Document type: Guide Document category: Training Date established: 2014 Date last reviewed: 2014

College of Intensive Care Medicine of Australia and New Zealand

Guide to CICM Training: Trainees

2

Contents

About this Guide ............................................................................................................. 4 

What is the Purpose of this Guide? ............................................................................... 4 

Conventions used Throughout this Guide ...................................................................... 4 

Introduction .................................................................................................................... 5 

Welcome to the College of Intensive Care Medicine (CICM) ........................................... 5 

About the CICM Training Program ................................................................................... 5 

Broad Aims of the CICM Training Program .................................................................... 5 

Competencies ............................................................................................................. 6 

Overview of the Training Program .................................................................................... 7 

General Intensive Care Medicine .................................................................................. 7 

Paediatric Intensive Care Medicine ............................................................................... 7 

Training Time .............................................................................................................. 8 

Foundation Training (6 months) ................................................................................. 8 

Core Training (24 months) ......................................................................................... 8 

Transition Training (12 months) ................................................................................. 8 

Anaesthesia (12 months) ........................................................................................... 8 

Medicine (12 months) ................................................................................................ 8 

Elective Training (6 months) ...................................................................................... 9 

Required clinical experience during training ...................................................................... 9 

Sub specialities ........................................................................................................... 9 

Paediatric experience ................................................................................................... 9 

Rural Experience (3 months minimum) .......................................................................... 9 

Approval of Training ...................................................................................................... 10 

Interrupted Training .................................................................................................... 10 

Overseas Training Experience .................................................................................... 10 

Part-Time Training ..................................................................................................... 10 

Research .................................................................................................................. 10 

Assessment Processes and Requirements ..................................................................... 11 

Examinations ............................................................................................................. 11 

The First Part Examination ...................................................................................... 11 

Exemption for the First Part Examination .................................................................. 11 

The Second Part Examination (General and Paediatric) ............................................ 12 

Workplace Based Assessment (WBA) ............................................................................ 12 

Objectives of the WBA Process .................................................................................. 12 

Online In-Training Evaluation Report (ITER) ................................................................ 12 

Formative Self-Assessment by Trainees ................................................................... 13 

Workplace Competency Assessment (WCA) ............................................................... 13 

Observed Clinical Encounter (OCE) ............................................................................ 14 

3

Courses ....................................................................................................................... 14 

Formal Project .............................................................................................................. 15 

How do I get the most out of the Training Program? ........................................................ 16 

Factors underpinning successful learning for trainees .................................................. 16 

Characteristics of Successful Learners in the Clinical Environment ............................ 16 

Willingness ............................................................................................................. 16 

Professionalism ...................................................................................................... 16 

Personal Attributes ................................................................................................. 17 

Communication and Interaction................................................................................ 17 

Knowledge, Understanding and Skills ...................................................................... 17 

Characteristics that Differentiate Successful from Unsuccessful Students ................... 18 

Giving and Receiving Feedback .................................................................................. 19 

Tips for Receiving Feedback ................................................................................... 20 

Tips for Giving Effective Feedback ........................................................................... 21 

Trainee Welfare ............................................................................................................ 21 

Overview ................................................................................................................... 21 

Professional .............................................................................................................. 21 

Academic .................................................................................................................. 22 

Administrative ............................................................................................................ 22 

Career ...................................................................................................................... 22 

Personal ................................................................................................................... 22 

Family Needs ............................................................................................................ 22 

Illness and disability ................................................................................................... 22 

Experiencing Difficulties During Training ...................................................................... 22 

Difficulties with Examinations ................................................................................... 23 

AbouThis guMedicin

What This tra assis prov prov

Conve

ut this Guide has bene of Austra

is the Puaining guide

st you as yovide answersvide contact

entions

Guide een develoalia and New

urpose oe is designed

ou progresss to questiodetails of r

used Th

Hyperlink to

Frequently

Important n

oped for regw Zealand.

of this Gud to:

s through yoons that mayelevant indi

roughou

o a website

asked ques

note

gistered tra

uide?

our trainingy arise duriividuals and

ut this Gu

or docume

stion

ainees of th

ng training d organisati

uide

ent

he College

ons

of Intensivve Care

4

5

Introduction

Welcome to the College of Intensive Care Medicine (CICM) As a trainee of the CICM you have elected to participate in a demanding and rigorous training program. Success in your training requirements will allow you to graduate as a Fellow of the College of Intensive Care Medicine (FCICM). Before this can occur there is a great deal for you to achieve. While you will receive lots of support, and have access to a number of excellent resources, the responsibility for your learning rests with you. You are encouraged to make use of all the training and educational opportunities that are available. Information contained within the guide is correct at the time of publication. However, due to the constant updating and modification of regulations, professional documents and procedures within the College, some information will change with time. Hence the guide will be updated periodically. You are therefore advised to check with the College before making any decision that may affect your training.

About the CICM Training Program

Broad Aims of the CICM Training Program During your time as a CICM trainee you will: 1. Acquire such knowledge, problem solving ability, practical skills and attitudes

appropriate for the safe and effective practice of intensive care medicine. This extends to patients, equipment and the intensive care environment.

2. Develop the ability to respond rapidly and appropriately to life threatening problems

and establish the priorities of management. 3. Be able to act appropriately as a member or leader of a team. 4. Acquire knowledge in those aspects of medicine, surgery, paediatrics, obstetrics,

anaesthesia and other disciplines, which are relevant to the practice of intensive care medicine.

5. Develop the ethic that the patient's welfare always takes precedence in the event of

medical, political or ethical conflicts. 6. Provide patients with the best possible care considering available resources. 7. Learn to identify and modify the stresses which the intensive care environment places

upon the patients, their relatives and hospital staff. 8. Participate in the processes of clinical audit and quality improvement activities. 9. Enquire into clinical and scientific problems, adopting systematic and critical appraisal

of available information. 10. Contribute to the education of medical, nursing and paramedical staff. 11. Develop a process of regular self-assessment so that limitations can be identified and

deficiencies corrected. 12. Be aware of current College policies on professional issues and act in ways consistent

with these policies.

CompThe comedicaFramewpracticeHealth programaligned program

The dedocume

petenciesmpetenciesl specialis

work whiche; Medical EAdvocate,

m (learning with this

m is compre

More inforPhysicians

etailed coment:

The Compin Genera

s s to be achst. These h defines Expert, ComScholar, an

g, teachingframework

ehensive an

mation abos and Surge

mpetencies

petencies, Tl Intensive C

hieved coveare base

the sevenmmunicatornd Professig, training k to ensurnd properly f

out the frameons of Can

for intens

Teaching, LCare Medic

er the varioed on thn domainsr, Collaboraional. All a

and assere that thefocused.

mework can nada websit

sive care t

Learning Opcine.

ous roles ofhe CanMes of medictor, Managespects of t

essment) ae education

be found bte.

training are

pportunities

f a ds cal er, he

are nal

y visiting th

e contained

and Assess

he Royal Co

d in the f

sments for

ollege of

following

Training

6

OverThe traterms in

GeneThere a

6 mo

24 m

12 m Traineeexperie

Card

Neur

Trau

Additio

12 m

12 m

6 mo

Trainee

3 mo

a ter PaediThere a

6 m

24 und

12 m Traineeexperie

Pae

Pae

Pae

Additio

12 m

12 m

6 m Trainee

rview ofining progran intensive c

ral Intenare 42 mon

onths Found

months of Co

months of Tr

es must coence in each

diothoracic s

rological / N

uma intensiv

onal trainin

months of an

months of m

onths of ele

es are also r

onths in a ru

rm in paedia

iatric Inteare 42 mon

months Foun

months of dertaken in p

months of T

es must coence in each

ediatric card

ediatric neur

ediatric trau

onal trainin

months of a

months of p

months of ele

es are also r For further

f the Traam in intencare units, a

sive Carnths of Inte

dation traini

ore intensiv

ransition tra

omplete terh of the follo

surgery inte

Neurosurger

ve care

ng includes

naesthesia

medicine (inc

ctive

required to

ural hospita

atrics in a u

ensive Cnths of Inte

ndation train

Core intenpaediatric in

Transition tr

omplete terh of the follo

diothoracic s

rological / n

ma intensiv

ng includes

anaesthesia

paediatric m

ective

required to

r details refe

aining Pnsive care manaesthetic

re Medicinsive Care

ing (pre-reg

ve care med

aining.

rms in unitowing:

ensive care

ry intensive

s:

cluding 6 mo

complete:

al and

nit approve

Care Mednsive Care

ning (pre-reg

nsive care ntensive ca

aining

rms in unitowing:

surgery inte

neurosurger

ve care

s:

a

medicine (inc

complete 3

er to CICM

Programmedicine is cs and med

ine e Medicine

gistration)

dicine traini

ts that are

e care

onths emer

ed for paedia

dicine e Medicine

gistration)

medicine re)

ts that are

ensive care

ry intensive

cluding 6 m

3 months in

Regulation

m a minimum

icine.

training tim

ng

e accredite

rgency/acut

atric training

training tim

training (1

e accredite

care

onths emer

a rural hosp

5.

m of six yea

me; consist

d for and

e medicine

g

me; consist

8 months

d for and

rgency/acut

pital.

ars, with pre

ting of

provide a

)

ting of

of which m

provide a

te medicine

escribed

dequate

must be

dequate

e)

7

Traini FoundThis 6 undertatraining

Core TEntry inExaminCollegecampus TransiAll trainCollege

AnaesTrainingapproveaspectsan inten

MediciClinical Collegeresponstraining

ing Time

dation Traimonth term

aken in unit program.

Training (2nto Core Trnation (unlee. Of these 2s.

tion Trainnees must se.

Entry into tPart Examiassessmenmedicine.

Trainees mcommencin

Transition t

For full dewebsite.

thesia (12g in clinicaled by the Cs of anaesthnsivist.

For furtherTraining –part of the

ine (12 mo medicine

e. Six montsibility for lo will provide

For compObjectives

e

ining (6 mm provides ts approved

24 monthsraining is dss exempte24 months,

ning (12 mspend their

the Transitination in ei

nt tasks du

must haveng the Trans

training mus

etails refer

2 months) anaesthes

College. Duhesia and p

r details on– The AnaeANZCA cu

onths) training conths must bongitudinal e you with e

plete detailss of Training

onths) a foundati

d by the Co

s) ependent ued). Core trat least 12

onths) final year o

ion Year rether Generaring Core i

submittedsition Year.

st be contin

to the Tra

sia consistsring this traperi-operati

the objectesthesia Trriculum ca

nsists of 12be in acute

care of meexperience

s on the g – The Med

onal experollege and

upon satisfaraining cons months mu

of training i

equires sucal or Paediaintensive c

d their Fo

nuous and u

ansition Ye

s of 12 monaining you wve manage

tives of anaTerm. Furthan be found

2 months ue medicine edical patiein, or know

objectives dicine Term

rience in inwill be com

actory compsists of traiust be conti

n an intens

ccessful comatric intensivare medici

rmal Proje

undertaken

ear Objectiv

nths undertawill acquire ement that a

aesthesia trer informaton the ANZ

undertaken (e.g. Eme

nts. It is noledge of, al

on clinicam available o

tensive carmpleted prio

pletion of thning in unitnuous and

sive care un

mpletion of ve care mene training,

ect for ass

in one unit.

ves availab

aken in anaknowledgeare relevan

aining, refeion on anaeZCA website

in positionrgency) an

ot expectedl medical co

l medicine on the Colle

re medicineor to entry

he CICM Fts approvedundertaken

nit approved

the CICM edicine and , anaesthet

sessment

ble on the

aesthesia pe and skills nt to the pra

er to Objectesthetic trae.

s approvednd six montd that this ponditions.

training, ege website

e and is into the

irst Part d by the n on one

d by the

Second all other tics and

prior to

College

positions in those actice of

tives of aining as

d by the ths with

period of

refer to e.

8

9

Elective Training (6 months) Trainees are required to undertake an elective period of six months in a position approved by the College for training in one of the following disciplines:

Intensive care medicine

Clinical anaesthesia

General medicine (adult and paediatric)

Specialist medicine

Emergency medicine

Surgery

Pain medicine

Research

Other disciplines related to intensive care medicine.

Required clinical experience during training

Sub specialities Trainees must complete terms in intensive care units that are accredited for and provide adequate experience in the following; Cardiothoracic surgery intensive care Neurological/neurosurgery intensive care Trauma intensive care

Paediatric experience Trainees in general intensive care medicine are required to gain experience in paediatrics by completing any of the following:

6 month term in an accredited Paediatric intensive Care unit 6 months in a general ICU with > 100 children admitted per year 12 months in a general ICU with > 50 children admitted per year 6 months Acute Paediatric Medicine 6 months Paediatric Anaesthesia 6 months Paediatric Emergency 6 months Mixed Emergency with a minimum number of paediatric presentations

Rural Experience (3 months minimum) Trainees must spend at least 3 months in a rural hospital in any approved discipline during training. This requirement may be retrospectively approved.

ApprAll trainmust suwhenevoffice w Traineeand eleprospec

InterrRegulattraining

OversAt leastZealandAustralioverseawell in a

Part-TPart-timtrainingboth in- ReseaThe Cotowardsperiod researcparticipconcurr

roval of ning must beubmit an Aver taking uwithin 30 day

es may appective trainctively appr

Application

rupted Trtion 5.9 in t may requir

seas Trat two yearsd, or Hongian or Newas prospectadvance of

Time Trame training c

must comp-hours and o

arch ollege encous elective twhich alter

ch is neceation. Somrently with t

f Trainine approved

Application fup an appoys of comm

ly for retrosing. Core i

roved.

ns must be

raining he College re additiona

ining Exs of the totag Kong. How Zealand tive approvthe appoint

aining can take plaprise a minout-of-hours

urages reseraining. Prirs the natussary. Thise trainees heir intensiv

ng by the Coll

for Approvaointment. S

mencing the

spective appintensive ca

lodged via

Regulational training tim

perienceal program owever, noposts. Whe

val must betment.

ace at any imum of 0.4s duties.

earch by traor approva

ure of norms supervisohave workeve care trai

lege. For traal of VocatiSuch inform

appointmen

proval of prare training

the CICM m

ns covers thme to be un

e must be sp

ormally mosen a local

e obtained f

time under4 of the co

inees and mal from the mal clinical or must reed towards ning.

aining to beonal Traini

mation must nt.

revious traing and Tran

members po

is issue. Endertaken.

pent in appst of the trgraduate w

from the Ce

r the rules smmitment o

may allow tiCensor is duties. A

eport on thresearch d

e approved, ng (AVT) fobe submit

ning in anaensition Yea

ortal.

xtended pe

roved postsraining timewants to sensor. This

set out in Rof a full time

ime spent innecessary designated

he outcomedegrees suc

registered orm to the tted to the

esthetics, mr training m

eriods of inte

s in Austrae will be s

spend trainis should be

Regulation 5e trainee, in

n research for any sig

d supervisoe of the tch as MD a

trainees College College

medicine must be

errupted

lia, New spent in ng time

e sought

5.6. The ncluding

to count gnificant r of the trainee’s and PhD

10

AsseRequContemeducatimultipleabilitiesabout p Educati(linked which m With thi 1. Exa The The

2. A n3. Ass4. For

Exam The FiThe Firbasic sExamin To be e be hav hav

ExempCandidaCICM F Succ Train

examCens

Train

the FCICM

essmentuiremenmporary ap

on emphase measures over timeprogress.

ional reseato feedbac

most strong

is in mind, a

aminations:

e First Part e Second P

number of Wsessment wrmal Projec

minations

rst Part Exrst Part Exasciences apnation is hel

eligible to pr

a registeredve submitteve paid the

Intensive ccarefully co

ption for thates who m

First Part ex

cessful com

nees who mple by othsor.

nees underFirst or PriM Core Tra

t Procents pproaches sise a pro

es of traine are aggre

arch has dek and reflecly influence

assessment

:

ExaminatioPart Examin

Workplace Bwithin requirct

s

xaminatioamination ispplied to thd twice eac

resent for th

d trainee wed full docum

appropriate

care mediconsult the F

he First Pmeet one oxamination:

mpletion of F

have compher College

rtaking a tramary comp

aining (ie ex

sses an

to assessogrammatic nees’ knowegated to in

emonstratedction) is the

es learning.

t throughou

on ation

Based Assered courses

on s a written ae clinical p

ch year.

he First Part

ith the Collementation e registratio

ine covers First Part Ex

art Examiof the follow

Fellowship w

pleted an ees oversea

aining progrponent of thxemption fro

nd

sment in mapproach

wledge, sknform judg

d that assee contextua

ut your train

essments (Ws

and oral tespractice of

t Examinati

ege

on fees

a wide ranxamination

nation wing criteria

with the AN

equivalent as) may als

ram with anhat programom the Firs

medical where

kill and ements

essment al factor

ing program

WBAs)

st of knowleintensive c

on, candida

nge of disciSyllabus on

a may quali

ZCA, ACEM

training anso be cons

nother Collem may be st Part exam

m has four m

edge and uncare medici

ates must:

plines and n the Colleg

ify for an e

M or RACP

d examinasidered for

ege and whgranted co

m). Howeve

main compo

nderstandinine. The F

candidatesge website.

exemption f

ations progrexemption

ho have coonditional ener condition

onents:

ng of the irst Part

s should

from the

ram (for n by the

mpleted ntry into nal Core

11

Traininclu

The SeThe Sepracticeanaesthyear an Candida at lea two O These examin

WorkWBA’s written more coThe asscompet

ObjecThe obj prov

impr deve facili mon prov

Overall directed

OnlinThe ITEIt comp The ITcommudomainacross Each itbehavioother reevidenc

ning will ouding award

econd Parecond Part e of intenshesia and cnd the Paed

ates presen

ast one yeaObserved C

requiremenation comm

Full detailsthe website

kplace Bform an esand oral e

omprehenssessment ptency based

ctives of jectives of t

vide a basrovement elop skills ofitate the devitor and rec

vide ongoing

the assessd and self-m

e In-TraiER is an invplements oth

TER coversnicator, cos of practithe seven d

tem has a ours that indelevant exace of compe

nly be ratid of Fellows

rt ExaminaExaminatio

sive care mclinical mediiatric Secon

nting for the

ar of Core TClinical Enc

nts must bmences.

s on the Fire.

Based Assential comexaminationive assessm

process follod and contin

the WBAhe WBA pro

is for feed

f self-evaluavelopment o

cord progresg formative

sment procemanaged life

ining Evavaluable assher methods

s seven doollaborator, ce are basdomains.

list of pedicate compamples to etence on a

fied on cohip.

ation (Genn comprise

medicine, iicine. The Gnd Part Exa

e Second Pa

Training in inounters (OC

e satisfied

rst Part Exa

Assessmmponent of s. This com

ment of skillows current nuous.

A Procesocess are to

dback of s

ation and reof strategiesss within anfeedback to

ess aims toelong learni

aluation sessment tos of evaluat

omains of manager,

sed on the

rformance petency for provide fee

a particular i

ompletion o

neral and Pes written ancluding reGeneral Secamination is

art Examina

ntensive caCE) for eac

by the da

amination a

ment (Wf the assessmbination ols, knowledassessmen

ss o:

strengths a

eflective pras to improv

nd across clo inform sub

o encourageing.

Report (ool that faction, such a

intensive chealth adv CanMeds

indicators each partic

edback on item.

of the othe

Paediatricnd oral secelevant aspcond Part E

s held once

ation must h

re medicineh six month

ate on whic

and the Sec

WBA) sment systeof assessmge and behnt theory, is

and areas

actice e performanlinical termsbsequent le

e reflection

(ITER) ilitates the o

as the exam

care practivocate, scho

standards

which provcular item. Sthe behavi

er College’s

c) ctions coverpects of thExaminationa year.

have satisfa

e hs of Core T

ch the writ

cond Part E

em to compent approaaviours.

s blueprinted

of clinical

nce s earning activ

and the de

ongoing edminations.

ce: medicaolar and p. There are

vide exampSupervisorsiours they

s training p

ring the thehe basic scn is held twi

actorily com

Training

tten section

Examination

plement theaches will e

d to the cur

practice r

vities

evelopment

ucation of t

al (clinical) professionale 23 items

ples of obss will use thare looking

program

eory and ciences, ice each

mpleted:

n of the

n are on

e formal enable a

rriculum,

requiring

t of self-

trainees.

expert, . These spread

servable ese and g for as

12

The ITEand reqprospecpreviou At the colleagbe subelectivemid-poito be su FormaUnless effectiveassessis compopportustrategi

WorkThe WCdirect ocompleof CICM

To be askill and

ER is a joinquires activctive goal ss terms. Th

end of eaues will submitted for

e training. Tnt of each submitted to

ative Self-Ayou develoe learners n

s’ using the pared to th

unities for des for achie

An examplon the Col

place CoCA’s have

observation ted prior to

M.

Cen

Ven

Bra

Inte

Com

Trac

assessed ad behaviour

The WCA

nt process ove participsetting for he process i

ach six mobmit a comevery appr

Trainees aresix month tthe College

Assessmeop the capanow or in thITER form

he assessmiscussion aeving this.

le of an In Tlege websit

ompetenbeen deveof key procentry into t

ntral venous

ntilator set-u

in death ce

er-costal cat

mmunicatio

cheostomy

as competer in all of the

forms are a

of evaluatioation by btrainees anis a collabo

nth period pleted ITERroved terme encourageerm as parte.

ent by Tracity to makee future. Toand discus

ment of youand a path t

Training Evate.

cy Assesloped to pr

cedural skillhe Transitio

s catheter in

up

rtification

theter insert

n (x2)

nt in each e performan

available in

on and goaboth partiesnd for a rerative one b

of trainingR to the Co of traininged to compt of the form

inees e judgmento foster actis discrepanur supervistowards co

aluation Re

ssment (rovide specls. In total thon Year. Ea

nsertion

tion

WCA, you nce indicato

the CICM m

al setting bes. The ITEeview of anbetween su

g, Supervisollege. Comg, includingplete an ITEmative proc

ts about youve involvem

ncies or simsor. Observnsensus ab

eport form a

(WCA) cific feedbachere are seach WCA ca

must demoors related t

members po

etween trainER offers tny relevant pervisor an

sors in conmpleted ITEg anaesthetER with theiess. This IT

ur own learnment, you ar

milarities whevation of dibout specific

nd a user g

ck and asseven WCA’san be signe

onstrate adeto the WCA

ortal.

nee and suthe opportumatters re

nd trainee.

njunction wR’s are reqtics, medicir SupervisoTER is not

ning you care required en self-asseifferences pc expectati

guide is ava

sessment bas to be succed off by any

equate knoA.

pervisor unity for elated to

with their quired to cine and or at the required

annot be to ‘self-

essment provides ons and

ilable

ased on cessfully y Fellow

owledge,

13

ObseThe OCrelevannon-tecYou shoor other You areCore Tr To achi

perfo

presman

Feedbaaside toIt is imundertaarea of Card Resp Neur Rena Gast Haem Trau Extra

CourTo suppintensivcourseswith the

rved ClinCE providest clinical kn

chnical) andould regular Fellow of C

e required raining.

eve a satisf

orm an app

ent your cliagement is

ack is an imo allow for rportant to

ake more thintensive c

diovascular piratory rological al trointestinalmatological

uma a-mural car

The OCE

rses plement clinvist are covs. Completioe developme

Refer to th

nical Encs Supervisonowledge (d behaviourarly performCICM with t

to satisfact

factory stan

ropriate clin

inical findinsues (sugg

mportant asrelevant discnote that o

han one clinare medicin

l l

re

form is ava

nically basevered, you on of theseent of comp

he Required

counter (ors with a s(including rers related tostructured

the goal of

torily compl

ndard you a

nical assess

gs to your ested time

pect of thecussion regobtaining a nical assessne, submitte

ailable in the

ed learning aare requir

e courses ispetencies re

d Courses d

(OCE) structured areasoning ao a traineeexaminatio

improving y

lete and su

are required

sment of a c

assessor w= 20 minute

e process. garding the

satisfactorsment. Addied OCEs sh

e CICM me

and ensurered to coms staged acequired.

document av

assessmentand underst’s managem

ons under oyour clinical

ubmit two O

to;

critically ill p

with an appres)

An additionclinical scen

ry assessmitionally to ehould focus

mbers porta

all aspectsplete specross the six

vailable on

t and feedbtanding), skment of a sobservation

knowledge

OCE’s for e

patient

ropriate dis

nal ten minnario and yoent may ofensure comon different

al.

s of competeified face tx years of tr

the College

back formatkills (technsingle clinicby your su

e and skills.

each six mo

cussion of

utes shouldour performften mean

mpetency in t organ sys

ency requirto face andraining and

e website.

t for the ical and

cal case. pervisor

onths of

relevant

d be set mance.

you will a broad tems;

ed of an d online aligned

14

FormTraineein which(but are

A quevalu

An opatie

A prevaluevalu

A stuThis

A sy Careful successtraineesrespons

mal Projes are requih you havee not limited

uality assuuation as fo

observationaents. Such c

rospective uation of auation of th

udy of a parwill likely re

ystematic re

planning ps. One of ths planning, sibility to cri

Note: YouTransition Full detailswebsite.

ect ired to com participate

d to):

rance audior a typical '

al study revcase series

scientific sta treatment e introducti

rticular aspeequire the a

view of the

prior to the he duties of executing aitically revie

ur Formal n training.

s on the

plete a Fored to a sign

t or a quaPlan, Do, S

viewing an acould be co

tudy. This or a proce

on of a new

ect of manaassent of the

literature p

commencethe superv

and presentew the final

Project m

Formal Pro

rmal Projecificant exten

ality improvStudy, Act' it

aspect of ponducted p

might entaess. Other

w treatment

agement of e principal

ertaining to

ement of thvisor is to prting the Formanuscript

must be s

oject Requ

t. The repont. Example

ement projterative qua

practice or trospectively

ail a randompossibilitieor process

patients invinvestigator

o a clinically

he project wrovide advicrmal Projectt to ensure i

ubmitted b

irements a

rt must be es of possib

ect with a ality cycle.

he managey or retrosp

mised or pes include a.

volved in a r for the stud

relevant su

will maximisce, supervist. Your supeits suitability

before you

are availabl

based on able projects

'before an

ement of a gpectively.

pseudo randa before a

multi-centedy.

ubject.

se the likelision and supervisor alsoy for submis

u can com

le on the

a project s include

nd after'

group of

domised nd after

red trial.

ihood of pport for has the ssion.

mmence

College

15

16

How do I get the most out of the Training Program?

Factors underpinning successful learning for trainees

Characteristics of Successful Learners in the Clinical Environment In the clinical setting successful learning depends on a collaborative relationship between the trainee and their educators. The onus for creating effective and successful relationships during clinical learning is the responsibility of both the trainee and supervisors. From the literature of health professional education a range of characteristics required for successful learning have been identified. It is important to note that the key characteristics are not possession of adequate knowledge, skills or understanding but rather a willingness to learn, seek out feedback and learning opportunities, complete tasks, effective communication and interaction with others and taking responsibility for learning. In order of priority the characteristics and associated behaviours were as follows:

Willingness Trainee is willing to:

seek and act on feedback

work as a team member with peers, colleagues and other health professionals

ask questions and clarify to ensure understanding

try new techniques

discuss and exchange ideas to maximise patient care

complete all tasks requested of them

take responsibility for their own learning

self-reflect and evaluate Professionalism The trainee:

respectfully engages with people from a wide range of cultures and backgrounds

is prepared to learn

maintains an appropriate appearance, is punctual, and has a clear understanding of their role

complies with professional matters such as confidentiality, ethical and legal requirements

maintains appropriate professional boundaries

has a self-awareness of own limitations and is honest about their current level of knowledge and skills

17

Personal Attributes The trainee:

has an internal locus of control (i.e. they believe that events in their life derive primarily from their own actions rather than blaming external factors)

demonstrates enthusiasm and interest in their work

is able to manage stress levels

demonstrates a desire to learn

is polite, helpful, self-directed, proactive, curious and asks questions

is sensitive and empathetic to patient and family’s needs and concerns Communication and Interaction The trainee:

communicates professionally with members of the health team

demonstrates respectful and non-judgemental communication

demonstrates effective written and verbal communication skills

appreciates non-verbal communication

has the capacity to adjust their communication style to meet the needs of the audience be they colleagues, patients, or others

Knowledge, Understanding and Skills The trainee:

demonstrates basic knowledge relevant to clinical area (including basic sciences and key features of common conditions)

is able to accesses information when a gap in knowledge or need for further knowledge is identified

is able to access and apply knowledge to clinical situations

demonstrates effective organisational skills

demonstrates effective problem solving skills (Chipchase et al 2012)

18

Characteristics that Differentiate Successful from Unsuccessful Students Looking at successful and unsuccessful students together, three categories describing these two types of students seemed to be opposites of each other: communication, preparation, and functioning in the clinical area. Communication. Successful students could build relationships and communicate with faculty, staff, patients, and peers. Unsuccessful students had difficulty communicating with patients, faculty, peers, and clinical staff. Preparation for the Clinical Experience and Use of Feedback. Successful students were prepared for the clinical experience. They showed progress, accepted feedback, and adapted easily in the clinical experience. Unsuccessful students were not prepared and did not show improvement. Functioning in the Clinical Area. Successful students could think critically, integrating theory into clinical experiences, developing a plan of care for patients, and providing safe care. Unsuccessful students could not function in the fast-paced clinical environment. Successful students had a positive attitude with an eagerness to learn. Unsuccessful students jeopardized patient safety, committed legal-ethical violations and their attitudes to learning were often criticised by their supervisors. (Chipchase et al 2012; Lewallen and DeBrew 2012)

19

Giving and Receiving Feedback Since feedback is the key

component to learning and changing performance, it is appropriate to understand how to effectively give and receive feedback. Effective feedback answers 3 questions:

1. Where am I going? (the goals) FEED UP

2. How am I going? FEED BACK

3. Where to next? FEED FORWARD When you receive feedback, be prepared that it is often uncomfortable but if you proactively engage in the process the outcome will be positive. “If learners are provided with information that they have to wrestle with, reflect on, experiment with, this can act as a potent stimulus for learning and for reconsidering new ways of knowing and doing” (Molloy, Borrell-Carrió, Epstein 2013 p. 51)

20

Tips for Receiving Feedback Listen candidly: This means not interrupting. Hear the person out, and listen to what they are really saying, not what you assume they are going say. You can absorb more information if you are concentrating on listening and understanding than if you are being defensive and focusing on your response. Be open: This means being receptive to new ideas and different opinions. Often, there is more than one way of doing something, and other people may have a completely different viewpoint on a topic. Remain open, and you may learn something worthwhile. You don’t have to believe it or act on it, but you must listen openly. Be aware of your non-verbal responses: Your body language and tone of voice can speak louder than words. Looking distracted and bored sends a negative message and can create unnecessary barriers. Attentiveness, on the other hand, indicates that you value what someone has to say, and puts both of you at ease. Know what you want: alert your feedback sources (your SOT and others) to the specific feedback you want. Place clear boundaries around the feedback: Let people know what you want and how much feedback you want to hear at one time. If you fail to define precisely what you want, you run the risk of hearing too much. Once that happens, it’s easy to get defensive. Clarify detail and ask for specifics: Ask questions to make sure you understand. “I’d like to understand what behaviours you saw so that I can better understand what to do differently next time.” Be accepting: Accept the impact of your behaviour as reality for the other person. You don’t have to agree with it. Focus on the future: Ask for specific advice on what to do differently and what to repeat going forward. Agree on an action plan. Reflect and decide what to do: Take time to reflect on the feedback and consider the consequences of using it or ignoring it, and then decide what you want to do. Follow up: There are many ways to follow up on feedback. Sometimes, your follow-up will simply be to implement the suggestions you‘ve been given. In other situations, you might want to set up another meeting to discuss the feedback or to request your supervisor to review your performance in another similar situation. Ask for feedback early and often: Giving effective feedback takes time and isn’t often at the front of people’s minds. We know that it’s easier to respond to feedback early when you have an opportunity to change something. As the person receiving feedback, it often helps to invite people to give you feedback as this alleviates the fear most people have when giving feedback.

21

Tips for Giving Effective Feedback

1. Invite the person you are giving feedback to, to self-evaluate (may need further probing- ask for examples)

2. Emphasise decisions and actions rather than assumed intentions

3. Ask learners to summarise key points

4. Clarify or check for shared interpretation of content

5. Encourage learners to record key points gained from the session

6. Be specific: Avoid general comments that may be of limited use to the receiver. Include

specific examples to illustrate your statements

7. Be realistic: Feedback should focus on behaviours that can be changed

8. Be timely: Find an appropriate time to communicate your feedback. Being prompt is key because feedback loses its impact if it is delayed too long

9. Negotiate when and where feedback will be discussed

10. Own the feedback: When offering evaluative comments, use the pronoun “I” rather than

“they” or “one”, which would imply that your opinion is universally agreed on. Remember that the feedback you provide is merely your opinion

11. Offer continuing support: Feedback should be a continuous process, not a one-time

event. After offering feedback, make a conscious effort to follow up

Trainee Welfare Overview Training, like many aspects of life, can be exciting and rewarding, but also has its ups and downs. As a trainee you are exposed to numerous sources of stress similar to those encountered by all students. This includes formal assessments, time management issues, information overload, paucity of time for personal relationships and/or recreation, financial and career concerns. Moreover you are also exposed to sources of stress not common to non-medical professionals. These include death and dying, relating to other health professionals and the potential fatal consequences of making a mistake. This is a fertile environment for the generation of problems as well as learning and positive experiences. Problems encountered by trainees typically fall into one of five types; professional, academic, administrative, career and personal.

Professional Some trainees encounter problems with professional or ethical conduct. To be effective, an intensive care specialist must be able to interrelate successfully with medical staff and colleagues. Patients increasingly and appropriately demand to be treated politely and with consideration. They also expect medical practitioners to be honest, trustworthy and empathic. As a trainee you may require support in these areas. This support may need to extend to professional counselling to enable you to develop appropriate attitudes and conduct themselves in a professional manner. This is particularly true for trainees who are unaware of personal limitations or who have a limited capacity for self-audit. Identification and correction of a problem in this area is of paramount importance as the majority of medico-legal problems have communication difficulties as a basic cause.

AcadeThis is FCICM seek ouelectivemedicaundertathese a

AdmiTraineerelatingquestiounnecesupervi

CareeThe wisSpecial

PersoPersonaclinical interpermust alto seekpersonn

FamilA numbas flexibminimisproposabecausdiscuss

IllnesIf you abasis wdocume

ExperShould should mannertheir traclinical rarely, s

emic perhaps thediploma is

ut advice ae periods ofl course. It

ake all the areas.

nistratives often en to the admns may se

essary angssor should

er se trainee ist Intensivi

onal al problemsrotations.

rsonal conflso be dealt

k assistancenel.

ly Needsber of traineble as is pose disruptioals for paree of individ

s their circum

s and disare ill or unwith the inteent ‘Examin

More detaSpecialists

riencing a trainee ealways be

r. It is imporaining. Diffperformanc

substance a

e most obvs high and yand feedbaf study eveis importanabove and

ve ncounter prministrative aeem trivial st. Fortunatebe consulte

will seek gists and trai

s can have Relationshilicts are just with urgene with thes

s ees seek heossible withions to trainental leave.ual circumsmstances w

sability nable to conention of mination Cand

ils are avails and Traine

Difficultxperience dto overcomrtant for traficulties encce below exabuse.

vious probleyou are encck on exam

en though ynt for you to

thus it is i

oblems of aspects of t

to non-traely they areed in the firs

guidance ainees are po

an enormop difficultie

st some of tntly in a sense (and all)

elp with then the Reguning. It is . On occasstances bef

with the Coll

ntinuing stunimising itsidates Suffe

able in the ees’.

ties Durindifficulty, theme any difficinees to becountered xpectation,

em area for couraged tom preparatyou may hao realise thaimportant to

a “when”, their departainees theye also amost instance.

about their otentially us

ous impact es, financialthe many p

nsitive and c) problems

e planning olations goveusually po

sions there fore and aftlege as earl

udying, the s effect on tering from I

Policy Docu

ng Trainey are urgeculty in a s

e aware of wby traineespersonal o

trainees. To seek out tion, study ave addresat no singleo identify s

“who”, “whment, hospy are oftenong those m

career patseful source

on your ovl worries, a

problems thaconfidential from supe

of parental lerning train

ossible to gmay need

ter the birthly as possib

College wiltraining. Sullness, Acc

ument IC-5

ing d to seek a

supportive, what is expes include d

or family pro

The academavenues oskills, time sed these

e individual suitable per

here”, “whaital or Colle

n the causmost easy t

th. Supervises of career

verall perforaccommodaat may arismanner. Yrvisors and

eave. The ing and willgive prospe

to be lateh. Trainees ble.

ll assess thupervisors sident or Dis

‘Guidelines

dvice early.constructiveected of thedifficulties woblems, per

mic challengof support. Y managemissues duriis ideally p

rsonnel to a

at” or “how”ege. Althougse of consto address

sors, HODr informatio

rmance duration concese. These pYou are encod other app

College aiml do all that ective app

e changes tare encour

his on an inshould be asability (Sec

s on the He

. The primae and collaem at each with examirsonality tra

ge of the You can ent and ing your laced to assist in

” nature gh these iderable and the

s, other n.

ing your erns and problems ouraged

propriate

ms to be it can to roval to to plans raged to

ndividual aware of ction 5)’.

ealth of

ary focus borative stage in inations, aits and,

22

Formal advice Most tramore th Sup A m A se The A s It may b

The

An

A p

A c

A m

A m

A m Traineespecificapproprexperiegroup leinclude presentshared DifficuDifficultcounsetraineessuch asthe suctrainee obtainin

College practitionpublishedcurrent acircumsta www.cicm This do

or informalcan play anainees will

han others.

pervisor of Tmentor enior memb

e College pouse, part

be appropria

e trainee’s G

appropriate

sychologist

leric or othe

member of th

member of a

medical care

es who encc remedial riate for eit

ences for traearning for the acquisi

tation, viva responsibil

ulties with ties with thlling. The Fs. Educatios optimisingccinct verba

who has fang help with

More detaTrainees w

documents aner should thd or become as possible at ances or inform

m.org.au

ocument is co

advice is an invaluableneed advicPossible so

Training

ber in the de

tner or fami

ate for the t

General Pra

e medical sp

t or psychia

er religious

he Doctors’

an Alcohol a

eers advisor

counter difflearning exther the suainees. Theseveral traiition of definpractice, eity, and a ve

Examinathe examin

First part exnal psycholg performanal presentatailed an exah their appro

ails are avwith Difficult

are prepared erefore have available sub

t the time of tmation or mat

opyright and ca

an importane role in thece at someources of ad

epartment

ly member

trainee to se

actitioner

pecialist

trist

office holde

Health Adv

and Drug De

r

ficulty in clxperiences

upervisor orese may benees. Difficnite clinical tc. It is impested intere

tions ations may

xamination logists can nce in a strion of factuamination ooach to the

vailable in ties”

based on infregard to a

sequently. Whtheir preparatiterial which ma

annot be repro

t componene successfu

e time durindvice may in

eek profess

er

visory Servi

ependency

inical or acfocused u

r Head of e arranged culties that cskills, inter

portant for test, in makin

y be an omay be theoften assis

ressful situaual informaton a secondexaminatio

the Trainin

formation avaany informatio

Whilst the Colleion, it takes nay have becom

oduced in who

nt of traineeul professiong their trainclude:

sional couns

ice

Agency

cademic arpon the arDepartmenas one-on-can be readrpersonal skthe trainee ng these ex

occasion we first majort with the c

ation. As weion can be d presentaton.

ng Docume

ailable at the on, research ege endeavouno responsibilme available s

ole or in part w

e guidance. onal developning, thoug

selling. Sou

reas will usrea(s) of dt to arrangone tuition

dily addresskills developto be awar

xperiences e

when trainer hurdle enccoaching of ell, coachinuseful for mion would b

ent, “Guide

time of theiror material w

urs to ensure ity for matterssubsequently.

without prior pe

Early and epment of a

gh some ma

urces may in

sually beneifficulty. It

ge specific for a traine

sed in this wpment, examre that theyeffective.

ees need countered btrainees in

ng in techniqmany trainebe wise to c

elines for A

Publishe

ir preparation,which may hthat documens arising from

ermission.

effective trainee.

ay need

nclude:

efit from may be learning ee or as way may mination y have a

specific by many matters

ques for ees. Any consider

Assisting

ed: 2014

, and the ave been nts are as

m changed

23