Cetiscape is the newsletter of the NSW Health Clinical Education and Training Institute

1. cetiscape
 Issue 1  October 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 1 
New leadership in clinical education and training
Steven Boyages
New names for old friends
Chief Executive, CETI
The NSW Institute of Medical Education
Welcome to cetiscape, the first newsletter and Training (IMET) is now
of the Clinical Education and Training Institute of the Medical Division of CETI.
New South Wales (CETI). Establishing CETI was
one of the key recommendations of the Garling The NSW Institute of Rural Clinical
Inquiry and was adopted by the government in its Services and Teaching (IRCST) is now
“Caring Together” Health Action Plan for NSW. the Rural Division of CETI.
CETI is a Statutory Health Corporation under the Health
Services Act 1997. Its principal functions, as determined by
the Minister for Health, are listed in this newsletter, but in short
CETI is to provide leadership which:

supports safe, high quality, multi-disciplinary team-based, In this issue
patient-centred care

Closing the gap in the Aboriginal medical

meets service delivery needs and operational requirements workforce 2

enhances workforce skills, flexibility and productivity.

Medical education and training in Australia:
Health is a knowledge-centred enterprise. Those working in what does the future hold? 3
health are involved in the business of generating new knowledge

Supervision Superguide 4
(research and evaluation), imparting knowledge to a future workforce
(education and training) and applying knowledge for the betterment 
Exciting opportunity for allied health and CETI 5
of health and healthcare (service delivery). 
2011 internship campaign places record number
CETI’s vision is to facilitate and build competency and of interns in NSW hospitals 6
sustainable capacity to achieve better health through education, 
Hospital Skills Program update 6
training and development of a clinical workforce that will meet
the healthcare needs of the people of NSW. 
Surgical Science Intensive Course 7
CETI will do its work through investment in new programs; 
Junior doctors drive positive change in their work
and training 8
by collaborating with other key stakeholder groups such as
universities, colleges, clinical leaders, hospitals, health services and  sustainable way to provide community-based
A
the community; and through innovation to improve communication, training 10
capacity and competency by using blended learning approaches, 
Psychiatry training update 11
including face-to-face teaching, simulation and e-learning.

Centralised recruitment works well for Paediatrics
CETI has a huge responsibility in working with others to ensure that Program 12
we have a future health workforce that is responsive and available in
appropriate numbers to meet the growing challenges. The 
Accreditation Surveyor Training Day 12
newsletter name ‘cetiscape’ reflects the importance of stakeholder  you or someone you know need help?
Do 12
involvement and the role that the newsletter will play in presenting
different perspectives, including those of stakeholders and staff.

Prevocational review 13
In a short time CETI has been able to build on the excellent work

Oncology training 13
of its foundation divisions, the Institute of Medical Education and 
Emergency medicine network directors appointed 13
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

2. cetiscape
 Issue 1  October 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 2 
Training (IMET) and the Institute of Rural Clinical Services and Teaching
(IRCST). Our stakeholders have a strong desire to maintain discipline-
specific divisions as well as creating cross-linking inter-professional units. CETI values
CETI will establish several new divisions, including education, e-learning,
allied health and nursing, as well as an interprofessional practice division. C Collaboration
CETI’s top three priorities are to: We work together in partnership and in

identify solutions to training challenges posed by the increased supply of teams for common goals. We engage
medical graduates (interns) stakeholders and bring together
and respect people with different

develop and implement an interprofessional team program for new starters
knowledge, skills and experience.
in the health system
Our culture encourages cooperation,

adopt common standards and platforms for a learning management system. respect and sharing.
I look forward to hearing your views and perspectives as to how CETI can
continue to add value to education for future generations. Please write to me: E Excellence
ceo@ceti.nsw.gov.au. We use best practice to develop and
deliver quality services and learning
opportunities. We ensure effectiveness in
the way we use resources. We review and
Closing the gap in the Aboriginal medical evaluate what we do. We are committed
workforce to professional development, competency,
capacity and being proactive.
Jacqueline Dominish
Network Coordinator, CETI T Transparency
CETI Medical Division (IMET), in partnership with the Australian Indigenous We are dedicated to accuracy,
Doctors Association (AIDA) and NSW Department of Health, has developed a pilot consistency, and clear and regular
program aimed at building capacity of the Aboriginal medical workforce in NSW. communication. We work in accordance
with organisational and professional
The pilot aims to support the national strategy of “Closing the Gap” in codes of conduct.
Indigenous health care outcomes. Increasing the number of Aboriginal doctors
improves access to culturally safe services for Aboriginal and Torres Strait
Islander peoples. The program supports the transition of Aboriginal medical
I Innovation
We use emerging technologies and
graduates to internship positions in NSW. Aboriginal medical students were
new ideas. We support and respect
able to apply for the program in their final year.
creativity and inspiration while building
Under the program, Aboriginal medical graduates are appointed to a training the evidence base.
network where they can show that they have one or more of the following
supports:

Family in the area
 relationship with the community
A
 connection to country
A
 pre-existing mentor
A

Training opportunities in line with the graduate’s career aspirations
 history of favourable experience during their undergraduate
A
training.
Applications were assessed by a panel with significant Aboriginal
representation, including Dr Marlene Kong (Member of the Board,
Australian Indigenous Doctors Association) and Mr Charles Davison
(Manager, Aboriginal Workforce Development Unit, NSW Department of
Health). Successful applicants have been allocated to their prevocational
training network of first choice in order to maximise their chance of Left to right: Dr Marlene Kong, Australian Indigenous Doctors
successfully completing prevocational training. The first cohort of trainees Association; Ms Jacqueline Dominish, CETI Medical Division
under the program will commence their internship in January 2011. (IMET); and Mr Charles Davison, Manager, Aboriginal
Workforce Development, NSW Health.
More information: Network Coordinator Ms Jacqueline Dominish
(02 9844 6558, jdominish@ceti.nsw.gov.au).

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 Issue 1  October 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 3 
Medical education and training in Australia:
What does the future hold?
Simon Willcock
Director, CETI Medical Division
The purpose of medical education and
training is to provide a highly skilled medical
workforce capable of delivering high quality CETI functions
health services to the entire population. In 2010 such training
should also equip the medical workforce to adapt to the As deternined by the NSW Minister for Health:
changing health care needs of the Australian population and 1 To provide leadership, and work closely with area health
should be economically sustainable. service and other public health organisations and clinical
training providers, to ensure the development and delivery
One of the outcomes of the 2008 “2020 Summit” was of clinical education and training across the NSW public
an ambition that Australia should have an “integrated health system which:
infrastructure for the health and education system”.1 The a Supports safe, high quality, multi-disciplinary team
incoming Commonwealth Labor government committed itself based, patient centred care
to developing an integrated health service delivery system that b meets service delivery needs and operational
is fiscally sustainable, flexible and designed around identified requirements
community health care needs rather than jurisdictional, c enhances workforce skills, flexibility and productivity.
institutional or current program boundaries.
2 To design, commission, conduct, coordinate, support
The achievement of this goal requires a national approach and evaluate a clinical education and training program
to health sector education and training (including medical for all new graduate clinical and clinical support staff
education and training), with a focus on defining the skills in the public health system, which supports their roles
required and the number of practitioners needed to deliver in providing safe, high quality, multi-disciplinary team-
this outcome. The National Health and Hospitals Reform based, patient-centred care.
Commission and the Preventive Care Taskforce each 3 To design, commission, conduct, coordinate, support and
identified the need to develop incentive arrangements evaluate such other postgraduate clinical education and
and financial consequences for performance against training programs as the Director - General may direct from
benchmarks,2 including a quantum of funds that is “at risk” time to time.
and tied to achievement of targets.3 Inevitably these incentive 4 To design, commission, conduct, coordinate and support
arrangements will also be applied to the education and professional development programs to enable clinicians
training component of the health sector. to become skilled teachers, clinical leaders, trainers and
supervisors.
For the past 50 years medical workforce training in Australia
has delivered highly skilled workers, but within an increasingly 5 To develop and oversee performance evaluation programs
for post graduate clinical education and training in the
silo-based model of training and service delivery. This model
NSW public health system.
has also influenced training in the nursing and allied health
professions, resulting in a health system that generally delivers 6 To set standards for prevocational medical training and
excellent care, but that can be expensive and poorly integrated. accredit institutions for prevocational education and
supervision.
Health economists have clearly documented the increased 7 To institute, coordinate and evaluate clinical training
costs associated with highly specialised and uncoordinated networks, including postgraduate medical training
models of care. The new Commonwealth focus on integrated networks, and ensure they support service delivery needs,
service delivery models therefore has implications for training meet operational requirements and are, as far as possible,
at all stages of medical training, including the undergraduate, consistent with, clinical service network;
early postgraduate and vocational training sectors. 8 In undertaking its functions, to consult and liaise with
COAG has established Health Workforce Australia (HWA) as patients and their carers, clinical and clinical support staff,
a national entity tasked with developing effective models for the Department of Health other public health organisations
predicting future workforce need and for identifying and funding and providers of clinical education and training.
gaps in undergraduate training resources. Most gaps relate 9 To provide advice to the Department of Health, Director-
to clinical training opportunities for students training in health General and Minister on matters relevant to its functions.
careers, along with supervisory and educational resources.

4. cetiscape
 Issue 1  October 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 4 
HWA therefore has a specific brief to fund new clinical 1 Australia 2020 Summit – Final Report, April 2008, p128.
training places across a broad range of health disciplines, to 2 Beyond the Blame Game: Accountability and performance
define and support the role of simulated learning in clinical benchmarks in next Australian Health Care Agreements, April
training, and to develop parameters for training, credentialing 2008, p4.
and support of clinical supervisors. There also exists a great 3 Australia: The Healthiest Country by 2020, October 2008, p50.
opportunity (indeed a critical need) to identify domains in
4 Also known as “pre-workforce-entry training”, given that some
which students can learn collaboratively, thereby developing
medical training courses enroll graduate students.
the skills associated with team-based care that are so crucial
to effective health service delivery. New graduates must
not only be competent in acute medical care skills, but just
as importantly must have skills in preventive health and the
management of chronic and complex co-morbidities.
CETI’s seven Cs
While HWA’s initial focus is on undergraduate training,4 the
intent is to align these initiatives with postgraduate training Capacity
at both prevocational and vocational level. The postgraduate Communication
environment is also changing, with the traditional public hospital-
based internship and vocational training programs evolving in Collaboration
recognition of the need to train graduates in a variety of settings,
including community and private hospital locations.
Coordination
In summary, Australia needs a skilled, flexible and integrated
Competency
health workforce to meet the needs of a diverse and ageing Care models
population. CETI, with its interprofessional training capacity,
is perfectly positioned to work with HWA, universities, Culture
colleges and other professional groups to develop a vertically
integrated model for postgraduate education and training.
Supervision Superguide
A new practical guide for supervisors and motivating,” Dr Crampton said.
of junior medical officers will soon “Successful supervision uses the
be available to all term supervisors in The Superguide necessities of clinical oversight as the
New South Wales. The guide is being a handbook for
opportunity for training and education,
developed in consultation with clinicians supervising doctors in training so that safe supervision today
across the State by CETI’s Medical becomes the foundation for safe
Division (IMET). August 2010
CONSULTATION DRAFT
independent practice by the trainee in
IMET | RESOURCE
the future.”
An advanced consultation draft of
The Superguide: a handbook for The consultation draft is available
supervising doctors in training was at www.imet.health.nsw.gov.au/
launched at the NSW Prevocational prevocational. Comments received
Forum on 6 August by the Chair of from many stakeholders throughout
the Prevocational Training Council, Dr NSW are being used to finalise
Roslyn Crampton. the first edition for publication in
November, ready for use in the 2011
“There is good evidence about what training year.
makes good clinical supervision, but
the literature is diffuse and not readily More information: Prevocational
accessible to busy supervisors. We IMET
NSW Institute of Medical
Program Coordinator Craig Bingham
Education and Training
wanted to publish a short guide based — a division of CETI
(02 9844 6511,
on the evidence that was practical cbingham@ceti.nsw.gov.au).

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 Issue 1  October 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 5 
Exciting opportunity for allied health and CETI
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
The creation of CETI is an important initiative that provides positions for education to particular allied health specialties,
an opportunity for Allied Health to support and improve the a project to determine the impact of the new NSW Health
ongoing supervision, training and development needs of the Service Health Professional (State) Award may identify
allied health workforce. opportunities to build on this foundation of allied health
student supervisors and allied health profession educators in
Recently the Area Directors and Advisors of Allied Health
each of the local health networks.
and Chief Allied Health Officer had a positive and productive
meeting with CETI’s Chief Executive, Professor Steven 3 Exploring opportunities to develop and evaluate new
Boyages, and General Manager, Dr Gaynor Heading. In line models of clinical supervision in allied health
with CETI’s role to develop and coordinate clinical training
As identified in Caring Together Action 45, one of the
and professional development programs, we discussed the
challenges recognised across NSW Health is the need for
important contribution of allied health in multidisciplinary patient
consistent access to quality clinical supervision as a vital
care and interprofessional learning, with a focus on identifying
part of efficient and effective health care. Allied health has
common aims and opportunities for future collaboration.
to improve access to training for clinical supervisors and
With a commitment from Professor Boyages to explore the increase support for the different clinical supervision needs of
development of a dedicated suite of clinical training and the allied health professional and assistant workforce.
professional development activities for allied health, a further By working in partnership with CETI, we have an opportunity
planning meeting will be organised to discuss issues important to identify models of clinical supervision that best meet the
to allied health. various needs of the allied health workforce and identify cost
Provisional priorities identified during the meeting for further effective and efficient ways of delivering essential training
discussion include: to allied health professionals who provide supervision.
There is also an opportunity through collaboration between
1 Developing a business case for the feasibility of “new the Directors of Allied Health and CETI to develop joint
starter” programs in allied health professions proposals for future funding opportunities.
Several allied health professions have identified the need
to improve professional development and support for new 4 Training allied health assistants
graduates during the first year of employment. CETI will be exploring registered training organisation access
and has expressed an interest in general training for allied
The discipline of physiotherapy has a new graduate allocation
health assistants. Establishing training for Certificate IV in
program which involves recruitment of new graduate
Allied Health Assistance is a key initiative to support the
physiotherapists into positions across NSW Health facilities.
growing demand for allied health professional services. As an
The program provides structured clinical supervision and emerging qualified workforce within allied health, there is a
opportunities for practical clinical skills training, and supports need to ensure quality of care and safety of patients through
the transition of new graduates to practising clinicians. clinical governance of training and supervision.
This type of “new starter” program would be an important We have an opportunity to establish a project officer position
mechanism for improving recruitment and retention within the within CETI to link with local health networks and directors
allied health workforce. It is proposed that existing models of allied health to ensure consistency in training, identify
within allied health, nursing and medicine will be reviewed to innovative training delivery options and explore supervision
determine applicability of other allied health disciplines. training needs for allied health professionals and assistants.
2 A project officer to investigate options for strengthening The Area Directors of Allied Health look forward to working
allied health clinical placement coordinator and in partnership with CETI to promote collaborative links with
educator roles allied health professionals. Outcomes from the planning
To date, there have been limited allied health clinical meeting will be detailed in a future article.
placement coordinator and allied health profession educator More information: Patricia Bradd, SESIAHS Area Allied
positions created across NSW. Some growth has occurred Health Director and Chair of the Area Allied Health Directors
as part of Caring Together initiatives with the appointment Group (patricia.bradd@sesiahs.health.nsw.gov.au),
of pharmacy educator positions. In line with Caring Together or Dr Gaynor Heading, CETI General Manager
Action 35b to consider cost effective creation of specific (gheading@ceti.nsw.gov.au).

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 Issue 1  October 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 6 
2011 internship campaign places record number of interns in
NSW hospitals
Vanessa Evans
Acting Head, Systems Support and Operations, CETI
Seven hundred and seventy medical graduates, more than Regional Preferential Allocation aims to build a sustainable
ever before, have been allocated to internship positions workforce in three regional areas (the Central Coast,
in New South Wales after CETI Medical Division (IMET) the Illawarra/South Coast and Hunter/New England) by
successfully facilitated another internship allocation and providing an opportunity for medical graduates of regional
recruitment process for the 2011 clinical year. We also universities to continue their training in their region.
filled a record number of positions (56) through the Rural
Preferential Recruitment process. The pilot program to build capacity of the Aboriginal medical
workforce supports the transition of Aboriginal medical
In fact the allocation process is continuing, with weekly offer graduates to internship positions in NSW, and is described
rounds scheduled up to January (if required) to ensure that in an article on page 2.
all intern positions for 2011 are filled.
The intern allocation and recruitment process for 2011 will
For the first time, NSW is participating in the National Audit be reviewed, and a report will be prepared by the end of the
of Internship Acceptances, a process which will give all year.
jurisdictions a clearer idea of how interstate applications and
allocations are proceeding. Two other initiatives implemented For the latest updates on offer rounds and internship
this year are Regional Preferential Allocation and the news: visit the CETI Medical Division (IMET) website:
pilot program to build capacity of the Aboriginal medical www.imet.health.nsw.gov.au.
workforce in NSW.
Hospital Skills Program update
Alpana Singh
HSP Coordinator, CETI
Health service implementation activities SESIAHS has also been organising airway/intubation training
for interested HSP participants in the Shoalhaven and
Hunter New England Area Health Service held a successful Shellharbour operating theatres. Other activities for 2010
HSP Emergency Medicine Education Day on Thursday 3 include central lines training in late August and September
June 2010. The day included skills workshops on airways 2010 as well as a dental trauma workshop in November
management and arrhythmia management in the emergency 2010. SESIAHS will also be holding their annual HSP
department, non-invasive ventilation and venous access. This Forum on 7 December 2010 which will focus on paediatric
workshop was attended by 34 doctors from across the Area emergencies.
who all provided positive feedback on the skills workshops.
SESIAHS mental health doctors have been invited to
HNEAHS will be holding an HSP Paediatric Emergency participate in the Hunter New England Area Health Service
Department Education Day in late October 2010. Psychiatry Training Program via videoconference on
South East Sydney Illawarra Area Health Service conducted Wednesday afternoons from 1445 until 1630.
an Emergency Medicine Workshop at Sutherland Hospital
on Tuesday 11 May 2010. The workshop was attended by
21 doctors from across the Area who participated in skills Enrolments
development workshops on venous access using ultrasound
guidance, advanced facial suturing, ECG interpretation and More than 200 doctors have been enrolled in the program to
an aged care module on falls and advanced life directives in date. All Area Health Services have received HSP modules
the emergency department. The feedback received was very and enrolment forms. Areas have been asked to enrol all
positive. interested doctors in the program.

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 Issue 1  October 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 7 
Module development and quality care is paramount and that the professional
development of non-specialist doctors is a core business
The completed modules in Emergency Department, Aged Care, activity of health services.
Mental Health and HSP Core Skills have been distributed
to Area Health Services and are also available via the CETI CETI is also developing a HSP Strategic Plan 2010–2013,
Medical Division (IMET) website (www.imet.health.nsw.gov.au). which will give the health services, the HSP State Training
Modules are being developed in Hospital Medicine (including Council and CETI some goals and key performance
perioperative surgical care, hospital therapeutics and trauma), indicators. The document provides a work plan for the
Child and Adolescent Health and Women’s Health, and are on Hospital Skills Program over the next three years.
track for completion by end of 2010.
Following an internal analysis of workforce data on current HSP assessment resources
roles of non specialist doctors working in NSW hospitals,
funding for further module development has been requested CETI submitted a request for funding under the Caring
under the NSW Government’s Caring Together response Together initiative proposed by Workforce Development and
to the Special Commission of Inquiry. The funding received Innovation Branch to provide statewide assistance in the form
includes supporting the delivery of medical education activities of a “train the trainer” package to support trainee assessment
to non-specialist doctors in four modules: Sexual Health, Drug in the program. This funding has been provided and work has
and Alcohol Medicine, Indigenous Health and Rural Medicine. commenced on developing DVDs as part of the package for
HSP assessment. Workshops will be run within all the Area
CETI has received funding to identify and develop Health Services for HSP assessment by the end of the current
online learning resources and activities that will promote financial year. Some of these workshops will be videotaped so
participants’ achievement of HSP workplace competencies/ that this can be provided as an online resource for review by
capabilities. This may involve: assessors at a later date.

creating properly configured online courses and tutorials

converting content provided by the HSP curriculum
developer into finished online tutorials. This will involve
HSP Education Strategy Forum
editing video, graphics, photographs for use in online HSP Education Strategy Forums provide an opportunity
pages, formatting text, and creating the instructional flow for HSP Area Directors and Education Support Officers
of tutorials and question pages to meet, network and help CETI develop sustainable and

linking and uploading ancillary resources, such as pdf effective educational strategies.
files and other documents, html pages and websites

creating other online activities, such as forums, calendars The forums will be held three times a year, with two one-day
and coordinating the development of assessment items. meetings and one two-day meeting. Each forum will include
all the HSP Area Directors and Education Support Officers
as well as two HSP participants from each area health
Principles for implementing the HSP service, CETI staff and co-opted members, as required.
CETI is developing principles to guide HSP implementation The first Education Strategy Forum will be held during
across health services. These principles are being developed the third week of November 2010, with a firm date to be
with the overarching goal of recognising that patient safety confirmed shortly.
Surgical Science Intensive Course
CETI will be delivering the next Surgical Science Intensive and Training (SET) program prepare for examinations, the
Course from 24 January to 4 February 2011 at the University course is open to prevocational, surgical skills and other
of Western Sydney. specialty trainees to enhance their surgical knowledge and
competencies.
The course teaches basic sciences (pathology,
pharmacology, physiology, microbiology and anatomy) Contact Jay Jacinto, Program Coordinator on 02 9844 6545
to junior doctors. Primarily assisting trainees in the Royal or jjacinto@ceti.nsw.gov.au to register.
Australasian College of Surgeons Surgical Education Hurry, places are limited.

8. cetiscape
 Issue 1  October 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 8 
Junior doctors drive positive change in their work and training
Craig Bingham
Prevocational Program Coordinator, CETI
 peer-to-peer mentoring scheme to support interns in
A All Safe Clinical Handover resources are available freely
their first months of hospital service at: <http://www.archi.net.au/e-library/safety/clinical/
 standard approach to shift handover designed to improve
A nswhandover>.
patient care and training opportunities for junior doctors
 coordinated approach to lectures to reduce redundancy
A Welfare
and improve the relevance of education sessions Expanding on a mentoring program initiated at Westmead
— These are just some of the initiatives Hospital in 2009 by Dr Farzan Fahrtash, the welfare group is
being developed this year with the leadership or creative working with DPETs and JMO management units at four sites
input of junior doctors in the NSW JMO Forum. to pilot peer-to-peer mentoring. In this voluntary scheme, new
interns are mentored by a more experienced junior doctor
The forum is an elected representative (PGY2 or above), with the aim of accelerating the transition
M body of the training networks. It is an
of JMOs (PGY1 and PGY2) from from student to doctor in a supportive working environment.
F ORU each
JMO advisory subcommittee of the NSW “Mentoring transfers institutional knowledge between JMO
Prevocational Training Council and groups from year to year, and has the potential to improve JMO
provides CETI and other statewide wellbeing and patient care,” says Dr Matt Stanowski, RMO at
NEW SOU TH WALES institutions with JMO input into Nepean Hospital and chair of the welfare group. “We’ve learned
projects to improve clinical supervision a lot from the pilot and hope to expand the scheme in 2011
and training. This year the JMO Forum organised itself into to more hospitals. We’re also working on a better advisory
‘portfolio’ groups to take action on five important areas: package for potential mentors, to equip them for the job.”
welfare, supervision, handover, education and assessment.
Supervision
Handover
The supervision group is gathering data on the supervision
The handover group has played a major role in the Acute Care of JMOs across the state. “We have a lot of ideas about
Taskforce’s JMO Shift-to-Shift Handover Project. The proposed supervision and how it might be improved, but thought it
reforms to handover procedures are being piloted at six sites. important to gather an evidence base before making any
recommendations,” says Dr Daniel Sumpton, chair of the
“The project has benefited greatly by having JMOs from a
supervision group.
range of networks representing their peers in all phases of
the project,” says Ian Richards, Principal Dr Roslyn Crampton, Chair of the
Project Officer. “Their hard work and creative Prevocational Training Council,
input gives us confidence that the project welcomes the data-gathering exercise.
is relevant to and meets the needs of newly “There is evidence that clinical
graduated medical officers.” supervision of JMOs is not always
JMO representatives involved at the pilot as close or effective as it should be.
sites report that the reforms represent a Health Workforce Australia, the Clinical
huge cultural change, as they require more Excellence Commission and CETI are
involvement of senior staff and a fixed time for all examining the supervision of JMOs.
handover, conducted formally with compulsory Information from the JMOs themselves
attendance by all JMOs on duty. A formal about their experience of supervision
evaluation of the pilot is in progress, with will be valuable in shaping the future
members of the handover group conducting direction of reform.”
interviews of participants at each pilot site. Chair of the JMO Forum’s
The supervision group invites all NSW and
handover group, Dr Hamish
Participants so far have reported benefits Dunn, RMO at Hornsby ACT JMOs to participate in a short online
in patient safety, learning opportunities for Hospital. survey at:
JMOs, and clinical team-building. http://www.surveymonkey.com/s/HB3GJLK

9. cetiscape
 Issue 1  October 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 9 
Education
“There is concern among JMOs about the lack of a unified
statewide education process for NSW JMOs, because the
quantity and quality of teaching across the 15 prevocational
training networks varies,” says Dr Helen Boyd, who shares
the chair of the education group with Dr Sarah Sasson.
The education group knows that there is some great teaching
going on, but wanted to suggest ways of ensuring that all
JMOs, particularly interns, receive the teaching that they
need in a timely and efficient manner.
Co-chairs of the JMO Forum’s education group: Dr Sarah Sasson,
“At the moment, lecture series are coordinated by individual RMO at Prince of Wales Hospital, and Dr Helen Boyd, RMO at Port
Macquarie Base Hospital.
hospitals, but trainees are rotated through networks. So you
might miss an important lecture topic while on rotation, or
receive two lectures on the same topic, says Dr Sarah Sasson. The group is now working on outlines of the lecture content that
“Another problem is that lectures are not necessarily organised JMOs most need in relation to each topic. Helen Boyd: “Some
so that the most important topics are covered first.” sites have world experts giving lectures, and these people don’t
need any guidance from us. But in other cases, the lecture may
The education group has drafted a lecture series proposal
be given by somebody with relatively little experience of training
for the intern year, in which critical topics are covered in
JMOs, and they could use an outline indicating what level of
term 1, then other topics in a logical order. DPETs were
knowledge the JMO already has, what clinical points are most
consulted closely in developing the lecture series, and many
important to cover and what subject matter is too advanced or
have embraced the concept enthusiastically, at least as an
specialised to be relevant.”
aspirational target. As all DPETs and JMO Managers are
aware, organising lectures for JMOs is a logistical challenge, The Prevocational Training Council has endorsed the concept
and the education group does not envisage that the of the unified lecture series and CETI will be working with
proposed series will be implemented exactly as shown. networks to provide online resources to support implementation.
JMO
FOR
UM Proposed lecture series for interns
N E W S O U T H WA L E S As proposed by the JMO Forum education group (see article for details)
Term 1 Term 2 Term 3 Term 4 Term 5
Advanced cardiac life Analgesia and pain Pleural and ascitic taps Introduction to ear, nose and Vascular surgery
support management and drains throat medicine
Urology
Chest pain, acute Interpreting chest and Geriatric medicine Fundamental orthopaedics
coronary syndrome, Introduction to oxygen,
abdominal x-rays
heart failure Recognition of the sick Intracerebral events delivery systems and
Gastrointestinal bleeding child intensive care medicine
Assessing shortness of Psychiatry 102: the psychotic
breath ECG interpretation Introduction to trauma patient, drug overdose and Oncology and palliative
and management of withdrawal syndromes care
Assessing syncope and Anticoagulants and
arrhythmias
loss of consciousness their use Basic anaesthesiology Advanced lines
Perioperative assessment
Diabetes management Looking after the junior Obstetric and gynaecological Radiology essentials
and management
medical officer emergencies
Fluids and electrolyte Neonatal and paediatric
Antibiotics and their use
management Psychiatry 101: Introduction to resuscitation
Pathology tests: ordering depression, anxiety and ophthalmology
Assessing abdominal and interpretation the Mental Health Act
pain Wounds, dressing and
Death certification, Medicolegal suturing
Assessing and breaking bad news, issues: privacy and
managing delirium communicating with confidentiality, informed
The deteriorating patient difficult patients and consent and open
families disclosure
Blood pressure
management

10. cetiscape
 Issue 1  October 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 10 
Assessment JMO and supervisor. We need to think about incentives for
engaging supervisors.”
At the recent NSW Prevocational Forum (6 August 2010),
CETI reported a study of over 3000 progress review forms The assessment group would like to increase the objectivity
used in assessing prevocational trainees, which suggested of assessment and decrease the amount of unnecessary
that the forms are not supporting formative assessment as information sent to different stakeholders. The group is
effectively as intended and are not being used to document working with the Prevocational Training Council and CETI to
underperformance when it occurs. The study raises questions develop better approaches to assessing JMO performance.
about the current approach to assessment. Similar questions
were raised by Dr Robert Russo, Director of Medical
Education at Concord Hospital, who conducted a qualitative
study of JMO assessment at Concord, and by Dr Farah UM
Need the advice, support or creative
FOR
Noaman, chair of the JMO Forum assessment group. JMO thinking of a representative group
N E W SO UTH WA L E S
of junior doctors?
“The assessment group would like to see a separation
of formative feedback from summative assessment, and Contact the JMO Forum via CETI’s Prevocational
assessment based on term-specific aims that assessed Program Coordinator: Craig Bingham
specific outcomes,” Dr Noaman says. “The assessment (cbingham@ceti.nsw.gov.au, 9844 6511).
process should encourage regular meetings between the
A sustainable way to provide community-based training
Jackie O’Callaghan
Deputy Head, Systems Support and Operations, CETI
New federal government funding will give more junior CETI supports this trainee initiative and has revamped
doctors in NSW a chance to train in general practice and its accreditation program to facilitate its rapid expansion.
provide extra training terms for the increasing number of Prevocational general practice training will be organised
medical graduates. through regional training providers accredited by the
Royal Australian College of General Practitioners and
The federal government has increased funding to the the Australian College of Rural and Remote Medicine
Prevocational General Practice Placement Program for the training of general practice registrars. CETI has
(PGPPP). The funding will result in approximately 50 general recognised the regional training providers as the leaders and
practices providing training in 2011 in NSW. As part of the coordinators of general practice training, introduced new
partnership between practices, regional training providers streamlined standards, defined the responsibilities of feeder
and hospitals, funding is available to back-fill the trainee hospitals and developed an accreditation process that
while they are placed in general practice. This provides recognises the training provider and practices’ accreditation
hospitals with a strategy to increase their rotation options by the general practice colleges.
and better manage the increasing numbers of medical
graduates expected in the next few General practices can be provisionally
G
years. accredited for prevocational training by
a
sending CETI a completed application.
s
For the first time in NSW both PGY1 More details about the program,
M
and PGY2 doctors will participate in accreditation model and requirements
a
general practice training. The program a available on the CETI Medical
are
provides a real life experience in general Division website (www.imet.health.nsw.
D
practice for prevocational trainees gov.au).
g
in metropolitan, regional and rural
areas. The direct patient care enables More information: Deputy Head,
M
trainees to develop their medical skills General practice training can provide trainees Systems Support and Operations,
S
with close patient interactions and a real sense
in a different context and gain greater Jackie O’Callaghan (02 9844 6546,
J
of managing patient care.
confidence and independence. jocallaghan@ceti.nsw.gov.au).
j

11. cetiscape
 Issue 1  October 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 11 
Psychiatry training update are currently finalising a learning package for e-Psych.
Thanks to Dr Jackie Curtis, Dr Kathy Samaras and Dr
Hannah Newell for their hard work on this project. The
Jan Veitch algorithm can be downloaded from IMET moodle site
Psychiatry Program Coordinator, CETI <www.imet.moodle.com.au>.
Psychiatry Supervisors’ Forum CBT skills
“Supervisors need to get to know their trainees early,” Dr Lisa Lampe has completed CBT Skills in Action, a DVD/CD
said Christine Senediak, a Clinical Psychologist from the resource pack for supervisors, which is being distributed via the
NSW Institute of Psychiatry, at the Waterview Convention training networks and will shortly be uploaded in e-Psych.
Centre on 10 August. “Effective supervision is a partnership
between supervisors and trainees for the purpose of Being launched in September is “The Psychotherapies”
optimising the professional development of the trainee. The website. This much anticipated site will support all trainees
approach has to be individualised.” learning in this specialty area. Dr Jeff Streimer, Dr Margot
Phillips and team have spent many hours developing this
Christine was addressing an audience of psychiatry resource with psychiatry ESF funding. Link to the site can be
supervisors who had come from across the state for a train- found on the IMET Psychiatry www.psychotherapies.org.au
the-trainer afternoon of presentations and case discussions,
with feedback from an expert panel synthesised by our New Psychotherapy Educators Group (PEG) has continued with
Zealand guest, Professor Pete Ellis, Head of Psychological its popular Saturday Workshop series. In May, 70 trainees
Medicine at the University of Otago. Our thanks to all and Psychology students from University of Sydney attended
involved in organising the day; to the facilitators, Murray a personality Workshop with guest presenter Dr Nancy
Wright and Ros Montague; presenters and panel members, Williams. In July, last workshop for 2010 on Formulation for
Christine, Cath Hickie and Pete Kelly. Integrated Care was very well received.
At the Forum CETI launched new resources for supervisors
and trainees. The E-IMET learning platform has a developing Hot news
e-Psych chapter where we are uploading education The Psychiatry Education Support Fund for 2011 is
resources. Go to www.imet.moodle.com.au to enrol, and supporting some more great workshops and resources.
check it out regularly for new resources, such as those Watch this space.
described below.
More information: Since writing this article, Jan has left
CETI to pursue other interests. For further information on the
Metabolic management workshop Psychiatry Program, contact Louise Rice, Head of Medical
The “Metabolic management for patients with mental health Education and Training Programs (lrice@ceti.nsw.gov.au,
issues” workshop developed a management algorithm and 02 9844 6535).
Obesity Polycystic
Smoking Lifestyle Blood Fasting Blood Fasting
Pressure Glucose Blood Lipids ovary
Weight Waist
syndrome
Current Poor diet BMI (kg/m2) Male≥94cm* >140 systolic > 5.6 mmol/L >6.5 TChol No periods
> 25 for 3
Smoker AND/OR Female≥80cm AND/OR (>5.5 TChol if months^
AND/OR diabetic)
diabet )
diabetic)
betic)
S dentary
Sedent y
Sedentary
Sedentary
t AND/OR
/O
AND/OR >90 diastolic
90 diastolic
diastolic
astoli
t li Acne
Ac
Acne
lifestyle
lifesty
lifestyle
estyle Weight
W ight
Weight ↑> 5kg
5kg
5k
kg Hirsutism
Hirsutism
Hi s tism
suti
Waist
Waist ↑> 5cm
5cm >2.0 Trig
>2 0 Trig
2 ig
Check out the whole algorithm at www.imet.moodle.com.au

12. cetiscape
 Issue 1  October 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 12 
Centralised recruitment works well Accreditation Surveyor Training Day
for Paediatrics Program
Pamela Bloomfield
Neha Broota Network Coordinator, CETI
Program Coordinator, Paediatrics and Basic Physicians
A surveyor training day on 30 July 2010 provided an
Training, CETI
opportunity for both new and experienced accreditation
Henry Ford, the American industrialist and founder of the surveyors to develop their surveying skills and network with
Ford Motor Company, once said that “Coming together is a other clinicians, administrators and trainees. The day was
beginning. Keeping together is progress. Working together hosted by CETI Medical Division (IMET) and the Prevocational
is success.” A new centralised recruitment system for the Accreditation Committee at the Harbourview Hotel North
Paediatrics and Basic Physicians Training networks has Sydney. Over 40 surveyors attended for training in application
proved the truth of this aphorism. of the accreditation standards, surveying processes, working
in teams, communication, interviewing and report writing.
Recruitment can be a nerve-wracking time for applicants, but
it’s also a busy time behind the scenes as Medical Support Surveyors are vital to the accreditation process, ensuring
Officers, Network Directors, NSW Health and CETI work to that there are high standards for prevocational trainees and
ensure a successful outcome. that amenities, supervision and training continue to improve.
Because of the expansion of prevocational training in NSW,
For the first time since inception of the paediatric networks, with increasing numbers of trainees and a wider range of
provisional fellows in the paediatrics stream were recruited training sites, CETI expects that the number of surveys will
through a centralised process. Interviews across the general, increase. CETI Medical Division is keen to extend its pool of
community and neonatal streams took place at CETI. Apart surveyors.
from a few teething issues, the centralised process greatly
benefited all three networks and applicants and should work Being a surveyor can have several benefits for the volunteer.
even more smoothly next year. It’s a good professional development opportunity: surveyors
learn new skills in interviewing, evaluating and reporting,
The Basic Physician Training networks have also worked discover how other hospitals are organised, and network
together to streamline recruitment. Medical Education with a wide range of health professionals from a range of
Support Officers brought together common selection disciplines.
criteria to be used within all nine networks, and the networks
worked with the NSW Department of Health to ensure that For more information on the survey process or how to
reference checks for each applicant only occur once. This become a surveyor, please contact Network Coordinator
is a significant improvement from the previous year, where Ms Pamela Bloomfield (02 9844 6555,
referees were contacted by each network separately. pbloomfield@ceti.nsw.gov.au).
Do you or someone you know need help?
The Medical Benevolent Association of NSW (MBANSW) They may be experiencing health problems, relationship
is a support service for doctors difficulties or be struggling with balancing the demands of
and their family members work, study and family life.
in NSW and ACT. The
Association is able to provide The Association’s social worker Meredith McVey has many
financial assistance and social years experience working with doctors
work support to medical and appreciates the difficulty that many
practitioners (including Junior doctors have asking for assistance. You
Medical Officers). can contact Meredith on 02 9987 0504
or via www.mbansw.org.au for a
The service is independent, free and confidential. It is run confidential discussion about your
“for doctors by doctors”. Those who request assistance health, work or personal life and how
from the association are at various stages in their career. MBANSW may be able to assist.

13. cetiscape
 Issue 1  October 2010  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 13 
Prevocational review
Amanda Harriss
2011
Project Manager, CETI Do you know someone starting their career in
Oncology? BSOC is the course for great foundation
CETI’s external review of the prevocational training and knowledge in the sciences that underpin this
education network system is now complete. The review discipline area.
panel is preparing its recommendations in a formal report
that will be made available to CETI in the coming weeks. Information and enrolment for BSOC 2011 can
be found on the CETI Medical Division website
IMET (now the CETI Medical Division) commissioned the
(www.imet.health.nsw.gov.au) or
review by an independent panel earlier this year. The panel
contact oncology@ceti.nsw.gov.au
was led by Professor Andrew Wilson, Executive Dean of
the Faculty of Health, Queensland University. The review
was fortunate to have an exceptionally high calibre team
reviewing the current prevocational system. Emergency medicine network
CETI and the review panel would like to thank all the people directors appointed
who participated in the review and gave up their time to ensure
a comprehensive and robust assessment was possible. The Lynny Groshinski
review process engaged with over 450 people across both Senior Program Coordinator, Emergency Medicine, CETI
NSW and the ACT and included everyone from JMOs to the
Network directors of training have now been appointed for
Principal Medical Advisor at ACT Health. Information regarding
the five emergency medicine training networks. The new
the review including the terms of reference can be viewed at
network directors had an induction meeting and an intensive
<www.imet.health.nsw.gov.au/projects/w1/i1005640/>.
education planning session in July.
The network directors are progressing emergency medicine
Oncology training education initiatives, including preparation for the primary
examination, preparation for the Fellowship examination and
BSOC 2010 (Basic Sciences in Oncology Course) is well support for the 4.10 research project.
under way, with seven teaching days completed and the final Education support officers have been appointed in two
three anticipated. Medical and radiation oncology trainees, networks and are actively being recruited in the other three.
medical physic trainees, allied health and oncology program They will work with the network directors to provide and
staff have all reported how valuable the presentations have promote education in the networks.
been and how they appreciate the interaction with the senior
clinicians and research staff contributing to the course.
Participants report that BSOC events are: Survey of emergency medicine training

enjoyable, with a good range of topics presented well In 2009 the survey of emergency medicine trainees and
directors of emergency medicine training provided valuable

practical, with material relevant to understanding clinical
data and comment for the Emergency Medicine Training
trials making a difficult topic easy to digest
Implementation Group in its planning for educational and

informative, with excellent quality and quantity of training initiatives for NSW trainees. The 2010 survey is
information currently taking place to update this information and provide

clinically relevant new trainees with an opportunity to comment on their
training experience.
 interactive.
really
More information: Emergency Medicine Senior Program
More information: BSOC Support Officer Coordinator Lynny Groshinski (02 9844 6576, lgroshinski@
(02 9844 6551, oncology@ceti.nsw.gov.au). ceti.nsw.gov.au).
Building 12, Gladesville Hospital Cetiscape is distributed widely in the NSW Health system.
Victoria Road, Gladesville NSW, 2111 Contributions to this newsletter on all subjects related to
CLINICAL EDUCATION
& TRAINING INSTITUTE Locked Bag 5022 clinical education and training are invited.
Gladesville NSW 1675
p: (02) 9844 6551 Please contact the editor, Craig Bingham (02 98446511,
f: (02) 9844 6544 cbingham@ceti.nsw.gov.au), to discuss potential
e: info@ceti.nsw.gov.au contributions and receive guidelines for contributors.