© BOA 160707 Trauma and Orthopaedic Specialty Induction OCAP Induction T+O curriculum OCAP and ISCP eLogbook Mike Reed MD FRCS(T+O) Deputy Programme Director.

© BOA 160707

Trauma and OrthopaedicSpecialty Induction

OCAP Induction

T+O curriculumOCAP and ISCPeLogbook

Mike Reed MD FRCS(T+O)

Deputy Programme Director

(Early Years)

© BOA 160707OCAP Induction

Orthopaedic Competence Assessment Project

A Competency Based Curriculum in Trauma and Orthopaedics

Accepted PMETB: September 2006

Authors: David Pitts, David Rowley, Clare Marx, Lester Sher, Tony Banks, Alastair Murray on behalf of the BOA and the Orthopaedic SAC

© BOA 160707OCAP Induction

What is a Curriculum? (adapted from PMETB definition)

• Aims and objectives• Content

– Experiences– Outcomes– Processes– generic professional– specialty specific

• Training structure– entry requirements– Length of programme

• Organisation of programme– flexibilities– assessment methods – learning, teaching,

feedback and supervision

© BOA 160707

How much is existing OCAP used

• Survey conducted during February & March 2008

• All UK trainees with locatable email address contacted by email

• Web based survey

• Over 800 participants

• 715 trainees completed the whole survey

David Boardman – Orthopaedic SpR South West Thames

Aware of OCAP 99%OCAP in portfolio 93%Cons. profile 11-42%Learning agreement 75%PBAs 4 in 6 months

© BOA 160707OCAP Induction

T&O curriculum – facilitating good practice

Evidence for

Accrediting bodies

Clear Aims & Objectives

Open, high quality, structured

feedback

PBA& other tools

Knowledge

ProceduresMini CV

PBA summaryLogbookLearning agreements

Reportsin various formats

Formative WPB Assessments

Learning

Agreement

© BOA 160707OCAP Induction

T & O CurriculumCT1-ST8

Trainer Profile

Learning Agreemen

t

Curriculum Vitae

Procedures Coaching

Assessment

Evidence

Applied Clinical knowledge

Applied Clinical skills

© BOA 160707OCAP Induction 1.Curriculum overview

© BOA 160707OCAP Induction 1.Curriculum overview

© BOA 160707OCAP Induction 1.Curriculum overview

Please note that this area of the curriculum is an ongoing development

© BOA 160707OCAP Induction 1.Curriculum overview

For further information

• Go to the OCAP website (www.ocap.org.uk)

• Look on the induction CDROM• Check the details of the

curriculum• Contact [email protected]

© BOA 160707

Later Years 3-8

Early Years 1-2

Foundation

Where do PBA’s fit in with other assessment tools?

Mini-PAT

Mini-CEX

DOPS

CBD

PBA

Mini-PAT

CBD

DOPS

Mini-CEX

PBA

mini-PAT

© BOA 160707

What do I do as an ST1 and ST2?• Register with ISCP

– Programme directors• ST1 Stefan Plusa

• ST2 Mike Reed

• Do ISCP but use T+O curriculum for guidance

• DOPS, MiniCex, CBD on ISCP

• Do 360 – mini-PAT in this deanery

• Use elogbook.org for logbook

• New agreement Aug 2008 – work in progress

© BOA 160707

What do I do as an ST3?

• Register with ISCP

• Use OCAPonline

• Use PBAs and mini-PAT (one per post)

OCAP Induction 4.Using PBA’s

© BOA 160707

Introduction to

David PittsAssociate Director, RCSED Leadership & Educational

Development

Andrew LambDirector of Web Services, RCSEd

Mike Reed Clinical Lead, OCAPonline

© BOA 160707

Overview

• How OCAP works at present

• HOW TO:– create a Trainer Profile– form a Learning Agreement– do assessments

• ARCP / RITA reports

© BOA 160707

Meeting1

Meeting2

Meeting3

LearningAgreement

ConsolidationSheet

CompletedPBA’s

How OCAP works at present

TrainerProfile

PBA

PBA

© BOA 160707

Meeting1

Meeting2

Meeting3

How it will work now

TrainerProfile

LearningAgreement

CompletedPBA’s

ConsolidationSheet

PBA

PBA

Via paper if you wish

ElectronicARCP

© BOA 160707

Creating an online Trainer Profile

(even if you are a trainee)

© BOA 160707

Log in as usual – www.elogbook.org

© BOA 160707

Go to Training area

© BOA 160707

Choose element of profile you want to create

© BOA 160707

Cut & paste from your existing cv

© BOA 160707

Choose another profile element

© BOA 160707

Created from historical logbook data.Add or remove procedures as you wish

© BOA 160707OCAP Induction 1.Curriculum overview

© BOA 160707

The new “Trainee Profile”

© BOA 160707

Trainees make their own trainee profile

© BOA 160707

© BOA 160707

© BOA 160707

Creating a Learning Agreement:

Before the first meeting

© BOA 160707

Trainee adds details of hospital attachment and reviews trainer profile – “whats on offer”

OCAP IS TRAINEE LED

OCAP IS TRAINEE LED

© BOA 160707

Checklist for Learning Agreement meeting 1

• Trainee– Agree date

– Set up the attachment

– Review Trainers Profile• Mini cv• Procedures

– Review own profile and set targets

• Trainer• Agree date

– (Set up all profile elements)

– Choose technology for meeting

• Paper• online

© BOA 160707

Creating a Learning Agreement:

The first meeting

© BOA 160707

Do it online, put it straight onto your logbook

© BOA 160707

Or do it on paper, transfer it at leisure, and send validation request

to trainer

© BOA 160707

On paper - A practicalities area

© BOA 160707

Online - A practicalities area

© BOA 160707

Top screen

© BOA 160707

Bottomscreen

© BOA 160707

Filling out the form

© BOA 160707

The electronic

form guides

you through

© BOA 160707

© BOA 160707

Trainee can fill in the form,send to trainer,trainer

validates

© BOA 160707

Validated form is

“locked”

© BOA 160707

Using Assessments

© BOA 160707

Select “assessments” in the training area

© BOA 160707

© BOA 160707

© BOA 160707

© BOA 160707

© BOA 160707

© BOA 160707

TRAINER

© BOA 160707

© BOA 160707

© BOA 160707

© BOA 160707

© BOA 160707

© BOA 160707

Automatic update of PBA and the summary sheet for trainee

© BOA 160707

PBA rules

• Trainer or trainee triggers PBA

• NB Trainer agrees to the PBA

• Trainee conducts agreed parts of procedure observed by trainer

• Trainer usually scrubbed

• Trainee verbalises, explains what intentions are

• Trainer steps in as/where necessary

• Forms completed and feedback given immediately after procedure

• Trainee includes all forms in portfolio, notes in logbook PBA summary sheet

© BOA 160707OCAP Induction 2.Basics

What does a completed PBA mean?

• NOT a license to operate unsupervised!

• DOES give trainer confidence to allow trainee greater responsibility

• “Completed set demonstrates competence to learn procedures and perform to set protocol and standard”

© BOA 160707

Email validation – no log in

PBA, miniCEX, DOP, CBDMini-CVProcedures ProfileOperations

360 appraisalsMSF-TAB and mini-PAT

© BOA 160707

Early years assessment tools are available

© BOA 160707

ARCP / RITA report

Automatically generated from all information in portfolio – paper / pdf

OCAPeLogbookResearch and auditStudy Leaveetc

© BOA 160707

The eLogbook

OVERVIEWOVERVIEW

© BOA 160707

Contents

• Background

• The role of the eLogbook

• Who should use it

• How it works

• National data analysis

• Future developments

© BOA 160707

Background

• Conceived in 1998

• Collaborative venture between: – BOA– BOTA– Orthopaedic SAC– RCS Ed

• Compulsory for trainees since 2003

© BOA 160707

Intended Users

Medical studentsFoundation yrs

ST 1 - 8

T&O Consultants

SpR

Career grade T&O surgeons

Surgical assistants etc

All grades of medically and non-medically trained personnel

involved with orthopaedic surgery are encouraged to use the eLogbook

Career progression

Users in ST years 1 & 2 Users in ST years 1 & 2 can enter data even while working in other

specialties. Supervisors = Trainers. All years of T&O Specialty training will be

analysed

© BOA 160707

Users

• >5000 users of pan-speciality eLogbook

• > 5 million procedures logged

• Medical students to Consultants

• Surgical assistants

• Overseas surgeons

© BOA 160707

Creating an account

Access the eLogbook at….

www.eLogbook.orwww.eLogbook.orgg

To create an account click here

© BOA 160707

Creating an account

Enter grade and specialty

Info needed to proceed: Name and address Training region Email address Completion date (for StR/SpRs – can be estimate)

© BOA 160707

User basics

Access via www.elogbook.orgwww.elogbook.org

OrDownload software, input data onto personal hard drive & synchronise with

main server later

Hospital terminal / home PC

Main server at RCSEd

Backup servers

Home computer

PDA / palm

All synchronised data is held on a secure server at the RCSEd

with 2 back-up servers

© BOA 160707

National training data

• Peer comparison data – for trainees / RITAs / programme directors

• Regional & chronological data– for programme directors / SAC

• Presentations at Meetings

• Peer reviewed journal articles– Influencing the national training agenda. The UK and Ireland

orthopaedic eLogbook. Sher et al. JBJS (Br) 2005;87(9):1182-86

© BOA 160707OCAP Induction 1.Curriculum overview

© BOA 160707OCAP Induction 1.Curriculum overview

© BOA 160707

Example of training analysis

National data analysed for hip

joint replacement based on SpR

year in training….

This provides reliable data on the expected

experience of a trainee for a specific

procedure at a particular time in their

training, based on national data

Mean number of procedures performed

by trainees with upper range figure

…. and level of supervision

© BOA 160707

Index Procedures

TraumaTrauma Hemiarthroplasty Compression hip screw Ankle ORIF IMN femur / tibia TBW patella / olecranon Tendon repair External fixation

ElectiveElective THR TKR Arthroscopy 1st ray surgery CTD Palmar fasciectomy Lumbar discectomy

© BOA 160707

Users can create Consolidation Reports Consolidation Reports based on their operative log, which can be used

for RITAs, job interviews, evidence of training, and

revalidation

Number of procedures performed, with a

breakdown of level of supervision

© BOA 160707OCAP Induction 1.Curriculum overview

© BOA 160707

Portfolio

Choose the appropriate

field…

Under ‘PortfolioPortfolio’ heading

.. add the details…

… then build your CV

© BOA 160707

Data control

PLEASE NOTE:

An individual must register with the Information Commissioner if he or she keeps patient-identifiable data for the purposes of research, private practice or as part of a logbook (the Data Protection Act 1998).*

It is MANDATORYMANDATORY for eLogbook users to register as a ‘data controller’. The user will then ‘own’ their own data and can do with it as they choose.

There is an annual fee of £35. For more information and registration visit:

www.ico.gov.uk www.ico.gov.uk

© BOA 160707

Thank you