The Dynamic GP training Critical appraisal training ‘in action’ C. Tulinius.
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Transcript of The Dynamic GP training Critical appraisal training ‘in action’ C. Tulinius.
In this introduction…
• Aims of the workshop• Background for CAT• Content & structure of CAT• The continuous development of CAT• Structure of the workshop
C. Tulinius
Aims of the workshop
• To demonstrate the different elements of CAT with the possibility to observe or participate
• Parallel fishbowls• Precise rules for how and when to participate • Plenary discussion with the possibility to ask trainees
and teachers
C. Tulinius
Critical reflection
Teaching
Managing several perspektives
Quality assurance and research
Applyingknowledge
Learning and development
Theoreticalframes of reference
The scholar/academic
Critical reflection
Critical reflection
Critical reflection
Critical reflection
Critical reflection
Critical reflection
Critical reflection
Critical reflection Critical
reflection
Overall aim for CAT
Aims:To develop the skills to find and digest new knowledge and apply it to the clinical work
Rationale:To support understanding of an approach that can provide the foundation for life-long learning
C. Tulinius
Learning objectives for CAT
• Describe a topic in the context of current clinical practice and illustrate existing knowledge – and gaps
• Review current knowledge by way of a systematic literature search
• Critically interpret results from the literature – proposing solutions for the problem
• Summarize the results, communicate these to colleagues
• Use research results to evaluate the organizational, economic and ethical consequences of changing practice
C. Tulinius
Medical postgraduate education in Denmark
10
3 regions, different programs. The experiences is from the Eastern Region
East
North
South
CONTENT AND STRUCTURE OF CAT
C. Tulinius
An educational experiment out of control
What exactly are we testing with this, Bob?
Haven’t got a clue!
12
GP specialist training in DK : 5 years
12
30
6
6Introduction to General Practice
General Practice – phase 1
6
Hospital
General Practice – phase 2
General Practice – phase 3
Months
17 days 3 days
All within12 months
13
= Seminar-days Groups of 10 trainees or less with a seminar leader. Discussions and presentations of project including feedback.
= Course-daysCritical appraisal of the literature in small groups and literature search in Relevant databases.
= Work in groups
= Home working days
20 days…
Academic supervision
Based on experiences with research training of GPs and GP trainees
• Based on their own experiences– Relevant to general practice• Participant activating & problem-based learning
• Working in groups of 3-4 to support the training of working in teams
• Critical reflection as a learning strategy• Formative and summative assessment strategy
Educational principles for CAT and the training of the teachers
Challenges
• Cutting down from 60 to 20 days• 90-100 trainees a year, a small handful of research
supervisors had to be trained– Defining curriculum for each teacher’s role– Designing and delivering teaching of basic and specific
medical education to the different kinds of teachers– Supporting the trainers and teachers working together
generally and around the individual trainee– Designing the review as an action research project
• General resistance , research as a non-value• Specific for general practice clinical work
The development of CATObserve
(research/data collection)
Reflect(critical reflexivity)
Plan(strategic action plan)
ActImplementation)
Observe
Reflect
Plan
Act
ObserveO’Leary’s cycles of research
Observations: Problem in forming the groups –
new focus point, or follow up on applied
new strategy
Application of strategy
Suggestions for changes
New teaching day with forming of
groups – how did it work out?
Suggestions: new strategies
Evaluation strategy
New observations
C. Tulinius
Status
• 95 trainees have been through CAT in the Eastern Region, all passed
• 36 motivated teachers and research supervisors, trained especially to their teaching role in the research training
Rewards
• Evaluation shows trainees training to the curriculum, and beyond
• Trainees are going further into research• Teachers are taking on the role as developers and
researchers on their own process• GP trainers talk about ‘their’ regional research
trainers• Educational research getting on the list of research
interests among GP trainers, teachers and trainees
Aims of the workshop
• To demonstrate the different elements of CAT with the possibility to observe or participate
• Parallel fishbowls• Precise rules for how and when to participate • Plenary discussion with the possibility to ask trainees
and teachers
C. Tulinius
Workshop structure
FOUR fishbowls2 x 20 minutes• Literature search• Critical reading of an article• 5th seminar day • SupervisionQuestions and discussion
C. Tulinius
Fish bowl messages
• Literature search: to show how that it is relevant to know how to do a literature search, and that a focused search gives a focused answer to your questions
• Critical reading: to show that it is possible to teach trainees to read an article in a systematic way
• Supervision: To show how you can supervise two groups with different project topics at the same time
• 5th seminar day: To show how the end assessment of the trainees can be done by the trainees themselves in a process facilitated by the seminar leader
C. Tulinius