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ADVANCED MASTERY OF THE e- PORTFOLIO HDR4.11.10. SET OBJECTIVES WHY this topic? WHY this topic? WHAT DO YOU WANT TO GET OUT OF TODAY? WHAT DO YOU WANT.

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Presentation on theme: "ADVANCED MASTERY OF THE e- PORTFOLIO HDR4.11.10. SET OBJECTIVES WHY this topic? WHY this topic? WHAT DO YOU WANT TO GET OUT OF TODAY? WHAT DO YOU WANT."— Presentation transcript:

1 ADVANCED MASTERY OF THE e- PORTFOLIO HDR

2 SET OBJECTIVES WHY this topic? WHY this topic? WHAT DO YOU WANT TO GET OUT OF TODAY? WHAT DO YOU WANT TO GET OUT OF TODAY?

3 Programme Objectives Objectives Changes to the eportfolio Changes to the eportfolio Engaging with the eportfolio Engaging with the eportfolio What to do pre ES meeting What to do pre ES meeting Why do trainees go to panel-what happens at a panel? Why do trainees go to panel-what happens at a panel? Naturally Occurring evidence. Naturally Occurring evidence. Log entries-How to make better reflection. Log entries-How to make better reflection. Exercises on reflection and validation Exercises on reflection and validation

4 UPDATE Eportfolio v5 Need to sign‘Probity: Professional Obligations’, ‘Health: Professional Obligations’ and ‘Educational Agreement’ need to be signed at the start of Training in a Deanery. If you change Deanery, you will need to resign these. You will not be able to enter Learning Log entries without these three being signed Need to sign‘Probity: Professional Obligations’, ‘Health: Professional Obligations’ and ‘Educational Agreement’ need to be signed at the start of Training in a Deanery. If you change Deanery, you will need to resign these. You will not be able to enter Learning Log entries without these three being signed. Your Educational Supervisor will not be able to start a review, without countersigning the Educational Agreement.. Your Educational Supervisor will not be able to start a review, without countersigning the Educational Agreement. Probity: Convictions and disciplinary actions, and Health: Regulatory and voluntary proceedings now must be signed for each review. There will be a review by review option for you to sign these. You cannot accept a review without signing them Probity: Convictions and disciplinary actions, and Health: Regulatory and voluntary proceedings now must be signed for each review. There will be a review by review option for you to sign these. You cannot accept a review without signing them

5 UPDATE Eportfolio v5 ES must create a review before you can update your self assesssment ES must create a review before you can update your self assesssment Educational Supervisor's review - Educational Supervisors cannot sign & submit a review unless the Trainee has completed the Competences Self- Rating. Educational Supervisor's review - Educational Supervisors cannot sign & submit a review unless the Trainee has completed the Competences Self- Rating. Expanded rating scales-relate to stage- Expanded rating scales-relate to stage- NFD – Below Expectations; NFD – Meets Expectations; NFD – Above Expectations NFD – Below Expectations; NFD – Meets Expectations; NFD – Above Expectations Competent for Licensing Competent for Licensing Excellent Excellent Reviews come in RDMP clustering model Reviews come in RDMP clustering model

6 Relationship Professionalism Management Diagnostics Maintaining an Ethical Approach to Practice Fitness to Practice Maintaining Performance Learning and Teaching Primary Care Admin and IMT Community Orientation Managing Medical Complexity Clinical Management Making a Diagnosis Making Decisions Data Gathering & Interpretation Practising Holistically Communication & Consulting Skills Working with Colleagues & in Teams RDMp Clustering Model

7 E –portfolio Version 6.0 – Planned release date - early August 2011 It was agreed that major changes to the ePortfolio will only be introduced at the start of a new ST year. Version 6.0 will be the next major update, and will be released in early August The list of work for Version 6.0 is still very much a work in progress, but at the moment we are planning to address the following: The list of work for Version 6.0 is still very much a work in progress, but at the moment we are planning to address the following: A major review of the curriculum and its likely impact on the ePortfolio A major review of the curriculum and its likely impact on the ePortfolio A review of the Learning Log functionality and linkage A review of the Learning Log functionality and linkage A review of the Case Based Discussion (CBD) WPBA tool A review of the Case Based Discussion (CBD) WPBA tool Minor aesthetic improvements e.g. text display and layout of tables Minor aesthetic improvements e.g. text display and layout of tables Housekeeping of the database and updating coding for the website Housekeeping of the database and updating coding for the website

8 Engaging with the E-portfolio Common Reasons Why Trainees don't make effective use of their e-portfolio do not understand its value (both in terms of assessment, i e for others, and in terms of recording experiences and reflection, i e for self do not understand its value (both in terms of assessment, i e for others, and in terms of recording experiences and reflection, i e for self does understand its value but hasn’t got into a routine of doing it, in which case may need rather explicit suggestion of a routine does understand its value but hasn’t got into a routine of doing it, in which case may need rather explicit suggestion of a routine does understand its value but thinks can’t find the time in his busy job does understand its value but thinks can’t find the time in his busy job does understand its value but is lazy and/or disorganised does understand its value but is lazy and/or disorganised doesn’t know how to do it – in this case, he might need to look at someone else’s. You could get permission from one of your other supervisees to show him/her theirs? Mainly the reflective aspects. doesn’t know how to do it – in this case, he might need to look at someone else’s. You could get permission from one of your other supervisees to show him/her theirs? Mainly the reflective aspects. confused by moving goalposts! confused by moving goalposts!

9 Engaging with the E-portfolio Make entries personal Make entries personal How many/often? per week avoid clustering How many/often? per week avoid clustering Quality not quantity Quality not quantity Have it open in surgery –so that can do brief one liner notes at end on relevant cases and develop later Have it open in surgery –so that can do brief one liner notes at end on relevant cases and develop later

10 Trainee suggestions to engage in e-portfolio What do I write? -familiarise with curriculum headings and competences and what they mean to use as framework to follow What do I write? -familiarise with curriculum headings and competences and what they mean to use as framework to follow Time issues- Time issues- consider coming in half an hour early each day during your hospital or GP post to add log entries consider coming in half an hour early each day during your hospital or GP post to add log entries load the e-portfolio at the same time as you do your GP surgery; in that way you can add 'rough notes' on interesting patients you see and you can then 'smarten' them up later load the e-portfolio at the same time as you do your GP surgery; in that way you can add 'rough notes' on interesting patients you see and you can then 'smarten' them up later -use your half day admin time to add in entries -use your half day admin time to add in entries use 'gaps' in your daily hospital work as opportunities to add stuff on use 'gaps' in your daily hospital work as opportunities to add stuff on - if it takes ages to drive home (because of rush hour traffic eg after half day release), consider pulling over and adding some stuff on until the traffic dies down. Of course, you may wish to invest in mobile broadband to do this. - if it takes ages to drive home (because of rush hour traffic eg after half day release), consider pulling over and adding some stuff on until the traffic dies down. Of course, you may wish to invest in mobile broadband to do this. Change your attitude: many of you hate the eportfolio and feel sick at the thought of it. But the e-portfolio is here to stay. If one cannot change the e- portfolio, then perhaps one needs to change oneself. Change your attitude and adapt to it. The more you start looking at it positively, the less it will impact on you negatively. LIKE LIFE! Change your attitude: many of you hate the eportfolio and feel sick at the thought of it. But the e-portfolio is here to stay. If one cannot change the e- portfolio, then perhaps one needs to change oneself. Change your attitude and adapt to it. The more you start looking at it positively, the less it will impact on you negatively. LIKE LIFE! Typing skills –consider typing tutor ('Mavis Beacon Teaches Typing' - type this into somewhere like Amazon; costs less that £20.) or digital dictation software eg Dragon Naturally speaking. Typing skills –consider typing tutor ('Mavis Beacon Teaches Typing' - type this into somewhere like Amazon; costs less that £20.) or digital dictation software eg Dragon Naturally speaking.

11 Suggestions re quantity Non WBPA MINIMUM criteria to be achieved prior to the end of the ST year Non WBPA MINIMUM criteria to be achieved prior to the end of the ST year ST1 96 quality log entries (10 pages of the e-portfolio) and 12 SMART PDP entries 96 quality log entries (10 pages of the e-portfolio) and 12 SMART PDP entries Reflections on post held, 2 Presentations, 6 x SEA Reflections on post held, 2 Presentations, 6 x SEA ST2 112 additional quality log entries (12 additional pages of the e-portfolio and an additional 18 SMART PDP entries - Running total = 22 pages of e-portfolio entries and 24 SMART PDP entries. Reflections on post held, 4 Presentations, 12 x SEA 112 additional quality log entries (12 additional pages of the e-portfolio and an additional 18 SMART PDP entries - Running total = 22 pages of e-portfolio entries and 24 SMART PDP entries. Reflections on post held, 4 Presentations, 12 x SEA ST3 144 additional quality log entries (15 additional pages of the e-portfolio) and an additional 18 SMART PDP entries - Running total = 37 pages of e-portfolio entries and 36 SMART PDP entries. Reflections on post held, 6 Presentations, 18 x SEA, 1 x two cycle audit 144 additional quality log entries (15 additional pages of the e-portfolio) and an additional 18 SMART PDP entries - Running total = 37 pages of e-portfolio entries and 36 SMART PDP entries. Reflections on post held, 6 Presentations, 18 x SEA, 1 x two cycle audit

12 PDP Linking Try and write PDPs in terms of either what knowledge, skills or attitudes you need to develop. Try and write PDPs in terms of either what knowledge, skills or attitudes you need to develop. Remember, you can "send" outstanding things from your learning log entries to your PDP - use it because it saves you writing it all out again for your PDP. Remember, you can "send" outstanding things from your learning log entries to your PDP - use it because it saves you writing it all out again for your PDP. If you don't have time to write out the PDP completely, why not just add something 'quick and dirty' for the time being to serve as a signpost for you to smarten up later? If you don't have time to write out the PDP completely, why not just add something 'quick and dirty' for the time being to serve as a signpost for you to smarten up later? Whilst you dont have to be too comprehensive, you do have to be specific. Whilst you dont have to be too comprehensive, you do have to be specific.

13 SMART PDP The SMART model was developed by psychologists as a tool to help people set and reach their goals. It’s a simple approach that lends itself to creating good PDP entries in your e-portfolio. The SMART model was developed by psychologists as a tool to help people set and reach their goals. It’s a simple approach that lends itself to creating good PDP entries in your e-portfolio. S pecific S pecific M easurable M easurable A ttainable A ttainable R elevant R elevant T ime-bound T ime-bound

14 SMART Specific Is your goal well-defined? Avoid setting unclear or vague objectives; instead be as precise as possible. Specific Is your goal well-defined? Avoid setting unclear or vague objectives; instead be as precise as possible. Instead of: To be a better GP Make it specific: To develop my consultation skills, especially those relating to communication. Instead of: To be a better GP Make it specific: To develop my consultation skills, especially those relating to communication. Measurable Be clear how will you know when you have achieved your goal. Using numbers, dates and times is one way to represent clear objectives. Measurable Be clear how will you know when you have achieved your goal. Using numbers, dates and times is one way to represent clear objectives. Instead of: Feel better about my consultations Make it measurable: Better PSQ outcomes and achieving more COT competencies during assessment. Instead of: Feel better about my consultations Make it measurable: Better PSQ outcomes and achieving more COT competencies during assessment.

15 SMART Attainable Setting yourself impossible goals will only end in disappointment. Make your goals challenging, but realistic. Setting yourself impossible goals will only end in disappointment. Make your goals challenging, but realistic. Instead of: Master consultation skills by the end of the month Make it attainable: I will go on a consultation skills course and read ‘The naked consultation’. Instead of: Master consultation skills by the end of the month Make it attainable: I will go on a consultation skills course and read ‘The naked consultation’.Relevant Try and step back and get an overview of all the different areas of your life: Academic, Personal and Career. Consider how relevant each objective is to the overall picture. Try and step back and get an overview of all the different areas of your life: Academic, Personal and Career. Consider how relevant each objective is to the overall picture.Time-bound Set a time scale for completion of each goal. Even if you have to review this as you progress, it will help to keep you motivated. Set a time scale for completion of each goal. Even if you have to review this as you progress, it will help to keep you motivated. Instead of: I will address these issues. Make it time-bound: By the end of the my current post I will have been on the course and read the book. Instead of: I will address these issues. Make it time-bound: By the end of the my current post I will have been on the course and read the book.

16 STRs-PRE ES meeting Arrange meeting! Ask ES to create a review. Arrange meeting! Ask ES to create a review. log and share an e-portfolio entry entitled Ed Sup Rev current date. Attach: log and share an e-portfolio entry entitled Ed Sup Rev current date. Attach: COT & CBD competency mapping COT & CBD competency mapping HDR spreadsheet and sick leave/all leave spreadsheet. List complaints. HDR spreadsheet and sick leave/all leave spreadsheet. List complaints. Ensure CSR report done. Ensure CSR report done. Ensure self rating assessment and PDP up to date. Ensure self rating assessment and PDP up to date. Ensure compulsory assessments (inc MSF in modular posts)?include NOE Ensure compulsory assessments (inc MSF in modular posts)?include NOE Ensure last objectives achieved. Ensure last objectives achieved. Ensure declarations all signed off Ensure declarations all signed off

17 Deanery Guidelines ES How Many ES Meetings and When? How Many ES Meetings and When? ST1: 2 meetings in first post, 1 meeting in second (i.e. 3 for that year: 1 informal + 2 formal) ST1: 2 meetings in first post, 1 meeting in second (i.e. 3 for that year: 1 informal + 2 formal) ST2: 1 per 6m post (ie 2 for that year: both formal) ST2: 1 per 6m post (ie 2 for that year: both formal) ST3: 1 per 6m post (ie 2 for that year: both formal) ST3: 1 per 6m post (ie 2 for that year: both formal) So, especially during the period Feb-Aug of every year (as that is when most trainees will move onto the next ST stage) make sure you have had your second ES meeting before the end of May So, especially during the period Feb-Aug of every year (as that is when most trainees will move onto the next ST stage) make sure you have had your second ES meeting before the end of May

18 WHY do STs get referrred to central Deanery panel Majority incomplete evidence eg Majority incomplete evidence eg out of hours sessions, out of hours sessions, patient satisfaction questionnaires and patient satisfaction questionnaires and other workplace based assessment tools. other workplace based assessment tools. NOE(Naturally Occurring Evidence) NOE(Naturally Occurring Evidence) Confusion modular posts /LTFTT Confusion modular posts /LTFTT Clustering minimal evidence. Clustering minimal evidence.

19 ARCP PANEL OUTCOMES SATISFACTORY –FOR PROGRESSION OR CCT SATISFACTORY –FOR PROGRESSION OR CCT OUT OF PROGRAMME OUT OF PROGRAMME MAINLY SATISFACTORY-ARCP NOT COMPLETED;FEEDBACK TO TRAINEE TO OBTAIN MISSING EVIDENCE-PANEL CHAIR REVIEWS EVIDENCE 2W LATER. MAINLY SATISFACTORY-ARCP NOT COMPLETED;FEEDBACK TO TRAINEE TO OBTAIN MISSING EVIDENCE-PANEL CHAIR REVIEWS EVIDENCE 2W LATER. POSSIBLE OR LIKELY UNSATISFACTORY- ARCP NOT COMPLETED ;WRITTEN EVIDENCE TO DEANERY RE REASONS POSSIBLE OR LIKELY UNSATISFACTORY- ARCP NOT COMPLETED ;WRITTEN EVIDENCE TO DEANERY RE REASONS ONLY ONE OUTCOME PER TRAINEE IN EACH ARCP CYCLE ONLY ONE OUTCOME PER TRAINEE IN EACH ARCP CYCLE

20 OOH There is the service commitment to out of hours work that is specified for each training post. Not attending OOH sessions is a probity issue. There is the service commitment to out of hours work that is specified for each training post. Not attending OOH sessions is a probity issue. In an Innovative Training Post (ITP) most ITPs will have the same monthly (6 hour) session of OOH work as normal GP training posts. Some will have on call commitments to the modular component of their post – eg on labour ward or hospice. make clear in the portfolio. If no OOH sessions logged panels will find the portfolio unsatisfactory. (PSQ also due in modular posts) In an Innovative Training Post (ITP) most ITPs will have the same monthly (6 hour) session of OOH work as normal GP training posts. Some will have on call commitments to the modular component of their post – eg on labour ward or hospice. make clear in the portfolio. If no OOH sessions logged panels will find the portfolio unsatisfactory. (PSQ also due in modular posts) Documentation of learning in OOH sessions -linking that to chapter 7 of the GP curriculum – Care of the Acutely Ill. Documentation of learning in OOH sessions -linking that to chapter 7 of the GP curriculum – Care of the Acutely Ill. One trainee documented 2 OOH sessions in two months prior to panel. A total of only 3 patients had been seen in these two sessions. This was considered to be unsatisfactory. One trainee documented 2 OOH sessions in two months prior to panel. A total of only 3 patients had been seen in these two sessions. This was considered to be unsatisfactory. Clustering/demand Clustering/demand

21 OOH cont Advise to document for each OOH The type of session – telephone triage, visiting doctor, base doctor The type of session – telephone triage, visiting doctor, base doctor The number of patients seen. The number of patients seen. A selection of the most interesting patients A selection of the most interesting patients The significant learning points and, The significant learning points and, Link these to the curriculum(esp care acurtely ill) Link these to the curriculum(esp care acurtely ill)

22 Naturally Occurring Evidence 1) Significant Event Analysis – 3 per 6 month post – file under Significant Event Analysis 1) Significant Event Analysis – 3 per 6 month post – file under Significant Event Analysis 2) Reflection on key learning points from each post – file in Reading – expected length 1 side A4 2) Reflection on key learning points from each post – file in Reading – expected length 1 side A4 3) Audit or QoF review or NPMS Project – x1 in 3 year training – file in Audit/ Project 3) Audit or QoF review or NPMS Project – x1 in 3 year training – file in Audit/ Project

23 NOE (cont) 4) Case study – 2 per year – file in Audit 4) Case study – 2 per year – file in Audit 5) Statement of Total Leave Taken – file in courses/certificates 5) Statement of Total Leave Taken – file in courses/certificates 6)Attendance Record at VTS teaching – supplied by VTS administrator 6)Attendance Record at VTS teaching – supplied by VTS administrator 7) Complaints and adverse incident reports – if any. File in Professional Conversations 7) Complaints and adverse incident reports – if any. File in Professional Conversations

24 Learning Log Role of the Learning Log Your learning log is your personal learning record. Log entries that you choose to ‘share’ can be read and commented on by your clinical or educational supervisor. These entries will contribute to the evidence that your educational supervisor will consider at your 6 monthly educational supervision meetings. Your learning log is your personal learning record. Log entries that you choose to ‘share’ can be read and commented on by your clinical or educational supervisor. These entries will contribute to the evidence that your educational supervisor will consider at your 6 monthly educational supervision meetings. Maintaining your log is therefore just as important as completing your formal assessments. Maintaining your log is therefore just as important as completing your formal assessments. Log entries can contribute to your evidence in two ways. They determine your curriculum coverage and contribute to the evidence in the 12 competency areas if they are ‘validated’. Log entries can contribute to your evidence in two ways. They determine your curriculum coverage and contribute to the evidence in the 12 competency areas if they are ‘validated’.

25 Learning Log When linking to curriculum headings take care to look at the learning objectives in the relevant curriculum statement and ask yourself: - does my log entry provide evidence that relates to the specific learning objectives in this statement? - does my log entry provide evidence that relates to the specific learning objectives in this statement? Although in many cases an individual entry may merit more than one curriculum heading, try to ensure that you don’t choose inappropriate ones. Although in many cases an individual entry may merit more than one curriculum heading, try to ensure that you don’t choose inappropriate ones. Greater reflection and ability to validate against competences is likely with clinical encouters;SEA rather than lectures or tutorials( which can still be useful for curriculum coverage) Greater reflection and ability to validate against competences is likely with clinical encouters;SEA rather than lectures or tutorials( which can still be useful for curriculum coverage)

26 Log entries Log entries should on average show: evidence of critical thinking & analysis, describing own thought processes evidence of critical thinking & analysis, describing own thought processes self awareness demonstrating openness and honesty about performance and some consideration of feelings generated self awareness demonstrating openness and honesty about performance and some consideration of feelings generated evidence of learning, appropriately describing what needs to be learned, why & how evidence of learning, appropriately describing what needs to be learned, why & how appropriate linkage to curriculum appropriate linkage to curriculum demonstration of behaviour that allows linkage to one or more competency areas demonstration of behaviour that allows linkage to one or more competency areas

27 Gibbs Reflective Cycle

28 Reflection template

29 Reflective Writing: role and functions To maximise the effectiveness of experiential To maximise the effectiveness of experientiallearning To evaluate one’s practice To evaluate one’s practice To promote critical thinking To promote critical thinking To facilitate the integration of theory with practice To facilitate the integration of theory with practice To generate theory To generate theory To evaluate a learning activity To evaluate a learning activity To demonstrate that learning has taken place To demonstrate that learning has taken place

30 Reflective writing: description What were the significant background factors to this experience? What were the significant background factors to this experience? Describe the experience Describe the experience – Sequence of events – Actions – Observations What essential factors contributed to the experience? What essential factors contributed to the experience?

31 Reflective Writing: analysis What were the consequences of my actions? What were the consequences of my actions? How do I feel about the experience? How do I feel about the experience? What factors influenced my decision and actions? What factors influenced my decision and actions? What knowledge influenced my decision and actions? What knowledge influenced my decision and actions?

32 Reflective Writing: evaluation What went well; what went badly? What went well; what went badly? Could I have dealt better with the situation? Could I have dealt better with the situation? What other choices did I have? What other choices did I have? What would have been the consequences of What would have been the consequences of acting on these other choices?

33 Reflective Writing: action plan How should I change my practice? How should I change my practice? Behaviour Behaviour Standards, procedures Standards, procedures Should I suggest changes in policy? Should I suggest changes in policy? What constraints may exist? What constraints may exist? Review changes and their effects!

34 Reflective Writing: new perspectives What have I learnt from this experience? What have I learnt from this experience? How has this experience affected my thinking? How has this experience affected my thinking?

35 Validation Why does validating entries matter? The learning log helps to balance the educational portfolio and provides additional evidence of learning and progression, capturing evidence from learning opportunities in the workplace. The learning log helps to balance the educational portfolio and provides additional evidence of learning and progression, capturing evidence from learning opportunities in the workplace. There is no limit to the number or quality of entries that trainees can make in their eportfolios, There is no limit to the number or quality of entries that trainees can make in their eportfolios, but not all of them can or should be validated. For example, attendance at VTS seminars. Entries which cannot be validated may still be useful for curriculum coverage. Once validated, each entry then forms part of the trainee’s evidence of progression. Once validated, each entry then forms part of the trainee’s evidence of progression. Entries are validated against the 12 areas of the competency framework. Entries are validated against the 12 areas of the competency framework.

36 Validation What does validating an entry mean? the entry fulfils the following two requirements: a) It addresses one or more of the 12 competence areas a) It addresses one or more of the 12 competence areas b) It demonstrates meaningful reflection b) It demonstrates meaningful reflection By validating a log entry you are confirming that this is valid evidence of learning in an appropriate competency area. You are not making a judgement about whether that competence has been achieved. By validating a log entry you are confirming that this is valid evidence of learning in an appropriate competency area. You are not making a judgement about whether that competence has been achieved. Who Reads entries and validates-ES or CS? Who Reads entries and validates-ES or CS?

37 Competence AreaMSFPSQCOTCbDCEXCSR Communication and consultation skillsxxx xx Practising holistically xxx x Data gathering and interpretationx xxxx Making a diagnosis/decisionsx xxxx Clinical managementx xxxx Managing medical complexity xxx Primary care admin and IMT x x Working with colleagues and in teamsx x x Community orientation x x Maintaining performance, learning and teachingx xx Maintaining an ethical approachx x x Fitness to practise x x x

38 Example of a good log entry Current Selections Professional competences 4 Making a diagnosis Professional competences 4 Making a diagnosis Professional competences 5 Clinical management Professional competences 5 Clinical management Curriculum statement headings 8 Care of children and young people Curriculum statement headings 8 Care of children and young people Curriculum statement headings 15 Cardiovascular problems Curriculum statement headings 15 Cardiovascular problems

39 What Happened? A 2 week old baby was brought to the surgery with a history of a few days of coryzal symptoms and poor feeding. The parents thought that the baby had a viral infection. I examined the baby and thought that she had some crepitations on the left lung. She was also tachypnoeic and tachycardic. I was concerned about this baby as she was not feeding well and the parents mentioned that she had been more sleepy than usual. I discussed the case with the paeds registrar on call, who said it sounded like bronchiolitis and suggested conservative management. However I stressed that I felt this baby needed to be assessed as she was not well and eventually the paeds registrar agreed to see the child. A 2 week old baby was brought to the surgery with a history of a few days of coryzal symptoms and poor feeding. The parents thought that the baby had a viral infection. I examined the baby and thought that she had some crepitations on the left lung. She was also tachypnoeic and tachycardic. I was concerned about this baby as she was not feeding well and the parents mentioned that she had been more sleepy than usual. I discussed the case with the paeds registrar on call, who said it sounded like bronchiolitis and suggested conservative management. However I stressed that I felt this baby needed to be assessed as she was not well and eventually the paeds registrar agreed to see the child.

40 What happened subsequently While in the children’s emergency department, the baby had a cardiorespiratory arrest, was resuscitated and transferred to a hospital in London. She had coarctation of the aorta and left basal consolidation of the left lung. She was subsequently operated on and is now progressing well in intensive care. While in the children’s emergency department, the baby had a cardiorespiratory arrest, was resuscitated and transferred to a hospital in London. She had coarctation of the aorta and left basal consolidation of the left lung. She was subsequently operated on and is now progressing well in intensive care.

41 What did you learn? To be aware that accurate assessment of a baby is vital as they can be seriously unwell and only display non-specific symptoms. I am very glad that I insisted on sending the baby to hospital despite the objections of the paediatric registrar. It felt very awkward at the time, but it has taught me to trust my judgement and I will find it easier to be more assertive next time To be aware that accurate assessment of a baby is vital as they can be seriously unwell and only display non-specific symptoms. I am very glad that I insisted on sending the baby to hospital despite the objections of the paediatric registrar. It felt very awkward at the time, but it has taught me to trust my judgement and I will find it easier to be more assertive next time

42 What will you do differently in the future? On reflection, the baby arrested while she was in the CED. The parents took her there by car. I could have arranged a blue light ambulance to take her to hospital. However, although I thought she was unwell, I did not expect such a serious underlying problem and she was certainly not looking like a baby that was about to arrest. On reflection, the baby arrested while she was in the CED. The parents took her there by car. I could have arranged a blue light ambulance to take her to hospital. However, although I thought she was unwell, I did not expect such a serious underlying problem and she was certainly not looking like a baby that was about to arrest.

43 An example of a good reflective log entry What further learning needs did you identify? What further learning needs did you identify? How & when will you address these? How & when will you address these? Record created Record created Comments Comments Need to refresh my memory re: congenital heart disease & its presentation in neonates. GP notebook & paediatric textbook, in the next couple of weeks. 15/12/ :24:32 [16/12/ :50:36] (Educational Supervisor) You did extremely well here, recognising the baby was not well and sticking by your own clinical judgment when a more specialist doctor was suggesting an alternative. This can be a difficult thing to do and in this case saved this baby’s life. Well done.

44 Example of a good log entry Current Selections Professional competences 4 Making a diagnosis Professional competences 4 Making a diagnosis Professional competences 5 Clinical management Professional competences 5 Clinical management Curriculum statement headings 8 Care of children and young people Curriculum statement headings 8 Care of children and young people Curriculum statement headings 15 Cardiovascular problems Curriculum statement headings 15 Cardiovascular problems

45 An example of a good reflective log entry How does this compare with your entries. How does this compare with your entries. Are the curriculum statements valid? Are the curriculum statements valid? What can you learn form this? What can you learn form this?

46 E portfolio Look at own entries in groups of 3. Look at own entries in groups of 3. How does your reflection compare against the criteria? How does your reflection compare against the criteria? Do you think these are correctly linked? Do you think these are correctly linked? Could these be validated against competences? Could these be validated against competences? How could you improve your entries? Provide examples. How could you improve your entries? Provide examples.

47 Reflection and validation exercises Eportfolio j smith2 Eportfolio j smith2 Password jsmith2 Password jsmith2 Dr Pauline example Dr Pauline example Can use dummy system Can use dummy system The username is trainer1 The password is rcgp The username is trainer1 The password is rcgp

48 PLENARY ANY LEARNING TO SHARE ANY LEARNING TO SHARE FEEDBACK FORMS FEEDBACK FORMS FUTURE LEARNING NEEDS FUTURE LEARNING NEEDS


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