Director of Supervisor Education update
GP supervisors are inspiring
In this report I would like to focus on the amazing contributions made by the GP supervisors and registrars of GP Synergy, along with their colleagues and staff, in caring for our communities through very tough times.
GP Synergy supervisors and registrars have been dealing with an array of disasters over the last few months, whether it be bushfire or drought, floods or storms, or now COVID-19, all the while continuing to deal with the day-to-day concerns of our patients.
At the first GP Synergy supervisor workshop of the year, held in Batemans Bay on 22 February, Drs Allison Miller and James Best had the opportunity to hear first-hand from GP supervisors in the South Eastern subregion so badly affected by bushfires over the summer. They heard descriptions of GPs and their staff going above and beyond in so many ways to continue to provide care for their patients in dangerous conditions with little or no recognition or integration into disaster management.
All of this is an illustration of the incredible role general practice plays in Australia. I am appreciative of all those supervisors who have been providing much needed services to devastated communities across NSW and the ACT for many months now, while continuing to support their registrars to progress in their training and learn from these challenging situations. Thank you – you are doing amazing work.
COVID-19 is having an additional significant impact on supervisors, registrars and their practices, with extra workloads and uncertainty on many fronts. Helping to maintain a positive learning experience for registrars in this stressful and changing environment can be very difficult.
GP Synergy continues to be involved in supporting supervisors, registrars and practices through a variety of means. Training related advice in the context of COVID-19 is being regularly reviewed and updated with the COVID-19 FAQs available on GPRime and emailed to you on a regular basis. We know that you are all facing unique challenges with different concerns so if you need our assistance please get in touch with your PLSO, Regional Head of Education, myself, or the Director of Education and Training.
Go to Need some help? to find contact details.
What are the impacts of COVID-19 on GP Synergy supervisor education?
Our goals for a variety of upcoming supervisor events in the 2020.1 term, including the annual 2020 Supervisor Development Day, were to continue to foster interactions like the recent workshop in Batemans Bay and provide opportunities for sharing stories and promoting collegiality, offering chances for supervisors to gather together and connect.
The impact of COVID-19 now means that this kind of face-to-face interactive learning is not possible for several months at least. We are reviewing all our supervisor educational events for 2020.1 and will keep you updated as modified plans are finalised. Some events will need to be cancelled, some postponed or presented in an online format.
Unfortunately, this years Supervisor Development Day, scheduled for 27 June, has been cancelled. We are exploring options for a session that was originally planned for the Supervisor Development Day, 'Supporting supervisors when disasters strike', to be presented online. We are also looking at other flexible online options to assist supervisors to meet PD requirements in 2020. More information will be forthcoming over the next few weeks.
I thank you all for your ongoing commitment to training registrars and hope it is not too long before we can resume our face-to-face supervisor education.
Dr Sarah Gani | Director of Supervisor Education NSW & ACT
We have been circulating information concerning the impact of COVID-19 on the training program. This includes FAQs and changes to our face to face education program.
Re-enrolment and term placement
If you are seeking a registrar in the second half of 2020 (2020.2 term), key dates are as follows:
- 9 March - 31 March – practices to update training capacity on GPRime2 for the 2020.2 term
- 31 March - 7 April – registrar re-enrolment
- 15 April – practices reminded of 2020.2 training capacity caps
- 16 April – registrars going into a GP term in 2020.2 notified of grouping allocation
- 20 April – 2020.2 term placement lists open for application.
We will be hosting a term placement webinar for practice staff and supervisors new to term placement. The webinar will provide an overview of the term placement process including groupings, updating your practice profile, selection techniques for selecting registrars, contracts and registrar negotiation.
23 March 12:30pm | Register here.
I have often reflected that the training of a GP registrar is unique and can be somewhat lonely. In the hospital setting, the trainee is part of a team who share responsibility for each patient admitted under the name of their consultant. In general practice, from day one the registrar is fully responsible for the care of each patient they see, alone behind a closed door.
There is a supervisor to call upon if needed, but how often should they call? Many will confide that they worried initially about calling too often, interrupting the supervisor who had patients of their own to see. Registrars worry about being seen as 'too needy' but weigh this concern against the worry that they will make a mistake.
This year has seen the introduction of Programmatic Assessment, with the change to the Initial Observation Session (IOS) in the first four weeks of term for all registrars except those in extension awaiting fellowship terms. While we have always been encouraged to sit in with our registrars, this now formalises direct observation as part of the educational program. For more information about the IOS go to the 'Quick Links and Subscriptions' tab on GPRime and click on 'Initial Observations Sessions (IOS)'.
Observing the registrar in consultation with patients has many benefits. A registrar presenting a case may say everything right, but without watching them relay that information to a patient, how can we know if they are communicating effectively? For example, many registrars are unaware of how often they use technical medical language which may not be easily understood by the patient. This is a difficult issue to pick up when discussing a case without the patient present, as we are comfortable with the use of medical terminology between colleagues.
Having a supervisor sit in can also help reduce that sense of isolation for the registrar. Being able to talk through a case in real time, with someone who saw the whole interaction, can provide valuable feedback and also reassurance. It can help us set up a culture of learning, in which the registrar feels comfortable to open up about their areas of uncertainty.
At our recent supervisor webinar on programmatic assessment we polled the audience to ask ‘Did the IOS help you better understand your new registrar?’. Of those supervisors who had already completed the IOS (113) 81% answered 'yes' and 13% answered 'maybe', a very encouraging response supporting the value of early direct observation.
For 2020 one of our core topics focuses on this important aspect of GP training. Entitled 'What’s Going On In There?', this session focuses on consultation analysis and aims to provide supervisors with some skills for assessing their registrar while sitting in on consultations. This topic has been presented and well-received at face-to-face workshops in Batemans Bay and Penrith in recent weeks, prompting thoughtful and interesting discussion. In light of the impact of COVID-19 on our supervisor education program over the next few months we are looking at options to deliver this session online in future. Look out for updates to the program over the next few weeks.
Dr Claudia Long | Medical Educator
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Registrars’ prescribing of LARC - encouraging evidence of uptake of the most effective form of contraception
Evidence for practice – findings from the GP Synergy Research and Evaluation Unit
Long-acting reversible contraception (LARC) includes implants, hormonal intrauterine devices (IUDs), non- hormonal IUDs and medroxyprogesterone injectables. It is the most effective form of contraception, but is used in Australia less frequently than is desirable. Uptake of LARC prescribing by early-career general practitioners (including registrars) has important implications for community reproductive health. During her academic post in 2018, Dr Rachel Turner (now a medical educator with GP Synergy) worked with our NSW & ACT Research and Evaluation Unit to investigate Australian GP registrars’ LARC prescribing.
In the first phase of her project Rachel and the team conducted a cross-sectional analysis of 2010-2017 data from the Registrar Clinical Encounters in Training (ReCEnT) study. The good news is that prevalence of LARC prescribing by Australian GP registrars is higher than has been estimated previously in established GPs. A number of factors were associated with prescribing LARC, including the registrar having postgraduate qualifications in reproductive health. LARC prescribing practice also differs according to rurality and relative socioeconomic disadvantage of the registrar’s practice location.
*Turner R, Tapley A, Sweeney S, Davey A, Holliday E, van Driel M, Henderson K, Ball J, Morgan S, Spike N, Fitzgerald K, Magin P. Prevalence and associations of prescribing of Long Acting Reversible Contraception by GP Registrars: a secondary analysis of ReCEnT data. 2020. BMJ Sexual & Reproductive Health.
2020 rural doctor refresher conference - now digital
The NSW Rural Doctors Network and the Rural Doctors Association (NSW) 2020 Refresher Conference will now be delivered online, over one day - Saturday 28 March. It's free to attend.
Everyone deserves the right to a healthy future and the opportunities this affords. However, many of Australia’s First Peoples are denied the same access to healthcare that other Australians take for granted. National Close the Gap Day is a day of action to pledge support for achieving health equality by 2030.
GP Synergy PD calendar
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