CETI Newsletter Highlights Excellence in Clinical Education

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newsletter of the Clinical Education and Training Institute
 Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 1 
Renovation, innovation, inspiration
NSW Prevocational Medical Education Forum
10-11 August 2011 Stamford Grand North Ryde

This year’s Forum was attended by more than 150 CETI Awards for 2010
participants, including directors of training, JMO managers, were presented at the
and representatives from general practice training providers, plenary session of the
universities, specialist colleges, the Clinical Excellence NSW Prevocational
Commission and the NSW Department of Health. Interstate Medical Education
representatives came from Queensland, South Australia and Forum.
the Australian Capital Territory. Dr Steve May won the
2010 NSW Geoff Marel Award and Dr Matt Stanowski won the NSW
Part of the objective this year was to give people more actual JMO of the Year Award.
hands-on training, so Teaching on the Run training sessions
The Awards were announced last year. “We had to wait until
were held for 50 people and an online learning workshop for 78.
now to find a suitably august audience to give the award winners
The online learning workshop featured eight demonstration the applause they deserve” said Dr Ros Crampton, Chair of the
stations where participants were introduced to a range of Prevocational Training Council, at the awards ceremony. In 2011,
technologies and e-learning options. Kate Jurd, our special CETI has added a new JMO Manager of the Year Award.
guest from Toowoomba Hospital, impressed the audience
with her highly polished demonstrations of interactive learning Look inside to see the 2011 CETI Award
modules developed in Moodle using tools such as Articulate Winners! (page 2)
and Code Baby. “You have to escape from read-and-click
online presentations if you are going to create resources that
people really engage with and learn from,” Kate said.
In this issue
(... continued page 3) 
Renovation, innovation, inspiration 1

General practice is the new black 1

2011 CETI Awards 2
General practice is the new black 
Simulation clinical lead appointed to CETI 4
Why you need it in your prevocational program 
Surgical wetlabs are fun! 4

eHealth: a future reality or a fantastic vision? 5
CETI is focused on ensuring that a wide range of high quality
training experiences are available to prevocational medical 
Surgical Sciences Course accredited by RACS 6
trainees. The Prevocational General Practice Placements 
Serious gaming? 6
Program (PGPPP) is proving to be a significant success in 
Interprofessional student unit 7
this area, providing JMOs with wide and varied experiences in

Bureau profiles demand in NSW hospitals 7
primary health care in a supportive learning environment.
 research continues to grow
Rural 8
PGPPP is relatively new to NSW. Almost 50 new general

National Stroke Awareness Week in rural NSW 9
practices came on board last year, due in part to a new and
streamlined accreditation process piloted by CETI.  and remote scholarship program
Rural 10

CETI is receiving exceptionally positive feedback from
 Risky Business website
The 10
trainees. The key message from both an online survey 
Preparation for the FRACP exam 11
and telephone interviews was that the trainees found the  Clinical Ethics Resource website
The 11
placement challenging, but that they felt very well supported 
Device wise 12
by the supervision provided in the practices. All the trainees
surveyed in Term 1 reported that they would recommend the 
Harvard course for simulation instructors 13
placement to colleagues. Two thirds said that their skills and 
Telling it like it is supervisor forum 15
confidence as a doctor were “significantly improved”. 
Master of Education (Health Professional Education) 16
A full report on Term 1 is available on our website.  beginning: Daniel Stewart
The 17
Further information: Program Coordinator Sharyn Brown: 
SimHealth 2011 18
sbrown@ceti.nsw.gov.au; 02 9844 6525.
 or HETI?
CETI 18

2011 CETI Awards
New Award!
NSW Geoff Marel Award 2011 NSW JMO Manager of the Year 2011
awarded to Associate Professor awarded to Ms Judy Muller
Michael Agrez CETI is delighted to announce that
Associate Professor Michael Agrez is Judy Muller, JMO Manager at Hornsby
highly regarded for his work on behalf of Hospital, is the inaugural winner of
junior medical officers and in particular this award. It is long overdue that
his passion and commitment to high there be an award for JMO Managers,
quality and relevant education programs, who in NSW play a vital role in
his concern for the needs and safety of supporting the education and training
individual junior doctors and his advocacy of junior doctors. Judy was nominated
for the junior medical workforce. for the award by several of her current cohort of JMOs.
Michael is a colorectal surgeon with a professional interest Judy has been passionate about the welfare of junior
in cancer research. He is involved in prevocational training doctors for 20 years as a JMO Manager at Westmead and
nationally as a member of ACF Project working groups, at Hornsby Hospitals. She has been an active participant in
a state level with the Prevocational Training Council and improving the working conditions of JMOs, ensuring safe
the Prevocational Accreditation Committee, at a district working hours, adequate orientation, protected teaching
level as head of the education subcommittee of the HNE times and a variety of clinical experiences, all while ensuring
prevocational network, and as a Director of Prevocational
adequate balance of service to the hospital.
Education and Training in John Hunter Hospital. He has a
rare flair for systematic approaches to medical education Judy has a huge reputation with several generations of
research, and presents findings at the Australasian JMOs as being tough but fair — a rock in uncertain seas.
Prevocational Medical Education Forum every year.
Judy is a leader among her peers. For many years, Judy
Michael recently climbed Mount Kilimanjaro as a charitable coordinated statewide meetings of JMO Managers
fundraiser for the Care Foundation, raising money for cancer which contributed to their professional development and
research. promoted their collaboration across the system. Judy has a
CETI is grateful to Michael for the work he has done with us legendary reputation as a straight shooter, and her forthright
over many years. He was nominated for this award by a large advice has been keenly sought and widely appreciated
cohort of the prevocational trainees in his network, which by clinicians and managers at all levels in CETI and NSW
spoke volumes for his qualities as an educator and mentor. Health.

NSW Junior Doctor of the Year Award 2011
awarded to Dr Lucy Cho
Dr Lucy Cho, Chair of the NSW JMO Improvement Branch to promote an improved shift handover
Forum, is an example of a JMO who process for all junior doctors. She led the JMO Forum in
goes way beyond what is required in the conducting an audit of handover across NSW which formed
course of duty. Dr Cho works tirelessly in the basis of the Departmental evaluation of the reforms.
her local Resident Medical Officer (RMO)
Dr Cho has been an active member of the NSW
Association and as a representative at
Prevocational Training Council and has contributed to
General Clinical Training Committtee
several other NSW health committees and working groups,
meetings, where she achieved local adoption of the Unified
such as the Acute Care Taskforce and the Intern Summit
Lecture Series for JMOs developed by the JMO Forum
on expanded settings for training. Her presentation to the
education group. Lucy is also a member of the AMA NSW
summit was a lucid highlight of the day, the product of her
Doctors in Training Forum.
personal consultation with JMOs across the state.
As a member of the JMO Forum handover working group,
Lucy collaborated with Health Services Performance

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 Issue 7  October 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 2

... Renovation, innovation, inspiration — NSW workplace-based assessments and a more explicit criterion-
Prevocational Medical Education Forum (continued based assessment form. The core competencies workshop
from page 1) reached a good consensus on some essential competencies for
JMOs to be developed and assessed in specific training terms.
David Peterson, from the South Australian Institute of Medical
Education and Training, spoke on narrative strategies for A meeting with JMO Managers led to proposals for a new
effective online learning. Tam Hennessy, from online learning JMO Manager guidebook. CETI representatives at the meeting
provider PrimEd, outlined strategic choices of technologies were pleased to commit to supporting this project. The JMO
and emphasised the importance of adopting and applying a managers also wanted to re-establish a regular forum where
standards-based approach to content development. they can provide support and share expertise within the group.

Trevor McKinnon, CETI’s Director of Learning Innovation and At the plenary session, Professor Peter Procopis, a member
Future Technology, offered a vision of a health system re- of the Medical Board of Australia, outlined the new proposed
enabled by adopting social media and Web 2 technologies. The national internship standard. Audience members were
risks this might pose to patient confidentiality and information concerned about the new emergency medical care training
control raised protests from some participants, but Trevor made requirement, which represented a dilution of the standard
the point that social media was in use “right here, right now” currently prevailing in NSW. Others expressed doubts about the
by clinicians, managers, patients and the community, and that new standard’s openness to internships completed in training
healthcare managers need to consider how to engage with the sites outside Australia.
technology to reap its benefits and reduce its risks. Dr Ros Crampton, Chair of the Prevocational Training Council,
Jay Jacinto, CETI Program Coordinator in vocational training, launched a consultation draft of new terms of reference for
brought along a Nintendo Wii and encouraged people to network committees of prevocational training. The new terms of
have a go at playing surgeon. It wasn’t all fun and games -- reference are more explicit about the level of coordination and
Jay and his co-presenter, Conjoint Professor Jane Conway cooperation required in training networks. They propose that
(University of Newcastle), raised issues of entertainment the committee needs to negotiate explicit agreements between
versus education, and asked participants to consider just network partners covering aspects of trainee management that
what it would really take to engage the gaming generation in have been contentious in some networks. The Prevocational
e-learning. Training Council is encouraging network committees to consider
and comment on these new terms of reference, with the hope
Jay Jacinto (standing) that they may be adopted for the 2012 clinical year.
demonstrates the Nintendo This year’s conference included a large contingent of general
course in surgery -- not practice educators from the GP regional providers. The
really, but how do we create Prevocational General Practice Placements Program (PGPPP)
compelling online learning for is relatively new in NSW (see page 1 story). The GP directors of
the Web 2 generation? training brought a valuable new perspective to the conference,
For one possible answer, see with fresh insights into how to train and supervise junior doctors.
page 4. Supervision is just one area where the GP experience may have
lessons for hospital-based prevocational training.
Another workshop at the conference explored the role
Toni Vial, Coordinator of CETI’s Hospital Skills Program, of vocational trainees in the supervision and training of
showed just how easy it is to record lectures and prevocational trainees. Recommendations arising from this
presentations using Camtasia, and Sharyn Brown (CETI workshop included adapting CETI’s Superguide for the
Program Coordinator, PGPPP) demonstrated an interactive vocational trainee audience and developing specific supervisor
case study created in Moodle. training for this group of doctors. CETI has now established a
“Our aim is to show examples that might inspire you to build working group to take this concept further.
online learning that works” explained Craig Bingham, convenor The Forum achieved its twin goals of providing professional
of the workshop. “Too much of what is done in this space fails development to the clinicians and administrators who deliver
to engage learners. Online learning is more than connecting prevocational training in NSW and setting the development
a learner to a computer. It is about connecting learners to agenda for the forthcoming year. CETI thanks all the participants
learners and learners to teachers, surmounting barriers of and presenters who helped make the event a success.
space and time to create learning environments that are Craig Bingham
interesting and thought-provoking.” Prevocational Program Coordinator
In other workshops on assessment and core competencies
for prevocational trainees, participants helped map out new Save the date
directions for education in the prevocational program. CETI is
investigating practical methods for improving the assessment NSW Prevocational Medical Education Forum 2012
of prevocational trainees, exploring the possibility of specific Thursday 9 August – Friday 10 August 2012

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Simulation clinical lead appointed to CETI
CETI is pleased to announce the appointment Rino currently chairs the Paediatric and Neonatal
of Dr Marino Festa as the Clinical Chair for Special Interest Group of the Australian Society
Simulated Learning Environments (SLE). Rino for Simulation in Healthcare (ASSH), is a NSW
will chair the Simulation Advisory Committee and representative on the Health Workforce Australia
provide professional leadership for the strategic Simulated Learning Environments Expert Reference
direction, statewide coordination and standards Group and a member of the Clinical Excellence
of simulated learning environments for NSW Commission Between the Flags Steering
Health. Committee and DETECT Junior Workshop
Advisory Committee.
Rino is a well-respected member of the simulation
community, both nationally and internationally. He CETI welcomes Rino to the team and looks forward
is a paediatric intensive care specialist and clinical lead of to his contribution to the simulation learning environments
the simulation program at the Children’s Hospital Westmead. project.

Surgical wetlabs are fun!
Andrew Kemp
Education Support Officer
Eastern & Greater Southern Surgical Training Network

The trainees who come together on a Saturday morning
for a surgical wetlab are so interested in surgery that
it’s a real pleasure to help them gain some skills. As
an education support officer (ESO), my role is to co-
ordinate the different people who will come together
to teach and learn. The collaboration of consultants,
fellows, registrars, industry representatives and trainees
is truly impressive and inspiring.

Good education programs bring together a number of elements for trainees.
The opportunity to reflect on a problem, to collaborate with peers and
instructors and to incorporate new skills are three essential elements to help
cement knowledge for later use. Surgical wetlabs (in which trainees practise
surgical skills on prepared animal specimens) are perfect for all these three
elements to combine, providing a great learning experience for all surgical
trainees.
When I see them working on their anastomoses, chest drains, sutures or
knots, the look on their faces is priceless. They are absorbed in a way I
rarely see elsewhere. I know they are learning and thankful for the surgical
training program. I also think the wetlabs inspire them to visualise themselves
performing these skills independently with real patients in the future.
Like the other surgical skills networks in NSW, we offer more places than
we have surgical skills trainees. This allows trainees from other networks to
attend. It also makes room for prevocational trainees, who can get a headstart
on skills that will enable them to perform better in theatre when the time
comes.
More information: Andrew Kemp, (02) 8382-2563, akemp@stvincents.com.au

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eHealth: a future reality or a fantastic vision?
Professor Steven people, it’s about high touch. When things go wrong it’s usually
Boyages because of a failure of people and process, not machinery.
Chief Executive of the Clinical Secondly, investment in health information technology is
Education and Training just that, an investment, but too often we see it as a magical
Institute (CETI) of NSW solution. Because of the electronic wizardry of health IT
Recently I attended the something amazing is assumed will happen to health care
Health Support Services delivery without doing the hard work.
Expo in Sydney. As with all Unfortunately, this is not the case in health or in any other
these events, it was large and industry where information technology has been rapidly
diverse. This year’s theme adopted. Information technology is an accelerator of best
was on ehealth and a series of speakers, including myself, practice workflow and is not a substitute for redesigning
debated its virtues and vices. The discussion was frank and processes and systems of delivery.
robust as we deliberated the merits of a personally controlled
electronic health record (PCEHR). We heard about curated Too often the introduction of a new IT system without requisite
electronic records, national identifiers, electronic blue books, redesign can lead to a worsening of workflows. My thesis is
and the need to make certain the community was on side. that we will never fully realise the investment in health IT until
we understand how we do our work, Other industries term this
The discussion wasn’t necessarily new; I chaired the State’s workflow or logistics or business process mapping. Information
first EHR committee in the year 2000. What is different on technology systems should emulate and support clinical and
this occasion is the momentum and scale of some of the pilot corporate processes.
studies that are being proposed by the National Electronic
Health Transition Authority (NEHTA). The flipside of all this is As I sat back on the panel, it reminded me of those early
the risk of not realising expectations, clinicians and patients not pioneers in any industry who advocated for a new way of doing
participating and another waste of taxpayers’ dollars. I did get things. Passion and persuasion will not be enough to get health
a sense that the audience was not entirely persuaded and was IT systems across the line. We are only at the beginning of a
thinking: sounds good, but we will believe it when we see it. it long journey of discovery that will require an understanding of
engineering and redesign principles and how these apply to
As I prepared for the panel, I was scrolling through the healthcare delivery.
latest LinkedIn news. There was a report that the UK Public
Accounts Committee was about to recommend to review The greatest value from health IT will be realised when these
whether the NHS program on IT should be continued. systems reduce duplication, avoid clinical error, improve patient
safety and improve health care worker experience. These
The Rt Hon Margaret Hodge MP, Chair of the Committee of benefits will not be derived without investing time and dollars
Public Accounts, was quoted: “The Department of Health is not in streamlining and, where appropriate, standardising clinical
going to achieve its original aim of a fully integrated care records workflow.
system across the NHS. Trying to create a one-size-fits-all
system in the NHS was a massive risk and has proven to be
unworkable. The Department has been unable to demonstrate
what benefits have been delivered from the £2.7 billion spent on
the project so far.”<www.parliament.uk/business/committees/ Social media survey
committees-a-z/commons-select/public-accounts-committee/
news/nhs-it-report-/>. You are invited to participate in a
survey of the use of social media by
This report was not a good omen. I sat back and reflected that Australian healthcare professionals. It
there was no other topic in health that generated so much heat will take no more than 10 minutes to
and passion. Further, there is no other strategy in health that has complete.
promised so much and delivered so little. Why is this so?
This survey is being conducted by the NSW Clinical
Is it because of a false belief that in healthcare we are a Excellence Commission to gather information about where
technologically advanced industry which is at the cutting and how often healthcare professionals access the internet,
edge of science and therefore we are able to integrate these and if they use social media sites such as Facebook, Twitter
sophisticated IT tools just as easily as we introduce new clinical and LinkedIn for professional purposes. The information
technology? Or is it because we over-sold the promise of health collected will be used for publications.
IT to our funders and are now reaping a poor harvest?
The survey is open to any registered health professional
The reality is probably somewhere in between. Firstly, health is practising in the Australian healthcare system.
not a high tech industry. It uses a lot of high tech equipment and
relies on high tech procedures; but, the health industry is about Do the survey at: www.asr2.com/cec/anon/146.aspx

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CETI Surgical Sciences Course accredited by RACS
In 2010 CETI worked with the University of Western Sydney
to pilot a Surgical Sciences Course. The course was designed
as an intensive method of teaching anatomy, physiology and
pathology to surgical sciences trainees over two weeks – an
alternative to weekend courses for which attendance had
become quite variable.
The pilot was repeated this year, with 66 hours of anatomy,
physiology, pathology, pharmacology and radiology teaching
being covered over 10 teaching days. Attendees also
completed 8 hours of trial examinations, anatomy spot
tests and assessments. The course required 15 anatomy
demonstrators, 5 physiology lecturers, 7 pathology lecturers, a
radiology lecturer and a pharmacology lecturer. Examinations Professor Fiona Stewart, University of New England, takes on the
were conducted on entry and exit. skeleton during the Surgical Sciences Course.

The course is the brainchild of Professor Robert Rae who has
worked tirelessly to bring this course to where it is today — one
that meets the curriculum requirements for surgical science as determined by
RACS.
The course will run again in 2012 from Monday 23 January to Friday 3
February and enrolment applications are now open – you need to be quick
because places are filling fast and numbers are limited to 30.
More information on the course, the 2012 timetable and application
form: www.ceti.nsw.gov.au/surgical

Serious gaming? Go to: investigate.med.unsw.edu.au
Learning by doing can be very effective, but no one working are presented with relevant information about their use and
in the health system wants to make significant errors while interpretation from the RCPA Manual.
learning. On the other hand, every learner wants feedback
A running tally of the estimated cost of all tests is provided,
from an expert about their learning.
based on the Medicare Benefits schedule. After reviewing
iNvestigate is an interactive website which can help junior the results, you may select further investigations, for up to a
doctors learn about the rational use of investigations. It maximum of 4 test-ordering encounters. Feedback is then
provides a simulation environment in which you can learn by provided, which allows comparison of cost, time to definitive
doing, but errors do not have serious consequences and you diagnosis, and overall diagnostic strategy relative to an expert.
have an opportunity to compare what you did with what an
iNvestigate might be described as a game — and hopefully
expert regarded as appropriate.
doctors will find it fun and interesting — but its purpose is
The cases in iNvestigate were selected in discussion with absolutely serious! To check it out, go to investigate.med.
advanced physician trainees and specialists. There are 22 unsw.edu.au and self-register via the link at top right.
case studies planned that are relevant to PGY1 and PGY2
iNvestigate has been developed with funding from the Quality
doctors, of which 17 are already complete.
Use of Pathology Program of the Commonwealth Department
For each case study, you review the clinical information, of Health. The project is a collaboration between UNSW and
prioritise differential diagnoses and then select appropriate the RCPA. It is led by Prof Rakesh Kumar of the Department
initial investigations. When ordering pathology tests, you of Pathology at UNSW.

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Interprofessional student unit
The Royal Rehabilitation Centre Sydney, in partnership
with the University of Sydney, has delivered a series of
interprofessional clinical placements in 2011.
The final placement for the year is currently underway, and
includes nurses, a physiotherapist, occupational therapists,
speech pathologists, and a dietitian. These students work
together to deliver community-based health care to Royal
Rehab clients.
The placement responds to the latest research, which shows
Beth Causa (centre) and Annie Roman (on Beth’s left) with
that health professionals benefit from learning with, from, and students on placement, hearing one of the students give an
about each other on clinical placement. Students attend tutorials interprofessional tutorial delivered on a cognitive assessment
together, set rehab goals together, and practice collaboratively technique.
with clients. Students learn to deliver client-centred care, and
discover the benefits of teamwork for improved client outcomes.
mobile phone, and mobile internet. These tools are used to plan
Interprofessional placements are complex to organise, requiring and deliver client care as well as to augment traditional clinical
lots of flexibility to ensure that each student’s placement education techniques. We look forward to evaluating the Mobile
requirements are met. However, it has been worthwhile to Learning Stations and sharing our findings in the future.
hear the positive feedback from students regarding the unique
More info: Beth Causa, Project Manager, Community Based
opportunity to collaborate with their student peers.
Multidisciplinary Student Clinical Training Program Royal
As a point of innovation, students are trialing Mobile Learning Rehabilitation Centre Sydney ,PO Box 6, Ryde NSW 1680;
Stations. Each student is provided with a laptop, webcam, beth.causa@royalrehab.com.au

Bureau profiles demand in NSW
hospitals
The Bureau of Health Information’s latest Hospital Quarterly “The highest rise was for non-urgent elective surgery with
profiles demand in NSW public hospitals in the April to June, 92% of patients seen within the recommended 365 days.
2011 quarter — showing a shift in the types of pressure That compares to 85% one year ago and 90% two years
being felt in NSW emergency departments. ago,” she said.
Emergency department attendances from April to June In NSW public hospitals, there were over 412,000 admitted
exceeded 512,000 — up by more than 16,000 or 3% from patient episodes, 12,000 or 3% more than a year ago and
one year ago but down 23,000 from the two-year peak that 28,000 or 7% more than two years ago.
occurred during the Christmas quarter last year.
In this latest Hospital Quarterly, the Bureau reports on
“This represents a decline in the number of people going to emergency department attendances while it considers
emergency departments since the 2010 Christmas peak, but new ways to report wait-time performance. The Bureau will
more patients are being admitted from emergency departments resume reporting of emergency department wait times in its
to hospital,” Bureau Chief Executive Dr Diane Watson said. next Hospital Quarterly due out in December.
“Emergency admissions of 120,000 represent an increase “We’ve seen some differences in how hospitals record
of more than 1000 since the 2010 Christmas peak, almost emergency department information and from what the
8000 or 7% since one year ago and 10,000 or 9% since two Bureau has seen so far, the varied recording methods can
years ago.” be clinically reasonable but make it difficult to fairly compare
There were 52,000 elective surgery procedures performed in hospitals. The Bureau expects to change the way it reports
NSW public hospitals. on emergency departments,” Dr Watson said.

“What we see is more elective surgery procedures being The report and supplements can be downloaded from the
completed than two years ago but also more patients being Bureau website:
seen on time,” Dr Watson said. www.bhi.nsw.gov.au

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Rural research continues to grow
2011 Rural Research Capacity Building Program (RRCBP)
Twenty research-ready rural health
workers commenced the RRCBP this
year, attending the first face-to-face
workshop in Sydney in September. This
brings the total number of candidates
accepted into the RRCBP to 124. The
Research Methods Short Course and
Project Development Retreat proved
an excellent introduction to research
methods, conducted by academics from
the University Centre for Rural Health
(Lismore) and the University Department
of Rural Health (Broken Hill) who are The 2011 candidates for the Rural Research Capacity Building Program at their
passionate about building research workshop in Sydney in September.
capacity in rural health workers.
The highlight of the week was “research
speed dating,” which involved each Successful candidates 2011 Expert mentors 2011
candidate spending 45 minutes with an Julie Adamson (HNELHD) Frances Boreland (Broken Hill UDRH)
expert mentor to discuss their research Patrina Byng (MLHD) David Lyle (Broken Hill UDRH)
proposals and refine and explore Atosha Clancy (NNSWLHD) Sarah Dennis (University of NSW)
alternative study designs. Special Rae Conway (NNSWLHD) Amanda Rosso-Buckton (University of
thanks go to the 18 expert mentors who Emma Davies (Ambulance) Sydney)
shared their collective brain power and Tracey Drabsch (WNSWLHD) Jenni Devine (SNSWLHD)
Kim Edwards (SNDSLHD) Tod Adams (SESILHD)
enthusiasm for research with the 20
James Ward (University of NSW)
candidates! Julie Hilditch (ISLHD)
Tony Lower (Australian Centre for
Anne Hills (HNELHD)
Agricultural Health and Safety)
Deborah Hoban (WNSWLHD)
Newsflash — Have you Bronwyn Leon (NNSWLHD)
Megan Passey (UCRH)
Lesley Barclay (UCRH)
heard? Katherine McQuillan (WNSWLHD) Jo Longman (UCRH)
Forty-one candidates have completed Monica Murray (WNSWLHD) Tina Navin (NSW Health Bio-statistics
their research reports. These can be Dean Phelps (NNSWLHD) program)
downloaded from our website: Kim Riley (HNELHD) Dona Powell (NNSWLHD)
www.ruralceti.health.nsw.gov.au/ Belinda Robinson (HNELHD) Stuart Garland (NNSWLHD)
initiatives/building_rural_research_ Matthew Simpson (Ambulance) Catherine Hawke (University of Sydney,
capacity/2007 Debra Tabor (SNSWLHD) School of Rural Health, Orange
Bridget Thompson (SNSWLHD) Campus)
Barbara Turner (FWLHD) Buck Reed (Ambulance Service of NSW)
Pauline Chiarelli (University of
The Rural Research Capacity Newcastle)
Building Program is a two-year Therese Jones (WNSWLHD)
program conducted by CETI
Rural Directorate. Applications
are called for annually in June
Save the date: 7–8 March 2012
(available on our website from Training & Support Unit for Aboriginal Mothers, Babies & Children (TSU)
April). Check the website for State-Wide Forum, ‘Strengthening Connections’
more information, eligibility This forum will focus on raising the awareness of current Aboriginal health initiatives and
services. Staff working in Aboriginal Maternal Infant Health Services (AMIHS), Building Strong
criteria and contact details. Foundations for Aboriginal Children, Families and Communities (BSF) programs, and those
For further information please working in close partnership with these services, will be able ‘Strengthen Connections’ and
contact Emma Webster or David build professional networks across NSW.
Schmidt, CETI Rural Directorate. For more details, contact the TSU, Orange, 02 6360 7847.

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2011 National Stroke Awareness Week across rural NSW
Jenny Preece
CETI Rural Directorate

Stroke affects about 53,000 Australians each year, week. There were also media releases and television
and is the third largest cause of death and the interviews with the local neurologist and two stroke survivors.
leading cause of disability in Australia. Orange/Bathurst: Fiona Ryan coordinated media releases
in the local papers and an afternoon tea for the hospital staff.
In 2007, following an evaluation of rural stroke services, the
Interviews with stroke survivors were played on the radio
Rural Stroke Coordinator Network was established to provide
a statewide coordinated approach to evidence-based care during the week and the Orange Stroke Recovery Group
for rural people with stroke. Evaluation revealed that stroke held a stall in shopping centre to sell ribbons. A healthy
care in rural hospitals had a low level of compliance with the afternoon tea was also held at Orange and Bathurst hospitals
National Stroke Guidelines and 94% of rural health facilities to promote the message for staff.
had no dedicated or organised stroke services. Port Macquarie: Kim Parrey continued the awareness
Know your stroke risk was the community awareness message with a bright board outlining risk factors and ways
message promoted by the Rural Stroke Coordinator Network to manage them. Staff were encouraged to attend with fruit
across NSW during this year’s National Stroke Week (12–18 salad cups for morning tea, a quiz and a thickened fluids
September 2011). challenge to try and identify which fluid was thickened and
which they liked the best? Surprisingly most staff selected
Armidale: Melissa Gill promoted stroke week with a media the thickened fluid as their preferred taste. Staff were also
release from a local stroke survivor. At the hospital, there was encouraged to complete the National Stroke Foundation
a focus on staff with morning tea, stroke promotion and a know your stroke risk factors and the local paper published
trivia quiz on stroke knowledge and risk factors. an article on stroke risk factors with a story from one of the
Tamworth and Narrabri: Rachel Peake coordinated local general practitioners, a recent stroke survivor.
a community stroke forum with a large
participation by the Aboriginal Community.
An afternoon tea and information stands
were held for the nursing and allied health
staff at the hospitals. Tamworth also had
media releases and editorials in the local
newspapers. Armidale, Tamworth and Port
Macquarie also had the stroke message as a
rolling banner on the staff intranet
Wagga Wagga: Katherine Mohr had an
information stand at the local RSL club
staffed by the stroke unit staff throughout

Narrabri: Rachel Peake, Rural Stroke Coordinator, Renee
Watmore (student nurse) and Bill Toomey (stroke survivor).
Tamworth: Staff afternoon tea at Tamworth Base Hospital.

the

cetiscape

Rural and remote scholarship program – a year in review
Jenny Preece and Karyn Sherman
Rural and Remote Health Projects, CETI
Scholarships
AHS/LHD awarded
GSAHS Workshop 11
The Rural and Remote Scholarship Program provides
National conference 2
financial assistance for rural and remote health service
staff to attend state, national or international conferences, State conference 1
workshops / seminars, and to assist in writing up Total GSAHS (incorporating MLHD and SLHD) 14
research. The program began in January 2009 to address
gaps identified in an audit undertaken in 2008. GWAHS Workshop/seminar 11
International conference 3
Providing scholarships is one means by which CETI’s
Rural Directorate supports a sustainable workforce and National conference 5
promotes excellence in rural and remote health services. State conference 4
Since the inception of the program, 229 scholarships Total GWAHS (incorporating WLHD and FWLHD) 23
have been awarded, totalling $262,568. This has enabled
HNEAHS Workshop/seminar 14
rural and remote health service staff to attend a wide
variety of educational forums, increasing exposure to National conference 7
best practice and new ideas, improving skills, providing State conference 6
opportunities to showcase achievements, strengthening Total HNEAHS 27
professional networks and earning valuable continuing
professional development (CPD) points. International conference 1
NCAHS State conference 8
Scholarship applications are predominantly for
financial assistance to meet registration, travel and Workshop 7
accommodation expenses, which can be prohibitive to
rural staff accessing educational opportunities. Total NCAHS (incorporating NLHD and MNCLHD) 16

In 2010/11, 84 scholarships totalling $89,316 and four SESIAHS State conference 1
applications for discipline-specific group educational National conference 1
activities totalling $45,729 were awarded. Of these, 18 Workshop 2
recipients had abstracts accepted for presentation at
international or national conferences. Total SESIAHS (incorporating ISLHD) 4

The Table gives a summary of scholarships by local health 84
Total 2010/11 scholarships
district for 2010/11 ($89,316)

To date all evaluations received have indicated that
individual learning objectives were met, with clinicians impact on decreasing the length and frequency of clinical
reporting the application of new skills and knowledge in the sessions needed to successfully treat clients, while outcomes
workplace and the sharing of outcomes with colleagues. for others have been more in reflective practice, reducing
Several recipients have reported that new skills acquired feelings of professional isolation and increasing networking
through attendance at workshops/courses have had direct and peer support opportunities.

Worth a look
The Risky Business
website is non-
profit collaborative
venture between:
 NHS Institute for Innovation and Improvement
The
 Ormond Street Hospital for Children NHS Trust
Great
 British Medical Journal
The

Children’s Hospital of Boston

Cincinnati Children’s Medical Center The site provides a range of fascinating talks on themes related

Children’s Hospital of Philadelphia to risks, errors and the measures we can take to reduce costly

National Patient Safety Agency (United Kingdom) mistakes in patient care. There is plenty here to inspire discussion
 Clinical Human Factors Group
The and local initiatives for patient safety. www.risky-business.com

cetiscape

Preparation for the FRACP exam
? ? ?
Muh Geot Wong

?
Director of Physician Training RNSH

? ?
Emma McCahon
State Chair Paediatric Training, Clinical Lead Leadership Programs, CETI

In preparation for the FRACP exam which of the We asked questions such as:
following is the key to success? 1 When learning something new do I
a) Sitting in a room on your own in the small hours of the a) prefer to talk through my thoughts as they come to me
morning memorising Harrisons and the last five years of

?
and try out new ideas straight away

?
NEJM articles.
b) take time to myself to work through the ideas, read about
b) Working with your study group through strict 18 month them and reflect.
timetable of topic summaries.
2 I do my best learning with teachers who
c) Doing endless past exam questions until you can recite
them in your sleep. a) organise the material in logical systems, use a cool and
objective approach, and give feedback that shows what I
d) Going to the pub after a long day on the ward and do and don’t accomplish
debriefing about the patients you saw.
b. focus on relationships with the learners, foster a
e) All of the above. harmonious learning environment, and give feedback that
This year a group of first-year basic physician trainees from shows appreciation of me as a person.
the Northern Sydney Central Coast Training Network, a And finally we felt confident to answer our first multiple
paediatrician and a director of physician training spent some choice question:
time thinking about the answer to this question.
e) All of the above.
To find out more about ourselves as learners we used the
Myers Briggs Personality Type Indicator (MBTI). The MBTI We concluded that we all learn differently, we all have
identifies preferences for where we focus our energy, how we different learning preferences and that the real key to
take in and process new information, how we make decisions success is to understand our own learning preferences.
and how we order our lives. Junior doctors are expected to learn and apply vast amounts
We used the MBTI to look at our learning preferences, of knowledge both in their everyday work and also in
including learning environment, interactions with teachers preparing for college assessments. However, learning is not
and other learners, how we look for new information, plan and just the realm of the junior doctor — we all need to be good
organise our studies, and our keys to motivated learning. learners.

Worth a look
The Clinical Ethics
Resource provides
an extensive
range of sources
addressing the
ethical and legal
issues experienced
by those working
in clinical
environments.

The website was developed by the University of Sydney and is funded by NSW Health. http://clinicalethics.info/

cetiscape

Device wise clinical equipment user manual library
April 04, 2011 Makes
George Koning
BioClinical Services library Library
george.koning@bioclinicalservices.com.au
help Select a make: Get Devices
search (by make/device) F Find
In 2009 the NSW Department of Health document request Frigitronics

entered into an infusion device contract which log out
Frigitronics :: Cryosurgical System
Fisher & Paykel Healthcare
resulted in the worlds largest roll-out and hence Fisher & Paykel Healthcare :: CPAP
standardisation of its kind. In the background, System
Fisher & Paykel Healthcare ::
NSW Health Support Services web portal, CiAP Humidifiers
(www.ciap.health.nsw.gov.au), was also quietly Fisher & Paykel Healthcare :: Infant
Resuscitation
making history with the world’s first and largest
Fisher & Paykel Healthcare :: Infant
standardisation of device instruction manuals, Warming

including the Frasenuis Kabi Injectomat and Fisher & Paykel Healthcare ::
Peripheral Nerve Stimulator
Volumat pump instructions manuals. Library | Help | Document Request | Terms Of Use | Privacy Statement
Flaem Nuova SpA

This information system means that throughout
Clinical Equipment User Manual Library in CiAP: search by make.
NSW Health, clinicians can access manufacturer-
supplied information on medical devices at the
point–of-care. clinical equipment user manual library
This standardisation has many benefits for patient April 04, 2011 Makes » Fisher & Paykel Healthcare » Humidifiers

safety, developing user competence, managing
consumables and accessories and reducing library Humidifiers Documents
total costs of ownership. However, the medical help Current Documents
equipment world is supplied by thousands of name description
document request Airvo Series Humidifier Hospital Use Operating Manual Hospital Use Operating Manual
small manufacturers, with many innovations, Bubble CPAP System Quick Guide Quick Guide

transfers of ownership and changes of branding, log out HC100 Respiratory Humidifier Operating Manual Rev 1
HC150 Respiratory Instruction Sheet
Operating Manual
Instruction Sheet
so keeping device instruction manuals up-to-date HC500 Respiratory Humidifier Operating Manual Operating Manual
MR410 Respiratory Humidifier Operating Manual Operating Manual
is a perpetual challenge. MR480 Respiratory Humidifier Operating Manual Operating Manual
MR630 Dual Mode Respiratory Humidifier Operating Manual Operating Manual
It’s quite common to compare safety in healthcare MR700 720 730 Respiratory Humidifier Operating Manual Operating Manual

to the commercial airline industry, but with MR810 Respiratory Humidifier Instructions Sheet Rev C
MR850 Respiratory Humidifier Instructions Sheet Rev D
Instruction Sheet
Instruction Sheet
respect to measuring and monitoring equipment, MR880 Respiratory Humidifier Instructions Sheet Rev C Instruction Sheet
OXYFLO Oxygen Therapy RT 308 Guide Guide
BOEING and AIRBUS operate on the basis that
suppliers need to customise their products and Library | Help | Document Request | Terms Of Use | Privacy Statement
services for them — which is extremely unlikely
ever to be the case in healthcare.The NSW Clinical Equipment User Manual Library in CiAP: selecting a user manual.
infusion pump contract management could only
select from a pre-existing range with very limited User Manual Library is a proactive step to support tech-savvy
options to customise. clinicians and help them to develop skills which are irreplaceable
Propriety features built into the devices by manufacturers place when things go wrong, when questions need answers instantly,
more responsibility on the user to know the equipment by make when you don’t get a second chance.
and model. Having a good working knowledge of the general
Food for thought
principles of devices will allow most people to get by under
normal circumstances, but with compromised patients, time 
Inquest into the death of Oliver Steven McVey. www.
courts.qld.gov.au/ [Search for “McVey”] (limited make and
constraints and pressure of work, technical competence needs
model experience [pp 10 & 27] may have contributed to a
to stepped up a notch.
death).
The Clinical Equipment User Manual Library, accessible via the 
Story of Bethany Bowen. www.risky-business.com/talk-
CiAP Web Portal ( under Clinical Tools) gives clinicians precise 18-story-of-bethany-bowen-2.html?channel_id=5 (a case of
guidance to devices by make and model. not following the manufacturer instructions – using a device
Nursing staff are the custodians of medical equipment in without training).
hospitals. They are ultimately responsible for its readiness and  a routine operation. www.risky-business.com/talk-89-
Just
spend more time in front of it than any other discipline. Rather just-a-routine-operation.html (nursing staff stepping up to the
than wait for a crisis, CiAP’s access to the Clinical Equipment plate with respect to “readiness”).

cetiscape

Preparing future leaders in health professional education
Master of Education (Health Professional Education)

Koshila Kumar, Sydney Medical School, koshila.kumar@sydney.edu.au
Christopher Gordon, Sydney Nursing School, christopher.gordon@sydney.edu.au
Christopher Roberts, Sydney Medical School, christopher.roberts@sydney.edu.au
Richard Walker, Faculty of Education and Social Work, richard.walker@sydney.edu.au
Victoria Neville, Faculty of Health Sciences, victoria.neville@sydney.edu.au

A new postgraduate degree in health professional education The MEd (HPE) is based on an interdisciplinary framework in
has been introduced at the University of Sydney. The Master two ways:

of Education (Health Professional Education) is a bold
 recognises the importance of students from across
It
approach to preparing future educators across the health

the health professions learning together. Students are
professions.
health professionals engaged in developing and delivering
The program aims to equip health professionals with
education in a range of health-related settings including
a deeper understanding of contemporary educational hospitals, clinics, professional organisations, staff
pedagogies and practices that underpin health professional development centres, and higher education institutions.
teaching and learning. Core content includes clinical Current students include clinical nurses, nurse educators,
teaching, clinical reasoning, assessment, simulation- medical staff specialists, surgeons, physiotherapists,
based learning, and the scholarship of teaching in health orthopists, and health lecturers.
professional education.
 is collaboratively managed by staff across multiple
It
disciplines. The degree is coordinated by the Faculty
of Education and Social Work and draws on teaching
expertise and resources from Sydney Medical School,
Sydney Nursing School, and the Faculty of Health
Sciences at the University of Sydney.
The program is underpinned by adult learning principles,
in that learners are considered proactive participants
in constructing their own learning, and students’ prior
knowledge and
experience informs
what and how they
learn. The MEd
(HPE) curriculum is
aligned with students’
educational needs in

classroom or clinical
settings. The program

is delivered in a
blended mode and
includes both face-
to-face and online
learning.
More details about the
MEd (HPE) program
are available at

sydney.edu.au/education_social_work/future_students/
postgraduate/med/health_professional_education.shtml

cetiscape

In practice
The beginning
Daniel Stewart
Intern, Network 1, based at Dubbo

The patient’s headache remained as severe as it had
been when I first introduced myself. Simple analgesia,
Nurofen and Panadol, might as well have been distilled
water for all the good they had done. Poor girl, she’d had
a lumbar puncture a week earlier and the small change in
pressure had likely precipitated the worst headache she’d
ever known. Apparently ‘LP’ headaches are particularly reviewed the previous notes, I checked the blood results as they came
painful and so far I’d seen nothing to suggest otherwise. In an effort to in and cast an eye over the brain CT from the week before. There was
establish some control of the pain I’d ascended the analgesia ladder nothing to find, but at least I was looking.
and prescribed some intravenous morphine to be given alongside IV
fluids. It’s not much, checking to see if a patient’s pain had subsided to a
more manageable level, offering what I could, then reviewing the
And here I was, sitting behind the desk, staring across the floor at background history. I’d done it dozens of times before for dozens of
the patient with the damp towel across her head, wondering if the other patients, but none of them were mine, and that’s what made it
morphine and fluids were starting to work. They should work, if not special. No doubt some of my contemporaries will scoff at how I laud
to extinguish the pain entirely then certainly to bring it down a notch the experience, but there will be others, some junior and some senior,
or two. At the moment the patient would be happy with a single who will remember forever the moment they actually became a Doctor
notch, she could barely open her eyes and nausea frustrated all her too. The moment when you no longer have someone to check and
attempts to eat and drink. How she managed to answer my questions correct, the moment when you assume the identity that comes with
at all intrigued me; she must have possessed some measure of inner the role; the moment when “the patient” becomes “my patient”.
strength hard to perceive from a casual glance, or perhaps she felt I’d
be the one to make the pain go away. The pain did eventually get better, as a consequence of good
painkillers, fluids and time; but I wasn’t around to see. My shift had
Thus my train of thought continued, as I sat in the office chair that finished and I’d gone home. I had wished my patient farewell upon my
swivels while she reclined on the mattress that sags, both of us departure and reassured myself she was at least a little better as a
focused on the same entity, her pain. By now, if the “morph” were consequence of my bumbling care, then left.
going to work, it would have done so. “Somebody should check
and see if it has,” I thought. And then, in a decidedly underwhelming Medical school finished months ago and since then my friends and
manner, that which could not or had not been taught during four years family have delighted in giving me the moniker “Dr Dan”. Hardly
of medical school came to me like a cut-out pass to the unmarked original, certainly catchy, and the appeal seems to lie predominately
winger; it was my job to go and check on the patient, because she in the alliteration. I didn’t mind and smiled politely whenever it was
wasn’t just a patient, she was my patient. thrown my way, but I didn’t believe it. I’d earned it by virtue of passing
a few tests and spending a few years living and studying off the public
Only death or dementia will wrest that moment from my mind’s grasp. purse, but the prefix “Dr” means so much more to the community
The moment when the role and the responsibility intertwine, daring than a passing mark, and so I’d refrained from using the term for no
me to accept the new paradigm, questioning my readiness. Doctor particular reason other than I felt something was missing.
in name but not yet in nature, still with a misplaced sense of comfort
that “someone else” would take responsibility, still maintaining the In a very small way a part of what was missing emerged the day I rose
distance. We’d spent so much time at medical school learning what from my swivel chair and closed the distance. I may be an Intern, and
not to do, courtesy of a professional development curriculum written I may be just a Junior Doctor, but I’m still a Doctor and that means
by a lawyer, that “the distance” was something that kept me safe. something.
Naturally the distance had to go, and so it did.

I rose, and asked how the pain was.

I was now at the centre of a relationship I’d never been in before,
where the half-closed squinting eyes simultaneously pleaded with Thanks Daniel — Editor.
me to help and thanked me for what little I’d done so far. It was now
incredibly important that we, the patient and I, get on top of this pain We’d like to invite all clinicians to send us
and “win”. The pain was a little better, but that didn’t mean much as stories from their experience for our “In
the drip had only just been connected and needed some time before practice” column.
we could establish its effectiveness. In the meantime I went back and

cetiscape

SimHealth 2011 CETI or HETI?
CETI was a gold sponsor for SimHealth 2011, the annual As we go to press, the Clinical Education and
conference of the Australian Society for Simulation in Training Institute is on the verge of a change of
Healthcare, held at the Sydney Hilton Hotel last month. name and about to become the Health Education
More than 300 keen educators, policy developers, clinicians
and Training Institute.
and researchers gathered to explore the theme of “patient-
centred simulation,” with keynote addresses from expert The planned change was announced by the
international and national speakers including patient safety Minister for Health, the Honourable Jillian
expert Dr Amatai Ziv. CETI’s Chief Executive Professor
Skinner, some time ago, but it has yet to be
Steven Boyages spoke on the final day about creating a
modern flexible health professional workforce. made official. It reflects a planned extension in
the responsibilities of the current organisation
This conference is an interesting blend of hands-on
workshops, free papers, plenary sessions, roundtable
to include education and training for all NSW
discussions and poster presentations. One of the highlights Health workforce, non-clinicians as well as its
included a moulage workshop which allowed the participants clinicians.
to make and take home reusable wounds for use in their
manikin-based simulations. SimWars, in which teams
The next issue of our newsletter will include
competed in their management of simulated emergency more information about the change and the new
room clinical situations was again very popular, with our own programs of work that HETI will be undertaking.
Stephanie O’Regan playing a key role in this event.
A minor casuality will be the name of this
newsletter. While “cetiscape” was fun,
“hetiscape” doesn’t have the same ring to it. We
will have to think of something new.
If you have any suggestions for a new name, or
comments to make on the newsletter, please let
me know.
Meanwhile, be assured that [the newsletter] still
needs your contributions and will continue to
appear.
Thank you,
CETI’s simulation learning and teaching coordinator, Stephanie
O’Regan, lends a hand during SimWars at SimHealth 2011.
Craig Bingham
Editor, cetiscape
Program Manager
SimHealth will be held again in Sydney next September. General Medical Training Unit
Details, including a call for abstracts and photos from this CETI
year’s conference, can be found at www.simhealth.com.au cbingham@ceti.nsw.gov.au

Contributing to [the newsletter]
The submission deadline for each issue is the middle of
This newsletter is published by email and online: the month. Articles can be submitted as Word documents.
www.ceti.nsw.gov.au/cetiscape Pictures and logos should be sent separately, using the best
We invite contributions on all aspects of clinical education available file. For logos, this is often an EPS file. Picture files
and training, in particular: should be sent at the highest resolution available.

Short news stories: achievements, launches, events. Articles are subject to editing (proofs are shown to the
(100 to 300 words, photos and illustrations desirable) authors).

Reviews or editorials commenting upon issues related
to health workforce education, training and development To subscribe or unsubscribe:
(300 to 1000 words, photos and illustrations desirable). email cbingham@ceti.nsw.gov.au

cetiscape

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