Empowering Foundation Trainees: Creating A Leadership Forum

1. The Creation of a Foundation Programme Forum Dr Marc Davison Dr Tamsin McAllister Mr Amir Khaki NAMEM September 2011

2. Introduction • What is the forum? Dr Marc Davison Associate Director FP • Trainees perspective of the forum Dr Tamsin McAllister Forum member 2009-10 • The leadership training Mr Amir Khaki Organisational Psychologist

3. Why create a forum? • Qualitative feedback that goes beyond tick boxes • ‘Gives trainees a voice and management an ear’ • LEP’s must • Ensure that there are systems and processes in place to induct, supervise, support, train, assess and monitor the progress of foundation doctors • Be responsible for the quality control of the training they deliver • Provide high quality and safe training UKFPO Reference Guide 2010 • Trainees must have involvement in their own education • There is the requirement for leadership training to be embedded into curricula at the earliest stage GMC - The new doctor: guidance on foundation training. 2009 UKFPO Curriculum 2010

4. Why ‘we’ needed a forum? • Increasing numbers of FP trainees • Poor completion and feedback on GMC/PMETB survey from trainees • Poor representation of trainees views to educational management • Little innovation occurring in Bucks FP • Struggling to solve issues in certain specialities with regard to training opportunities/rotas

5. Aims of Bucks forum • Representing trainees • Addressing educational and developmental needs • Feedback to trainees • Disseminate information to colleagues • Help to • Improve teaching • Improve supervision • Improve training posts • Enhance learning opportunities • Create better training for future years

6. Forum structure • 8 members to constitute forum • 4 F1: 4 F2 3 F1: 5 F2 • Chaired by associate director of foundation programme • Formal meeting 4x year with agenda/minutes • Standing items – bullying, ed/clinsupervisers, rotas • Other items driven by forum members • Informal contact throughout the year • Chair empowers and facilitates change by the forum rather than leads it • Chair provides continuity over the years to avoid repetition

7. How we selected the forum • Problem: How to select trainees that no one knows? • Application form (400 words) • Why do you want to be a forum member? • What do you think you can contribute to the programme? • What are you hoping to gain from the programme? • Tell us about any other skills or experience that you think might be relevant. • Problem: trainees who are only in trust for 6 months • Unfortunately excluded from applying Darwin misses witnessing unnatural selection

8. What are the costs to the LEP? • 8 half day sessions of leadership training by external facilitator • To equip forum members with the skills to carry out role • Leave for forum members to attend meetings & management training • F1’s no S/L provided normally • Buy-in from DME/MD • Financial • Willingness to allow change where appropriate • Support to run innovative projects

9. Role of forum representatives • Identify themselves and represent the views of the FP trainees to the FP committee • Pass feedback to FP trainees from FP committee • Help find innovative solutions to problems within Bucks FP training • Identify and run projects to benefit Bucks FP • Attend • 6/8 management training sessions • Quarterly forum meetings • Post graduate medical education (PGME) board • Deanery forum when set up

10. The future • Continue innovation • Fully establish a deanery level forum • Continue publishing papers Peer led E-Portfolio training NACT UKFPO Sharing notable practice - June 2011 Dr James Wigley, Dr B Wildblood, Dr C Greszczuk, Dr M Johnston, Dr A Tse and Dr M Davison The Development of a Foundation Programme Trainee Forum NACT UKFPO Sharing notable practice - June 2010 Dr L Creasy, Dr S Dunkerley, Dr. T McAllister, Dr K Sahota, Dr M Sinczak, Dr S Edmonds, Mr. P Lintott, Dr M Davison

11. Foundation Medical Leadership Programme

12. What is it? • An innovative training programme to give foundation representatives leadership skills in the context of the NHS • A safe testing ground for practicing new interpersonal skills • A proven way to empower Junior Doctors to start supporting each other

13. Components • A medical leadership competency framework • Facilitation (medical context) • Representation from the FY1 & FY2 cohort • Training modules • Monitoring & evaluation

14. Programme structure • 8 half day sessions • Lectures & interactive workshops • Guest speakers • Foundation Medical leadership framework • NHS institute of innovation & improvements (2009) • Emotional intelligence (Salovey & Myer 1993) • Leadership & Followership (Lewin 1939) • Designed specifically for Foundation years training doctors

15. Program content • The ever evolving NHS & the drivers for change • Why is it important for doctors to be leaders? • Defining the key challenges facing doctors now & in coming years & how to address these • Difference between leaders & managers • Understanding basic principals of communication • Using basic leadership skills to enhance effectiveness

16. Programme overview

17. Benefits • Improving personal effectiveness & providing better patient care • Embedding leadership training as part of FY training (GMC – The New Doctor) • Understanding the NHS business model & be better prepared for the requirements of their future roles • Enhanced skills in recognising & avoiding conflicts • Dealing with & understanding emotions & their impact on decision making

18. Evaluation • Last 2 years data (2009, 2010) • Buckinghamshire Hospitals Trust

19. Sound bites “I have used questioning skills a lot, mainly to get most from patients when taking history.” “A fascinating and relevant course which offers junior doctors the competitive edge to differentiate themselves from their peers.” “Recognising my values & beliefs (ideal self) has helped me in my choice of career.” “… one of the best, most enjoyable & most valuable bits of FY1.”

20. Long term evaluation • Comparing patient’s perception of doctors; • Within participants ( Pre & Post FMLP) – 2012 • Between participants ( FMLP attendees & equivalent FY2s) • Initial data supports a positive correlation • Small sample • Individual differences

21. The Foundation Programme Forum – A Trainee’s Perspective Dr.Tamsin McAllister CT2 Anaesthetics

22. Why apply for the forum? • Frustration at lack of structured feedback mechanisms • All F2s felt we had issues to bring to the forum • “No point complaining if you’re not going to do anything about it” • Experience of management and leadership • Leadership training

23. Leadership from junior doctors • The Medical Leadership Competency Framework • built on the concept of shared leadership • Acts of leadership can come from anyone in the organisation, as appropriate at different times NHS Institute for Innovation and Improvement • Foundation Doctors often required to show leadership • In presence of more experienced team members.

24. Areas of benefit • Creation of forum • Leadership and Management training • Activities and Outcomes from forum

25. Creating the forum • Introduced ourselves each to a group of F1/F2s for whom we would act as representative • Able to get to know a larger proportion of foundation doctors within the trust, improving working relationships, support and handover • Experience of process

26. Management and leadership training • Speakers • Understanding of NHS / Trust Management structure • Opportunity to meet Trust managers providing insight into goals and directions • More able to liaise appropriately with members of management and work together to achieve common goals

27. Management and leadership training • Leadership Styles • Emotional Awareness • Parent / Child / Adult communication styles • Listening / Active listening

28. Achievements 2009/10

29. Achievements 2009/10

30. Achievements 2009/10

31. Achievements 2010/11

32. Achievements 2010/11

33. Any Questions?