Trainer-trainee relationships

The development of the trainee

Safety (child) | Competency (parent) | Self-development (adult)

An example: diabetes

Stage	Curriculum	Method
New (safety)	Diagnosis Initial management Prescribing Investigation Referral	Learner assessment Confidence rating MCQ RCA PCA Resource pack Tutorial
Practising (competence)	Structured care Chronic disease management Teamwork Audit Protocols Knock-on effects Work Family Psychological Counselling Skills	“Specialist” clinic Video/sitting in Tutorial Audit review PCA Skills assessment
Practitioner (self-development)	CME Audit review Practice philosophy Screening EBM Financial Resources	Critical reading Medline Need > resource awareness Research In-depth case analysis

An example: evidence-based medicine

Stage	Curriculum	Method
New (safety)	Aim: demonstrate the evidence base of GP. Objective: to understand the concept of evidence based assessment.	Joint surgeries Library (journals) Case discussion Practice meetings Prescribing issues Protocols
Practising (competence)	Aim: to develop critical skills in evidence based GP. Objective: to develop appropriate skills. PROJECT Search Appraise Present Effect change	Journal clubs Treatment review Protocol review
Practitioner (self-development)	Aim: to continue to apply the skills in practice. Objective: to develop continual critical appraisal in practice.	Case work New developments/ideas

Addressing problems

eg teamwork

• Define the core together: “what is a good team?”
• Look at the good points: “what are they doing well in that area?”
• Areas for improvement with specific examples: feelings: behaviour not attitude.

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Source: group work with Peter Havelock 1997