Network principles for prevocational medical training - HETI

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About this document This guide is addressed to directors of education and training and others responsible for managing prevocational training networks. It describes a learning model (how and what trainees learn) and a network model (what a network needs to deliver the learning model) for prevocational medical education and training in New South Wales. It also describes the structures governing the network system from the State level to the training sites. Effective networked training requires open communications and collaboration between clinicians and administrators working in a diversity of settings. This guide suggests ground rules for cooperation when managing issues that arise in a complex work and training environment. Background Prevocational medical training in New South Wales has been run on its current networked training model since 2007. Networked training was established on these core principles: • z patient safety and quality care is paramount • z equity of access to high quality care for patients is supported by a well trained and fairly distributed workforce • z the medical workforce deserves equity of access to excellent medical training • z medical workforce development is a core business of health services • z teaching and training are integral and rewarding parts of medical practice. In 2010, the Health Education and Training Institute (HETI) commissioned an external review of the networks to see how well the prevocational program was working. The report of the review team recommended that HETI establish a learning model for the networks which: zz promotes the implementation of the Australian Curriculum Framework for Junior Doctors (ACF) zz promotes the concept of the prevocational training years as experiential-based with a heavy emphasis on clinician-led learning involving patient encounters. — Report of the external review of the prevocational training network system, and HETI’s response: www.heti.nsw.gov.au/prevocational#reports The Prevocational Training Council (HETI’s clinician-led governance committee for the prevocational program) endorses this recommendation. Everybody involved in prevocational training — trainees, supervisors, directors of training, JMO managers and others — needs a clear understanding of the aims of the training program and the purposes of training networks. About HETI As an outcome of the Director-General’s Governance Review on the future directions for NSW Health completed in October 2011, the Clinical Education and Training Institute was restructured to become the Health Education and Training Institute (HETI). HETI has an enhanced focus on clinical and non-clinical education and training for the health system. HETI will establish itself as a national leader in people development within the health sector in NSW. The role of HETI is to work closely with local health districts and other health organisations and clinical training providers to develop and deliver education and training across the NSW public health system. Supporting clinical training networks will continue to be a core activity of HETI. iv
HETI NETWORK PRINCIPLES Section one: the learning model Prevocational medical education and training is based upon adult learning principles Seven principles of adult learning 1 Adults are internally motivated and self-directed 2 Adults bring life experience to learning experiences 3 Adults are goal oriented 4 Adults are relevancy oriented 5 Adults are practical 6 Adult learners like to be respected 7 All learners benefit from feedback … and their implications for the prevocational program • z Trainees have primary responsibility for the direction and pace of their own learning. The program facilitates learning, but it is appropriate for trainees to manage many aspects of their training personally. • z Trainees should be responsible for recording their objectives and progress in a journal. Self-assessment should be encouraged and developed. • z Trainees and their representative organisations should play a role in structuring the program • z The program should place the curriculum and all resources needed to plan training into the hands of trainees as well as supervisors, directors of training and administrators. • z The previous experience and existing knowledge of trainees can be used to enrich learning opportunities. • z Senior clinicians should take the time to establish what trainees already know as the starting point for teaching. • z Trainees play an important role as teachers themselves. • z Trainees are more motivated to learn when they see that the lesson will help them reach their personal objectives. • z Assessment should be meaningful and rewarding. The outcomes of successful learning (including registration and career progression) should be explicit. • z Advancement should be linked to the achievement of goals. • z Learning on-the-job is central to prevocational training. • z Formal teaching should relate closely to the work demands and career objectives of trainees. • z The system’s goals for training (eg, safety, efficiency, excellent patient care) need to be made relevant to trainees. • z Case studies and problem-based learning can be used to demonstrate the relevance of clinical knowledge. • z Lectures should focus on the practical aspects of the subject. • z Simulated learning environments assist in bridging the gap between theoretical knowledge and immediate clinical application • z Opportunities for teaching and learning have to be integrated into clinical practice at patient encounters, ward rounds and ward handovers, and when clinical procedures are being performed. • z Trainees should be treated with the respect they are expected to show to others. • z Trainees should be integrated into mutually supportive clinical teams. • z Procedural fairness should be demonstrated in all decisions affecting trainees. • z Learners should expect feedback about their strengths and areas for improvement. • z Providing feedback is necessary for developing confident and competent clinicians. • z Providing feedback can ameliorate uncertainty and stress in trainees. 1
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Network principles for prevocational medical training - HETI

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