Department of Medical Education Trust Board Overvie · Department of Medical Education – Trust Board Overview ... Dr Roland McKane1 ... Mr Brendan Hanna

Medical Education - Trust Board Overview

Department of Medical Education – Trust Board Overview

The Department of Medical Education is responsible for providing and quality assuring clinical

education to undergraduate medical students, clinical training to Foundation Programme and

Specialty Trainees and the provision of training for permanent medical and dental staff to fulfil these

roles.

The Department is based in the new purpose designed Medical Education Centre in Trust

Headquarters and comprises an e-Library, training rooms, High Fidelity Simulation Suite and

administration support offices. There are also facilities and administrative support on the Lagan

Valley and Downe Hospital sites.

Structure:

Executive Lead: Mr Charlie Martyn, Medical Director

Director of Medical Education: Dr Craig Renfrew

Undergraduate Sub-Dean: Dr Niall Leonard

Education Lead Lagan Valley site: Dr Rosemary Kelly

Education Lead Downe Hospital site: Dr Cathal Foy

Foundation Programme Director, UHD: Dr Kevin Dynan

Administrative Support:

Undergraduate Secretary, UHD: Mrs Lee-Ann

Foundation Programme Secretary, UHD: Mrs Jayne Anderson

Specialty Trainees and Librarian, UHD: Mrs Mary Napier

Lagan Valley Site: Mrs Maura McVicker

Downe Hospital Site: Mrs Lisa Nelson

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Specialty Tutors:

Anaesthesia: Dr David Lee

Intensive Care Medicine: Dr Claire Jamison

General Medicine: Dr Janet Harding

General Surgery: Mr Jeffrey Campbell

Paediatrics: Dr Nuala Flanagan

Obstetrics and Gynaecology: Dr Caroline Bryson

Trauma and Orthopaedics: Mr Paul Maginn

Plastic Surgery: Mr Alastair Brown

Oral MaxilloFacial Surgery: Miss Ann Garrahy

Psychiatry: Dr Mark Finnerty/Dr Rachel Smylie

Radiology: Dr Joanna Turner

Emergency Medicine: Dr Jill Stafford

Foundation Programme Educational Supervisors:

Dr Alastair McIlwee Dr Jill Stafford Mr Sam Gray

Mr Keith Mulholland Dr Richard Hewitt Dr Cathal Foy

Dr Cathal Foy Dr Ciaran O’Gorman Dr Orla Gray

Undergraduate Lead Educators

Anaesthesia: Dr Rachel Deyermond

General Medicine: Dr R McKane

General Surgery: Mr S Kirk

Trauma and Orthopaedics: Mr Andrew Adair

Paediatrics: Dr Beirne O’Connor

Obstetrics and Gynaecology: Dr Sandra Mawhinney

Psychiatry: Dr Jonathan Green

Emergency Medicine: Mr Kevin Maguire

Radiology: Dr John Turkington

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The Medical Education Committee meets three times each year to discuss topics relating to medical

education and to review any external assessments by QUB and NIMDTA and issues raised through

GMC National Trainee Survey. The committee is chaired by Dr Craig Renfrew and membership is

comprised of all those named above and representatives from QUB, NIMDTA and Foundation

Programme and Specialty Trainees.

NIMDTA meet each year with Officers of the Trust to discuss the Learning and Development

Agreement for the Provision of Postgraduate Medical & Dental Training and Education. There are

presently 88 Foundation Programme Trainees and 131 Specialty Trainees on clinical placement in

the Trust. The Learning Agreement describes the agreed method of clinical and educational

supervision of trainees. This year there were very few changes to the Agreement and discussions

were mainly around potential ways of improving training. The provision of the new Medical

Education Department was welcomed by NIMDTA. NIMDTA also discussed our SQE programme

which has proven very successful in the past few years providing opportunities for trainees to

present findings at national meetings and to win prizes for their work.

2014 Presentations: International Forum on Quality & Safety in Healthcare Royal College of Medicine Winning Poster: Post Ward Checklist Presentations: International Forum on Quality & Safety in Healthcare All Ireland Quality & Safety Conference, Titanic Conference Centre 2013 HQIP: Winner of the Inaugural Quality Improvement Competition, Leicester: Improving the Identity Checking of Theatre Specimens Presentations: International Forum on Quality & Safety in Healthcare 2012 HQIP: Junior Doctor Clinical Audit of the Year, Leicester: Falls Reduction in Elderly Care

Quality assurance of training posts is provided by NIMDTA. This is performed in several ways

including end of post surveys, GMC National Trainee Surveys and departmental visits. Following

visits departments are sent a report in which issues regarding educational or clinical governance are

described. All issues are discussed by Medical Director, DME, Educational Lead for the area and the

Clinical Lead. A Trust Action Plan is then devised and agreed with NIMDTA who then grade the

Department.

Recent departments to have been visited with grading are:

Trauma and Orthopaedics: A2

Gastroenterology: A2

General Surgery: A2

Anaesthetics and Intensive Care: A2

Rheumatology C

MaxilloFacial Surgery: E

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(This rating reflected the problem of providing all indicative numbers required to complete a CCT.

This issue has required discussions with NIMDTA, SE Trust and DoH to devise an agreed training

scheme for a maxillofacial surgical trainee.)

Quality assurance of medical student clinical teaching is provided by QUB through a process of end

of placement surveys yearly site visit and review by QUB SUMDE Office. Any issues raised are dealt

with by Dr Niall Leonard, Undergraduate Sub-Dean. Clinical teaching is given to students at all stages

of the undergraduate curriculum, from first year through to final year. Over 1500 sessions of clinical

teaching are provided yearly. New developments include the introduction of Quality Improvement

training during the final year studentship and introduction of simulation training in the 4th year

POEM course. (SUMDE Accountability Report included below)

The Department of Medical Education has developed a teaching programme for Clinical and

Educational Supervisors. By July 2016 all those consultants performing these roles will be required to

have GMC Trainer Status Approval. This is achieved by undergoing four areas of training: Equality

and Diversity, Trainees Requiring Support, Clinical Supervision and Teach the Teacher. All of these

are now provided twice annually on the Ulster Hospital site. The numbers of consultants undergoing

this training is progressing well and we are on target to have the training completed by July 2016.

The National Foundation Programme Office of the GMC has recently announced results of how

Foundation Year trainees rate each of the trust’s where they are employed. We were delighted to be

informed that the South Eastern Trust was rated 6th place for ‘Overall Satisfaction’ out of all trusts in

the United Kingdom. This reflects not only the hard work of the Foundation Education Supervisors

and the Consultant Trainers but also all the nursing staff and other PAMS colleagues who ensure

that this trust provides a welcoming, supportive and safe training environment.

Dr Craig Renfrew MB (Hons) MD FRCA PDCE

Consultant Anaesthetist

Director of Medical Education

South Eastern Trust

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Medical SUMDE

Accountability Report

South Eastern

Templates and Guidance

for

2013-14

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Quality of Clinical Teaching

Summary of Student Evaluations

Please use Appendix 1 to describe the main positive and negative student feedback on clinical teaching for each specialty delivered by the Trust, then present key points in an overall summary below. Excellent feedback: See appendix 1. Where a percentage rating is given this refers to students’ overall satisfaction with the placement / teaching. The percentage given is the proportion who rated their level of satisfaction either ‘Very good’ or ‘Good’ or any equivalent on the top two points of the Likert scale applied. Improvements required: Consistent provision of induction in the following placements

3rd year medicine

Fractures

POEM

Please describe any recurrent problems and the action taken to address these. As detailed above

New leads for 3rd year medicine / POEM

Revision of role for lead in fractures programme: in progress.

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Quality of Clinical Teaching

Best Practice

Please give examples ofinnovation or best practice in relation to clinical teaching or other area of provision:

What is needed to extend or promote this work?

FY0 Assistantship: Quality Improvement Pilot Project

Aim: to introduce all SE Trust FY0s to QI methodology and participation in defined QI projects. Components: 1. Mandatory completion of 3 selected Institute for Healthcare Improvement (IHI) online learning modules 2. Attendance at learning sessions during the assistantship period (3 sessions) 3. Participation in a defined QI project Evaluation questionnaires were completed by all participants. 70% of students stated they were actively interested in participating in quality

improvement work as a Junior Doctor, 70% felt that as junior doctors they could drive improvement and 79% students agreed that quality improvement training had a place in the undergraduate curriculum.

Pharmacy Workshops: FY0 Assistantship Delivered throughout the assistantship, these focussed on common prescribing pitfalls and offered the opportunity to simulate real life prescribing and drug administration scenarios. Feedback from students excellent.

GP Pilot Programme: FY0 Assistantship

FY0 Assistantship: Quality Improvement Pilot Project

On-going collaboration with QUB CME and development as an extended pilot project 2014-2015, within SE Trust.

Pharmacy Workshops: FY0 Assistantship

On-going developments to enhance inter professional learning and delivery.

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In collaboration with SE Trust primary care leads a Pilot GP Programme was incorporated to the assistantship in SE trust. In its second year the programme continues to focus on the primary care and secondary care interface and on information sharing. The aim of the attachment was to provide FY0 doctors with a deeper understanding of issues of patient safety and communication in relation to patients as they transit from hospital to Primary Care and vice versa. Student feedback remains extremely positive and this has become a valued component of the programme.

Medical education centre/Quality improvement innovation centre (QIIC)

Infrastructure top slice, 2013, supported high fidelity simulation facilities which are complimented by a faculty of SUMDE funded simulation teaching fellows. The simulation suite is now operational and simulation teaching fellows are developing and integrating Inter professional simulation programmes into existing undergraduate placements. From pilot programmes conducted during 2014, student feedback has been extremely positive.

Summer Studentship programme 2014 SE Trust, SUMDE funded 8-week research project for two QUB second year students. This pioneering study examined the patient safety culture within an acute health and social care trust and characterised differences in perception of culture across a range of professions and seniority.

GP Pilot Programme: FY0 Assistantship

On-going communication and

development between primary care,

SE Trust subdeanery and QUB.

Would support roll out to all trusts

pending feasibility.

Medical education centre/Quality improvement innovation centre (QIIC)

Development, delivery and evaluation of simulation programmes across SE Trust undergraduate placements / programmes. On-going funding of simulation fellows from SE trust SUMDE budget.

Summer Studentship programme 2014

Sharing of work through presentation at local, national and international education and patient safety meetings planned. Bid for further Summer Studentship projects 2014-2015.

Quantity of Clinical Teaching

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Sub-deanery Structure

Please present an organisational chart of the Sub-deanery (to include clinical staff only)

Have you ensured that the staff members named agree that their names can be included in this document which will be accessed by the public? Yes

Medical Education - Trust Board Overview

Medicine 1&2Ulster

Dr Jennifer Elder

Dr Niall Leonard Sub Dean SE Trust2

Undergrad Secretariat

Ulster+ Ards: Lee Ann Irvine

LVH: Lisa Nelson

Downe: Maura McVicker

Medicine 3 Ulster

Dr Roland McKane1

Medicine 5 Ulster

Dr Richard Hewitt 1

5th Med 5th Card

Surgery 3&5 Ulster/LVH Mr

Stephen Kirk 1

*Medicine 5LVH

Dr Rosemary Kelly

Dermatology 3Ulster

Dr Elizabeth McMullen

Haematology 3UlsterDr

Margaret Bowers 1&3

for Haematology, Dermatology & ENT

ENT 3 Ulster

Mr Brendan Hanna

Medicine 1&2Ulster&LVH

Dr Simon Au1&3

Psych 4&5Ards

Dr Jonathan Green 2&3

Psych 4&5LVH

Dr Heather Hawthorn

Psych 4&5 Downe

Dr Mark Finnerty1, 2&3

COE 4 Ulster

Dr Sanjeev Sarup

COE 4 LVH

Dr Rosemary Kelly 1&2

COE 4 Downe

Dr Khalil Amir

Dr Cathal Foy 3

Paeds 4 Ulster

Dr Bernie O’Connor 1

O&G 4 Ulster

Dr Sandra Mawhinney 1

POEMS Theatre 4 Ulster 1 Dr Rachel Deyermond

POEMS Theatre 4 LVH

Dr Dhananjaya Potti

POEMS A&E 4 Ulster

Dr Kevin Maguire

Fractures4 Ulster

Mr Andy Adair

Radiology 4

Dr John TurkingtonUHD

Dr Sale Ogbobi LVH

Deputy Director of Medical Education QUB

Dr Kieran McGlade

SUMDE Office

Edel O’Hara Director of Medical Education

Dr Craig Renfrew

Cardiology 5 Ulster

Dr David Cochrane

Plastics 5Ulster

Mr Alastair Brown

A&E 5 Ulster

Dr Kevin Maguire

Medicine 5 Downe

Dr Helen Whitehead

Sub Deanery Committee 1 Clinical Co-ordinator

2 Hospital Clinical Co-ordinator

3Pastoral care

* Dr Stephen Tate deputy 1st, 2

nd, 5

th Med

LVH

MaxFac1 5Ulster

Mr Mike Perry

MaxFac, A&E, Plastics, surgical dental teaching

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Are all areas of clinical teaching delivery represented by this sub-deanery structure?

Yes/No

If No, what action has been taken (please give action taken and expected date of resolution):

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Quantity of Clinical Teaching

Clinical Timetables

Timetables for each placement are being updated continually and Lee Ann Irvine will continue to

liaise closely with CME in order to ensure provision of up to date timetables.

Each Timetable (or set of student documents) for a specialty should include as a minimum:

1. Hospital 2. Specialty 3. Ward/ location 4. Sub rotations where applicable (e.g. where a group of 8 students are assigned to a hospital

but they are split up or rotated through various areas of the unit to experience different activities).

5. Name of supervising clinician 6. Date of placement 7. Where a single timetable is used repeatedly during the year (a generic timetable) this should

be clearly stated on the return for that specialty

Guidance Notes

1. Trusts are required to provide clinical timetables to students on placement from 1st to 4th

Year. These should also be submitted to SUMDE Office.

2. Of particular interest to the DHSSPSNI and the University is the proportion of time spent

attending clinical sessions compared to self-directed learning (SDL). It is acknowledged that

students must be allowed time during placements to work independently on case studies

and personal study or preparation. However, SDL should not form the majority of

placement time in Years 1-4.

3. No timetables are required for students in 5th year (FY0).

4. No template is proposed for timetables to allow hospitals a flexible approach.

Infrastructure Provision for Undergraduates

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The following infrastructure requirements are considered by the University as being necessary for

delivery of clinical education to students. Please indicate if they are provided by the Trust.

Residential Accommodation

Is there a sufficient number of rooms to meet demand by students at each hospital? How many rooms are offered?51 Where are these rooms located? Ulster – 19 Lagan Valley – 24 Downe/Downshire - 8

Yes/No

Are you satisfied that the standard of rooms meets HMO standards and is adequate for students?

Yes/No

Please state any concerns (include timescale from report to resolution and how this has been reported to the appropriate directorate/committee within the Trust)

Travel within Placements

Where students have to travel from base hospital to other sites within the Trust, is clear information available to students on how to access travel arrangements/have costs reimbursed?

Yes/No

Please state any concerns (include timescale from report to resolution and how this has been reported to the appropriate directorate/ committee within the Trust)

Information & Communication Technology

Do students have access to recommended reading materials for all specialties?

Yes

Do students have access to the websites recommended by CME?

See below

Do all students have sufficient access to ICT such that their studies are not impaired?

Yes/No


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We have requested a list (white list / black list) be made available from QUB CME for cross checking with SE Trust IT. Request made July 2014 from Michelle McQuaid, SUMDE office and included in ‘Areas for consideration’ in this report.

Clinical facilities appropriate for the delivery of undergraduate medicine

Do students have access to the appropriate clinical facilities & staff for the delivery of the agreed specialties for undergraduate medicine?

Yes/No


Study Space

Do students have access to a Tutorial Room or similar study space?

Yes/No


Lockers/safe storage of students’ belongings

Do students have access lockers/ safe storage of their belongings?

Yes/No


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Health & Safety

Are students considered as a specific group when undertaking normal Trust Health & Safety audits?

Yes/No


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InfrastructureTopslice Projects

Progress Report

Brief Description of Project Financial Year

awarded

Trust funding contribution to project

Progress

Internet access multi-site/SimMan

2010-11 £20k DHSS Topslice + £20k SUMDE Trust

Project completed

Old Mitchel Ward refurb for education centre

2011-12 £20k DHSS Topslice + £20k SUMDE Trust

Project completed.

Sim Baby

2012-2013 £20k DHSS Topslice + £20k SUMDE Trust+ £5k Trust funded

Project completed.

Audio-visual and videoconference systems within Trust–funded Medical Education and Simulation Centre. A faculty of Trust/SUMDE-funded teaching fellows for simulation

2013-2014 £20k topslice + £20k Trust Total cost of Medical Education Centre facilities: £120k

Project completed. Simulation suite operational. Simulation teaching fellows developing and integrating simulation across existing undergraduate programmes.

Guidance Notes

1. Include all projects funded through the Infrastructure Topslice. Describe the benefit to

undergraduate activities. Describe arrangements for sharing the resource with other

groups. Describe proportional contribution to funding where applicable.

2. Projects reported as complete need not be included in subsequent Financial Year.

3. Please indicate the hospital/site/location where infrastructure project is

proposed/underway.

4. Describe progress - include delays or outstanding issues to be resolved.

5. Sub-deans should seek advice from the Trust Finance Department to ensure they observe

any restrictions on projects. Uses proposed should be within the normal financial

restrictions approved for minor works.

6. Early discussion of proposed projects with the Director of the Centre for Medical Education

(QUB) will ensure that project bids do not get rejected as being low priority for

undergraduate education.

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Areas forConsideration

Please describe any areas where provision needs further development

What needs to be done to address these areas?

Information & Communication Technology Do all students have sufficient access to ICT such that their studies are not impaired?

We have requested a list (white list / black list) be made available from QUB CME for cross checking with SE Trust IT. Request made July 2014 from Michelle McQuaid, SUMDE office.

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Sub-dean’s Statement

This is a true and accurate account of undergraduate activity. Supporting documentation

can be provided if required.

Signed: (Sub-dean)

Date: ____________________11/9/14_____________________________

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Appendix 1 Trust comment on Student feedback Academic Year 2013-2014

Lagan Valley Hospital

Subject Rating Comments Agreed Trust Action Plan

Clinical Skills 100% The teachers encouraged us to think and apply our lectures by asking questions. We were always given the opportunity to visit relevant patients, and given feedback on our performance

None required.

Ageing & Health 100% Excellent programme None required.

Mental Health 100% Excellent programme.

None required.

Radiology 78% ‘This was the best clinical attachment I have been on all year’.

None required.

Medicine (5thYr) 68%

Well organised attachment. Helpful and approachable teaching staff The small team of staff allows students to become more involved and feel like a contributing member of the medical team.

None required.

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Ulster Hospital


Cardiology 3rd year

100% 1. Outstanding teaching every session.

They were also punctual and well prepared with a format for each teaching session

None required.

Dermatology 93% 1. Good clinical exposure; quality

teaching; interested staff. 2. Many requests for a longer (2 week)

placement.

1. None required. 2. Feedback to QUB

CME

ENT 100% 1. Good teaching; great timetable; staff

enthusiastic. 2. Better communication re. Clinic

schedule changes across the 5 sites required

More contemporaneous timetable emailed to students 1 week prior to placement.

Haematology 76% 1. Staff helpful; tutorials took place as

scheduled; good learning experience.

None required.

3rdYr Medicine 89% 1. Case feedback, timetable, standard of teaching and attitude of staff fantastic.

2. Timeliness of feedback on cases improved but further improvements required

3. Medical Admissions Unit (MAU)

programme highly rated but students seeking more structure.

4. GI teaching highly rated but students

wanted more sessions scheduled. This has been implemented for 2013-2014 programme.

5. Induction to programme of variable

consistency. Due to changing workload of current clinical lead.

2. Case re allocation now operational with subsequent improvement in feedback mid-year.

3. MAU consultant to co-lead programme 2014-2015. Will enable and enhance on-going development and delivery.

4. More GI sessions

now included.

5. MAU consultant to co-lead programme 2014-2015. Will allow greater flexibility, diversity and innovation.

1. Most organised, consultant-led teaching all 2. Theatre access:

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3rdYr Surgery 85% year. Outstanding teaching. 2. Request for swipe card access to theatres after 17:00.

mechanism ensuring improved access and patient safety now in place.

Aging & Health 96% 1. Excellent teaching programme

None required.

Child Health 100% 1. Excellent teaching programme. 2. Log book amendments requested.

2. Feedback to QUB CME.

Fractures 66% Quality of teaching good, but:

1. Students remain unhappy about the structure and organisation of the module.

2. Lead not always available for induction

due to change in working pattern.

1. Review of

programme delivery and support with Fracture lead, SE Trust and QUB CME: Work in progress.

O&G 100% 1. Excellent teaching programme. 2. Hugely positive feedback on teaching and new medical education centre located in Quality Improvement and Innovation Centre.

None required.

POEM 98% Excellent teaching programme.

1. Excellent programme

2. Inconsistent delivery of formal induction at start of programme and on-going support during anaesthetic component: due to change in working pattern of clinical lead responsible.

3. Complaints re. Student learning facilities on old site: temperature and IT access.

1. New clinical lead appointed August 2014

2. New Medical

Education Centre opened in interim. All issues resolved.

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Radiology 93% 1. Staff helpful and friendly 2. Request for study guide and online material 3. Several enquiries re. utility of such a short placement 4. Poor IT facilities on old site

2/3. Feedback to QUB CME 4. New Medical Education Centre opened in interim. All issues resolved.

Assistantship 100% 1. Overall satisfaction rating extremely

high.

2. Students felt that they were an integral part of their teams.

3. Pharmacy led educational seminars:

extremely useful

4. GP pilot programme: feedback extremely positive.

5. QI pilot: excellent feedback

4,5. Pilot extension into 2014-2015. Commented elsewhere on report

Medicine 5thYr

87% Staff very friendly and approachable. Plenty of learning opportunities and chances to practise clinical skills

None required.

Surgery 5thYr

79% Team very enthusiastic and dedicated. All staff approachable and willing to teach

None required.

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Ards Hospital


Mental Health 90% Doctors approachable, encouraging and helpful Home visits beneficial Old Age Psychiatry week great Teaching was brilliant.

None required.

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Downe Hospital


Ageing & Health 77% The consultants were approachable and gave us plenty of opportunity to learn on the wards and in tutorial settings. Really great learning experience

None required.

Medicine (5thYr) 94% Wide range of clinical exposure. ‘The best attachment I have ever had’.

None required.

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Downshire Hospital


Mental Health 100% Excellent teaching programme None required.

Department of Medical Education Trust Board Overvie · Department of Medical Education – Trust Board Overview ... Dr Roland McKane1 ... Mr Brendan Hanna

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