1. The Dynamic GP training Critical appraisal training ‘in action’ C. Tulinius

2. Who GP trainees Teachers The Steering Group C. Tulinius FishCats

3. In this introduction… Aims of the workshop Background for CAT Content & structure of CAT The continuous development of CAT Structure of the workshop C. Tulinius

4. Aims of the workshop To demonstrate the different elements of CAT with the possibility to observe or participate Parallel fishbowls Precise rules for how and when to participate Plenary discussion with the possibility to ask trainees and teachers C. Tulinius

5. BACKGROUND FOR CAT C. Tulinius

7. Critical reflection Teaching Managing several perspektives Quality assurance and research Applying knowledge Learning and development Theoretical frames of reference The scholar/ academic Critical reflection Critical reflection Critical reflection Critical reflection Critical reflection Critical reflection Critical reflection Critical reflection Critical reflection

8. Overall aim for CAT Aims: To develop the skills to find and digest new knowledge and apply it to the clinical work Rationale: To support understanding of an approach that can provide the foundation for life-long learning C. Tulinius

9. Learning objectives for CAT Describe a topic in the context of current clinical practice and illustrate existing knowledge – and gaps Review current knowledge by way of a systematic literature search Critically interpret results from the literature – proposing solutions for the problem Summarize the results, communicate these to colleagues Use research results to evaluate the organizational, economic and ethical consequences of changing practice C. Tulinius

10. Medical postgraduate education in Denmark 10 3 regions, different programs. The experiences is from the Eastern Region East North South

11. CONTENT AND STRUCTURE OF CAT C. Tulinius An educational experiment out of control What exactly are we testing with this, Bob? Haven’t got a clue!

12. 12 GP specialist training in DK : 5 years 12 30 6 6 Introduction to General Practice General Practice – phase 1 6 Hospital General Practice – phase 2 General Practice – phase 3 Months 17 days 3 days All within 12 months

13. 13 = Seminar-days Groups of 10 trainees or less with a seminar leader. Discussions and presentations of project including feedback. = Course-daysCritical appraisal of the literature in small groups and literature search in Relevant databases. = Work in groups = Home working days 20 days… Academic supervision

14. Based on experiences with research training of GPs and GP trainees Based on their own experiences – Relevant to general practice Participant activating & problem-based learning Working in groups of 3-4 to support the training of working in teams Critical reflection as a learning strategy Formative and summative assessment strategy Educational principles for CAT and the training of the teachers

15. The continuous development of CAT C. Tulinius

16. Challenges Cutting down from 60 to 20 days 90-100 trainees a year, a small handful of research supervisors had to be trained – Defining curriculum for each teacher’s role – Designing and delivering teaching of basic and specific medical education to the different kinds of teachers – Supporting the trainers and teachers working together generally and around the individual trainee – Designing the review as an action research project General resistance, research as a non-value Specific for general practice clinical work

17. The development of CAT Observe (research/data collection) Reflect (critical reflexivity) Plan (strategic action plan) Act Implementation) Observe Reflect Plan Act Observe O’Leary’s cycles of research

18. Observations: Problem in forming the groups – new focus point, or follow up on applied new strategy Application of strategy Suggestions for changes New teaching day with forming of groups – how did it work out? Suggestions: new strategies Evaluation strategy New observations C. Tulinius

19. Status 95 trainees have been through CAT in the Eastern Region, all passed 36 motivated teachers and research supervisors, trained especially to their teaching role in the research training

20. Rewards Evaluation shows trainees training to the curriculum, and beyond Trainees are going further into research Teachers are taking on the role as developers and researchers on their own process GP trainers talk about ‘their’ regional research trainers Educational research getting on the list of research interests among GP trainers, teachers and trainees

21. Structure of the workshop C. Tulinius

22. Aims of the workshop To demonstrate the different elements of CAT with the possibility to observe or participate Parallel fishbowls Precise rules for how and when to participate Plenary discussion with the possibility to ask trainees and teachers C. Tulinius

23. Workshop structure C. Tulinius Literature search Critical reading 5th seminar day Supervision bell

24. Workshop structure FOUR fishbowls 2 x 20 minutes Literature search Critical reading of an article 5th seminar day Supervision Questions and discussion C. Tulinius

25. A decision you have to make… Cat …. … …………………………………………… or fish ? C. Tulinius

26. Workshop structure C. Tulinius Literature search Critical reading 5th seminar day Supervision bell

27. Little helpers…. Meta communication, translation,… supporting your understanding C. Tulinius

28. Fish bowl messages Literature search: to show how that it is relevant to know how to do a literature search, and that a focused search gives a focused answer to your questions Critical reading: to show that it is possible to teach trainees to read an article in a systematic way Supervision: To show how you can supervise two groups with different project topics at the same time 5 th seminar day: To show how the end assessment of the trainees can be done by the trainees themselves in a process facilitated by the seminar leader C. Tulinius