C1: Strengthening professionalism training in postgraduate medical education: Integrating Generic Professional Capabilities (GPCs) into medical curricula and assessment

The General Medical Council has developed the Generic Professional Capabilities (GPC) framework in partnership with the Academy of Medical Royal Colleges to ensure that doctors in specialty training develop holistically as responsible professionals.

The aim of integrating GPC in postgraduate curricula is to ensure that:
The attainment and assessment of GPC is as important as the attainment and assessment of core and specialist knowledge and technical or clinical competence
All trainees develop and demonstrate these GPC as they progress through training
GPC are clearly emphasised and prioritised in curricula
- And that those areas most likely to be associated with Fitness to Practise issues are given particular priority and emphasis
GPC are assessed in a way that identifies trainees whose professional performance gives cause for concern at the earliest possible stage of their careers, and that such trainees are supported with appropriate and timely feedback, and appropriate remediation. This approach will minimise the possibility that any deficit is identified during the final phases of training or assessment, immediately prior to receiving a certificate of completion of training.

The framework will be relevant at all levels of medical training and practice, from medical student to consultant.

C4: New approaches to training

The time available for training within the NHS is under major pressure due to the need to meet ever increasing service demand. Whilst much valuable learning can take place at the same time as providing service, to do so effectively increasingly requires a different approach.

In this session, we will present several novel ways to do just this. These will include multiprofessional working between doctors and Prescribing Pharmacists, a collaborative ‘virtual’ model for on-call trainees in Radiology, joint approaches to training between vascular surgery and radiology trainees, Quality Improvement training sharing a digital platform with cross-organisation collaboration and the increasingly popular ‘Boot Camps’ in Surgery which bring some unexpected benefits.

Delegates will be able to see the principles of all of these initiatives and understand how these can be adapted to their own training needs.

C9: Exploring two educational toolkits used to improve scores in the AKT and CSA components of the MRCGP licensing examination

This session is intended to allow GP educators to explore two educational toolkits used across HEE NW to improve re-sit trainees pass rates in the AKT(Applied Knowledge Test) and CSA(Clinical Skills Assessment) components of the licensing GP examination(MRCGP). In order to support these trainees in the CSA, a dedicated group of educators was formed and trained. The group used a specifically designed educational tool to analyse trainee developmental needs and form the basis of a subsequent triadic tutorial with the trainee and their educational supervisor. In the AKT, very specific reasons why candidates fail were identified and an online resource designed to support a stepwise approach to preparing and passing the AKT. The AKT package was used with several cohorts of serial AKT re-sits and produced very encouraging results which proved to be directly linked to engagement with the package. Delegates will be given the opportunity to explore both the AKT package and the CSA Tool in order to analyse learning needs and plan some educational strategies using a number of case studies. The interactive format will also allow discussion concerning the concurrent use of both toolkits in order to prevent MRCGP re-sits.

D1: Enhancing support for trainees

Trainees in all areas of the NHS are currently under huge pressures to maximise their educational opportunities at the same time as both they and their supervisors are facing relentless service demand. Supporting these doctors in training is one of the most important functions of Health Education England and over the last year there have been several initiatives to improve this support and reduce attrition.

This session will explore the factors which contribute to individual trainee difficulties and outline a variety of ways to address these.

Several different approaches will be described in this session-including trainee’s peer mentoring, bespoke trainee risk assessments, translating research in this area into practice and demonstrating the utility of a dedicated trainee support lead for a specialty school.

Delegates will be able to appreciate the range of strategies available which are very likely to be applicable to their own trainees and challenges.

D3: Technology enhanced learning and simulation 2

This session focuses on new simulation based education (SBE) technologies and their application and how they could potentially revolutionise healthcare education. The presentations include an evaluation of new “wearable” systems, an e-learning programme for pathology, cadaveric gynaecological based training, an in-situ programme for paediatrics and the experience of setting up a new virtual training school. All presenters are Professorial level and are experts in the field of SBE and technology enhanced learning and the session will explore personal and organisational issues surrounding the introduction of sustainable SBE programmes based upon new ideas and platforms.

D6: New working paradigms

In this session three examples of new working paradigms will be presented and discussed:

The Deloittes Leadership and Transformation Fellowship, developed in partnership with the Royal College of Anaesthetists & HEE, is designed to equip senior clinicians with leadership skills for both local and system-wide transformation. Discussions will centre on the fellow’s experience in the industry placement, their management and leadership skills development and the outcome of a major service improvement project undertaken during the role.

The Medical Education Fellowship in Anaesthesia PA(A) project aims to support the integration of the Physicians Assistants in Anaesthesia (PA(A) workforce into multi-professional anaesthesia delivery. They are an established group of healthcare professionals assisting in the delivery of anaesthesia under the supervision of medical consultants. Their scope of practice presently varies from non-theatre sedation to general anaesthesia, tailored to local needs. Discussions will consider the output of the role.

The chief registrar programme was developed by the Royal College of Physicians following The Future Hospital report. A number of these roles have been developed across the U.K. The discussion will focus on the how, since their inception, they have made an impact on local services, improving patient flow and quality of care.

D7: AoME@DEMEC: Developing career pathways in medical education

Career progress in the field of clinical education is rarely clear and straightforward. The aim of this session is to promote and enhance careers in medical, dental and veterinary education. We will look at the ways in which individuals can harness formal and informal networks, engage in scholarship, and seek out structures and career pathways to help them develop a rewarding and worthwhile career in an exciting but still professionalising field. Facilitators and delegates will share practical experiences, insights and advice on developing careers in medical, dental and veterinary education leadership, management, research and practice. We will outline some of the ways in which medical, dental and veterinary educators can achieve recognition for their skills and commitment, and will assist delegates to produce their own career plans.

C2: Education scholarship and faculty management

An exciting session on educational scholarship and faculty management will focus down onto 3 broad themes for the 90-minute workshop.

a. Improving Integrated academic-clinical training (IACT):

i. What do trainees and other stakeholders think about the current state of integrated academic-clinical training (IACT) for doctors and dentists. How can we use qualitative research findings to further refine and improve this successful initiative?

ii. What can we change through the Shape of Training initiative, to assure and develop IACT?

b. Cutting teeth – academic publications for the enthused educator:

i. Turning small educational projects into publishable research

c. Faculty management:

i. Using educational theories to develop effective training interventions to improve clinical performance

ii. Transfer of learning: the challenge for health professions education to improve performance and care.

D8: Undergraduate issues

This session will focus on current issues in undergraduate medicine.

The first workshop will investigate current initiatives aimed at selecting those applicants to medical school who have the potential to become excellent doctors in the future. It will consider the evidence that Situational Judgement Tests (SJTs) and Multiple Mini Interviews (MMIs) differentiate usefully and accurately between candidates and offer advice on how to create effective SJT scenarios and MMI stations.

It will them move to the undergraduate curriculum and using an example from a medical Royal College (RCPCH) reflect upon how the College engaged with the Regulator, students and academics to develop a child health curriculum found helpful and engaging by medical schools.

Professionalism and fitness to practise are key attributes for medical students. The joint GMC/MSC guidance published in 2016 has been supplemented by additional resources for medical schools and students and this will be explored in the session.

Finally the workshop will consider the GMC’s plans to develop a Medical Licensing Assessment in the light of feedback to its consultation in Spring 2017. The responses are being analysed as this programme is being developed but the meeting will provide an opportunity to explore ways forward.

D13: Longitudinal Integrated Foundation Training (LIFT); Developing doctors with better ‘patient centeredness’

From August 2016 the North West of England Foundation School piloted Longitudinal Integrated Foundation Training (LIFT) for newly qualified doctors. This was a collaborative quality improvement Innovative between Foundation Trainees, Supervisors, Health Education England, and partnering Local Education Providers; to enhance professionalism and patient centeredness and care. In LIFT the trainees accompany the General Practitioner’s (GP) panel of patients’ across the health care system. This increased exposure to primary care, with its consequent role modelling, is expected to enhance recruitment in primary care. In this interactive workshop we will share the many lessons learnt from LIFT, and explore with you how you can translate this learning to your own area of medical education.

C13: The Learning Environment

The Academy of Medical Royal Colleges Creating Supportive Environments (CSE) group attended previously and published the perspective gained on the supportive issues faced within the medical profession. The next step on this journey is to put practical applications in place. The symposium focuses on the practical applications that are currently working within our profession and how the AoMRC CSE group is moving this work forward nationally.
Assessing culture effectively in organisations is challenging, and requires all staff groups be involved. Results of the implementation of a formal cultural values assessment tool in two NHS Trusts where all staff are asked about their personal values and those of the current and desired cultures of the organisation.
An understanding of how groups function is a key ingredient of effective team performance and part of the session will explore some of the barriers to this and how they may be recognised and mediated. This element will explore a theoretical model and will attempt to examine this experientially through small and large group activities.

C5: Addressing differential attainment:

A workshop led by the General Medical Council and COGPED

Differential attainment refers to the differing levels of educational achievement between demographic groups. The Equality Act makes it unlawful to discriminate against people on the basis of their membership of a group with a protected characteristic, and provides a framework for taking positive action to support groups at risk. This workshop will share understanding about the importance of addressing differences in attainment, and share ideas and practice about how to identify and support trainees in the context of their demography. It will explore barriers to and enablers of progression, including access to curriculum, fairness, opportunities for flexibility in training, unconscious bias and cultural factors as well as a number of possible interventions. These include promoting cultural intelligence for educators, delivery of the curriculum and one area’s programme of Closing the Gap.

The workshop will be interactive and allow delegates to discuss and express their opinions and experiences. This should allow delegates to develop more confidence in delivering effective support to their trainees.

B9: Remediation

This interactive session, delivered by two members of the team from the Collaboration for the Advancement of Medical Education Research and Assessment (CAMERA) Team at Plymouth University, will explore the increasing attention given to remediation and the impact that this has on individuals who go through the process.

The session will examine the current approaches used across the UK in both undergraduate and postgraduate medical education settings and consider the impact that structured revalidation, as mandated by the General Medical Council has on individuals. We will also consider some of the research and educational principles relating to professional identity formation at different stages of career development.

Participants will then be invited in groups to discuss remediation processes within their own organisations and to consider how these process may impact on learners who are involved in the process.

Finally, we will consider the idea of identity disruption and invite discussion about how this can be tackled as part of a holistic approach to remediation.

C12: Managing underperformance among supervising faculty in postgraduate medical education

Much attention has been paid to the management of underperformance among trainees in postgraduate medical education. However, underperformance among supervising faculty, although less commonly highlighted in the literature, has important implications to good quality training. In this workshop, we will be discussing the symptoms of underperformance with clinical and educational supervision and how we could recognize, prioritize and manage concerns that could be due to the supervisor.

Symptoms of poor educational supervision may range from unhappy trainees to suboptimal patient care. What presents as an underperforming trainee issue may in fact be attributable to the supervising faculty, although hard to prove and even harder to tackle. Information may sometimes be gathered from trainee feedback surveys and quality visits. Solutions may require the necessary engagement of stakeholders from within the training program and the employing institution.

The chairs of this session have collaborated in the past in managing complicated issues with learning environment and trainee underperformance. We will work through some case scenarios from our own experiences and encourage participants to share theirs. Finally, we will attempt to identify possible strategies for dealing with these issues in the most effective manner.

D9: Additional support for trainees

This workshop considers the early identification of trainees who could benefit from additional support so they can successfully complete their training without the need for any additional training time. We will do this by discussing a method of identifying trainees which is based on the results from a quantitative research project. This work allowed the development of ‘In Training Assessment Profiler’ (iTAP). iTAP has the potential of being a cost-effective evidence based method that can be used across different specialties. It is currently being used in general practice training.

We will also discuss why these trainees might have difficulty in progressing with their training. While it is accepted that many trainees who have difficulty in progressing come from particular demographics, such as not being a UK graduate, this workshop challenges the notion that demography is needed to identify these trainees and tools such as iTAP allows us to identify these trainees without the use of demography. These are complex issues but this workshop will allow participants to discuss these issues.

D2: Personal values assessment

As medical educators, we are expected to ensure that trainees develop the right values. This can be difficult to teach, and experience suggests that trainees may be uncomfortable with the topic when they feel their own personal values are already sound. A simple free tool is introduced which can be used with trainees alone or in a group, to explore their own personal values in an engaging and non-threatening manner. This workshop will allow participants to undertake the tool themselves, and discuss options for its use in practice

C8: Primary Care (Supporting Primary Care Recruitment)

Starting with a brief overview of the national priorities, drivers and initiatives the session will then follow a journey across some of HEE‘s local GP teams and through the continuum of initiatives to enhance recruitment into GP Specialty Training. Each HEE office has its own ways of attracting GP trainees: wonderful location, innovative training or marketing strategies. Some of these will be shared explored with an opportunity to contribute to further innovations. The workshop will then share experiences including clinical leadership in commissioning roles and explore how to best engage GPs to remain in a locality beyond training. These experiences will highlight inter professional relationships and the relevance of different professions’ cultural awareness and maturity. The session will then consider 2-year complex analysis of training programmes suggesting changes in the breadth and balance of programmes that might make them both more attractive and better preparation for GP careers.

It is hoped that the session will bring together GP educators and others involved in recruiting into Primary Care and ensuring a sufficient and sustainable workforce, to share experiences and good practice, to also share what has not worked and also to brain-storm further initiatives.

B8: Educating the primary care workforce

This session will contain a number of presentations looking at different aspects of the primary care workforce and its education and development, and will include Medical Assistants in General Practice, using Training Hubs to help Practice Nurse recruitment, and an example of inter-professional learning between GP Registrars & pre-registration Community Pharmacists, followed by questions and hopefully sharing of examples of good practice from the audience

D4: Supporting career choices

Traditional career pathways in defined specialty areas are well established and described with plentiful information from Medical Royal Colleges and Specialist societies. However for those doctors that are less certain, may require additional support or advice or are not in training posts advice is harder to come by and requires a different knowledge base. This session aims to explore other options and how these may be delivered individually as well as supporting system wide change to support this work whilst valuing the entirety of our work force.

Areas that will be explored are detailed individual careers advice particularly for non- training grades of doctors- including consultants, maximising support including different methods of delivering careers advice, implementing a four nation careers strategy and supporting an equal and diverse workforce, the latter being particularly relevant with regards to the issue of differential attainment.

D12: Educating the educators

The GMC defines “Educators” as individuals involved in teaching, training, assessing and supervising learners in the course of their daily clinical practice; and that these educators should be trained and appraised to reflect their education responsibilities.
Alison Cooper & Liz Spencer will discuss the definitions of “faculty” and the various models of educating the educators from informal department conversations to regional and national faculty development / Train the Trainer courses.
Suzi Ceasar will discuss the variation in the reported benefits of medical appraisal for revalidation. Appraisal should be a formative and developmental experience that is valuable to the individual doctor in facilitating self-reflection and planning quality improvements across the whole scope of work. Doctors deserve well trained appraisers and the right resources and support to make valuable appraisals a reality.
If the benefit of appraisal is related to the skills of the appraiser – what are those skills and how are we educating the appraisers?

In this session there will be very brief presentations by the speakers and then round table discussions addressing the questions….how to develop faculty and appraisers, do we have a language to discuss quality improvement?

D10: Improving assessments and ARCPs

The Annual Review of Competence Progression (ARCP) is the formal method by which a trainee’s progression through their training programme is monitored and recorded. Consistent and high quality processes to manage ARCPs are crucial in order to ensure fair outcomes for trainees and robust decision making for ARCP panels. This interactive workshop will share insight into improving the quality of the ARCP process and invite attendees to share their own insights.

Reviewing and Enhancing Assessment
Share the purpose and early findings of a review of the ARCP process undertaken by HEE with key partners and explore the implications of the findings and possible future recommendations.

What does the College ever do for Quality Managing ARCPs?
Share the RCGPs revised QM processes the RCGP follows, their effectiveness with the opportunity for participants to reflect upon their experience of ARCPs and feedback on what would make the RCGP QM more effective in supporting deaneries and HEE local offices enabling a fair and robust system for ARCPs.

ARCP Appeals: How they work and how to avoid them
Presentation of anonymised accounts of ARCP appeals and discussion of how to collect information for ARCPs to ensure that outcomes may be correctly applied

General Internal Medicine ARCP process – auditing for high quality decision making
Explores local auditing process used to ensure e-portfolio evidence matches outcomes awarded for GIM ARCPs, including practical tools and tips for ensuring robust ARCP decision making.

C7: Multi-professional working 2

This session brings together a plethora of initiatives across a variety of clinical settings that have successfully developed and implemented collaborative approaches to multiprofessional training. Speakers will discuss barriers and solutions to multiprofessional training and focus on resources involved and outcomes achieved, both in terms of educational goals and health-care delivery. This will include discussion of programmes for an interprofessional workforce in medicine, surgery and beyond with identification of mechanisms to improve patient safety as well as support networks and feedback strategies for trainees from different disciplines.

The session promises to incorporate a mixture of examples of good practice and interactive group discussion, facilitated by leaders in the field. Speakers include Heads of School and Postgraduate Deans with a wealth of expertise in the development and delivery of blended educational programmes.

Developing Excellence in Medical Education Conference (DEMEC)

Monday 2 – Tuesday 3 December 2019
Manchester Central

DEMEC 2017 Video

DEMEC 2017 medical educator top tips video

Hosted by:

C1: Strengthening professionalism training in postgraduate medical education: Integrating Generic Professional Capabilities (GPCs) into medical curricula and assessment

C4: New approaches to training

C9: Exploring two educational toolkits used to improve scores in the AKT and CSA components of the MRCGP licensing examination

D1: Enhancing support for trainees

D3: Technology enhanced learning and simulation 2

D6: New working paradigms

D7: AoME@DEMEC: Developing career pathways in medical education

C2: Education scholarship and faculty management

D8: Undergraduate issues

D13: Longitudinal Integrated Foundation Training (LIFT); Developing doctors with better ‘patient centeredness’

C13: The Learning Environment

C5: Addressing differential attainment:

B9: Remediation

C12: Managing underperformance among supervising faculty in postgraduate medical education

D9: Additional support for trainees

D2: Personal values assessment

C8: Primary Care (Supporting Primary Care Recruitment)

B8: Educating the primary care workforce

D4: Supporting career choices

D12: Educating the educators

D10: Improving assessments and ARCPs

C7: Multi-professional working 2

Monday 2 – Tuesday 3 December 2019 Manchester Central

DEMEC 2017 Video

DEMEC 2017 medical educator top tips video

Hosted by:

C1: Strengthening professionalism training in postgraduate medical education: Integrating Generic Professional Capabilities (GPCs) into medical curricula and assessment

C4: New approaches to training

C9: Exploring two educational toolkits used to improve scores in the AKT and CSA components of the MRCGP licensing examination

D1: Enhancing support for trainees

D3: Technology enhanced learning and simulation 2

D6: New working paradigms

D7: AoME@DEMEC: Developing career pathways in medical education

C2: Education scholarship and faculty management

D8: Undergraduate issues

D13: Longitudinal Integrated Foundation Training (LIFT); Developing doctors with better ‘patient centeredness’

C13: The Learning Environment

C5: Addressing differential attainment:

B9: Remediation

C12: Managing underperformance among supervising faculty in postgraduate medical education

D9: Additional support for trainees

D2: Personal values assessment

C8: Primary Care (Supporting Primary Care Recruitment)

B8: Educating the primary care workforce

D4: Supporting career choices

D12: Educating the educators

D10: Improving assessments and ARCPs

C7: Multi-professional working 2

Monday 2 – Tuesday 3 December 2019
Manchester Central