Director of Education and Training
Welcome to the August 2021 training update for supervisors and facilities, and the start of the 2021.2 training term.
I would like to start by thanking all of you for the contributions you are making to Australian health care at this time. When we stop and take breath and think about the enormity of what we have achieved over the past 18 months it is undeniably gobsmacking. Even if you haven’t been at the absolute coalface, everyone is contributing in some way, shape or form to ensure that we make it through this global pandemic. I think something we will look back on in years to come and marvel at how we managed to pull through. That’s general practice!
COVID-19 FAQs
In response to the changing environment in Greater Sydney with the COVID-19 pandemic we made significant updates to our COVID-19 FAQs. This is to let you know of options available to you and your registrar/s if there are impacts from lockdown and/or isolation rules. Please take a look at the latest updates and keep an eye out for future updates as well.
Practice orientation and direct observation during COVID-19
COVID-19 restrictions bring new challenges to registrars starting in your practice. Have you thought about how you might manage a remote or semi-remote orientation? If the registrar is in their first term they might need more time to get used to COVID-19 protocols in the community and may also need upskilling in telehealth and video-health. Is a telehealth supervision plan required?
We have also recently sent out some information about how to assess registrars during COVID-19, if you missed this take a look at the updated GP supervisor guide to assessing competency using direct observation during the COVID-19 pandemic to help you undertake the direct observation required for the Initial Observation Sessions (IOS) in weeks 1-4 and subsequent competency assessments.
Wellbeing
I’m pleased to update you on the work of the GP Synergy Wellbeing Committee, which I chair. The committee consists of registrar, supervisor and staff representatives and meets monthly. The work of the committee involves reviewing the Every Doctor Every Setting Framework and is creating actions around this framework for GP Synergy to work towards to improve the wellbeing of doctors in training. There are a lot of fantastic ideas and work is progressing well. The Committee will be providing an official report in September so watch this space.
Transition
As we work with ACRRM and RACGP towards transition to profession-led training, GP Synergy is committed to quality general practice education and training (as below). In fact, we are committed to ensuring that registrars, practices and supervisors are impacted as little as possible. We want to ensure that you still get backup and support when you need it to help you and the practice assist the registrar to achieve their fellowship goals.
Please reach out at any time to your local team members for support and, if at any time you wish to feedback to me, please do so at vanessa_moran@gpsynergy.com.au.
Vanessa Moran | Director of Education and Training, Deputy Chief Executive Officer
COVID-19
We continue to circulate information concerning the impact of COVID-19 on the training program, including the ongoing COVID-19 situation. This includes FAQs and changes to our face-to-face education program.
Applications for the 2022 final intake for ACRRM are open 9 - 30 August 2021 and for RACGP 30 August - 21 September 2021.
Don't forget that the 2021.2 supervisor professional development calendar is available for both regional and statewide workshops. Due to COVID-19 there have been some updates made to the calendar.
Do you know a registrar, supervisor, practice manager or GP Synergy team member who shows excellence and commitment to GP training? The GP Synergy award nominations open soon in GPRime!
2021.2 new term reminders
At the start of every new training term there are a number of important activities for supervisors and practice staff to undertake as part of welcoming registrars to the practice, including:
- Orientate the registrar into the practice.
- Review the registrar's Pre-Term Assessment Report (PTAR).
- Directly observe the registrar consulting and complete an Initial Observation Session (IOS) assessment in GPRime (IOS is not routinely required in Extended Skills, Mandatory Elective and Extension Assessment terms). Refer to the GP supervisor guide to assessing competency using direct observation during the COVID-19 pandemic.
- Discuss your registrar’s learning needs/learning plan and develop your supervision plan (including high-risk presentations) with the registrar.
Medical Educator Supervisor Portfolio (MESP) update
Supervision in general practice – a MESP’s reflection
Most GPs would agree that the current challenges of general practice have never been greater. These of course affect how we support and teach our registrars. For me as a GP Synergy medical educator, I find that without face-to-face teaching for the registrars from either CTVs or GP Synergy workshops, my role as a supervisor seems even more important to ensure our registrar’s examination and procedural skills have achieved competency.
On the upside though, I never tire of passing on the wisdom of years of experience of general practice as a GP supervisor to our younger registrars. They always have lots more enthusiasm and often up-to-date knowledge on evidence-based guidelines and this inevitably rubs off.
Supervisor education
I enjoyed recently seeing and sharing with supervisors for the first face-to-face workshop for a long time in Coffs Harbour. Feedback from the workshop was overwhelmingly positive. There were many positive comments in our evaluation about the value of the short teaching tip vignettes from fellow supervisors and how they provided a great trigger for discussion to follow. Hearing different views of how each teaching tip might or might not work or how it might be modified for individual supervisors was invaluable.
Currently we are in the process of recording more supervisors who have a teaching tip ready to share. We anticipate all the tips recorded will be available for supervisors to access online later this year.
Just as valuable to me at the recent workshop was the informal interaction with colleagues at meal and tea times. Chatting generally about work, families, and our personal lives and how we juggle all this allowed for the rekindling of old friendships. Meeting some of the newer supervisors reassured me that GP practice supervision is in good hands in the long term despite the changing goal posts that are looming over the next couple of years for us.
Currently I am excited to be working with a couple of fellow MESPs to develop a supervisor masterclass for next year. This will involve small groups of supervisors using some of the Balint principles to explore the challenges that we may encounter in the registrar supervisor relationship. Look out for more information about this exciting opportunity in coming months.
Looking forward to continuing my role supporting supervisors into the future.
Dr Rob Trigger | Medical Educator and MESP North Coast
Supervisor Toolkit hot tip:
I have found it helpful to look at the competency grid together with my registrar when giving feedback after competing their IOS or CA. Take a look at the toolkit for more information on the competency grid and formative assessments. The link to the Supervisor Toolkit can be found on the top toolbar in GPRime.
Supervisor Snippets
The importance of connections
Dr Sara Townend, Senior Medical Educator and Medical Educator with Supervisor Portfolio for Central, Eastern and South Western Sydney, discusses her 14 days in isolation, which prompted her to reflect on the value and importance of connections as a GP supervisor during the pandemic.
If you're a rural GP supervisor don't forget that GP Synergy, and other organisations, have a range of supports, financial subsidies and incentives to assist rural GP registrars.
Since the start of the year, our Research and Evaluations Unit, and their collaborators, have been involved in 15 research papers that have been published or currently awaiting publication.
GP Synergy is pleased to be able to support the NSW Refugee Health Service by opening our Liverpool office for use as a vaccination hub for refugees.
Meet one of our rural generalist registrars
Dr Vanessa Hewitt is a rural generalist working in Grafton where she splits her time between GP training, working in the emergency department of Grafton Hospital, teaching and mentoring medical students, and enjoying a few laughs over regular pub trivia.
GP Synergy’s membership of Supply Nation reinforces our commitment to diversity both within our workforce and procurement processes through support of Aboriginal and Torres Strait Islander businesses.
Congratulations to GP Synergy academic registrar Dr Katie Fisher on her project that has won the 2021 RACGP Foundation Charles Bridges-Webb Memorial Award!
General practice registrars’ clinical uncertainty, and in-consultation information and assistance-seeking
Evidence from the GP Synergy NSW & ACT Research and Evaluation Unit – each month we present findings from our work that may be of interest to registrars and their supervisors.
Uncertainty is unavoidable in clinical practice, particularly in general practice. Undifferentiated illness and presentation earlier in the course of illness are more common in generalist practice than in specialist settings, increasing levels of uncertainty. Clinical uncertainty can adversely affect clinicians (e.g. professional satisfaction and burnout), and health systems (e.g inappropriate test-ordering). We hypothesized that registrars’ tolerance of uncertainty may influence decisions to seek information and assistance during consultations, especially from their supervisors.
We performed an analysis of ReCEnT project data to establish if registrars’ responses to uncertainty were associated with their recourse to in-consultation information, advice, or assistance.
The outcome factors in our analyses (using logistic regression) were whether a registrar sought in-consultation information or assistance from (i) their supervisor or (ii) an electronic or paper-based source.
Our measures of responses to uncertainty were the four independent subscales of the Physicians’ Reaction to Uncertainty (PRU) instrument: ‘anxiety regarding diagnosis/management’; ‘concern about a bad outcome’; ‘reluctance to disclose uncertainty to patients’; and ‘reluctance to disclose mistakes to physicians’.
We had data on this issue for 589 registrars and 70,412 consultations.
On multivariable analysis, scores on the two ‘affective’ PRU subscales ‘anxiety regarding diagnosis/management’ (OR 1.03; p = 0.003) and ‘concern about a bad outcome’ (OR 1.03; p = 0.008) were significantly associated with seeking supervisor assistance. There was no association with the ‘behavioural’ subscales ‘reluctance to disclose uncertainty to patients’ and ‘reluctance to disclose mistakes to physicians’.
None of the PRU subscales were significantly associated with information-seeking from electronic or hard copy sources.
We do not know from this analysis whether registrars’ seeking assistance resolved or attenuated, for the index problem, their anxiety or concern. But we think it likely that in-consultation assistance-seeking from their supervisor may enhance registrars’ tolerance of uncertainty. It may also, however, have implications for supervisor workload. Further evidence for how supervisors can best, and most efficiently, foster their registrars’ tolerance of uncertainty is needed.
Magin P, Cooke G, Tapley A, Wearne S, Holliday E, Morgan S, Ball J, Spike N, van Driel M. General practice registrars’ clinical uncertainty, and in-consultation information- and assistance-seeking. 2021. Health Education in Practice: Journal of Research for Professional Learning. 4(1). 5-30. doi: 10.33966/hepj.4.1.14765
If you have any questions about the analyses or the study, please contact Parker Magin.
GP Synergy PD calendar
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External activity noticeboard
Explore a list of activities and online modules. This includes modules on children's health, dermatology, mental health, prescribing and more!
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