Undergraduate Curriculum – Preparing for Professional Practice

1. Undergraduate Curriculum – Preparing for Professional Practice Nigel Rawlinson Director of Student Affairs Bristol University Medical School Preparing for professional practice

2. Introduction • Appointed Director of Student Affairs (previously entitled Clinical Dean) May 2011 • Surgical route: FRCS(Ed) - more than 1 attempt • Self belief and resilience • Neurosurgery, Frenchay Hospital; Acting SR • Research; stalled for reasons that I could not solve; I resigned • A&E , BRI; FFAEM (exam); Consultant 1999 - 2010, Assoc Clinical Director 2003-2006 • Personal Tutor, UoB • Clinical Sub-Dean BRI 2001-2004 • 2008 – Staff Doctor in Palliative Medicine, Dorothy House Hospice Preparing for professional practice

3. Professional Knocks • Jobs • Failing exams • Life planning • “Injustice” • No-one loves me! • How am I recognised? • Avoid the “chip on shoulder” • Enthusiasm is the key Preparing for professional practice

4. Challenges to professional development • NSS feedback • Not known by name; not valued • Learning in service time – the change in the health care environment • Loss of personal tutor scheme – medical students no longer affirmed by the profession • CV’s no longer valid currency – how do I shine? • Selection for medical school – academic and vocational • Inter-professional training - “the flip side” • Life experience sets medical students apart from other student friends • GMC expectations – how can I still be a student? Preparing for professional practice

5. Time line of development • Personal development – Year 1 & 2 • Understanding the workplace – Year 2-3 • Professional development - Year 3-5 • Inter-professional development – Year 5 • Uni-professional • Multi-professional • Inter-professional Preparing for professional practice

6. Job analysis of F1 Doctor - UKFPO • Commitment to professionalism • Coping with pressure • Effective communication • Learning and professional development • Organisation and planning • Patient focus • Problem solving and decision-making • Self-awareness and insight • Working effectively as part of a team Preparing for professional practice

7. 3 inter-related areas of work • Professional affirmation - Academic Mentors • Relationship with the foundation school - UMeP • Learning in service time – the new log book Preparing for professional practice

8. Aim of Academic Mentors • to nurture the professional and academic development of undergraduate medical students within Bristol • a new and focused role • It is intended to achieve the following: • Affirm students from the start as “doctors of the future” • Help students establish their professional identity • Create a roadmap for medical training • Guide professional and career decision making. • This record to be designed to produce the reference to support professional progress, F1 applications etc. Preparing for professional practice

9. New Role New level of support, and not a return to the variable “personal tutor” scheme. • Name • Students do not have a choice • Within the structure of undergraduate learning • Building a more seamless transfer to the foundation school - UMeP Preparing for professional practice

10. How do we improve our student support? • Establishing their trust • New era in the life of the medical school • In response to changing needs • They see our enthusiasm • Respect for them, clear boundaries • Joined up thinking • Confidentiality • Educational evidence for Mentors Preparing for professional practice

11. Function of Academic Mentor • To record and monitor a student’s academic achievement over the whole 5 years • This is a new strand of continuity • To mark this progress against the general landmarks of the undergraduate curriculum • To mark and record extra achievements, such as prizes, commendations • To enquire and encourage a student’s reflection on career progression • This is a formal academic relationship • Academic mentors are not expected to provide pastoral care in the event of personal difficulty, exam failure or appeal. Such issues are referred back to the DSA Preparing for professional practice

12. Undergraduate Medical ePortfolio (UMeP) • NHSe Scotland • Based on Foundation e-Portfolio • Educational agreement – signed • Meeting record • Career thinking • information • Pastoral flags – e-mail the hub - med-dsa@bristol.ac.uk • Upload reflections and core skill competencies • 360 degree feedback – 3 people, patient feedback Preparing for professional practice

13. Student generated • Students learn to drive their portfolio – be proud of it • “Professional facebook” • New attitude • They maintain it: “can I show you my ePortfolio?” • Professional development • Different to postgraduate training. Minimise the work for the Mentor Preparing for professional practice

14. Skills logbooks • To facilitate learning • Doctor as scholar and scientist • Doctor as practitioner • Doctor as professional. Preparing for professional practice

15. The learning of skills is necessary to become a practitioner. However the doctor as scientist seeks to understand the rationale behind a skill, and what it means or does. The doctor as professional will keep these skills honed and in use, doing the necessary practice. If asked to perform a skill that has become unfamiliar, then the professional will ask for someone of more experience, and at the first opportunity revise that skill. This process is both non-hierarchical and inter-professional. What counts is experience and not rank. It is not uncommon for example for a consultant to ask their trainee to help in certain procedures that were once routine to them. Now teams work in an inter-professional way, and nurses, physiotherapists or other colleagues often have more experience in certain areas. As a medical student you will be assessed by them as well. Preparing for professional practice

16. Final Year • Transition • Final exams at Christmas • PPP • 4-5 weeks in surgery • 4-5 weeks in medicine • General practice Preparing for professional practice

17. Aims of PPP • Roles and responsibilities of F1 • Skills of F1 • Communication strategy • Administration • Prioritising • Team work – their roles and responsibilities • Team formation – “form/storm/norm/perform” • When and how to ask for help Preparing for professional practice

18. How • Student assistantships • Shop floor management • On call – weekends and nights • ILS and surgical skills course • GP • Vertical themes • Scientist and scholar • Practitioner • professional Preparing for professional practice

19. Questions Preparing for professional practice

20. Thank you. • Professional development • Fulfilment • Enthusiasm! Preparing for professional practice