Chapter 7: Medical Training Review Panel Subcommittees and National Projects

This chapter reports on the activities of the MTRP's subcommittees and on the national projects in the area of medical education and training funded by the Australian Government in 2007-08 and 2008-09.

Medical Training Review Panel Subcommittees

Medical Training Review Panel Clinical Training Subcommittee The MTRP Clinical Training Subcommittee was established in August 2006. The role of the Subcommittee is to progress work recommended by the 2005 Biennial Review, and to monitor and report regularly on the progress being made to ensure adequate intern and training positions are in place to meet the increase in the number of new medical graduates.

To facilitate the task of the subcommittee, the Australian Government Department of Health and Ageing commissioned the following:

• the Medical Deans Australia and New Zealand (MDANZ) to examine and report on clinical training for medical students; and
• the Confederation of Postgraduate Medical Education Councils (CPMEC) to examine and report on prevocational clinical training.

The subcommittee reported the findings of these two studies to the MTRP in February 2008.
Electronic versions of these studies, their findings and recommendations are available at:

• http://www.medicaldeans.org.au/publications.html; and
• http://www.cpmec.org.au/Page/cpmec-publications.

Medical Training Review Panel Data Subcommittee

The MTRP established a subcommittee in August 2006 to review its data collection and reporting requirements. After completing its initial tasks in 2007, which were tabled in the Eleventh MTRP report, it was agreed that the subcommittee should continue as a working group to oversee the collection and integrity of medical training data.

National Projects

Since 1998, the Australian Government Department of Health and Ageing has funded a number of innovative projects of national significance in priority areas identified by the MTRP. These projects are intended to support research that:

• enhances the education and training of hospital medical officers;
• promotes interaction between the various postgraduate medical councils in developing national standards; and -
• disseminates information, and the principles of various 'best practice' postgraduate training models consistent with the principles of a national curriculum framework.

Funding of $750,000 was allocated by the Australian Government for ten national projects to be administered across the 2007-2008 and 2008–2009 financial years (Table 7.1). The nine projects, which received funding, are now completed.

Table 7.1: Summary of national projects, 2009

National project	Organisation	Period
Implementation of Handheld Electronic Devices to Improve Handover on Medical Wards at Shellharbour Hospital	Shellharbour Hospital	Offer of funding withdrawn May 2008
Developing Mentoring and Supporting Programs for Junior Doctors in Rural Settings to Promote High Quality Educationl Outcomes	Australian College of Rural and Remote Medicine	Completed June 2008
National Accreditation Framework - Piloting and Adaptation for use in Prevocational General Practice Training Program and Community Settings	Postgraduate Medical Council of Victoria	Completed June 2009
Mapping of University Medical Curricula and Hospital Rotations to the Australian Curriculum Framework for Junior Doctors	Postgraduate Medical Council of Victoria	Completed June 2009
Development and Piloting of Patient Safety Education and Modules for Junior Medical Officers	Postgraduate Medical Council of Victoria	Completed June 2009
Intern Modelling Tool	Princess Alexandra Hospital Brisbane	Nearing completion
National Stocktake and online Catalogue of Courseware Mapping to Australian Curriculum Framework for Junior Doctors	University of Queensland Centre for Health Innovation and Solutions	Completed June 2009
Peer Review Assessments in Junior Doctors - Development and Pilot	Australian National University Medical School	Completed June 2009
How Well Do Junior Doctors Practise Evidence Based Medicine?	University of Sydney School of Rural Health	Completed June 2009
Emergency Medicine Capacity Assessment Study: An Identification of the Capacity and Strategies of Emergency Departments and Staff to Support Increasing Numbers of Medical Graduates and Implement the National Curriculum Framework	St Vincent's Hospital Melbourne	Completed June 2009

The nine funded projects are described in more detail in the following paragraphs. The final reports of all of these are available on the CPMEC website at: http://www.cpmec.org.au/Page/mtrp-projects-2008

Mentoring and Support Programs for Junior Doctors in Rural Settings

The Australian College of Rural and Remote Medicine (ACRRM) MTRP National Project examinedsupervision and mentorship requirements in rural and remote Australia. A series of wide rangingconsultations that encompassed junior doctors, their supervisors and members of rural educationnetworks were conducted. The results of these consultations will assist with national planning bypostgraduate councils for the support of junior doctors whose training is delivered in rural areas.In particular, it provided valuable data to assist rolling out the Australian Curriculum Framework forJunior Doctors. It also enhanced understanding of those components of community placementsseen as contributors to excellence by supervisors and junior doctors.

National Accreditation Framework - Piloting and Adaptation for use in Prevocational General Practice Training Program and Community
Settings

This project was undertaken by the Postgraduate Medical Council of Victoria. The aim of this project was to map the learning opportunities offered by prevocational general practice rotations to the Australian Curriculum Framework for Junior Doctors to inform the development of national standards and accreditation criteria that can be applied in general practice and community settings. A model set of accreditation instruments were developed and piloted in general practice and community settings in Victoria.

A review of the accreditation standards and the training curricula offered by both the Royal Australian College of General Practice (RACGP) and the ACRRM was also undertaken. This review will ensure consistency between general practice and hospital accreditation standards, and requirements for education and supervision.

Mapping of University Medical Curricula and Hospital Rotations to the Australian Curriculum Framework for Junior Doctors

This project, conducted by the Postgraduate Medical Council of Victoria, aimed to develop an instrument that would map medical student curricula to the Australian Curriculum Framework for Junior Doctors.

The instrument was piloted with a number of Victorian hospitals in metropolitan, suburban and rural settings to determine the learning opportunities for junior doctors during their core intern rotations. The project also identified areas where additional clinical experience or training may be required.

Development and Piloting of Patient Safety Education Modules for Junior Medical Officers

This project was a joint initiative between the Postgraduate Medical Council of Victoria, Southern Health (Victoria), the Postgraduate Medical Institute of Tasmania and the University of Tasmania.

The Australian Curriculum Framework for Junior Doctors includes the concept of 'Safe Patient Care' as a key component. However, an education program to address the complexities of this issue has not yet been implemented.

The project developed two patient safety education modules that incorporated topics from the Australian Curriculum Framework for Junior Doctors: 'Systems and Incident Reporting' and 'Adverse Events and Near-misses'. The two modules utilised flexible delivery principles to improve the understanding by junior medical officers of the health care system. These modules will assist in developing an understanding of the complex nature of human errors, and empowering junior medical officers to consider and discuss systemic solutions that will improve patient safety.

Each module was piloted and evaluated at two sites, in Victoria and Tasmania, prior to preparation for national roll-out. The modules will be available electronically. Manuals, PowerPoint presentations and reading materials will be produced.

Intern Modelling Tool

The Princess Alexandra Hospital was awarded funding to research, develop and pilot a modelling tool that will enable the early identification of those interns who have difficulty in the transition from medical student to practising medical doctor.

The intern modelling tool aims to identify and explain the cause(s) of any difficulties experienced by medical students about to enter this transitional phase of their careers. The evidence gathered by this study will be important to target appropriate professional and personal development programs and it is hoped it will accelerate the rate at which competency is achieved.

National Stocktake and Online Catalogue of Courseware Mapping to Australian Curriculum Framework for Junior Doctors

This project, undertaken by the Centre for Health Innovation and Solutions at the University of Queensland, aimed to develop a consistent national standard for the cataloguing of educational assets, to undertake a stocktake of current educational resources that are consistent with the Australian Curriculum Framework for Junior Doctors, and to develop a searchable, sustainable online catalogue of these resources.

Educational approaches for training junior doctors vary across jurisdictions and utilise a range of teaching methodologies and technological platforms. No central register of educational resources had previously been established.

The catalogue will provide a useful asset for medical educators and other stakeholders. It will offer potential users teaching and learning resources, including online courseware, e-learning objects, ready-to-use curricula, train-the-trainer guides and student kits.

Peer Review Assessments in Junior Doctors - Development and Pilot

This project was undertaken by the Australian National University (ANU) Medical School. The aim was to develop and pilot a peer review process for use by junior doctors in the workplace, laying
the foundation to establish sustainable self assessment into professional life.

All medical professionals require assessment of their own skills and competencies throughout their practice life. Peer review is a performance appraisal tool that uses reviewers who are the professional equals of an individual or group of people. Peer review has been demonstrated to be a potent modifier of professional behaviour.

The project used the established ANU Medical School peer review model, and engaged junior doctors to develop suitable assessment criteria and pilot an assessment cycle.

How Well Do Junior Doctors Practise Evidence-Based Medicine?

This project was undertaken by the School of Rural Health at the University of Sydney. The aim was to evaluate the many important factors that promote the practice of evidence-based medicine by doctors in their first and second postgraduate years of internship in New South Wales.

The Australian Curriculum Framework for Junior Doctors includes the practice of evidence-based medicine in the curriculum, outlining the knowledge, skills and behaviours required of prevocational doctors. This study also promoted the ongoing work toward implementing the Australian Curriculum Framework for Junior Doctors by providing insights into an understanding of what facilitates and impedes the practice of evidence based medicine.

Emergency Medicine Capacity Assessment Study

This project was undertaken by St Vincent's Hospital, Melbourne. The project used survey and interview methodology to identify the capacity and strategies of emergency departments to support increasing numbers of medical graduates, and to implement the Australian Curriculum Framework for Junior Doctors.