take personal responsibility for outcomes Managing People  Ensures that HR processes are in place e.g. recruitment and selection, appraisal, mentoring and coaching.  Undertakes appraisals with more junior clinical colleagues  Manages the performance of staff within their area of responsibility Managing Resources  Works closely with the business manager to manage the budget for the service  Reviews current service delivery, identifies opportunities for minimising waste and able to introduce change for more efficient working Planning  As a member of a management team, contributes to the development of business and service plans  Contributes to the development of organisational responses to emerging health policy

11. Supporting Excellence In Medical Education How to support Specialty Tutors

12. Supporting Excellence In Medical Education MMC  What do you understand by this?  What was good about it?  What didn ’ t go so well & why?

13. Educational appraisal Education Accountable Training Formative NHS Appraisal Mandatory Training Competence/Competency/Competent Evidence Feedback on performance Post approvalV Poor Performance Portfolio Curriculum Education agreement Learning Plan Reflective Learning Reflection SUMMATIVE Assessment ARCP WPBA PSG SLE PYA TAB MSF PBA

14. At a NACTUK meeting you hear from a colleague that your Foundation School Director is planning on using the scores from F1 work based assessments in order to rank F1s for allocation to their F2 programme.  Is this the correct use of workbased assessments?  If WBA are used in this fashion, what will be the effect on the assessments themselves?  What is the purpose of workbased assessments?

15. You have been contacted by the Clinical Risk Manager of the Trust to inform you that you have been nominated as the person responsible for one of the Healthcare Commission Standards around patient consent. This is not an area of expertise or one in which you have shown previous interest in, apart from ensuring that the topic is on the formal Trust induction programme in August.  What is your role in clinical governance?  You are assured that the attendance at induction and the self reporting form is completed at induction, but the form detailing exactly what training is required or has been received is stored in the trainees eportfolio. Should you have access to this eportfolio to ensure that clinical governance requirements can be evidenced?

16. One of your F2s come to see you prior to their paeds ST1 interview. There will be a “ portfolio ” station at the interview and he wants your advice on this. He has an excellent eportfolio with twice the minimum number of assessments, reflection on cases and mapping of learning against the curriculum. He has not done paeds in his FP and is concerned about this. He is not sure what to print off for a paper-based portfolio for the interview F1 Med/Surg/A&E F2 Oncology/T&O/GP  What is a portfolio?  What is your advice?

17. In your hospital there is currently no Clinical Director of Surgery and the General Manager is running the division. He has decided that as the ST4 has been signed off in the ISCP portfolio as competent for varicose veins they can do a waiting list a fortnight of veins. He has spoken to the StR who has agreed.  Is this acceptable?  What is meant by competent?  As DME do you need to do anything?

18. Supporting Excellence In Medical Education People management  Encouraging consultants to take part in training doctors  The weak Educational Supervisor  Supporting trainees in difficulty  Working with Training, leadership & nurse/AHP education List various approaches What is your action plan Can you anticipate their reactions and how will you manage them?

19. Supporting Excellence In Medical Education The Trainee (& trainer) in Difficulty  Clinical (educational) performance (knowledge, skills, communication)  Personality and behavioural issues (professionalism. motivation)  Sickness/ill health (personal/family stress, career frustrations, financial)  Environmental issues (organisational, workload, bullying and harassment)

20. Supporting Excellence In Medical Education Motivating Trainers

21. Supporting Excellence In Medical Education Motivating People Maslow

23. Supporting Excellence In Medical Education What motivates  Fear of failure  Success  Money / Reward / Promotion  Self / job satisfaction  Doing something new/ difference  Helping people  Having fun  Challenge  Being valued / loved

24. Supporting Excellence In Medical Education Be Optimistic  Improved moral & productivity  Use positive language  Be optimistic about the future  Park your pessimism – look for hidden positive in every negative situation  Do something unexpected everyday  helps to develop your optimistic muscle & involves an expectation of pleasurable experience  Imagine success–leads to more confident manner  Frame experiences & goals from a favourable standpoint

25. Supporting Excellence In Medical Education Review of Educational Roles

26. Supporting Excellence In Medical Education Money  Where does the money come from  What money do you have  What do you need more for?  Think of ways to obtain / generate funds

27. Applying a Coaching Approach Why, How & When www.doctorstraining.com

28. What is Coaching? A means of assisting individuals to COME TO THEIR OWN CONCLUSIONS about the best actions to take and/or way to achieve improved performance or achieve their objectives

29. What is Coaching? “ Coaching aims to enhance the performance and learning ability of others. It involves giving feedback, but also includes other techniques such as motivation and effective questioning…… Overall, the coach is aiming for the coachee to help themselves. It is a dynamic interaction – it does not rely on a one-way flow of telling or instruction” Max Landsberg Jan 2003

30. What is Coaching? “ Whether you are a sports coach or business manager you depend on other people to achieve success. Even if you could work better, harder or longer hours yourself, that wouldn’t do it. It has to be through getting the best out of others” David Whitaker

31. Why a Coaching Approach?  Build greater interpersonal skills  Encourage advanced self awareness  Nurture innovation and creativity  Create more time  Leads to enhanced reflective practice  Creates open, honest, respectful dialogue & relationships  Develops trust  Increases your own effectiveness and self awareness whilst developing others Develops, inspires, motivates & improves performance of colleagues

32. Core Skills Coaching Skills Building Rapport Different Levels of Listening Using Intuition Asking Questions Giving supportive feedback

33. How…? Key/Essential Skills Good communication is the cornerstone of the coaching process  Questioning  Listening  Reflection/summarising  Gaining commitment to action

34. Ask… don’t tell…. Dominate with Open Questions: What…Which…..Where…. How… When….  Probing – follow up, open questions  Reflective – reflect their views back to them  Hypothetical – what if…  Justifying – “what makes you say that….”  Comparative – “how does this differ from…”

35. So what do you say to David?

36. How? The GROW Model G oal R eality O ptions W ill

37. Supporting Excellence In Medical Education A successful tutor To be a competent leader requires the individual to be able to manage themselves and their time, work within a team, understand when to lead and when to follow and to be able to influence more effectively by knowing how the system within which they work functions. NHS Institute for senior leaders Journal Issue 10, June 2006

38. Leadership ManagementEducation What makes a successful tutor?

39. Supporting Excellence In Medical Education Individual task  Consider your strengths & weaknesses in each of these areas  Write down something to work on  What are your next steps to develop yourself in your educational role?  What makes a successful tutor?

40. Supporting Excellence In Medical Education Closure Personal Reflection What have you learnt What are you going to do / change? What are your development needs Evaluation of course Share one Take Home message Plan Where are you now? Where do you want to be? How will you know you’ve arrived How will you get there?