Random Case Analysis

Ramesh Mehay

Aims:

to remind you about RCA To help refine your skills To revisit JoHari

Why do RCA?

encourage reflective practice and lifelong learning

encourages use of evidence assess learning needs (knowledge, skills,

and attitudes) identify learning opportunities help GPR to increase self-knowledge of

their own strengths, weaknesses, and attitudes

The biggest advantage…..

RCA provides opportunities to explore cases where the registrar does not recognise a problem, or

where they may be avoiding having to deal with a problem.

This obviously requires sensitivity on the part of the trainer.

Johari window

Unknown

Things I know about

me

Things I don’t know about me

Things others know

about me

Things others don’t know about

me

Arena

Facade

Blind spot

SAFE EDUCATIONAL CLIMATE

Mechanics

be in the right place protected time - no interruptions on first occasion, agree purpose and rules case selection should be random Listen and then respond - using the same

skills that you would in a consultation Take notes – it makes the task easier

Mechanics 2

agree learning needs, negotiate a plan give feedback – reinforce good things,

descriptive, constructive consider alternatives Practise alternatives build skills summarising - by you or by GPR attitudinal issues reversal of roles

You as the teacher are not expected to have all the answers - the need to look up the best evidence in order to answer a question provides a good role model.

The difficulty with RCA is that any number of avenues can be followed up.

The trainer has to be on his toes to spot problem areas of which the trainee may be unaware.

Remember that the aim is to help the registrar construct their own knowledge

you need to find out where they are at, and build on that

RCA profile

Previous scales mapped for content areas

New scale drawn up, piloted, and trainers surveyed

Refined scale used to rate 2 groups of trainers – training in RCA makes a difference!

Use of RCA profile

For trainers to analyse their own performance

To provide a structure for giving feedback

No reliability testing on scores – forget the numbers

Case-based discussion

Registrar selects 3 cases and prepares them

Trainer selects 2 to discuss Start with written record and then

explore the GPR’s professional judgement in the case in each of 10 domains

Case-based discussion

Trainer records ‘needs further development’, ‘competent’ or ‘excellent’ for each domain

Trainer makes recommendations for change

Training for trainers happening soon!