Monday, July 30, 2007
Procedural Skills Checklist
Welcome to the second issue of Tips on TREAT. This is going to be a regular e-mail highlighting a single assessment tool on TREAT each issue. As you may remember, TREAT, is the Wentwest Trainer-Registrar Education Assessment Toolkit, and can be found here: www.wentwest.com/treat
I intend sending out an e-mail like this regularly. Feel free to send me feedback, or to let me know if you don’t want to receive the e-mails any more. Similarly, send these on to others if you think they might be interested. You’ll find these e-mails archived on http://www.tipsontreat.blogspot.com/. So far there’s last week’s Tip on the Medical Record Review, and soon this will appear there too.
The tool for today is the Procedural Skills Checklist, which can be found here: http://www.wentwest.com/treat/index_files/Page770.htm
This checklist has been knocking around the college training program for a long time now, and it’s still available in the Companion to the RACGP curriculum. This version is taken from the GPET Assessment During Training document, and is a (quite long) list of all the procedural skills required of a GP. The definition of procedural is quite broad however, as it includes things such as interpretation of an ECG or spirometry, as well as simple and more complicated procedures.
The idea is that the registrar assesses themselves for each skill as either Competent (C), Not Competent, (N) or Not Sure (?). The supervisor or any other qualified person can then teach the required skills and assess the registrar. Once the registrar is Competent and Assessed, they can be ticked off (in the sense of completing it, rather than in the sense of being a bit cross).
It might be reassuring to note that this tool should be used over a long period of time! It would be best to print it off early in a Basic term and ask the registrars to keep it with them throughout their training.
What next? You could ask your registrar if they are aware of the checklist. Pencil in a time to discuss procedural skills they want to learn while with you (using the Term Planner Andrew sent out, perhaps). Let the other doctors know in the practice to call the registrar through if they are doing a procedure (especially early in the term, when the registrar might not have so many patients).
Remember, this is not compulsory. And do feel free to e-mail feedback about the tool or the website, or any suggestions or questions, or if you’d rather not receive the e-mails.
Medical Record Review - And another thing...
The medical record review could also be used in conjunction with direct observation, or even better, some consultation videos. Were the important bits of the consultation recorded in the notes? Does it reflect what happened. This could be a very powerful bit of learning for the registrar - particularly if you think their notes could be better.
Monday, July 23, 2007
Medical Record Review
Welcome to the first issue of Tips on TREAT. This is going to be a regular e-mail highlighting a single assessment tool on TREAT each issue. As you may remember, TREAT, is the Wentwest Trainer-Registrar Education Assessment Toolkit, and can be found here: www.wentwest.com/treat
I intend sending out an e-mail like this regularly. Feel free to send me feedback, or to let me know if you don’t want to receive the e-mails any more. Similarly, send these on to others if you think they might be interested. You’ll find these e-mails archived on www.tipsontreat.blogspot.com
The tool for today is the Medical Record Review, which can be found here: http://www.wentwest.com/treat/index_files/Page767.htm
This tool helps supervisors to assess and feedback to registrars what their medical record keeping is like. It looks at individual consultations and the overall record.
It points up the following for discussion:
Individual records made by the registrar
Records made over a longer period of time (2 yrs in the example, but for registrars would be shortened to the length of their attachment so far)
Allows discussion of what makes for a good medical record
Selected components – referral letters (though TREAT has another tool for doing this) certificates, reports, managing results etc.
There are also suggestions about how to discuss this with a registrar, though I would think that your imagination is the only limit in ways of doing this.
Discussions starting on the medical record review could take in
Medico-legal issues – what if something went wrong in this consultation? How much would you recall about what happened? What would a court or lawyer or expert witness think?
Use of the computer – adding recalls, actions, tracking results
Managing results – what happens when a registrar notes an abnormal result?
Could another doctor take on the management based on these notes?
These issues will all link in together, but the emphasis might be different depending on the needs of that registrar.
Have a go at this tool with your registrar! Remember, this is not compulsory. And do feel free to e-mail feedback about the tool or the website, or any suggestions or questions, or if you’d rather not receive the e-mails.
Monday, July 16, 2007
Welcome to Tips on TREAT
There are 2 types of assessment, summative and formative. Summative assessment is the one everyone gets anxious about, as you can pass/fail and it matters. If you fail you have to resit to continue.
Formative assessment is much more soft and fluffy. It's designed to provide feedbck for improvement, not stop progression through a course. These tools are all supposed to help provide feedback in the different knowledge, skills and even values to those doctors training to become general practitioners. They are designed for the Australian system, but many have been cribbed from the UK (and I know, and would like to welcome, the UK visitors the site has been having).
Because the tools are designed for providing feedback to individual registrars, they are not necessarily validated or reliable in the scientific meaning of those terms. In other words, a registrar's score on one tool can't be compared to another registrar's score on the same tool, or even the same registrar's score at another time. They are not designed to do this, so please don't do it, and please don't let your registrars do it either. It may lead to upset!
So what will you find here?
I will be posting a regular round-robin e-mail here which takes a tool at a time, so this will form an archive of those e-mails. I may also post updates, thoughts, responses to feedback as well, which I don't think will get put into the e-mails.
Feel free to post comments here or questions.