Trainer doctors’ activities to support learning at work in specialty...
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Background Specialty training for Occupational Health (OH) is regulated by universities (curriculum, logbook, service requirements, theoretical courses, written summative examination), in close collaboration of the 5 universities providing medical education in Finland. However, the essentials are learned at work, in 200 university-approved training centers with the support of 300 trainer doctors. The trainer doctors are specialists in OH. They complete short pedagogical courses and commit to keeping contact with their universities. In aligned training, the trainers 1. Assist in planning: in defining the trainee’s individual learning needs and plans according to the curriculum 2. Support learning at work, e.g. through weekly tutorial sessions, ad hoc consultations, by contributing to the variety of trainee’s work tasks and local meeting activities 3. Evaluate progress every 6 months together with the trainee to define the plans for the next 6 months Aim To further develop the trainer doctors’ pedagogical training, we examined their present use of various educational activities. Methods We constructed a questionnaire by extracting potentially relevant and feasible educational activities from the literature and from focus group discussions with senior trainers. In 2012, 148 trainer doctors (response rate 45%) participated in a nationwide electronical survey on their use of 39 various educational activities. Results In terms of planning, scheduling concrete activities was more usual (very/quite often, 69% of trainers) than planning for the evaluation of the period (40%). The use of activities to support learning ranged from discussing trainee’s cases during tutorial sessions (90%) or answering immediate questions (82%) to critical reading of scientific articles (16%). Among evaluative activities, the methods ranged from case-based discussions (79%) to multidisciplinary feedback (23%). Discussion Trainer doctors are most familiar with traditional consultative and case-based discussion activities. In light of Eraut’s intention-based classification of learning at work (implicit, reactive, deliberative), the prevalent activities are helpful in making implicit learning visible and in strengthening reactive learning at work. These remain needed. To support more planned learning at work, the use of a wider repertoire of educational activities should be encouraged. It is also worth noting, that the curriculum in OH is constantly updated to meet the changing needs of the society. The trainers’ further pedagogical training should thus enhance both theoretical knowledge and facilitating skills to support systematical learning at work. These results have been carefully considered while preparing new pedagogical courses and the new edition of the OH trainer’s guide book (2016): References Ala-Mursula L, Horppu R, Heikkinen J, et al. Työterveyshuoltoon erikoistuvien lääkärien ohjaaminen palkitsee. Suomen Lääkärilehti 2014;69:139-44. (in Finnish) Eraut M. Informal learning in the workplace. Studies in Continuing Education 2004;26:247-73. Räsänen K, Toivonen A, Pyörälä E, Hakkarainen K. Työterveyshuollon erikoislääkärikoulutuksen arviointi kaudelta 2009-2013. STM raportteja ja muistioita 2015:11. (External evaluation of OH specialization studies in 2009-2013, in Finnish) Further information Työterveyshuollon virtuaaliyliopisto www.tthvyo.fi (Virtual university for occupational health care) Trainer doctors’ activities to support learning at work in specialty training for Occupational Health Leena Ala-Mursula, MD PhD, Professor of Occupational Health, University of Oulu, Finland Ritva Horppu, PhD, Senior Specialist, Finnish Institute of Occupational Health, Finland Virpi Liukkonen, MD PhD, Clinical Lecturer, University of Tampere, Finland Kati Päätalo, PhD, Coordinator, University of Oulu, Finland Educational activity Very/ quite often (%) PLANNING We define together plans for the next months (programs for tutorial sessions, workplace meetings, external courses, literature, courses in virtual university, other specific tasks, etc) 69 We study together the goals of the curriculum and logbook 62 I check the trainee's study plan and help in revising it, if needed 62 We evaluate together the trainee's present level of knowhow (with the help of the logbook) and tailor specific goals for the next months 57 We plan together, how we will evaluate progress after this period 40 SUPPORTING LEARNING We discuss the trainee's cases during tutorial sessions 90 I respond to trainee's ad hoc questions in between the work tasks 82 We discuss to clarify the doctor's role in multidisciplinary teamwork 80 We discuss ethical aspects in OH 64 We discuss the characteristics in the thinking patterns of an OH specialist, as compared to those of other specialties 61 We discuss the trainee's own well-being related to work 56 I encourage the trainee towards continuous self-reflection regarding own knowledge, presumptions, actions, feelings and attitudes 51 I prescribe reading literature before upcoming sessions 45 I prescribe small investigative tasks (related to individuals, workplaces, branches of industries etc) 39 I prescribe small writing tasks before upcoming sessions 22 I prescribe learning activities related to the OH virtual university 21 We read and evaluate scientific articles 16 I encourage the trainee to participate in the developmental activities of the workplace 48 I prescribe small presentations e.g. at workplace meetings 43 I prescribe activities aimed at leadership and management skills 37 I encourage the trainee to visit and build networks with various partners and authorities in the fields of rehabilitation, employment services, insurance companies etc 32 I make arrangements so that the trainee can visit diverse workplaces 48 I invite the trainee to follow my own performance e.g. at workplace visits 41 I invite the trainee to follow my own performance at consultative meetings concerning work ability before the trainee starts acting independently 37 EVALUATING PROGRESS I ask for wishes and expectations concerning further training 66 We conduct the evaluation of the trainee’s progress in the studies systematically, at least twice a year 60 We evaluate our collaboration, in which way I have been of help, and how the trainee has experienced the training 41 We discuss how the trainee has managed diverse cases and situations and I give feedback 79 We discuss and evaluate different documents made by the trainee (workplace surveys, action plans etc) 73 I evaluate the trainee's progress in relation to the logbook goals 62 As part of the evaluation, we define new learning goals for next months 57 I ask for the trainee's self-evaluation of his/her progress and we discuss upon it 49 We discuss feedback received from clients and patients concerning the trainee's performance 43 I make observations on the trainee's working in authentic situations and give feedback 37 I ask for other employees at our workplace to give feedback on the trainee's performance and we discuss upon it with the trainee 23 Take home messages The know-how of the trainers in the field is crucial for the high quality and development of the specialty training for OH. To support and develop the trainer doctors’ important work, the universities need to provide dynamic, versatile, in-depth enough and continuous pedagocical training.
Transcript of Trainer doctors’ activities to support learning at work in specialty...
BackgroundSpecialty training for Occupational Health (OH) is regulated by universities(curriculum, logbook, service requirements, theoretical courses, written summativeexamination), in close collaboration of the5 universities providing medical educationin Finland.
However, the essentials are learned at work, in 200 university-approved training centerswith the support of 300 trainer doctors.
The trainer doctors are specialists in OH. They complete short pedagogical courses and commit to keeping contact with theiruniversities.
In aligned training, the trainers1. Assist in planning: in defining thetrainee’s individual learning needs and plansaccording to the curriculum2. Support learning at work, e.g. throughweekly tutorial sessions, ad hoc consultations, by contributing to the variety of trainee’swork tasks and local meeting activities3. Evaluate progress every 6 monthstogether with the trainee to define the plansfor the next 6 months
AimTo further develop the trainer doctors’ pedagogical training, we examined theirpresent use of various educational activities.
MethodsWe constructed a questionnaire by extractingpotentially relevant and feasible educationalactivities from the literature and from focusgroup discussions with senior trainers.
In 2012, 148 trainer doctors (response rate45%) participated in a nationwide electronicalsurvey on their use of 39 various educationalactivities.
ResultsIn terms of planning, scheduling concreteactivities was more usual (very/quite often, 69% of trainers) than planning for theevaluation of the period (40%).The use of activities to support learningranged from discussing trainee’s cases duringtutorial sessions (90%) or answeringimmediate questions (82%) to critical readingof scientific articles (16%). Among evaluative activities, the methodsranged from case-based discussions (79%) to multidisciplinary feedback (23%).
DiscussionTrainer doctors are most familiar withtraditional consultative and case-baseddiscussion activities.
In light of Eraut’s intention-basedclassification of learning at work (implicit, reactive, deliberative), the prevalent activitiesare helpful in making implicit learning visibleand in strengthening reactive learning at work. These remain needed.
To support more planned learning at work, the use of a wider repertoire of educationalactivities should be encouraged. It is also worth noting, that the curriculum in OH is constantly updated to meet thechanging needs of the society. The trainers’ further pedagogical training should thusenhance both theoretical knowledge and facilitating skills to support systematicallearning at work.
These results have been carefully consideredwhile preparing new pedagogical courses and the new edition of the OH trainer’s guidebook (2016):
References
Ala-Mursula L, Horppu R, Heikkinen J, et al. Työterveyshuoltoon erikoistuvien lääkärien ohjaaminen
palkitsee. Suomen Lääkärilehti 2014;69:139-44. (in Finnish)
Eraut M. Informal learning in the workplace. Studies in Continuing Education 2004;26:247-73.
Räsänen K, Toivonen A, Pyörälä E, Hakkarainen K. Työterveyshuollon erikoislääkärikoulutuksen
arviointi kaudelta 2009-2013. STM raportteja ja muistioita 2015:11. (External evaluation of OH
specialization studies in 2009-2013, in Finnish)
Further information
Työterveyshuollon virtuaaliyliopisto www.tthvyo.fi (Virtual university for occupational health care)
Trainer doctors’ activities to support learning at work in specialty training for Occupational Health Leena Ala-Mursula, MD PhD, Professor of Occupational Health, University of Oulu, Finland
Ritva Horppu, PhD, Senior Specialist, Finnish Institute of Occupational Health, Finland
Virpi Liukkonen, MD PhD, Clinical Lecturer, University of Tampere, Finland
Kati Päätalo, PhD, Coordinator, University of Oulu, Finland
Educational activity Very/
quite
often
(%)
PLANNINGWe define together plans for the next months (programs for tutorial
sessions, workplace meetings, external courses, literature, courses in
virtual university, other specific tasks, etc)
69
We study together the goals of the curriculum and logbook 62
I check the trainee's study plan and help in revising it, if needed 62
We evaluate together the trainee's present level of knowhow (with
the help of the logbook) and tailor specific goals for the next months
57
We plan together, how we will evaluate progress after this period 40
SUPPORTING LEARNINGWe discuss the trainee's cases during tutorial sessions 90
I respond to trainee's ad hoc questions in between the work tasks 82
We discuss to clarify the doctor's role in multidisciplinary teamwork 80
We discuss ethical aspects in OH 64
We discuss the characteristics in the thinking patterns of an OH
specialist, as compared to those of other specialties
61
We discuss the trainee's own well-being related to work 56
I encourage the trainee towards continuous self-reflection regarding
own knowledge, presumptions, actions, feelings and attitudes
51
I prescribe reading literature before upcoming sessions 45
I prescribe small investigative tasks (related to individuals,
workplaces, branches of industries etc)
39
I prescribe small writing tasks before upcoming sessions 22
I prescribe learning activities related to the OH virtual university 21
We read and evaluate scientific articles 16
I encourage the trainee to participate in the developmental activities
of the workplace
48
I prescribe small presentations e.g. at workplace meetings 43
I prescribe activities aimed at leadership and management skills 37
I encourage the trainee to visit and build networks with various
partners and authorities in the fields of rehabilitation, employment
services, insurance companies etc
32
I make arrangements so that the trainee can visit diverse workplaces 48
I invite the trainee to follow my own performance e.g. at workplace
visits
41
I invite the trainee to follow my own performance at consultative
meetings concerning work ability before the trainee starts acting
independently
37
EVALUATING PROGRESSI ask for wishes and expectations concerning further training 66
We conduct the evaluation of the trainee’s progress in the studies
systematically, at least twice a year
60
We evaluate our collaboration, in which way I have been of help, and
how the trainee has experienced the training
41
We discuss how the trainee has managed diverse cases and
situations and I give feedback
79
We discuss and evaluate different documents made by the trainee
(workplace surveys, action plans etc)
73
I evaluate the trainee's progress in relation to the logbook goals 62
As part of the evaluation, we define new learning goals for next
months
57
I ask for the trainee's self-evaluation of his/her progress and we
discuss upon it
49
We discuss feedback received from clients and patients concerning
the trainee's performance
43
I make observations on the trainee's working in authentic situations
and give feedback
37
I ask for other employees at our workplace to give feedback on the
trainee's performance and we discuss upon it with the trainee
23
Take home messagesThe know-how of the trainers in the fieldis crucial for the high quality and development of the specialty training for OH.
To support and develop the trainer doctors’ important work, the universities need to provide dynamic, versatile, in-depth enoughand continuous pedagocical training.
