Network principles for prevocational medical training - HETI

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Section two: the network model No single health care facility can provide all the training and experience required to prepare new doctors for the diverse range of medical practice, so facilities are organised into networks that cooperate to deliver training to a group of prevocational trainees. From an educational perspective, the key requirement of a network is that it should be capable of delivering all the elements of the learning model. In practical terms, several sets of factors need to be considered in composing networks: 18 Training components Infrastructure Geography Size Relations to the system Network governance • z ability to deliver the curriculum outlined in the Australian Curriculum Framework for Junior Doctors • z sufficient core terms in medicine, emergency medicine and surgery • z an appropriate mix of specialty terms • z an appropriate mix of training settings (general practice and community settings, large and small hospitals, and a range of patient types) • z a lecture series for trainees coordinated at a network level • z specific teaching in each training term • z supervisors who understand the importance of teaching and providing feedback to trainees • z a workplace culture supportive of training and education, with training and support for all levels of the workforce and a commitment to continuous professional development • z physical amenities • z internet access • z educational infrastructure such as libraries, simulation training facilities, video-conferencing, lecture theatres and learning centres • z minimising the distances between networked facilities has advantages, but • z trainees benefit from receiving training in both rural settings and metropolitan settings and • z historical links between facilities may need to be considered • z at least one major metropolitan hospital • z home hospitals for 5/10 terms of all trainees • z rural sites for 1/10 terms for most trainees • z general practice or community sites for 1/10 terms for most trainees • z minimising the number of local health districts involved in a prevocational training network is efficient • z links to undergraduate clinical programs, vocational training programs, interdisciplinary programs influence the effectiveness of prevocational training • z cooperative relations between facilities within the network • z cooperative planning for education and training • z effective processes for allocation of trainees and resources • z an effective network committee • z effective lines of reporting • z executive sponsorship of the network • z effective procedures for dispute resolution • z cooperative relations with HETI and other networks • z capacity to implement, evaluate and improve the prevocational program z • effective role definitions, staffing and resourcing for network committee, hospital training committees, directors of training, JMO managers, supervisors, educators, and trainees.
HETI NETWORK PRINCIPLES Network model part 1: Training components Every network should be able to supply these training components for all the trainees in the network. • z Ability to deliver the curriculum outlined in the Australian Curriculum Framework for Junior Doctors (ACF). This requires: zz zz zz directors of training, supervisors and trainees who are familiar with the ACF term descriptions written using the ACF a network lecture series and term-specific teaching that addresses the leaning outcomes described in the ACF. • z Sufficient core terms in medicine, emergency medicine and surgery (see core term requirements on page 21). • z An appropriate mix of specialty terms, including availability for most trainees of zz zz zz zz zz a general practice or community term paediatrics psychiatry obstetrics and gynaecology geriatrics or rehabilitation. These are terms which are fundamental to general medicine and essential background to most specialties. • z An appropriate mix of training settings (general practice and community settings, large and small hospitals, and a range of patient types). • z Sufficient terms so that no trainee repeats a term (except emergency) in their 10-term, 2-year program. • z Relief terms: a maximum of 2 of 10 terms for each trainee. This includes terms in which the clinical duty is providing bedside care after hours. These terms are a valuable practical learning experience for trainees. • z All terms have to be accredited, which requires that: zz zz zz zz The term description uses the ACF and sets clear and achievable training outcomes, monitoring and assessment procedures. Clinical supervision is sufficient for both clinical effectiveness and the education and training of trainees. Responsibility for direct oversight of all patient care is explicit, senior supervision is active and ensures patient safety at all times, and trainees have immediate access to senior experienced clinicians. The workload is appropriate to maximise both patient care and trainee development. Processes for assessing trainees and evaluating each term are effective. Use of workplacebased assessment tools (including miniCEX and multi-source feedback) are strongly encouraged. Formal assessment according to the prescribed form is essential at the end of each term. • z A lecture series for trainees coordinated at a network level. See next page. • z Time available to attend formal prevocational teaching (minimum one hour weekly). z • Specific teaching in each training term. Lectures, demonstrations, journal clubs, morbidity and mortality conferences and quality assurance processes consolidate the trainee’s work experience. Teaching activities should be routinely evaluated using trainee feedback, and trainee attendance and participation at should be used as part of the term assessment of the trainee. 19
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Page 4 and 5: Health Education and Training Insti
Page 6 and 7: About this document This guide is a
Page 8 and 9: The learning cycle The learning mod
Page 10 and 11: Workplace-based training Supervised
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Page 14 and 15: Trainee assessment Workplace-based
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Page 18 and 19: Curriculum • z Framework: ACF •
Page 20 and 21: Learning model part 5: Network lect
Page 22 and 23: Learning model: summary The learnin
Page 26 and 27: Specific assessable assignments as
Page 28 and 29: Network model part 2: Infrastructur
Page 30 and 31: Network model part 4: Size There ca
Page 32 and 33: Network model part 6: Network gover
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Page 36 and 37: NSW state structures The NSW Minist
Page 38 and 39: Role of local health districts Each
Page 40 and 41: GP DPETs must be involved in the pl
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Page 44 and 45: • z Coordination of training •
Page 46 and 47: General practice training terms At
Page 48 and 49: Appendices Available on the web: NS
Page 50 and 51: In networks with rural preferential
Page 52 and 53: • z senior representatives of JMO
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Page 58 and 59: Appointment process A formal letter
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