Example Learning Agreement - ST1 ST1 Placement 1 General Surgery Global Objective Programme Director s Selected Topics General Surgery Intial Core surgical skills and knowledge for all specialties ST1 Emergency Other ST1 Emergency Trauma ST1 General ST1 Urology Programme Director s Supporting Statement You will rotate through General Surgery, A&E and Urology this year. Since these are 4 month placements, you need to be very focussed on achieving the appropriate parts of your global objective in each placement as time will pass very quickly. Your mini-pat should be completed towards the end of your first placement. Objective Setting Part 1 Topics for this placement
Part 2 Actions to meet learning objectives Assessments CBD for the assessment and management of the surgical patient. Surgical DOPS for minor surgery including drainage of abscesses and excision of skin lesions, mini-cex for examination of acute abdomen and outpatient skills. Mini-PAT for communication, time-management, team-working and professional behaviour. Resources Required Training from senior staff, StRs for acute surgery and other members of the team as appropriate. Weekly main theatre list and day care list assisting, Weekly out-patient clinic with 1 slot per month dedicated to assessment. Access to minor ops list supervised. Access to basic surgical skills equipment and simulations in the clinical skills centre. Half day study leave. Learning Opportunities Participation in on call rota based in the surgical admissions unit and in the emergency theatre. Teaching in out-patients, on ward rounds and during elective operating lists. Attendance and presentation at weekly Multi-disciplinary Team (MDTs) and departmental meetings. School of Surgery teaching. Attendance at clinical skills centre and dissecting room at medical school. Exams MRCS Part 1 and Part 2 this year to cover basic sciences Courses Deanery MRCS revision course. Basic skills course, ATLS, CrISP. Details of Audits/Research/Projects Central line complications in surgical patients with a focus on line infections. Aim to present the completed audit at the departmental weekly meeting towards the end of the placement. Part 3 Comments Comments by the Trainee By the end of this placement I want to feel confident in the assessment of the acutely ill surgical patient, improve my communication, clinical and time management skills in out-patients and on the ward and achieve competence in basic surgical skills such as knot tying and suturing. Comments by the Assigned Educational Supervisor Initiate the arrangements agreed including the dedicated mini-cex assessment slots at clinic with the GS Clinical Supervisor. Speak to the StR about mini-cex and DOPS. Make an appointment in my diary for the mid-point meeting, including a CBD and review of the progress with your audit. Give me an update next week on how things are going. Part 4 Sign off and complete Trainee signed off on 03 March 2007 Assigned Educational Supervisor signed off on 05 March 2007
Interim Review Part 1 Review and update details Before the meeting please review: The Programme Director s Global Objective Completed Assessments Objective Setting stage of the Learning Agreement Part 2 Comments by the Trainee I feel I am progressing well and gaining both theoretical knowledge and practical experience with good supervision and mentoring. I am working towards the MRCS which is perhaps taken my focus off workplace-based assessments. I found it easy to recruit enough raters for my mini-pat but I had to chase a few colleagues to ensure it got done on time. I get the best in depth feedback in the coffee room between theatre cases - really helpful. Signed off on 01 May 2007 Part 3 Comments by the Assigned Educational Supervisor The courses and exams agreed are on schedule and you ve managed to get a lot of theatre, this is going well. However your audit is overdue and we agreed an extended deadline of next Sunday. You need to be more proactive in initiating workplace assessments because there is scant evidence in the portfolio for an end of placement review. We agreed some more DOPS and at least one more CEX. Signed off on 01 May 2007 Final Review Assigned Educational Supervisor s Comments Please mark with a tick if you agree with the statement. If you do not agree, mark with a cross and give reasons 1. The trainee s reflective practice was satisfactory (including self-evaluation and plans for development) Yes No This was assessed primarily through CBD. In appraisal meetings the trainee was able to discuss a number of cases by comparing and contrasting them. There was also an audit and case presentation at a departmental/hospital meeting. 2. The trainee followed an agreed timetable and on call rota Yes No
3. Were there any issues? Yes No Overall Summary Statement Please make a statement about the trainee s overall performance including strengths and areas for development. Please include any recommendations relevant to the next placement/stage Progress is satisfactory overall. Attendance was excellent. The planned audit took place and workplace assessments were satisfactory, showing good communication skills with patients and improved intra operative technique in particular. There is a need for more confidence in teamworking although the trainee is very well thought of and I m sure this will develop with some planning. Generally, there should be quicker follow up of cases and provision made for more feedback from peer presentation. In summary, I would recommend some more time is given to planning and prioritising to manage and improve on weaker areas although all objectives were met in time. Recommendations Please check off one of the following statements as applicable: No further action required, the trainee should progress to the next placement/stage Trainee needs further development or targeted training but should progress to the next placement/stage Trainee needs further development or targeted training before progression to the next placement/stage Please give details of the relevant areas for improvement. It is crucial that evidence of poor performance is identified so that remediation plans and progress reviews can be in place as soon as possible. These actions serve to maximise patient safety as well as providing trainees with honest analysis of how their training is progressing. Signed off on 18 June 2007
Trainee Comments I attended an induction programme. Learning opportunities were provided within an agreed placement timetable and on call rota I attended an educational programme There were no issues Please make a statement about your overall performance including strengths and areas for development. Please include any requests relevant to the next placement/stage. I feel I have performed well in this placement and achieved greater confidence and knowledge regarding the management of in-patients and out-patients. I feel my strength lies in theatre and I hope my next placement will give me as much time in theatre and clinic to develop my ability to examine surgical patients and devise suitable management plans. I found that having access to a mentor very useful. The informal feedback I received was also great. I recognise that I do need to be more proactive when interacting with colleagues. I feel this improved over the course of the mini-pat. I have read and agree with my learning agreement and my assigned educational supervisor s comments Signed off on 18 June 2007