GP ASSISTANTSHIP STUDENT HANDBOOK 2020 - 21

TEACHING AND LEARNING ACTIVITIES

We want you to experience the breadth of Primary Care Medicine, and increase your understanding of the holistic approach to care in the community. You should undertake a mixture of tasks in order to improve your communication and clinical skills.

CENTRAL TEACHING & CORE CASES: ON-LINE

First (Intro Day) and Last (Closing Day) days of the block. The Introductory morning includes an orientation to GP placements in the new environment.

Closing day includes an ethics lecture and discussion of ethical cases on the placement as well as a formative Mock OSCE in clinical and communication skills relevant to Primary Care. You will be expected to complete the managing risk on clinical placement module prior to starting the GP placements.

Core Cases: on-line fortnightly (NEW) – You are required to work though and complete clinical scenarios (including catching up on Year 4 work) and applied ethics for Year 5. You will do the cases in self directed time and be supported virtually by central GP tutor for a case discussion every two weeks.

STUDENT SURGERIES

During this placement you are required to see and assess patients independently and then discuss the management and prescribing needs with your GP tutor. This should include regular sessions to see ‘your own’ patients. The supervising GP should always make their own assessment of the patient and will need to prescribe any medication required. This experience represents independent practice in a safe setting. In the new environment, your consultations will largely be by telephone or video.

Where possible, we would request that your have opportunity to do face to face examination as much as possible in preparation for when you become Foundation doctors.

On occasion students may work in pairs. When this happens, one should consult whilst the other observes, takes notes, and gives feedback to their colleague at the end. This supports independent practice and the development of skills in giving professional feedback.

SELF-DIRECTED LEARNING

You are expected to learn independently as part of your time in Primary Care, and will undertake a shared project during the placement. It is appropriate for you to use self-directed study time for both the completion of assessed work, and to follow up learning from patient contact.

SMALL GROUP TUTORIALS

Tutors should arrange at least one Tutorial a week for the group of students at the Practice. These should cover the breadth of Primary Care learning, and consider your learning needs. There are specific placement objectives which may provide a useful guide.

ASSITANTSHIP & PROFESSIONAL SHADOWING

This is a GP Assistantship and we would encourage you to be involved in chronic disease management as much as possible and also develop experience of e-consulting in this area.

‘Sitting in’ is not the main aspect of this placement, some time can be spent ‘sitting in’ with or shadowing members of the Primary Care Team. Particularly relevant experiences include District Nursing, Community Pharmacists, Palliative Care Specialist Nurses, and Practice Nurse Clinics specialising in Chronic Disease management.

Where possible this should involve active particpntion and includes reflection and summarising what you have learnt.

HALF DAY VIRTUAL MORNING IN PALLIATIVE CARE

This session has been arranged by St Joseph’s Hospice, Mare Street, London E8 4SA.

It consists of a virtual half-day session facilitated by Palliative Care Specialists, and you will be informed of the date.

All students including those on self-organised GP placements will be expected to attend this session.

OUT OF HOURS Care

We are not arranging an out of hours session for students on this GP placement. We are asking you to complete written work on the interface between Primary and Secondary Care and the lived experience of patients trying to access care out of hours.

You should consider how risk is managed by Clinicians seeing patients without access to notes, without continuity of care, and without the tests available in A&E. You should complete a coordinate my care plan.

PRACTICE BASED PROJECT

You will be expected to work in pairs during their placement on a short Practice Based Project (those students placed individually in a Practice should work on their own). The subject and type of project can vary but should be related to an area of Primary Care where a team approach to care is needed. We would encourage you to focus on aspects of leadership or teaching within the practice.

A topic for the project should be agreed with the GP Tutor, and you are encouraged to develop your own ideas, whilst considering the needs of the Practice. There is no set type of project, and options include a quality improvement project, audit, a patient survey, a leaflet, or a poster. The GP Tutor will assess and grade the project at the end of the placement. You should be given the opportunity to present their project to the practice team.

We hope that the project will provide an opportunity for you to learn, as well as allowing the Practice to positively impact patient care. The practice project can also be submitted for the North East London Faculty RCGP prize.

PATIENT CASE AND REFLECTION ON PROFESSIONAL PRACTICE PRINCIPLES

This task consists of a reflective case write-up followed by a discussion between you and Tutor about the issues raised. Both aspects of the task are important, and contribute towards the assessment. The write-up should be now more than 1000 words long, including a short case summary of no more than 300 words.

The patient chosen should have complex needs such as Palliative Care, or a high risk of admission. You must show reflection on two of the GMCs "Duties of a Good Doctor" criteria.

At least one of these principles should be either "Relationship with Patients" or "Working with colleagues". Once the cases have been marked Tutors should arrange for the learning outcomes to be shared and discussed in a group session, to encourage peer review and learning.

COMPLEX CARE PLAN

The aim of this task is to develop skills in gathering relevant clinical information about a patient with chronic conditions and needs, summarising this information, and communicating the management plan to colleagues in an appropriate written manner. This is particularly important in the Primary Care setting where chronic issues present often.

You should spend time interviewing and examining a patient, whilst reviewing the medical record. The patient selected should have chronic and complex needs, more than one chronic condition, and be taking multiple regular medications. The patient may be seen on a virtual home visit.

The task provides you with an opportunity to assess a case in further detail, review a patient in their own setting, and consider how you can share and communicate your plan effectively with colleagues.

The Care Plan should be written for colleagues, using the template available on QMPlus.

For students on two shorter placements see details under Assessment