Regional Head of Education update
Thank you for your invaluable contribution to general practice training! I am passionate about training quality GPs who will have a positive impact on the health of their local community. It takes a large and dedicated team to achieve this goal and you are an integral part of that team.
Within the Central, Eastern and South Western Sydney subregion we are training 354 registrars, including 10 who are part of the Australian Defence Force, five who are Aboriginal and Torres Strait Islander and two undertaking an academic post which involves primary care research. This year 66 registrars completed their training and achieved fellowship
In our region we have 532 accredited supervisors and 290 general practice and community extended skills practices, including one Aboriginal community controlled health service. As an apprenticeship model of training, much of registrar learning occurs in general practice, seeing patients, seeking your assistance, observing you as a role model and learning how each practice is managed. Consistently registrars tell us what they value most is a supportive practice environment with an approachable and interested supervisor. I encourage you to provide constructive feedback to your registrars on their progress this term, including what they can continue to work on. Both registrars and medical educators find these specific comments the most helpful of all. Registrars also provide valuable feedback on their practice experience.
2020 will see the gradual introduction of a more coordinated approach to assessing your registrars, looking at the bigger picture of competence as a GP. Supervisors will continue to play an important role in this. The aim is for assessment to be more meaningful, useful and usable for both the registrar and supervisor. Please do get in touch with us if you have any concerns regarding your registrar as early intervention is best.
Our supervisor professional development program continues to go from strength to strength with strong attendance and positive feedback. We provided workshops across multiple sites within the subregion, including a new combined workshop with the Nepean, Western and Northern Sydney supervisors held every semester. It has been great meeting many of you at these workshops. I love the buzz of conversation as supervisors share their stories and gain support from their peers on the topics under discussion.
As Medical Educators (ME) we support registrars throughout their training path and are involved in coordinating and teaching at registrar educational release workshops as well as clinical teaching visits. It is a joy to see the registrars progress through training developing skills. I particularly value the dedication and enthusiasm of the wonderful ME team. During the year, a few staff have left the team to pursue other ventures and we have welcomed new staff. I’d like to thank the outgoing staff for their contribution to medical education and warmly welcome the new members to the team.
It takes a large team to deliver registrar training and I’d like to extend a large thank you to our Practice Liaison and Support Officer, Alyce Piggott, medical educators with supervisor portfolios, the supervisor liaison officer, the events team, the accreditation team, and all operational staff plus the clinical teaching visitors.
I look forward to working with all our stakeholders and building on the strengths of our region in 2020. We hope the changes to the recent placement process have been valuable and look forward to the introduction of the composite pathway next year.
On behalf of all the Central, Eastern and South Western Sydney team, thank you again for your care and expertise in training our registrars. We wish you a very Merry Christmas and safe and happy holidays. Take time to rest, recharge and care for yourself.
Dr Marisa Magiros | Regional Head of Education Central, Eastern & South Western Sydney
Deadline for 2020.1 Medicare paperwork now 6 December:
The deadline to submit an application for Medicare provider numbers for the 2020.1 term is Friday 6 December not Friday 13 December as previously advised. Registrars are being advised to ensure they have submitted the signed AGPT paperwork for a placement to GP Synergy by 6 December 2019, and any Medicare initial provider number applications and other Medicare paperwork to Medicare by 6 December 2019 to avoid MPN processing delays.
Medicare provider number check:
If you are training a GP registrar in a GP term in 2020.1 (Feb-Aug), please ensure they check the letter from Medicare advising them of their provider number approval.
Registrars should confirm that they been issued with a provider number with full billing rights before they commence billing patients. Registrars with refer and request rights will only be able to refer patients and request investigations for them, until a provider number with full billing rights is received.
2020.1 term dates:
3 February 2020 – 2 August 2020
Annual supervisor and practice manager survey results
Thank you to all the supervisors and practice managers that provided feedback via our annual supervisor and practice manager surveys circulated earlier this year. The number of responses received increased again from last year, with 536 supervisor and 391 practice manager respondents.
Whilst the annual feedback surveys form an important part of our quality improvement process, they are only one of many ways we collect feedback. If you have any feedback you would like to share with us, at any time of the year, please don’t hesitate to let us know via your local Supervisor Liaison Officer (SLO), Practice Liaison and Support Officer (PLSO) or Medical Educator with a Supervisor Focus (MESP). You can also submit feedback on our website, via our complaints and compliments register, or via professional development evaluations.
Firstly, I’d like to introduce myself as I take up my new role as MESP for the Nepean, Western and Northern Sydney subregion of GP Synergy. I’m excited to be sharing this position with Sarah Gani.
I worked in general practice in Western Sydney for many years and have been a GP supervisor since 1990. I commenced work as a medical educator in 2013, initially with Wentwest and then in 2016 with GP Synergy. I am currently working in the Practice Experience Program (PEP) as well as ongoing work with AGPT.
At our recent medical educator meeting we were discussing the need for registrars to be on a quick learning curve in order to understand Medicare and the need for each individual doctor to be responsible for their own billings. I was reminded that under the NTCER agreement the registrar should have regular access to their billing sheet so that any inaccuracies can be corrected at the end of their working day. You will find further information about this in the Supervisor Toolkit under Contracts and Payments.
That link then takes you to the GPSA website where you will find the full NTCER document. You may also be interested in viewing the recent GPSA webinar about MBS billing.
I have recently been giving much thought to the topic of providing effective feedback during direct observation. Because of my work with registrars and PEP I spend a lot of my working hours giving feedback in one form or another and despite doing it regularly I still find it the most challenging part of my work. Feedback depends on the situation, the registrar, the type of patient and even the time of day, and can prove a daunting experience for both the giver and receiver. I find that I need to individualise and subtly change my feedback in every situation and tailor it to the context in which I am working.
Over the years I have used tried and true models such as Pendleton’s rules, but another model of feedback I quite like is ALOBA (Agenda Led Outcome Based Analysis). I can use this model when I am doing direct observation. I would initially discuss what the registrar wants help with (their agenda), then decide together with them how to reach their desired outcome or goal. I can then offer alternatives or make suggestions that I think are relevant to the subject or to what I have observed (my agenda). The registrar and I can then, together, fine tune the learning need, how it might be achieved and the final goal (shared agenda). I find this process creates an equal learning environment between the registrar, myself and even occasionally the patient contributing to the learning opportunity.
For those of you who would like more detail about ALOBA, it is more fully described in this article by Chowdhury and Kalu (2004).
Dr Margaret Stellingwerff | Senior Medical Educator
Supervisor Toolkit tip
Follow the link below to a great section on Assessment and Feedback in the supervisor toolkit. In the resources there is also a link to a GPSA Feedback Guide: 'Giving effective feedback in general practice'.
Where do registrars go for in-consultation information, advice and assistance?
Evidence for practice – findings from the GP Synergy Research and Evaluation Unit
Answering clinical questions arising from patient care improves care and increases patient safety. It is also a rich source of learning for registrars. Some questions need to be answered immediately – within the consultation that prompts the clinical question. Registrars seek in-consultation information and assistance in 21% of consultations, for 15% of all problems/diagnoses managed, and from multiple sources. The most common sources of information/assistance are the supervisor (or their delegate) in 45% of instances, and electronic sources (42%). Specialists (5.8%), other health professionals (3.9%) and hardcopy sources (9.7%) are much less common (note that more than one source can be used for a single question and more than one question can be generated per consultation).
Information is sought in 9.9% of instances for diagnosis, in 61.3% for management, and in 28.8% for both diagnosis and management. The most common systems for which information is sought are skin (16.0%), musculoskeletal (10.8%) and respiratory (10.7%).
The proportion of problems/diagnoses for which Term 1 registrars seek information or assistance is 21%; in Term 2 13%; in Term 3 11%; and in Term 4 8.6%.
Human information sources (rather than, mainly electronic, non-human sources) seem to be preferentially sought for more complex problems, even by these registrars who have trained in the ‘internet era’.
Magin P, Morgan S, Wearne S, Tapley A, Henderson K, Oldmeadow C, Ball J, Scott J, Spike N, McArthur L, van Driel M. General practitioners’ in-consultation information-seeking: associations with human, paper and electronic sources. 2015. Family Practice 32 (5): 525-532. doi:10.1093/fampra/cmv047.
For further information contact Professor Parker Magin, Director, NSW & ACT Research and Evaluation Unit: email@example.com
Launch of the Learning Activities Packages!
The Learning Activities Packages (LAPs) are a set of learning activities GP Synergy registrars complete to
- help prepare them for their first GP term
- progress through GP training in their subsequent GP terms.
These activities are accessible through the GPRime Quick Links and Subscriptions tab. Some learning activities are compulsory for registrars to complete, such as the Pre-GP Term Assessment and the Procedural Skills Log. Others are not but are highly recommended (e.g. PBS and Medicare online modules).
All RACGP and ACRRM registrars should review the LAPs as they will assist in addressing and identifying their learning needs as well as developing competency in clinical practice.
GP Synergy PD calendar
Make sure you don't miss an event or webinar by accessing the supervisor professional development calendar on our website.
External activity noticeboard
Explore a list of activities and online modules including RACGP point-of-care ultrasound workshops in Canberra and Sydney.
Need some help?
Find key GP Synergy contacts including Practice Liaison and Support Officers, Supervisor Liaison Officers and Medical Educators with a Supervisor Portfolio.