Cetiscape 2 December 2010

cetiscape
CLINICAL EDUCATION
& TRAINING INSTITUTE

 Issue 2  December 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 1 

Allied Health Clinical Education and Training Division to be established
Patricia Bradd1, Brenda McLeod2 and Richard Cheney3
1 SESIAHS Area Allied Health Director and Chair of the Area Allied Health Directors Group, 2 Chief Allied Health Officer,
NSW Health, 3 Allied Health Advisor, Greater Western Area Health Service

Professor Boyages, CETI Chief Executive, announced
that three positions will be created to form the Allied
In this issue
Health Clinical Education and Training Division within 
Nursing and Midwifery building a collaborative
CETI, including an Allied Health Divisional Head partnership with CETI 2
position. The Area Directors of Allied Health and the
Chief Allied Health Officer warmly welcomed this news 
Farewell Marie-Louise Stokes 3
during their second meeting with Professor Boyages 
Award: Improving cardiac care for Aboriginal
and CETI General Manager Dr Heading. communities 3
The new division will provide support and expertise for an allied 
2010 CETI Awards: Dr Steve May, Dr Matt Stanowski 4
health education program in line with the aims and functions
of CETI. It will lead the design, development, implementation 
Racing to the Future: the 15th National Prevocational
Medical Education Forum 2010 5
and evaluation of state-wide clinical education and training
strategies in collaboration with allied health clinicians. This will  Superguide: coming soon to a supervisor near you 6
The
support safe and sustainable high quality allied health practice
across NSW Health. Watch this space for further news about

Tribute to Professor Annemarie Hennessy, welcome to
Professor Iven Young 7
recruitment to these exciting new positions.
Other topics discussed at the meeting included identifying

NSW Health Expo and Awards 7
existing resources within CETI that might be adapted for use  Training Support Unit for Aboriginal mothers,
Rural
in allied health, developing networks to increase capacity babies and children 7
within allied health and strategies to improve communication

2010 NSW Rural and Remote Health Conference 8
and collaboration in education and training across the range
of allied health professions. 
Spring symposium: e-learning in medical education 10

E-learning resources: iNvestigate 11
Clinical supervision resource 
Setting up safe handover 12
One of the first resources within CETI to be adapted for allied 
International medical graduates get ready for
health clinicians will be The Superguide: a handbook for supervised training in NSW 13
supervising doctors in training. The Allied Health Directors have
commenced a review of this practical guide for supervisors of 
Coming events 13
junior medical officers. The guide includes many of the core 
Progress in hospital skills 14
elements common to sound, evidence-based supervision of
health professionals in a clinical setting. To ensure that examples 
Leading the way: CETI’s leadership programs 15
provided in the handbook are relevant, the Allied Health 
National audit of medical internship acceptances 16
Directors will be seeking volunteers from allied health disciplines
to help develop clinical scenarios for use within the allied health  Forum 2010
JMO 17
Superguide. Please contact your Area Director/Advisor of Allied 
Leading ideas 18
Health if you are interested in being part of the working party to
develop these clinical examples. 
NSW ranked against Australia and 10 countries 18

è... 2

Building 12, Gladesville Hospital, Victoria Road, Gladesville NSW, 2111 Editor: Craig Bingham
Locked Bag 5022, Gladesville NSW 1675 02 9844 6511
CLINICAL EDUCATION
& TRAINING INSTITUTE p: (02) 9844 6551 f: (02) 9844 6544 e: info@ceti.nsw.gov.au cbingham@ceti.nsw.gov.au

cetiscape
 December 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 2 
CLINICAL EDUCATION
 Issue 2

Allied health educators been expanded from GESCHN to state-wide and are being
coordinated by the CHN allied health educators.
Allied health educators, both general and discipline-specific,
are a critical part of the allied health workforce that is only just More recently, the CHN allied health educators have called
developing. To support existing allied health educators and for expressions of interest from allied health practitioners who
promote development of these roles, it was agreed to explore wish to be involved in writing clinical practice guidelines on
the feasibility of an allied health educator network. cerebral palsy and paediatric feeding. This project will provide
an opportunity for allied health professionals to work closely
The value of allied health educators is already being with their nursing colleagues to enhance multidisciplinary
demonstrated within the three paediatric child health networks care. The CHN allied health educators are also developing
(CHNs). Dr Maree Doble, Greater Eastern Southern Child paediatric allied health webpages and a discharge/referral
Health Network (GESCHN), Sonia Hughes, Northern Child form for children being referred back to local centres from the
Health Network (NCHN) and Emma Geor, Western Child tertiary children’s hospitals. This form is currently being trialed
Health Network (WCHN) have been collaborating over the before being made available to all allied health professionals
past five months to coordinate and facilitate clinical education working with children across NSW.
for NSW Health allied health professionals who work with
children. Their appointments were the outcome of two funded
projects by the NSW CHNs which assessed and implemented Allied health learning and education plan
recommendations in relation to the clinical support and
education needs for allied health professionals working with To ensure that the Allied Health Clinical Education and Training
children across NSW. Division is able to manage the professional development,
education and training needs of the 23 allied health professions
The highly successful GESCHN allied health TeleHealth and associated assistant and technician workforce, work on a
program has resulted in a comprehensive allied health TeleHealth clinical education and training plan for allied health will continue.
calendar being made available to paediatric allied health The plan will provide a framework for future development of
professionals for 2011. The CHN allied health educators are also allied health learning resources, a consultation mechanism
working with clinicians from the three NSW tertiary children’s for identifying priorities, and clinician networks to support the
hospitals to provide educational workshops in 2011 on various work of the division. It is envisaged that the division will develop
topics, including cerebral palsy and paediatric feeding. resources and strategies to support in-house clinical education
Allied to Kids, a monthly e-newsletter for allied health and professional development and supervision, training and
professionals, is produced by the CHN allied health education by allied health clinicians in the field.
educators, with contributions from clinicians across NSW.
Secondments to the three children’s hospitals and specialty This is an exciting time for allied health and the support of
clinics for allied health professionals needing to up-skill in allied health clinicians will be critical to our success as the
the clinical management of tertiary diagnoses have also division develops.

Nursing and Midwifery building a collaborative partnership with CETI
Mardi Daddo
Principal Adviser Nursing Strategy and Innovation, Nursing and Midwifery Office

Nursing and Midwifery have an exciting opportunity to 
developing e-learning modules to support the professional
work with CETI to identify areas for collaboration, as well development of the nursing and midwifery workforce
as building a relationship that fosters an inter-professional 
developing modules that build the knowledge and skills
approach to clinical education and training. required to support a team approach to patient care.
The Chief Nursing and Midwifery Officer, Adjunct Professor Nursing and Midwifery looks forward to building a partnership
Debra Thoms has met with CETI’s Chief Executive, Professor with CETI that supports and builds the education and training
Boyages, to discuss possibilities for collaboration. provided within and by the Nursing and Midwifery workforce
Opportunities to be explored in the immediate future include: and the opportunity to engage with other professions on
inter-professional education and training strategies in the
 supervision abilities of the Nursing and Midwifery
the
future.
workforce and the development of tools to support the
workforce into the future More information: Mardi Daddo, Principal Adviser Nursing
 implementation of the transition to ED practice
the Strategy and Innovation, Nursing and Midwifery Office, NSW
resource manual Health (mdadd@doh.health.nsw.gov.au).

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Farewell Marie-Louise Stokes
The team at CETI will farewell Dr Marie-Louise the first Medical Advisor for the NSW Medical
Stokes at the end of January. We are delighted to Education and Training Council (MTEC) when it
see her talents recognised in her new position as was established in 2004, and carried on in this
Director of Education for the Royal Australasian role when MTEC merged with the NSW PMC
College of Physicians, but sad to lose a great in 2006 to form the NSW Institute of Medical
friend and colleague from our workplace. Education and Training.
Marie-Louise has been a committed advocate for At a national level, Marie-Louise has been a
postgraduate medical education for more than a member of Australian Health Ministers’ Advisory
decade. She was the NSW Health Department Council working parties on specialist training
representative on the NSW Postgraduate outside public hospitals and general practice
Medical Council from 2000 to 2004. As Chair workforce. She has participated in medical
of the Education and Resource Development school accreditation for the Medical Board of
Subcommittee in 2003–2004, she supported the establishment Australia and, as a member of the Australasian Faculty of Public
of the NSW JMO Forum, the first JMO Forum in Australia and Health Medicine, serves on its Education Committee and NSW
a body that has continued to thrive, contributing significantly to Regional Committee.
enhancing prevocational training.
Throughout her career, Marie-Louise has shaped education
Marie-Louise also made major policy contributions to the with a collaborative spirit. Her combination of expertise,
development of network-based specialist medical training. commitment, and an extraordinarily compassionate and
She played a leading role in a significant research project, The supportive approach to the business of medical education
Delivery of Postgraduate Medical Training in NSW Health will be missed by all at CETI, but are a gift to those lucky
Services. This paper provided a framework to change and enough to work with her in the future.
enhance the delivery of medical education. Marie-Louise was — The CETI team

Award: Improving cardiac care for Aboriginal communities
In 2010 the Institute of Rural Clinical Service and Teaching to local Aboriginals and a range of resources which highlight key
(now the Rural Division of CETI) helped fund a new cardiac program messages.
care Aboriginal education initiative designed by the Ambulance
Service of NSW. This funding enabled the Ambulance The project won an Excellence Award in the Management
Service to develop a targeted cardiac health care message Practice Category at the 2010 Council of Ambulance
for Aboriginal community members in rural and remote Authorities (CAA) Ambulance Awards. The CAA Ambulance
locations. The initiative supported the evidence-based Awards were developed to acknowledge and encourage
proposition that clinical intervention should be provided as innovations from Ambulance Services throughout Australia, New
soon as possible after the onset of symptoms. The significant Zealand and Papua New Guinea. These awards also provide
adverse outcomes attributed to the platform for the industry to
delay between symptom onset learn from each other and reduce
and treatment, particularly in the duplication of effort.
Aboriginal community, supported
There are four broad categories in
the introduction of this project.
which individuals or groups/units
The project educated the can enter their project, and four
community about “THE 3 R’s” awards given for each category,
of a heart attack: ranging from the Excellence

Recognising acute cardiac Award to a Commendation. The
symptoms Management Practice Category

Ringing triple zero encompasses any project which

Responding to the Ambulance involves management culture,
operator’s advice. open communication, diversity of
staff and treatment, accountability,
Interested paramedics apply to
receive the Cardiac Care Aboriginal management development,
Education Package which includes professional standards, or
Paul Stewart, Cardiac Care Manager, Ambulance Service
a paramedic education refresher, NSW (right) accepting an award from Tony Ahern, Chair of
community education.
tips on disseminating information the Council of Ambulance Authorities.

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2010 CETI Awards
Dr Steve May wins NSW Geoff Marel Award
The Geoff Marel Award is an annual prize awarded by CETI, named in honour of Clinical
Associate Professor Geoff Marel, a committed contributor to prevocational medical training
and an advocate for trainee welfare who is remembered for his vision, creativity, insight
and humanity The award recognises the work of an individual who has made a substantial
contribution to the education and support of prevocational trainees.
Dr Steve May, Director of Prevocational Education and Training at Tamworth Rural Referral
Hospital, is the winner of the Geoff Marel Award in 2010 in recognition of his outstanding
contribution over many years to the education and welfare of junior doctors in New South Wales.
Dr Steve May, a great teacher
Dr May is well known at Tamworth for his work on behalf of junior doctors. His contributions and advocate for the welfare of
to their education program, willingness to make himself available to them at all hours for his trainees, has been Director
advice and support, continuing enthusiasm and involvement in hospital committees and of Prevocational Education
concern for the needs of each individual doctor have earned him the respect and admiration and Training at Tamworth
of his fellow staff at Tamworth and his fellow directors of training across NSW. Hospital for nine years.

Dr Matt Stanowski wins NSW Junior Doctor of the Year Award
The NSW Junior Doctor of the Year Award is an annual prize
awarded by CETI to a junior doctor who has made a substantial
contribution to the education and support of prevocational trainees.
Dr Matt Stanowski, Resident Medical Officer at Nepean Hospital,
is the winner of the 2010 NSW Junior Doctor of the Year Award
in recognition of his outstanding contribution to the education and
welfare of his fellow junior doctors.
Dr Stanowski’s work on JMO welfare, in particular the peer
mentoring program at Nepean and the pilot of similar programs at
other sites, has been a valuable innovation and a real benefit to new
interns. He has taken an enthusiastic role as a JMO representative
Dr Matt Stanowski, shown here at the graduation night
in hospital committees and the NSW JMO Forum, where he chaired
of CETI’s leadership program. Among his other activities
the welfare working group.
this year, Dr Stanowski completed the LEAP course and
was a member of the team that presented the winning
presentation at the course, with a proposal for “CAPS: CETI congratulates Dr May and Dr Stanowski, who will be
Clinical acquisition of procedural skills”. formally presented with their awards at the NSW Prevocational
Forum on Friday 12 August 2011.

Recommended reading: transforming medical education
“ Glaring gaps andinfectious, environmental, and behavioural risks, at a
countries ... New
inequities in health persist both within and between qualitative imbalances in the professional labour market; and weak
leadership ...
time of rapid demographic and epidemiological transitions, threaten
We regard transformative learning as the highest of three
health security of all. Health systems worldwide are struggling to
successive levels ... Informative learning is about acquiring
keep up, as they become more complex and costly, placing additional
knowledge and skills; its purpose is to produce experts. Formative
demands on health workers.
learning is about socialising students around values; its purpose
Professional education has not kept pace with these challenges, is to produce professionals. Transformative learning is about
largely because of fragmented, outdated, and static curricula ... developing leadership attributes; its purpose is to produce
mismatch of competencies to patient and population needs; poor enlightened change ...”
teamwork; persistent gender stratification of professional status;
— Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new
narrow technical focus without broader contextual understanding; century: transforming education to strengthen health systems in
episodic encounters rather than continuous care; predominant an interdependent world. The Lancet 2010; 376: 1923–1958.
hospital orientation at the expense of primary care; quantitative and www.thelancet.com

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Racing to the future
Craig Bingham
Prevocational Program Coordinator, CETI

“Innovation, Integration and Transformation” were
the three themes of this year’s conference, an event
attended by over 400 delegates from Australia, New Health Workforce Australia has a significant budget for
Zealand and other countries. developing expanded settings of training, supervisor training,
simulation training and other initiatives; on the other hand,
the Confederation of Postgraduate Medical Education
Innovation Councils reported that funding for the Australian Curriculum
With the pressure of increasing numbers of prevocational Framework for Junior Doctors project had run out and that
medical trainees and ever-expanding domains of medical further development was suspended pending renewed
knowledge, innovation, especially the use of technology to support from the federal government.
augment the educational capabilities of clinician educators,
is the essential oil of prevocational training. Several speakers
presented innovations in e-learning. Keynote speaker Transformation
Professor John Sandars made some important points about What is the future of prevocational training?
the deep objectives of e-learning:

Workplace-based assessment: Dr Julian Archer reported

Education is about enquiry and collaboration, and about on experience in the UK Foundation Program, which
life. It is not about preparing for life. We should not suggests that 360o assessment and greater use of
separate clinical education from the clinical immersion structured assessment tasks can provide more valid and
experience any more than we have to. reliable workplace-based assessment of junior doctors.
 clinicians as teachers, it is better to be the “guide
For However, Dr Archer sounded a cautionary note: assessors
on the side” than the “sage on the stage”: no longer the need training and a substantial level of commitment for
these changes to work. He hinted that Australia could
dispenser of wisdom but instead a navigator through seas
benefit from examining the UK experience with a sceptical
of electronic information.
eye on the evidence before adopting change.

Ubiquitous technology leads to ubiquitous learning. This
is not of itself a bad thing, but does mean that you can’t
 attention to supervisor training and support will be
More
required, or a dwindling resource of senior clinicians will be
fully control the learning environment. If you want to
swamped by rising numbers of trainees.
ensure core curriculum coverage, you need to provide
appropriate focused education.  ownership of their own training: The National JMO
JMO
Forum and participation by JMOs in the conference

Medical education in the next
were highlights of the meeting. Several JMO-initiated
generation will require a mixture of
innovations and surveys were presented. There is
 learner enquiry
yet more potential for JMOs to play a leading role in
 learner participation
transforming JMO education.
 learner digital literacy
 production of appropriate  training in general practice and community settings.
More
resources. This is where the majority of doctors will work after
training, so training in these settings is appropriate and
Dr John Sandars,
University of Leeds.
becoming more common.
Integration 
Simulation: Health Workforce Australia is promising
National integration of medical training was high on the agenda significant funding, and the National JMO Forum has the
this year. The establishment of the Medical Board of Australia widespread availability of high-fidelity simulation on its
and Health Workforce Australia has created an expectation that wishlist for the future.
training accreditation, internship standards, trainee assessment
and perhaps even workforce allocation will eventually move to
a national model, although keynote presentations by Dr Joanna
CETI at the conference
Flynn (Chair, Medical Board of Australia) and Mr Mark Cormack Staff from CETI played an active role. David Lochhead attracted
(Chief Executive Officer, Health Workforce Australia) reminded plenty of interest from other States when he presented CETI’s
us that there was a long way to go. online solution for administering the prevocational training

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application and allocation processes. Jackie O’Callaghan
presented a streamlined solution for accrediting general practice
training positions. Craig Bingham presented one of the largest
studies at the conference: an evaluation of 3390 prevocational
trainee assessments which raised serious questions about the
effectiveness of current processes.

Next year:
The conference will be held for the first time in New Zealand,
with the theme of “bridging the gap” between undergraduate
and vocational medical education.

CETI team members presented six posters at the National Prevocational 16th Australasian
Prevocational Medical Education Forum
Medical Education Forum, three of which were selected as finalists in
6-9 November 2011 Auckland, New Zealand
the conference poster competition.

The Superguide: coming soon to a supervisor near you
CETI’s new guide for supervisors of junior medical officers is now being
distributed via training sites to all term supervisors in New South Wales.
The Superguide
a handbook for
The guide was developed in consultation with clinicians across the State by
supervising doctors in training CETI’s Medical Division (IMET), and has been well received by its intended
audience. Dr David Lester-Smith, Associate Director of Clinical Education,
August 2010
CONSULTATION DRAFT
IMET | RESOURCE
The Children’s Hospital at Westmead, writes:
There is truly something here for all clinical supervisors, whatever their
level of previous experience. We all recognise good clinical supervision as
key to sound clinical education and training, but know many colleagues
find the role challenging. For most, without any formal guidance or training,
supervision is an assumed skill. This is the first document I have read that
usefully defines what supervision actually is and how to best supervise
trainees, including hints on managing the trainee in difficulty. I am sure
many colleagues will find valuable guidance and advice here.
The book is available at www.ceti.nsw.gov.au/prevocational.
For more information, or to order printed copies, contact:
IMET
NSW Institute of Medical
Prevocational Program Coordinator Craig Bingham (02 9844 6511,
Education and Training
— a division of CETI
cbingham@ceti.nsw.gov.au).

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From strength to strength
Marie-Louise Stokes
Senior Medical Advisor, CETI

Tribute to Professor Annemarie Hennessy
“If you want something done, ask a busy person.”
On 17 November, Professor Annemarie Hennessy completed
her term as Clinical Chair of the NSW Basic Physician Training
Council after four years in the role. During this time, Annemarie
led CETI Medical Division’s (IMET’s) flagship networked
training program with great flair, passion and a commitment to
the values of excellence and equity that underpin the networks.
Professor Iven Young, the incoming Clinical Chair of the Basic
Anyone who knows Annemarie will tell you that they can’t Physicians Training Program, with the past Program Coordinator Ellen
see how she fits everything in: research and supervision of Rawstron and outgoing ClinicalChair, Professor Annemarie Hennessy.
multiple PhD students, teaching (students, junior doctors, basic
and advanced trainees), academic leadership as Foundation
Professor of Medicine at the University of Western Sydney, Welcome to Professor Iven Young
clinical service work, work for the Royal Australasian College
CETI is delighted to welcome Iven Young as the incoming
of Physicians and, fortunately for us, the Clinical Chair role.
Clinical Chair of the NSW Basic Physician Training Council.
Somehow Annemarie manages to do all this and more.
Professor Young is a well known and respected senior
During her time as Clinical Chair, Annemarie developed closer respiratory physician and physician educator at the Royal
links with the networks and the College, negotiated changes Prince Alfred Hospital. He is Clinical Professor of Medicine at
to network structures (always a tricky undertaking) and Central Clinical School, the University of Sydney, was Head of
steered the program towards a greater focus on education. Respiratory Medicine at the Royal Prince Alfred Hospital for
Annemarie’s personable and straightforward approach earned 17 years and was foundation Chair of the Royal Prince Alfred
great respect and appreciation among trainees, network Basic Physician Training Network Governance Committee.
directors, education support officers, directors of physician Professor Young has first hand experience of implementing the
training and staff from CETI and NSW Health.
network system and seeing its benefits and challenges. We
Thank you Annemarie. warmly welcome him to the Clinical Chair role.

NSW Health Expo and Awards Training Support Unit for Aboriginal
The Rural Division of CETI supported 39 delegates to mothers, babies and children
attend the 2010 Health Expo and Awards. This program was
introduced in 2006 in recognition of the difficulties faced by The Training Support Unit will support Aboriginal Maternal
rural and remote health workers in attending such an event. Infant Health Service staff in improving primary and community
health services for Aboriginal people, particularly mothers and
Over the years, several delegates have introduced programs their babies.
or methods observed at the Expo, and others have been
finalists in their own area health service quality awards. The inaugural meeting of the implementation group was
This year it was exciting to see 2008 delegate Rosanna held at NSW Department of Health on 11 November. The
Robertson of Shoalhaven presenting as a finalist. membership of this group was reviewed and some new faces
are invited to the December meeting.
Afterwards, Roseanna said “I was so inspired when I came
here two years ago, that I decided I’d work on my own project Jennifer Wannan manages the unit within CETI’s Rural
— and here I am!”. Division. Recruitment is under way for the remaining 11
positions in the Training Support Unit, and it is anticipated
Roseanna’s project was titled “Shouldering Education;
Enhancing Skills and Outcomes”. Roseanna analysed the that the successful applicants will commence in the new year.
use of electrical stimulation in occupational therapy stroke Planning has commenced for the biennial forum. Input
services in the Southern Hospital Network, then developed and ideas are welcome, and can be forwarded to: Jennifer
clinical guidelines and an education program. This led to the Wannan (jennifer.wannan@gwahs.health.nsw.gov.au). The
incorporation of electrical stimulation in all Southern Hospital forum will be held in the first half of 2011 and will give
Network occupational therapy stroke services. service providers an opportunity to showcase their excellent
Congratulations to Roseanna and the team. work.

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RURAL DIVISION

2010 NSW Rural and Remote Health Conference
“Many paths to follow”

The second NSW Rural and Remote Health Conference was held at
Albury on 4th and 5th November.
Delegates were treated to a range of excellent speakers who supported
the conference themes:
• The path to a healthier community
• The path to “closing the gap”
• The path to a stronger workforce, and
• The path to improving the quality of our services.
The Hon. Carmel Tebbutt, Deputy Premier and Minister for Health, ad-
dressed the conference and reinforced her commitment to rural and
remote health.
The conference was enhanced by a series of workshops provided by
highly regarded academics and health and business professionals.

www.ircst.health.nsw.gov.au

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RURAL DIVISION

Conference Dinner
The Italian themed conference dinner was held on the banks of the lovely Murray River, which was in
flood at the time.
The evening commenced with delegates designing their own pizzas, made in the city’s community
wood fired pizza oven. This was followed by a very entertaining evening, which included the piano
accordion, opera and some fabulous dancing (yes, there was even a conga line).
We were delighted to share the evening with some of our keynote speakers, including Prof. Stefan
Grzybowski (pictured right with Dr Vahid Saberi), Dr Juanita Sherwood and Assoc. Prof. Sabina Knight
(pictured below left).

Rural Research Capacity Building Graduation
One of the highlights of the conference dinner was the graduation ceremony for 11 research
A special congratulations goes to Kerith Dun-
candidates, who have completed their projects: Tod Adams, SESIAHS; Cath Bateman, GSAHS; canson, who won the “Best Report” award
Jenni Devine, GSAHS; Kerith Duncanson, HNEAHS; Barbara Fetherston, GSAHS; Michelle for her project: “Feeding Healthy Food to
Murray, HNEAHS; Rachael O’Brien, HNEAHS; Rachel O’Loughlin, GSAHS; Judy Reinhardt, Kids randomized control trial: three month
NCAHS; David Schmidt, GSAHS; Christian Tremblay, NCAHS. These graduates are pictured analysis”. This award includes sponsorship
below with Linda Cutler and Dr Austin Curtin. for attendance at a national or international
Additional information about this program can be obtained by contacting Dr Emma Webster, conference where she has had an abstract
Rural Research Project Officer at emma.webster@gwahs.health.nsw.gov.au accepted.

Kerith is pictured above with Dr Austin Curtin
and Linda Cutler.

www.ircst.health.nsw.gov.au

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Spring symposium: e-learning in medical education
Hosted by South Australian Institute of Medical Education and Training (SAIMET) and Clinical Education and Training Queensland
(ClinEdQ), Adelaide October 2010

Peter Davy
Curriculum Developer, Medical Education and Training Team, CETI

How best can we support e-learning in medical 
establishing relationships which allow the sharing of
education and training? How can we increase access learning resources and the intellectual property to develop
for clinicians and trainees to high quality e-learning learning resources.
resources? These are two important questions asked at On the other hand, delegates acknowledged a number
a recent national symposium. of challenges that needed to be addressed by their own
organisations before collaboration could succeed, including:
The symposium brought together practitioners and decision-
makers in medical education and e-learning to share ideas 
difficulties with stakeholder engagement and agreement
and to propose solutions to challenges such as collaboration 
varying compliance requirements
and sharing of resources, integration of e-learning into
medical curricula, and identifying attributes of best practice  rotation of technical staff to maintain and sustain a
high
in e-learning design. There were delegates from state consistent effective approach to e-learning design
government clinical education and training organisations  potential costs involved in developing high quality
the
(CETI, SAIMET, ClinEdQ, PMCV, PMCT), universities e-learning resources (estimated to be between 15 and 20
(Flinders, Melbourne, Griffith and the University of Western hours for each hour of e-learning resource).
Sydney), hospitals and specialist colleges (ACEM, RACMA,
RANZCOG, ANZCA).
Integrating e-learning into curricula
e-Learning is just one part of the learning design to support
Why e-learning?
educational activities in medical education and training.
Symposium delegates acknowledged that e-learning covers a There was consensus that blended learning is the favoured
wide set of applications and processes, such as web-based approach for curriculum development and learning design.
learning, computer-based learning, virtual classrooms and
clinics, and online collaboration. With careful targeting of appropriate learning outcomes,
integrating e-learning into the curriculum can enhance
The advantages of e-learning include: learning. Delegates identified the following strategies to

potential savings compared with conventional training support this integration:

 capacity to communicate consistent educational
the 
educators acting as curators of learning guides, resources
messages to learners and teachers across locations and and other materials for learners
at any time 
educators assembling learning resources in content

potential for enhanced learning effectiveness with well repositories and allowing content sharing and and
designed e-learning programs. appraisal across organisations and jurisdictions

enhancing the sharing of e-learning resources by clearly
stating learning outcomes and specifically linking them to
Why collaborate?
important components of curricula (such as core clinical
Collaboration between government clinical education and skills and patient safety).
training institutes, universities, hospitals and specialist
colleges will enhance the sustainability, integration and
effectiveness of learning across clinical disciplines and for e-Learning best practice
different levels of learners. Delegates identified attributes of best practice in e-learning
Other reasons for collaboration identified by delegates design for clinical education. Discussion centred on three main
included: aspects of e-learning design:

 scope to provide economies of scale to fund the
the 
understanding the characteristics and needs of learners
design of learning resources who will be using e-learning tools

 opportunity to reduce costs for software licensing and
the 
design based on core effective principles of learning
development 
opportunities for building learner communities.

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CLINICAL EDUCATION
 Issue 2

Delegates identified specific attributes of best practice E-learning best practice
design based on these three points (see Box). Their list is not
exhaustive, but does give important points to consider. Understanding the learner

analysis of learning requirements
Where to now? 
catering to the experience and maturity of learner,
learning styles, and capacity and willingness to
Delegates were enthusiastic about advancing the participate in e-learning
discussions of this symposium. A webinar in six months was 
well-defined learning outcomes
proposed.

control of screen information
One agenda item suggested for the webinar is to identify 
capacity for self assessment and quizzes
possible sources of e-learning project sponsorship and 
content integration
funding support.

document management
 facilities
help
Conclusions 
simple user interface
e-Learning provides a valuable set of tools to support 
communication interactivity
clinician and trainee education, but it is just one part of the 
calendar to assist learner time management.
learning design to support medical education and training.
The consensus at the symposium was that blended learning Core principles of learning
is the favoured strategy. 
stimulating and meaningful learning activity

Sustainable e-learning will involve sharing of learning

motivation of learners and rewards for participation
materials and collaboration between education organisations 
transferability of skills/knowledge
and jurisdictions. 
quality of learning environment, including opportunity
for prompt feedback and formative assessment
Development of e-learning content needs to be measured;

learner-centred focus of teachers.
taking on too much all at once can result in expectations not
being met and projects being disbanded or downgraded.
Communities of learning
Targeting important learning outcomes which are well aligned
with e-learning delivery would be a good start to planning

clearly stated purpose for learning within communities
e-learning projects. 
experienced teachers to guide learning in this context

appropriate use of synchronous and asynchonous tools

opportunities for group problem solving

maximising the level of interaction.

E-learning resources

iNvestigate is an interactive website designed for use iNvestigate allows trainees to role-play ordering tests and
by prevocational medical trainees which focuses on interpreting results based upon given case histories. The
the appropriate and cost-effective use of diagnostic tool shows the cost of investigations, and allows users to
investigations. The project was funded by the Australian compare their choices with those of an expert.
Government under the Quality Use of Pathology Program,
Three new cases by Dr Kate Webber have been added to
and developed by a team led by Professor Rakesh Kumar,
iNvestigate, replacing the case used in the pilot version of
Professor of Pathology and Director of Academic Projects for
the program.
the Faculty of Medicine, University of New South Wales.
See iNvestigate at https://investigate.med.unsw.edu.au

cetiscape
CLINICAL EDUCATION
 Issue 2

Setting up safe handover
Shireen Martin, Ian Richards and James Dunne
Health Service Performance Improvement Branch, NSW Health

Handover is the transfer of patient care from one clinician to Dubbo Base, Campbelltown, Sutherland, Prince of Wales
another. It is a crucial moment when information about the and John Hunter. Each site chose the scope for the local
patient must be communicated effectively if patient care is to implementation based on their specific needs.
continue safely.
Representatives from CETI’s JMO Forum contributed to the
In 2008 the Special Commission of Inquiry into Acute piloting and evaluation process, attended each of the sites
Services in NSW Public Hospitals (Garling Report) and conducted a qualitative review of the pilot based on
recommended that each facility in NSW Health should have interviews with local JMOs. The Acute Care Taskforce was
a mandated clinical handover policy within 18 months. This impressed by the eager engagement to effect change and
recommendation was supported in the government response improve patient safety shown by this team of junior doctors,
to the report, Caring Together. Improving clinical handover is who gave a great deal of their own time to the project.
also a high priority at a national level (Australian Commission
The importance of the program is highlighted through the key
on Safety and Quality in Health Care, National Clinical
messages that have come directly from the JMOs:
Handover Initiative).

Senior leadership is critical: executive and clinical
In 2009, the Acute Care Taskforce commenced the NSW
leaders must model and reinforce the value of shift
Safe Clinical Handover Program and developed key
handover by leading handover, policy, training and
principles for clinical handover that have been mandated
aligning of rosters.
for state-wide implementation. NSW is the first Australian
jurisdiction to tackle system-wide improvement in clinical 
Involve JMOs in change: involving JMOs ensures
handover. that new processes meet their needs and gain their
commitment.
During implementation, many junior and senior clinicians

Senior nursing involvement: significant value was
reported that processes for handover at shift change were
reported by clinicians in all models where senior nurses
ad hoc or absent, and requested a specific focus on junior
were integrated into the handover.
medical officers (JMOs). The literature has shown that
failures of clinical handover are most likely when clinical 
Relationships = communication: an environment
staff are inexperienced, communication quality and content where all doctors feel comfortable to call and discuss
is suboptimal, there is a lack of standardised protocols and clinical care develops a good culture for communication
clinicians are fatigued. during and between shifts.

Education: doctors place high value
In response, the Acute Care Taskforce
on the teaching they can receive
began the JMO Clinical Handover Project RemembeR
IsBar at handover, led by consultants.
in 2010.
In some cases, education =
IntroductIon

I
Through early engagement of junior and Identify yourself (name/role/location) sustainability.
senior clinicians from both metropolitan and and give a reason for calling 
Undergraduate education: junior
“I am calling because…”
rural facilities, the project developed three and senior doctors have called for
sItuatIon

s
key elements for effective shift handover: elements of JMO handover and
Give the patients age/gender and status
1 A standard communication framework a: Stable (at risk of deterioration) ISBAR to be universally taught in
b: Unstable
for JMOs (ISBAR). undergraduate education.
Background

B
2 Senior leadership determining who and Give the relevant details: 
Documentation not duplication:
what should be handed over. Presenting problems...? it is important to ensure that clinical
Clinical history...
3 Standard key principles for locally documentation in the medical record
assessment

a
appropriate implementation (so that is effective and not replaced by
Put it all together.
the handover process is consistent, but Current condition/risks/needs handover documentation.
“My assessment is….”
locally appropriate).
recommendatIon

ISBAR: junior and senior clinicians

r
see value in ISBAR. They report that
These elements were tested through Be clear about what you are requesting
Transfer/review/treatment? it should be used as a framework,
a consultative process across NSW When should it happen?
not a rigid structure, to help effective
and then pilot implementation at Hunter New England Health is acknowledged for developing this resource
communication.
six hospitals: Wagga Wagga Base,

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CLINICAL EDUCATION
 Issue 2

The Acute Care Taskforce and NSW Health are collaborating will be sent to all facilities in the NSW prevocational training
with CETI on system-wide implementation of the JMO networks shortly.
clinical handover project in 2011. CETI has endorsed the
All resources and project reports can also be downloaded
project’s key elements and is working towards an appropriate
from the Safe Clinical Handover web page:
accreditation standard.
http://www.archi.net.au/e-library/safety/clinical/nsw-handover
Following consultation, the Acute Care Taskforce has For more information, please contact Shireen Martin,
developed a package of tools to support implementation that smart@doh.health.nsw.gov.au

International medical graduates get
ready for supervised training in NSW Coming events
A new cohort of overseas-trained doctors have been

National Rural Health Conference
scholarships
The 11th National Rural Health Conference will be held
in Perth, 13–16 March 2011, and the Rural Division of
CETI is funding 25 scholarships to assist health workers
from rural and remote NSW to attend.
Twenty-five successful applicants were selected from 74
applications after a very competitive selection process.
Successful applicants have itemised comprehensive
learning objectives to be gained from attendance, the
preparing for work in NSW with help from CETI. The outcomes of which will be evaluated. Applicants were
group of 77 Australian Medical Council (AMC) graduates notified on 29th November.
commence supervised training in January 2011 in hospitals
across the state. While many of these AMC graduates have
worked in medicine overseas, the transition to the Australian
health care system can be daunting, particularly adapting Rural Allied Health Conference,
to the hospital hierarchy, patient expectations and the 10-11 November 2011
Australian culture surrounding health care.
Preliminary planning has commenced for the 5th Rural
Each year CETI runs the AMC Pre-employment Program, Allied Health Conference, which is to be hosted by
which includes a one-week lecture series and clinical skills the North Coast Area Health Service. It will be held in
workshop followed by an observation placement in the Port Macquarie on 10-11 November 2011. Similar to
hospital where the AMC graduates will be starting their previous conferences, it is anticipated that numerous
supervised training.
pre conference workshops will be held preceding the
This year the lectures and workshop were held at the Kolling conference. Additional information will be posted on the
Building, Royal North Shore Hospital, 22–30 November. CETI Rural Division (IRCST) website early next year.
The graduates learnt a range of survival essentials, including
understanding the hospital hierarchy, managing the
deteriorating patient, prescribing, documentation and working
in a interprofessional team. During the clinical skills workshops NSW Prevocational Forum,
the graduates had an opportunity to practice skills such as 11–12 August 2011
cannulation, airway management and advanced life support.
If you are interested in prevocational medical education
The program also gave the group an opportunity to network and training, keep 11–12 August 2011 free in your
with each other and elect two of their colleagues as calendar so that you can attend this event.
representatives to the NSW JMO Forum. Congratulations to
Dr Juan Dong and Dr MD Masum Alam who will be the AMC
graduate representatives for 2011.

cetiscape
CLINICAL EDUCATION
 Issue 2

Progress in hospital skills
Alpana Singh
Acting Program Coordinator, CETI

How far has the Hospital Skills Program being achieved at Hunter New England Area
come since its launch in March 2010? Health Service. She showed other areas
that providing education for both ED trainees
This was one of the topics discussed at the
and HSP participants was an opportunity for
inaugural HSP Education Strategy Forum
HOSPITAL SKILLS PROGRAM collaboration and networking which is not
(23 November). Thirty-five people (including
always possible.
HSP Area Directors and Education Support The Hospital Skills Program supports
Officers, HSP participants, CETI staff and the training and professional The Royal Australian and New Zealand
HSP State Training Council members) development of non-specialist doctors College of Obstetricians and Gynaecologists
attended the forum, which had a full day’s working in NSW hospitals. gave an update on the collaboration between
program of presentations and a plenary CETI and RANZCOG and provided
discussion. attendees with a picture of content within the new RANZCOG
Certificate, Diploma and Diploma Advanced which would
Collaboration has been the buzz word for the Hospital Skills
articulate with the HSP Women’s Health Module. There was also
Program since it was developed and presentations and
an excellent section on online learning and how this would be
discussions during the Forum supported this approach.
incorporated into the courses provided.
Dr Danielle Morris, the HSP Area Director for Greater Western
Dr Alan Giles, the HSP Area Director from Sydney South West
Area Health Service, presented on education initiatives used to
Area Health Service provided an entertaining session on the
promote the Hospital Skills Program within GWAHS.
challenges in delivering education to CMOs in the south west
GWAHS launched the Hospital Skills Program in conjunction and what he has learnt from this experience. To accommodate
with a two-day resuscitation procedures workshop on 6–7 the different learning styles of HSP participants, Dr Giles
November. More than 30 doctors from all over GWAHS suggested that the best method for providing education and
attended the workshop which included practical skills stations training was a blended learning model that included online
for joint relocation, emergency delivery, plastering, airway resources, lectures and face-to-face teaching.
management and emergency ultrasounds. Feedback from the
The plenary discussion on progress and challenges for the HSP
workshop showed overwhelming support for the program,
was lively, but the day’s presentations had demonstrated that the
which allowed participants to refresh their procedural skills in
HSP has come a long way since the launch in March 2010. Area
emergency care and gave them an opportunity to network with
Directors and Education Support Officers have been appointed
other doctors across the greater western area.
in all Area Health Services, which has provided an impetus
Professor Graham Reece spoke on the Oasis Simulation Centre which had been lacking, but the main achievement has been the
based in Blacktown and how HSP participants from Sydney engagement of doctors in the HSP. Most HSP participants have
West Area Health Service are able to access training provided been receiving an enhanced level of education and training and
there. The cost for training and education sessions is very have developed good communication networks, and there has
reasonable and there is certification for any training provided. been increasing engagement from doctors who will be providing
Professor Reece has indicated that training is available for all the education and training as well as supervising and assessing
HSP participants regardless of which health service they are the HSP participants. This has been the big step forward within
located in. the program, with many more steps to come in 2011.
Dr Briege Hamill talked about sharing training resources Presentations from the HSP Education Strategy Forum are
between HSP and the emergency department and how this was available on the CETI website: www.ceti.nsw.gov.au

Hospital Skills Program launch at GWAHS.

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CLINICAL EDUCATION
 Issue 2

Leading the way
CETI provides leadership in clinical education, and it and competence in clinical leadership skills; that workshop
also provides education in clinical leadership. Here are learning objectives have been met; and that key learnings
three programs that aim to build the leadership skills of have come from group discussions and sharing ideas, as well
our health workforce. as from the formal learning activities.
All participants have had a face-to-face feedback session

1 Rural Division: Leadership and
Management Essentials Program
This is an experiential program for rural and remote health
about their 360o leadership survey report and have
commenced developing their own personal learning
development plan. This involves the participants using the
various self reflection activities and the themes from the 360
workers tailored to meet individual learning needs and offers report to establish personal goals and identify strategies
core topics in leadership, management, communication in the areas of leadership styles, emotional intelligence,
and team building, and a selection of elective topics such assertive communication and self care.
as financial management, strategic planning, performance
Each team has commenced planning a local clinical practice
management and conflict resolution, depending on what
improvement project. From now until June 2011 the group
each participant identifies in their personal development
will work on their projects, participate in monthly group
plan. It is conducted through distance education, monthly
teleconferences and have individual coaching with the
teleconferences and two two-day workshops in Sydney.
facilitator, Jan Dent.
This year’s program is coming to an end in December with

3
27 of the original 32 participants completing all program
requirements. Medical Division: Future Leaders
Development Program
“I feel I have grown as a person, am more confident making
decisions, am able to acknowledge that I made an error and Two programs in one (LEAP and LEAD), the Future Leaders
apologise if needed, feel more confident delegating, am Development Program has a stream for doctors in training
more in control of my emotions and more aware of how they and a second stream for senior doctors.
can impact on the team,” wrote one participant in providing LEAP – the future LEAders development Program will be
feedback. “I have learned techniques on how to get staff to running for its third year in 2011. LEAP prepares doctors-
be more responsible for their actions and also to give them in-training for leadership roles within the NSW public health
the ability to make decisions.” system. No other program exists in NSW that is focused on
The program will run again in 2011. Application forms are the needs of doctors in training in relation to leadership skills
available on the CETI Rural Division (IRCST) website (www. for medical education and training.
ircst.health.nsw.gov.au) and will close on 14 January 2011. LEAD – the LEAdership Development program in medical
education and training for consultant medical practitioners

2 Rural Division: Clinical Team Leadership
Program
This program for rural clinicians was modelled on the Clinical
in NSW focuses on the needs of consultant medical
practitioners in relation to leadership skills for medical
education
The aim of these programs is to deliver a high quality,
Excellence Commission’s clinical leadership program. The
innovative, interactive and inspirational leadership program
main modification was asking participants to pair with a GP
for current and future clinician leaders in medical education
to undertake a clinical practice improvement project.
and training within the NSW health system.
The program aims are to:
The major component of each program is five face-to-face

increase the participants’ leadership and management workshops, a total of 10 days. Workshops are objective-
skills and confidence driven, focusing on experiential learning through simulation

strengthen partnerships between public health services group exercises, interactive lectures and feedback.
and GP-VMOs
Skills learnt in the workshops are complemented and developed

increase the participants’ competence at leading a team- by an ongoing program of projects completed in syndicate
based clinical improvement project. groups, self-directed and web-based training, a mentor program
The program includes eight full-day workshops held in and practical leadership experience in the workplace.
Sydney. Applications for both 2011 programs will close on Friday 21
Workshops evaluations have shown high levels of satisfaction January 2011. For more information and an application form:
with the program content, organisation and presentation. go to www.ceti.nsw.gov.au and search for “future leaders”,
Participants report that they have increased confidence or email <leadership@ceti.nsw.gov.au>.

cetiscape
CLINICAL EDUCATION
 Issue 2

National audit of medical internship acceptances
Kirsten Campbell
Project Manager, CETI

A national audit of intern acceptances of job offers has found  2 – Extended Audit: Applicants identified as having
Part
41 applicants who accepted more than one position. As accepted multiple positions were contacted and asked
one of these had accepted three positions, there were 42 to decide which position they wished to accept for
intern positions that may have been made available for other January 2011. Only four jurisdictions — Australian Capital
applicants who had not at the time received an offer. Territory, New South Wales, Northern Territory, and South
This was the first national audit of intern acceptances. It was Australia — participated in the extended audit.
conducted in August of all intern acceptances for the clinical
year 2011 by the National Intern Allocation Working Party. The
working party was set up in February 2010 under the oversight
Key findings
of the Confederation of Postgraduate Medical Education The total number of acceptances reported by jurisdictions
Councils to develop opportunities for sharing information related by 27 August was 2697. The audit only examined 2313
to multiple acceptances of intern offers across jurisdictions. intern acceptances as 384 applicants did not agree to their
information being sent to the central administrator. Of these,
The working party was chaired by Professor Geoffrey
374 were Queensland applicants who were limited by local
Thompson, Chair of the South Australian Institute of
issues in their ability to ensure privacy law compliance.
Medical Education and Training (SAIMET), and included
representatives from each of the jurisdictions responsible for Eighty-three duplicate acceptances were identified, which
intern recruitment policy or allocation, junior doctors, medical represented 4% of the total number of acceptances. Forty
students and Health Workforce Australia. Project support applicants had accepted two positions and one applicant
was provided by CETI and SAIMET. had accepted three positions. At the time of the audit, there
were potentially 42 positions which could have been freed up
Reaching national agreement on what to audit and how it
if all of the duplicate acceptances were resolved.
would operate was challenging. The working party had to
overcome a number of hurdles, as set out below, in order to
ensure participation by all of the jurisdictions.
Next steps
Jurisdictions reached agreement to undertake the audit as a
A second audit is currently being conducting to see if the
two-part pilot for 2011.
number of duplicate acceptances has changed and further
 1 – basic audit: Agreement to share intern acceptance
Part audits are planned for early next year. The working party will
information but not to follow-up individual applicants be looking to build on the audit next year and are hopeful that
identified as having multiple acceptances. All of the all of the jurisdictions will participate in the full audit process
jurisdictions participated in this part — Australian Capital for clinical year 2012. The working party will also be looking
Territory, New South Wales, Northern Territory, Queensland, at other areas where national harmonisation of policies and
South Australia, Tasmania, Victoria and Western Australia. processes would be beneficial.

Clearing the “hurdles” to implement the National Audit of Intern Acceptances Process
4. Privacy
3. Communication
2. Process 5. Common Dataset
1. Buy-in
6. Confidentiality
The Finish
Intern positions left Privacy concerns Data on intern eligibility
vacant in January due to about sharing applicant criteria collected and
Intern allocation last minute withdrawals information. classified differently in
Organisations approached differently from interns who had each Jurisdiction.
responsible for intern Jurisdictions sought
in each Jurisdiction been holding multiple Agreed on a simple
allocation are different in advice and locally
– therefore process, acceptances. common dataset using
each Jurisdiction making accepted processes Jurisdictions concerned
communication and
participation in a central Potential applicants were implemented and MTRP classifications. about conflict of National agreement
timings differed.
process difficult. advised about impact integrated with the interest of central reached that all
Following extensive of holding multiple national process – audit administration. Jurisdictions would
Early communication
discussion, agreement acceptances. Audit split into two parts (Part Confidentiality participate in a two part
by the Jurisdictions
reached on a wash brought applicant 1 and Part 2). agreements drafted National Audit Pilot.
about the audit ensured
successful participation up process that took decision making process and signed by central
by all. into account these forward so vacancies administrator.
differences. were known sooner.

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Cetiscape 2 December 2010