Junior Medical Officer. Supervision Guideline SAMPLE ONLY

Transcription

1 Junir Medical Officer Supervisin Guideline SAMPLE ONLY Versin 1.0 February 2011

2 The Junir Dctr Supervisin Guideline has been develped by SA IMET t prvide facilities with a plicy guideline. Facilities may wish t adapt this r use it as framewrk fr develping their wn Junir Dctr Supervisin plicy. Page 2 f 7

3 Scpe Fr this guideline, Clinical Supervisin invlves direct r indirect mnitring f junir dctrs by a mre senir medical practitiner t: > ensure practices are perfrmed safely fr bth patients and junir dctrs (clinical versight); > prvide junir dctrs with training, feedback and assessment f clinical prcedures and patient care (educatinal supervisin); and > ensure junir dctrs have access t apprpriate supprts fr administrative, human resurce, mentrship and cunselling functins (administrative and prfessinal supervisin). The guideline applies t all facilities and accredited terms where junir dctrs are emplyed. Cntext The Suth Australian Institute f Medical Educatin and Training (SA IMET) recgnises that adequate and apprpriate supervisin is critical t the training and develpment f junir dctrs. Guideline Detail Supervisin Principles A junir dctr will: > nly assume respnsibility fr r perfrm practices and prcedures in which they have sufficient experience and expertise. A Term Supervisr will: > make themselves knwn t the junir dctr and ensure that the junir dctr is aware f the name and cntact details f their supervisr at all times f service during the term. This will include apprpriate handver f supervisin when the term supervisr is absent. > be a medical practitiner with unrestricted general registratin with the Medical Bard f Australia. > have at least three years clinical experience since btaining vcatinal qualificatin > be aware f their respnsibilities in prviding clinical supervisin. > have demnstrated cmpetencies t prvide clinical supervisin. > ffer a level f supervisin apprpriate t the cmpetence and experience f the individual junir dctr. The level f supervisin f the junir dctr will als depend n: the hspital setting, type f term, and cmplexity f patient care. > be respnsible fr: the rientatin f the junir dctr t the unit/department and develping mutually agreeable educatinal bjectives based n the Australian Curriculum Framewrk fr Junir Dctrs (ACF) at the beginning f each term (this may be delegated t an apprpriate persn); the welfare f junir dctrs allcated t their team r unit; Page 3 f 7

4 ensuring apprpriate supervisin fr patient safety; enabling prvisin f training t meet the learning bjectives f the term; mnitring junir dctr prgress; assessing junir dctr perfrmance using the prescribed wrkplace based assessment tls facilitating, where necessary, access t apprpriate human resurce, administrative, cunselling, prfessinal develpment and mentrship functins, either directly r by apprpriate referral r delegatin; recgnising a junir dctr in difficulty, s as t prvide additinal supprt. Supervisrs will ntify the Directr f Clinical Training if the junir dctr requires additinal supprt. > supprt and facilitate infrmal teaching when apprpriate pprtunities arise (e.g. bedside, clinical skills and prcedures). A facility will: > ensure every junir dctr has a Term Supervisr allcated fr each term. > ensure there is cntinuity f supervisin during perids f supervisry leave (i.e. if the supervisr is nt present n site, supervisin must be delegated t anther suitably experienced medical practitiner n site). > mnitr the wrklad f supervisrs t ensure they can effectively fulfil their rles as clinical supervisrs. > ensure psitin descriptins are prvided fr all staff respnsible fr supervising junir dctrs which clarify their rles and respnsibilities fr supervisin. > ensure the adequacy and effectiveness f junir dctr supervisin is evaluated. Levels f Supervisin A Term Supervisr shuld prvide r ensure prvisin f, supervisin t junir dctrs t the level apprpriate t their year f training. Requirements f supervisin will vary depending n the type f term and cmplexity f patients. Where the Term Supervisr delegates supervisin, the delegated Supervisr shuld be at least 3 years mre experienced than the supervised trainee and have adequate training in the area f clinical care. The levels f supervisin are: Level 1 Supervisin the supervisr r nminee is nsite at all times. Level 2 Supervisin the supervisr r nminee is ff site, but available n site within 10 minutes and regularly reviews all cases. Level 3 Supervisin the supervisr r nminee is ff site, but accessible prmptly by telephne and shuld be able t attend if needed. Level 4 Supervisin the supervisr r nminee is ff site, but accessible by telephne at all times. Level 5 Supervisin the supervisr r nminee is ff site, but accessible by telephne during usual business hurs Page 4 f 7

5 Junir Dctr Supervisin Guidelines PGY 1 Dctr / Intern > The Supervisr takes respnsibility fr individual patients > The PGY 1 Dctr must be prvided with supervisin levels 1 r 2 (i.e. be nsite r available n site within minutes). This level f supervisin must be prvided t the PGY 1 dctr fr all perids f duty (i.e. day, evening, night and weekend shifts). > The PGY 1 dctr must cnsult with their Supervisr abut the management f all patients. > If the Supervisr is nt available n site, supervisin respnsibility must be delegated t anther suitably experienced medical practitiner n site. The delegatin must be made knwn t the delegated supervisr/s and the PGY 1 dctr. PGY 2/3 Dctr > The Supervisr shares limited respnsibility fr individual patients > The Supervisr must prvide supervisin levels 1, 2 r 3 (i.e. be physically present at the wrkplace, r be in accessible cntact at all times whilst the PGY2/3 dctr is prviding clinical care and able t attend if needed) > At a frequency determined by the Supervisr, the PGY2/3 dctr must infrm the supervisr abut the management f all patients with serius medical prblems. PGY 4+ Dctr > The PGY 4+ dctr may take primary respnsibility fr individual patients if permitted under the gvernance system f the facility. > Supervisin Levels 1, 2, 3, 4 r 5 must all be prvided but be apprpriate t the clinical setting. > The Term Supervisr must ensure there are mechanisms in place fr mnitring whether the PGY 4+ dctr is practising safely. > At a frequency determined by the Supervisr, the PGY4 dctr must infrm the supervisr abut the management f all patients with serius medical prblems. After Hurs A great deal f the junir dctr s experience is drawn frm perids f care prvided after hurs. Supervisin and training needs after hurs are greater and require careful invlvement f all senir clinicians at the pint f care, at handvers and n the phne t ensure active supervisin in prvided. After hurs ward runds can ften be a surce f unease fr junir dctrs as bth the patients and their cnditins are unfamiliar. The supervisr must be aware f this unfamiliarity and prvide a supprtive envirnment fr the junir dctr t explain the situatin. The supervisr must emply respnsive versight and be alert t every signal that the junir dctr may need direct supervisin. This is ften the mst incnvenient time fr bth the junir dctr and supervisr, yet the pwer f interpreting a clinical prblem tgether can enhance the patient s safety and imprve the junir dctr s ability t manage independently in the future. Addressing perceived inadequacy f supervisin There ften will be differences f pinin between the supervisr and the junir dctr. Sme f these differences can be used in a psitive way t help each individual challenge their thinking and assumptins. Page 5 f 7

6 Even an experienced supervisr may nt be aware f certain things that are imprtant t a junir dctr in helping them develp their clinical skills. Therefre, it is imprtant that supervisrs participate in prfessinal develpment aimed at imprving their clinical teaching and supervisin skills. If either the supervisr r junir dctr feels that the supervisin prcess is nt wrking successfully, they need t knw where t g fr help (e.g. discuss with the DCT). It may smetimes be the case that either r bth f them wuld develp a mre helpful wrking relatinship with a different persn. Key Stakehlders Term Supervisrs manage the welfare, training and assessment f junir dctrs within a training team, but their rle is supprted by the belw individuals and institutins: Directr f Clinical Training directs the educatin and training f prevcatinal trainees in each training facility, and generally has mre cntinuus invlvement with junir dctrs than their supervisrs, wh change frm term t term. The DCT is a clinician wh prvides supprt t prevcatinal trainees that is independent frm the line management, and helps slve the prblems that can arise during the training (e.g. underperfrmance, junir dctr distress and cmmunicatin issues between the junir dctr and team). The DCT is an advcate fr the welfare f junir dctrs within the hspital. The DCT is respnsible fr prviding a structured educatin and training prgram fr junir dctrs and evaluating its effectiveness. Trainee Medical Officer (TMO) Unit is respnsible fr the administrative aspects f emplyment (e.g. rsters and leave) and fr administratin f the frmal educatin and training prgram fr junir dctrs. Directr f Medical Services (DMS) the senir clinician in charge f managing medical services in the hspital is the respnsible fficer fr issues affecting the emplyment, prgressin and registratin f junir dctrs. Educatin and Training Prgram (ETP) Cmmittee versees the welfare and training f pstgraduate trainees. The SA IMET Accreditatin Standards required that the Cmmittee is adequately resurced, empwered and supprted t enable develpment and implementatin f institutinal pstgraduate training plicies. SA IMET has a respnsibility, in partnership with hspitals and Clleges, t supprt pstgraduate medical educatin and training in Suth Australia. Medical Bard f Australia (MBA) Interns must cmply with the requirements f the MBA t achieve general registratin. If an intern r resident is unfit t practise medicine, the MBA must be ntified. Key Cncepts, Terms and Definitins Facility the institutin r clinical setting which pstgraduate Trainees wrk and train. These rganisatins will usually be in hspitals but may be health care centres r supervised practice lcatins in cmmunity settings which have met SA IMET Accreditatin requirements fr pstgraduate trainee educatin. Junir Dctr medical practitiner in their early pstgraduate years f clinical practice (PGY 1/2/3/4+) wh have nt yet entered a vcatinal training prgram. Supervisr a medical practitiner wh is respnsible fr ensuring the clinical supervisin f junir dctrs. A supervisr must be a medical practitiner with unrestricted general registratin with the Medical Bard f Australia and have at least Page 6 f 7

7 three years pstgraduate clinical experience mre than that f the supervised trainee. Term Supervisr a medical practitiner designated t be respnsible fr the crdinatin f clinical training f junir dctrs attached t their unit. Term the specific clinical team, service r unit attachment in which junir dctr s wrk and in which clinical training takes place. Each f these represents a term fr training purpses and each must be accredited in rder t receive prevcatinal trainees. Related Dcuments > SA IMET Accreditatin Standards References > PMCQ: Supervisin Plicy fr Interns in Accredited Facilities > Guidelines fr Supervisin f PGPPP Dctrs Nvember 2008 > PMCWA Supervisin f Prevcatinal Dctrs > NSW IMET Clinical Supervisin Plicy Page 7 f 7