Personal and Professional Development Portfolios in Phase 2

Personal and Professional Development Portfolios in Phase 2 Dr Isobel Braidman Portfolio Lead

Your journey • From newcomer to final goal • What is your final goal? • What helps you decide? • What are your key experiences? • How are you learning? • Vital to understand what do

By now you are familiar with portfolios as….. Evidence of • Increasing understanding • Acquiring competencies and skills • Critical thinking and reflection • Achievements

University requires students to maintain portfolios GMC requires doctors to keep record of continuing professional development Portfolios are part of the undergraduate curriculum Portfolios are now a requirement

And portfolios are intrinsic to…. • Postgraduate education in foundation years • Appraisal and revalidation throughout your careers • Important evidence for Foundation Year applications and subsequent job applications

Portfolios and your job applications • Portfolios accustom you to reflecting and understanding the basis for sound professional judgements • Important for content of Foundation Year applications • Specialist Training – 18 months after graduation; experiences recorded in your undergraduate portfolios form the basis for aspects of these applications and interviews GP practice – patient has cold but believes that antibiotics are the only cure How does the doctor handle this? What are the professional issues involved? What would you do?

And portfolios reviews are important too • Excellent preparation for those of you interested in Academic Track Foundation Years • Portfolio is a station at interviews • Likewise for specialist training

Portfolio group discussions Supported by tutor facilitator Phase 1 Personal and Professional Development Portfolios PHASE 1 Years 1 and 2 GMC’s Good Medical Practice

GMC’s Good Medical Practice In Phase 2 • Audit • How do I become a safe and effective prescriber? • Reflection on events which are significant to you • Evaluation of your own skills • What makes a good newly qualified doctor • Research – evidence based medicine • Governance Set in the context of your work place learning environment

GMC’s Good Medical Practice + Extra sections (research, governance) appropriate for work place learning Phase 2 Personal and Professional Development Portfolio + Supported by peer facilitators from same year as students On line discussions through Blackboard

Role of Student Facilitators • Facilitate online discussions • Support for portfolios • Act as “sounding board” for questions and can provide clarification

Online discussions • Two main topics (one per semester) • First is on a code of professional behaviour for medical students • Second is “How do I become a safe and effective prescriber” • Commence with face to face meeting of your group with their facilitator • Excellent start for reflective writing • Download evidence of participation for reviews

Online discussions - wider implications • Excellent opportunity to record reflections on issues of professional behaviour and standards • Year 4 deals with specific medical and professional issues • Exactly what is expected of a phase 2 portfolio • Highly relevant to the Foundation Year Application, no matter what format is used

Specific Issues….Skills • Year 5 – you are responsible for ensuring that you are competent in key skills for graduation • The time to start is now! Build on your evaluation of skills that you began in phase 1 • Ensure that you reflect on your strengths and weaknesses in learning new skills - devise clear and precise action plans • Indicate how you respond to feedback (both verbal and written) - from peers - from patients - clinical tutors - examiners OSCEs

Specific Issues….Research • Familiarity with weighing up evidence • Important for Evidence – Based Medicine • Gain experience, knowledge and understanding of the research literature • Increased understanding of statistics and experimental design • Fourth Year Project Options • SSC’s • Intercalated Year

Specific Issues….Governance • Accountability – who is responsible to whom and for what? • Requires clear communication and openness • Demands good teamwork, leadership and commitment • Enables the NHS as an organisation to maintain high standards of patient care and safety. • You may see this in operation with Audits and when you participate as a member of a clinical team • The Support document provides further explanation. Please read this!!

Importance of critical thinking and reflective learning • Reflection that helps you develop addresses “Why” do events occur • Good doctors always attempt to find the reasons behind situations

Reflective learning and critical thinkingFoundation Year doctor I was asked to put a venflon in a young man who had a PCA as he had a bowel anastomosis two days previously. I couldn’t get a venflon is and asked my Senior to take over. The patient was in a lot of pain but the PCA had been down for about 90mins by the time my Senior managed to canulate the patient. I reviewed him an hour later and he seemed to still be in a lot of pain so I discussed it with my senior and we gave an IM injection of Morphine. When I went to review the patient another hour later he was centrally cyanosed and felt his abdomen which was very tender. I gave him O2. I went to call my Registar as I thought he may have leaked, as I did this the patients consultant walked on the ward and I asked him to review the patient. Unfortunately the patient had leaked and had to be taken back to theatre. Note - not afraid not afraid to say that he/she had missed something

How did this affect the Foundation Year doctor? I was very worried that I had missed this leak earlier in the day. I had been talking to the patient and asking him about the pain, once he began to deteriorate the patient told me something had changed and he was feeling different. I learnt good communication with patients is key. He/she expresses feelings but also learns something about the centrality of the patient

How did this affect the patient? The patient went to theatre very quickly as once the Consultant saw the patient he asked for a CT. It was 4pm and finding a radiologist to perform the CT was rather tricky but as soon as he had this he was taken to HDU and then to theatre. Aware that delays in finding the appropriate specialties can affect the patient

How did it affect the team? The team were all worried about their own part in the sequence of events. After discussing with the Nursing Staff and the Medical staff, I learnt that surgical patient’s become very ill very quickly and it is no one persons fault when they do occur.

What did you learn from the experience, and what (if anything) would you do differently next time? • Always re-examine the patient • Don’t just ask the question back it up with proof. Logical explanations like his PCA being down are not always the right explanation I should have thought about his recent surgery being a possibility for the pain as well and examined his abdomen thought out the day. • Always keep relationship with patient open and honest.

What can we learn from this? • Realistic view of capabilities • Communication with team and patient • Clarity on issues that need to be addressed • Addressing underlying reasons

Use your SWOTS!!! • In just 3 – 5 mins jot down your Strengths, Weaknesses, Opportunities you have to address these and build on strengths and what might Threaten this • How about using this after specific situations to formulate an Action Plan • What do I do? How do I do it? When do I do this - be specic and include timelines

Implications for your portfolios • Explore your experiences more deeply • Examples: Teamworking – what makes a good team? • What are your experiences of teams, both clinical, academic and non academic? • Record (however briefly) specific examples, - your role, did you work within your limits? How did this help the team • What is the relevance to Foundation Year training • This level of reflection essential for good foundation job applications

Something new this year – University of Manchester Academic Advisors • Requirement from University of Manchester • Opportunity for the Medical School to maximise and improve support for each individual student • Each Year 3 student will have a University of Manchester Academic Advisor • Remain with you throughout the rest of the programme • Each advisor is a clinician (requested by students)

University of Manchester Academic Advisors • Clinician • “Critical friend” • Point you in the appropriate direction • Help you to address concerns • Aid you in maximising your potential • Support and assess your personal and Professional Development • Advisors have been trained for this role

Meetings with UoM Academic Advisors – Phase 2 To get the best out of your meetings with your advisors, please remember to allow advisors to share your portfolio review forms in phase 1, your assessments results and feedback, SSC feedback etc. Click on the share symbol and enter your advisor’s name

Meetings with UoM Academic Advisors – Phase 2 • Expect to meet twice per semester • ALL meetings are recorded by an electronic medlea form • PLEASE INCOPORATE THEM INTO YOUR PORTFOLIO • One of these will be your portfolio review • Even if your meeting is not a review TAKE YOUR PORTFOLIO WITH YOU • Reviews in Phase 2 are for guidance, feedback , help and support • THERE IS DETAILED ADVICE AND GUIDANCE IN YOUR PORTFOLIO SUPPORT BOOKLET ON HOW TO PREPARE FOR YOUR PORTFOLIO REVIEW • Bring along your Review form from Phase 1 and demonstrating how much you think you have developed • Reviews take place in end January/February and in May/June

Review Forms for Phase 2 Name of Student : Advisor Date 1. Responses to clinical learning experiences • Cases Seen • Prescribing • Development as a learner • Responses to feedback from tutors 2. Critical Thinking • Meeting challenges • Personal and professional development • Learning from experiences inside and outside medical school • Understanding issues such as team working • Learning from online discussions • Reflecting on SPECIFIC experiences

Review Forms for Phase 2 3. Acquiring skills and competencies • Ability to plan • Self evaluation • Responses to OSCE results and feedback 4. Preparation for next stage • SWOT • Learning plans based on feedback from assessments Agreed Plans Date for next meeting

Support Booklet for Phase 2 Portfolio • This is a guide!! (not a straight jacket) • The types of reflective pieces are suggestions – it really is up to you!! • You can be as electronic or as paper based as you like.

Reviews in Year 5 • Reviews in Phase 2 are for guidance, feedback help and support • Year 5: two reviews – first is formative, second is summative • Portfolio and the second review MUST be satisfactory for graduation • Includes required skills and competencies, satisfactory continuous assessment based on those in Foundation Year • Development as a reflective learner and critical thinker • Ability to plan for the next stage

Preparation for Year 5 BEGINS NOW!

Support Booklet for Phase 2 Portfolio We have used some icons and symbols to draw your attention to various features: Denotes the main sections of the portfolio Indicates portfolio entries that can be relevant to Foundation Year applications Indicates preparation for review

Developments for portfolio • Planning for an electronic portfolio next year • Based on current paper portfolio • We have amended the support booklet so that it has the same format and wording as the eportfolio • We will be running pilot versions in the New Year and will be looking for people to test it - your feedback will be important to us • All help gratefully received

St Andrews Students/Direct Entry • There is help available, please do not be afraid to ask it will NOT be counted against you • Help from • Academic Advisors • Student Facilitators • Your sector portfolio lead • From me

One last suggestion…. Always have a note book with you

Any problems… You can always contact me Isobel.braidman@manchester.ac.uk Or your site portfolio lead

Personal and Professional Development Portfolios in Phase 2