Learning What do we want to learn…. ….and how do we do it?

Think about what youre going to have to learn on the VTS

Bradford VTS aims Knowledge of clinical medicine Knowledge of clinical medicine Understanding of health care for populations Understanding of health care for populations Broad understanding of medical ethics Broad understanding of medical ethics Evidence based medicine Evidence based medicine Preventive medicine Preventive medicine Patient centred medicine Patient centred medicine Use time effectively Use time effectively Good communication skills Good communication skills Organise an efficient and caring practice Organise an efficient and caring practice Work effectively in teams Work effectively in teams Audit own performance Audit own performance Able to adapt to change Able to adapt to change Plan continuing professional development Plan continuing professional development Balance demands of work and personal life Balance demands of work and personal life Tolerate uncertainty Tolerate uncertainty Value diversity Value diversity

MRCGP: 17 domains Knowledge: factual, evolving, evidence base Knowledge: factual, evolving, evidence base Evaluating and using knowledge: critical appraisal, application of knowledge Evaluating and using knowledge: critical appraisal, application of knowledge Problem solving: general, specific Problem solving: general, specific Personal care for patients Personal care for patients Communication: written, spoken Communication: written, spoken Practice context: practice issues, regulatory framework Practice context: practice issues, regulatory framework Broader context: medicopolitical/legal/social, cultural/ethnic Broader context: medicopolitical/legal/social, cultural/ethnic Values/attitudes: ethics, commitment to maintaining standards, self awareness Values/attitudes: ethics, commitment to maintaining standards, self awareness

Think about how you learned something

Experiential learning Experience Observe and reflect Make abstract concepts and generalisations and generalisations Test implications of concepts in new situation

The reflective practitioner The professional practitioner reflects on their knowledge whilst engaging in activity. This enables them to adapt to the potentially unique context or problem with which they are faced (Schon, 1983) The professional practitioner reflects on their knowledge whilst engaging in activity. This enables them to adapt to the potentially unique context or problem with which they are faced (Schon, 1983) Professional education should provide people with the opportunity to reflect on their practice and identify the theories embedded in their routine work (Coles, 1994) Professional education should provide people with the opportunity to reflect on their practice and identify the theories embedded in their routine work (Coles, 1994)

Constructivism (3 Cs) Construction - you build your knowledge on what you know already Construction - you build your knowledge on what you know already Context - important both in learning and in applying it Context - important both in learning and in applying it Collaboration - work together and explore each others perspectives: knowledge varies across contexts and cultures Collaboration - work together and explore each others perspectives: knowledge varies across contexts and cultures

Adult learning Learning whats important to you Learning whats important to you Applicable in the real world Applicable in the real world Learner, not teacher, is responsible Learner, not teacher, is responsible Learning is self directed Learning is self directed Learning is continuous, adapts to new situations Learning is continuous, adapts to new situations

Think about feedback

Definition of feedback Information about performance or behaviour which leads to action to affirm or develop performance or behaviour - i e Information about performance or behaviour which leads to action to affirm or develop performance or behaviour - i e To affirm what you do well To affirm what you do well To help you develop in areas you do less well To help you develop in areas you do less well

Useful feedback Is well timed (enough time, full attention, calm, prepared) Is well timed (enough time, full attention, calm, prepared) Involves mutual goodwill Involves mutual goodwill Is balanced Is balanced Is specific Is specific Is descriptive Is descriptive Can lead to change (if change required) Can lead to change (if change required)

Receiving feedback May need to ask May need to ask Listen carefully Listen carefully Ask for clarification, examples, alternatives Ask for clarification, examples, alternatives Give it time to sink in Give it time to sink in Think about your relationship with the giver Think about your relationship with the giver Dont let small criticisms devastate you Dont let small criticisms devastate you Dont be defensive Dont be defensive

Giving feedback GP trainers value feedback GP trainers value feedback Be balanced Be balanced Be specific Be specific Make suggestions for change Make suggestions for change Dont wait till youre about to leave Dont wait till youre about to leave

Think about learning from each other

Learning from each other Feedback Feedback Facilitating reflection Facilitating reflection Sharing knowledge Sharing knowledge Sharing resources Sharing resources Teaching skills Teaching skills Different perspectives Different perspectives

Some learning tools Problem case analysis - things you know you dont know Problem case analysis - things you know you dont know Random case analysis - issues you havent identified Random case analysis - issues you havent identified Critical incident analysis - learning from mistakes and near misses Critical incident analysis - learning from mistakes and near misses PUNs - patient unmet needs PUNs - patient unmet needs DENs - doctors educational needs DENs - doctors educational needs

Summary Theres a lot to learn Theres a lot to learn Knowledge is only part of it Knowledge is only part of it Even knowledge isnt straightforward Even knowledge isnt straightforward There are many ways to learn There are many ways to learn Most of your learning will be from yourselves, each other and your patients, not your teachers Most of your learning will be from yourselves, each other and your patients, not your teachers Understanding learning helps you do it more effectively Understanding learning helps you do it more effectively

Recording educational experience - why? As evidence of learning (for Trainers report etc, and for appraisal) As evidence of learning (for Trainers report etc, and for appraisal) To enhance learning To enhance learning To plan future learning To plan future learning To reflect To reflect

Recording educational experience - how? Log book with tick boxes Log book with tick boxes Reflective diary Reflective diary Critical incidents Critical incidents Cases with learning points Cases with learning points Electronic diary Electronic diary exchange with trainer exchange with trainer

Whatever method you choose Record it somehow Record it somehow and choose something and choose something (or several things) (or several things) which works for YOU which works for YOU