1. Teaching Exchange From PUNS and DENS To RUNS and TENS! Thanks to Fiona Nicol, Rod Shaw and Chris Creber Edinburgh.

2. A Way of analysing tutorials. Registrars Unmet NeedS (RUNS) Are they an indication of Trainers Educational NeedS (TENS)

3. Decision making during the tutorial… Influence the direction in which the tutorial goes And therefore what the Registrar learns. Does this meet their agenda? Do we address their needs rather than their wants? Do we avoid knowledge gaps / areas of need – for a host of reasons?

4. RUNS and TENS Using the PUNS and DENS model to analyse the tutorial. Maybe access the unknown unknowns – Johari window! How – analyse a tutorial to look for RUNS and TENS

5. Analysis of tutorial – objectives… Analyse video using RUNS Identify the multiple ways the tutorial could develop Raise awareness of the path the tutorial took. Was that the registrars most important need? What stopped trainers tackling certain areas? Identify ways of addressing this i.e. identify TENS Does this method help over other video analysis techniques?

6. Instructions…. View first few minutes of video to identify Registrars main problem. Individually write all Registrars potential unmet needs on the form provided as you watch the tape. Now as an individual categorise each RUN into type….

7. Types… Clinical Knowledge – C Non Clinical – N Skill – S Attitude – A Organisation - O

8. In groups… Share each RUN and its category. Prioritise these for potential TENS Then we will view the next ten minutes of the tape and see what actually happened…. The aim – to identify and discuss strategies to help the trainer meet TENS

9. TENS What happened? What did not happen that might have helped the Registrar? Any factors influencing this? E.g. Trainer lack of confidence? Time? awareness of the problem at the time? Knowledge of the problem? Different prioritisation of RUNS during the tutorial?

10. What they found! Stimulated a lot of discussion- different and fun to use. Easy to identify a lot of RUNS True or not true RUNS – too many to explore them all. General consensus about the RUNS. But…..

11. What they found… Simply categorizing all the RUNS not helpful and time consuming. 90 minutes not long enough to fully explore the TENS More time needed for Trainers to reflect on areas not explored and why? Develop list of TENS to address with Registrar. Look for common themes.

12. Use of the tool.. Used by single trainer or group. Allow Trainer to reflect on choices of direction for the tutorial…. Does this really meet the RENS? Or simply avoid the TENS??