BASIC PHYSICIAN TRAINING How will the PREP Programme ...

BASIC PHYSICIAN TRAINING
How will the PREP Programme (Physician
Readiness for Expert Practice) affect you?

Overview:
1. Basic Physician Training -the “PREP”
program
a. – aims, structure and requirements
2. Focus on Mini-CEX

Why change Basic Training?
International changes in educational
philosophy (UK, US, Canada)
Australian Medical Council (AMC) review

Changes in Educational Governance in RACP
“Education Committees” have replaced the
Committees for Physician Training
Similar role – both Basic and Advanced
Training
Implementing “PREP”
Creation of an “Education Deanery”, based in
Sydney – development of educational resources

PREP Program Structure – Training Duration
Training duration – 36 months of accredited
core and non-core clinical experience
Similar to existing requirements
Handbook updated (2008) – on line

PREP Program Structure – Curricula
Published curricula – both clinical competencies
and professional qualities

PREP Program Structure – Supervision
Supervision
Trainees progress will be monitored
Regular meetings with an Educational
Supervisor (DPT + …….)
Educational Supervisors will complete
regular progress reports

PREP Program Structure – Progress Reports
Educational Supervisor’s report
1-2 annually
Run Supervisors reports
At the end of each run
Transitional year 2009 – no trainee will be
disadvantaged

PREP Program Structure – Formative Assessment
Regular “mini-CEX”
15-minute observed snapshot of a
focussed, clinical interaction
(Multisource Feedback – will be evaluated for
future use)

PREP Program Structure – Teaching and Learning Tools
Learning Needs Analysis
Completed by the trainee, discussed at
Supervisor meeting – in current use
Reflective Learning
Significant Incident Analysis – future use

PREP Program Structure – E-learning

PREP Program Structure – Prospective Training
Can enter PREP at PGY-2 level
Likely only one year of retrospective credit will
be granted [“Recognition of Prior Learning”].

PREP Program Structure – Summative Assessment
Written and Clinical Examination
No major changes
Require 24 months of accredited Basic
Training prior to sitting the written exam.

Progression through Basic Training - envisaged

Progression through Basic Training (PREP) in 2009

Run Supervisors: Responsibilities
Continue the excellent supervision and teaching that you have
provided to Basic Trainees over many years, including
appropriate feedback etc
Carry out Mini-CEX with your Basic Trainee
If required, complete a Progress Report at the end of the run,
which the trainee will discuss with their DPT or Educational
Supervisor

Continuum of Learning
Formative Assessment: Mini - CEX
15-minute observed snapshot of a focussed, clinical doctor/patient
interaction
Undertaken in normal clinical / workplace setting using actual
patients
1 every 6 months in 2009, across a range of specialty environments
Assesses clinical skills, attitudes and behaviours eg:
Medical interviewing skills (history taking)
Physical examination skills
Consideration for patient/professionalism
Clinical judgement
Counselling and communication skills
Organisation / efficiency
Overall clinical competence
Structured “marking” sheet that covers pre-defined generic areas

Mini – CEX paper form

How does it work?
Trainees identify opportunities to be observed by their Run
Supervisor, using the Mini-CEX process (one each 6 months in NZ in
2009)
Observation may be about 15-20 minutes and feedback may take
about 10-20 minutes
The Trainee will keep the rating form, and will discuss this with their
Educational Supervisor/DPT

Mini-CEX on a busy medical team…..