Open - HETI

TRIM No: DOC10/9180
Minutes
JMO Forum
8.30am — 5.00pm
Friday 3 December 2010
Cochlear Implant Centre Conference Room
Building 39, Gladesville Hospital
1. Attendees and apologies
Present:
Dr Penelope Aligiannis
Dr Richard Atkinson
Dr Helen Boyd
Dr Amanda Brownlow
Dr Lucy Cho
Dr Joanna Dargan
Dr Hamish Dunn
Dr Melanie Fentoullis
Dr Nishmi Gunasingam
Dr Vikas Gupta
Dr Cameron Korb-Wells
Dr Sonali Pandey
Dr Shehnarz Salindera
Dr Ricki Sayers
Dr Negin Sedaghat
Dr Erin Stalenberg
Dr Matt Stanowski
Dr Daniel Sumpton
Dr Christine Velayuthen
Dr Emily Zammit
Apologies:
Dr James Alexander
Dr Nelson Agostinho
Dr Abigail Attwell-Heap
Dr Chantelle Berenger
Dr Julianne Burton
Dr John-Paul Favero
Dr Nicole Hersch
Dr Yun Hwang
Dr Kirsty MacDonald
Dr Nicholas Mills
Dr Farah Noaman
Dr Katelyn Priester
Dr Blake Sandery
Dr Sarah Sasson
Dr Kirsty Sharplin
Dr Jock Simpson
Dr Claire Stewart
Dr Russell Thomas
Dr Sarah Tolerton
Dr Anastasia Volovets
2. Opening and welcome – Dr Ricki Sayers, Chair
Dr Sayers opened the meeting and accepted apologies from those not able to attend.
3. LEAP: CETI’s leadership program – Dr Emma McCahon, Director CETI leadership
program and State Director of Paediatric Training
LEAP ensures preparation of doctors in training for leadership roles within the NSW
public health system. No other program exists in NSW that is focused on the needs
of doctors in training in relation to medical education and training in leadership skills.
The major component of the program is five face-to-face workshops, a total of 10
days. The workshops focus on experiential learning through group exercises,
interactive lectures and feedback.
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Chairperson: Ricki Sayers Date: 3 December 2010

Skills learnt in the workshops are complemented and further developed by an ongoing
program of projects completed in syndicate groups, self-directed and web-based
learning, a mentor program and practical leadership experience in the workplace.
The dates for 2011 program will be released on the CETI website shortly.
Group numbers for the program are generally up to 25 people.
As a demonstration of the program, Dr McCahon led a group activity within the JMO
Forum. Groups were asked to work together without using verbal communication to
form paper shapes on their desks. This proved to be both entertaining and
educational, as participants were able to see their own different leadership styles.
Action:
CETI to:
upload dates for the 2011 Leadership Program on their website.
[Done: see http://www.ceti.nsw.gov.au/lead-and-leap-leadership-developmentprograms/w1/i1002706/]
4. Report from the Australasian JMO Forum – Dr Ricki Sayers
Dr Ricki Sayers presented on the Australasian JMO Forum held in Melbourne
November 2010.
The resolutions of the meeting and related documents are attached to these minutes:
2010 Australasian Junior Medical Officer Forum Report and Resolutions
PMCV JMO Forum & AMA Victoria Doctors-in-training Subdivision: guidelines on
internship mentoring programs
PMCV JMO Forum Guidelines on protected teaching time
NSW JMO Forum proposed lecture series for interns
Implementing electronic discharge summaries: the JMO perspective. A
submission to the National e-Health Transition Authority (NeHTA) prepared by
the Australian Medical Association Council of Doctors-in-Training (AMACDT)
5. Group Workshops
The supervision, handover, welfare and education groups worked on their projects
and a small group reviewed QHealth training vodcasts.
6. Reports from groups (outcomes 2010, plans 2011)
Each workgroup gave a small presentation on what they have been doing for the
year and where they expect to go next year.
Handover group – Dr Hamish Dunn
The handover group conducted focus group interviews at each of the pilot sites
for the new JMO shift handover process.
Thematic analysis revealed four common themes. (1) Efficiency: JMOs wanted a
time efficient process with senior leadership and a locally appropriate review of
attendance. (2) Tools involved in handover should ensure documentation not
duplication of work, with a dominant focus on patient care not administration. (3)
Education and supervision are the ‘selling points’ of the handover process to
JMOs. They help to instil a strong hospital handover culture. A guide for senior
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clinicians to facilitate JMO handover is suggested. (4) The significant impact on
patient safety and continuity of care was acknowledged at all sites.
The report of the handover group was provided to the Acute Care Taskforce and
has been used in finalising the implementation toolkit and other supporting
documents for statewide implementation of structured JMO shift handover.
The work of the group will be written for publication in the professional literature.
The Handover group will be going into sleeper mode next year, as the project is
complete.
Supervision Group
The Supervision Group conducted a survey online that received a good response
from JMOs.
The presentation of the survey results to date is attached.
The survey is still collecting responses, and there is a possibility that the results
can be prepared for publication.
It was suggested that a matching survey of supervisors might be informative.
Education Group
The Education group presented on its proposed unified lecture series for interns.
New lectures on pathology and paediatrics have been added to the series. Topic
outlines for each lecture are being prepared.
Ricki Sayers will compile an online document adding all the working groups
supporting documents with links to specific group documents for everybody’s
information.
The Education group needs to get the lecture series sent out to hospitals in time
for first term 2011 so it can be implemented.
Welfare Group
The welfare group has been involved in piloting the peer mentoring project at
three sites.
Evaluating the pilots is a task for 2011.
The group needs new members: a 50:50 mix of PGY1 and PGY2 is required for
continuity of the group’s projects.
Vodcasts
Dr Amanda Brownlow wrote a statement regarding the Queensland Health JMO
Vodcasts, “Supporting Junior Medical Officers”.
The topics covered are areas of the ACFJD not directly related to clinical learning or
direct patient care. As an educational resource they are inadequate to cover these
ACFJD topics on their own. Additionally, to be useful they would have to focus more on
specific ACFJD topics as an adjunct to other teaching, not just refer to the ACFJD.
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We feel that audiovisual material is a very useful and important teaching and learning
resource. However, these vodcasts are poorly created, artificial, condescending to the
audience for whom they are directed and clichéd. They are ineffective as a teaching tool.
A better resource for example, is the TV show Scrubs, which covers similar issues, but in
a clever and accessible way. Scrubs has been used as a discussion point in JMO
teaching. These vodcasts feel like a bad day-time melo-drama. They need to be more
realistic and applicable to everyday situations for them to be an appropriate and useful
(and actually watched!) resource.
Action:
Supervision group to consider conducting a survey of clinical supervisors.
Ricki Sayers to compile a report on the projects of all the working groups.
Education group to send lecture series to hospitals before term one 2011 for
implementation.
7. Orientation week planning – Dr Lucy Cho, Craig Bingham, Dawn Webb.
Craig Bingham demonstrated a powerpoint presentation that will be used during
orientation week.
8. The TALL MAN project
Daniel Lalor from the Clinical Excellence Commission presented on a project to
investigate typographic methods of preventing drug name confusion (“TALL MAN”
lettering uses selective capitalisation to highlight distinguishing syllables in similar
drug names).
Mr Lalor sought the Forum’s advice on the best method of gathering a large group of
JMOs for testing of possible interventions.
Mr Lalor’s presentation is attached.
9. Between the Flags
Dr Charles Pain and Ms Colette Duff from the Clinical Excellence Commission
presented on the Between the Flags project.
Dr Pain observed that: “Clinicians are against standardisation, but one of the things
that contributes to patient safety is having a standard approach.” He observed that
the younger generation of clinicians were more positive about standardisation.
A free-ranging discussion of the effect of “Between the Flags” followed.
JMOs reported issues with being called every time a patient reaches the yellow zone:
eg, the patient’s blood pressure drops by one point with no other issues being
present. They feel the nurses rely too much on the black and white of the forms. Dr
Pain: “standardisation and clinical judgement are not opposed to each other.” It was
suggested that there was a learning period involved and that the correct
interpretation of the “Between the Flags” guidelines would take time to learn.
Dr Pain said that there were 65,000 NSW Health staff to train in the DETECT program
for managing the deteriorating patient — a project that would clearly take some time.
Dr Pain’s presentation is attached.
10. Pre-surgical training in New South Wales
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Dr Kerin Fielding and Dr Chaminda Wijeratne presented on CETI’s pre-surgical training,
a flexible training program designed to address a gap in education in NSW public
hospitals. It offers higher quality and safer care for patients because doctors will have
the education and support to enable them to do their jobs well.
The surgical skills training course run within the program costs $2500 and runs for 2
weeks 2 days, directly before the college exam. Further details are available on
CETI’s website.
11. TAG- Therapeutic Advisory Group – Erin Stalenberg
Erin Stalenberg reported on her involvement with TAG:
I have been one of the "Expert Advisory Committee" for the NSW Therapeutic Advisory
Group's current project - advising on Quality Use of Medicines Program with specific
reference to medications in hospital discharge summaries. The panel is made up of
Hospital Consultants, Pharmacists, Pharmacologist, a community GP and me a JMO,
representing the people who actually write the D/C summaries!
A pilot project is being rolled out at 16 sites across NSW (public and private
hospitals) which will analyse the discharge summaries of medical patients with particular
reference to the medications (ie, if they are on the D/C summary, if changed or ceased
medications have been included, reasons for changes etc). This analysis will be followed
by an intervention strategy which will involve JMO education, hospital wide promotion and
patient targeted education.
The Panel has been advising on tools and interventions to include in the strategy. JMOs
across NSW can be advised to be on the lookout for such projects in their own hospitals
and look forward to increased knowledge and awareness for this important
communication tool - the hospital discharge summary.
That's all for now! Meeting again in early 2011
12. CETI update - Craig Bingham
Dr Sonali Pandey did a lecture at the AMC orientation where two new reps will be
required for next year.
Craig Bingham asked for suggestions for a new name for the NSW Prevocational
Forum, due to there being too many forums. Some of the suggestions raised were:
Congress
Symposium
Summit
Prevocational Mash Up
The forum was asked whether they thought CETI should be on social networking
sites. The response was unenthusiastic. Comments:
Unprofessional
We are not allowed facebook at work – sends the wrong message for CETI to be
on facebook
Facebook is for social life, not work communications
Public social networking is not an appropriate channel for clinical information. For
instance, it is not appropriate to put clinical training material on youtube where it
can be accessed by non-doctors.
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A wikipedia entry on CETI would be appropriate
13. CETI’s Hospital Skills Program – Alpana Singh
Alpana Singh presented on CETI’s hospital skills program. See attached presentation.
14. Issues affecting prevocational training
The forum held an open discussion on some of the issues affecting prevocational
training.
People leaving their contracts early. Many PGY2s resign before the end of term 5,
often after giving the minimum required notice. We need to find out why people are
leaving in large numbers in PGY2 term 5 and find positive methods to reduce the
problem. It was acknowledged that PGY2s leaving early made life more difficult for
those remaining, but opinions differed on the appropriate response. Some thought
that the problem should be solved by hospitals hiring more PGY2s in the first place,
or being more willing to hire temporary staff (eg, backpacker doctors from the UK).
Others thought that some pressure or incentive should be brought to bear on PGY2s
to encourage them to stay. There was some support for the introduction of a
certificate of completion to be awarded to PGY2s at the end of term 5, but others
thought that this represented a punishment of those who left before the end of the
year, who might have good reasons for doing so.
Term dates across the nation do not match up, thus making it hard for those that
wish to move interstate to complete their prevocational training. Term dates
should be made the same nation wide.
JMO reps feel there should be more flexibility within the workforce.
15. Planning for 2011
Dr Lucy Cho led a discussion of plans for 2011.
Working groups:
Education: continuing
Supervision: continuing
Welfare: continuing
Assessment: merge with Education or Supervision
Handover: not continuing
Training: to work on an ongoing information pack for JMOs about vocational
training options, courses, admission requirements, recognition of prior learning
and similar issues.
A communications team with representation from each working group should
consider the best methods of communicating the activities of the JMO Forum to
JMOs and the rest of the health system.
Next meeting
The next JMO Forum meeting is scheduled for;
Friday 11 March 2010
Sydney Cochlear Implant Centre Conference Room, Building 39, Gladesville Hospital
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