David Black¹
1 Federation of the Royal College of Physicians of the UK 

Abstract 

Starting in Iceland in 2015, then expanding to sites in India and UAE, the three UK Colleges of Physicians are now providing Internationally delivered three year UK equivalent Internal Medicine Training completely aligned with the GMC approved UK IMT curriculum. Previously called Core Medical Training it is a competency based curriculum based on Entrustable Professional Activities. This builds on the work of delivering the MRCP UK Diploma on an International basis for over 40 years. 

In some countries trainees take the MRCP as a stand-alone qualification but it seems increasingly anachronistic to provide a qualification rather than integrating it into high quality education and training. There are currently a total of 250 trainees in 8 programmes; 6 in India and one each in Iceland and Dubai. 

To implement and embed the program all the educational and clinical supervisors undergo up to 5 days of local education and training in the operation and delivery of the program. The first cohort of trainees at each site also receives hands on training including the e-portfolio. To ensure and demonstrate UK equivalence, a senior UK Physician educator provides externality for all the Annual Review of Competence Progression panels annually onsite and there is also a process of review and accreditation by UK educators of each program on a three-year cycle. 

Challenges have included the delivery of Geriatric Medicine and Palliative Medicine, maintaining faculty training, delivering meaningful quality improvement programmes and the disruption of COVID. 

Evidence for the success of the program includes: trainee success in directly applying for and achieving higher speciality training posts in the UK in open national competition, MRCP PACES pass rates similar to UK trainees in the UK, successful site reaccreditations and increasing competition for places. 

A complex competency based postgraduate curriculum can be successfully delivered on an international basis. 

References (maximum three) 

Black D. Use of an accreditation process to embed UK-equivalent Core Medical Training in an International Context. J R Coll Physicians Edinb 2018 Dec; 48(4):341-345 

Black D, Baker T, Freeth D. Celebrating the success of International internal medicine training programmes. Royal College of Physicians Commentary August 2022 44-45 

https://www.jrcptb.org.uk/about-us/international-programme-accreditation 

Ruchi Sharma¹
GV Rashmi Aradhya¹, Swati Sethi¹, Princy Fernando¹ and Arun Samuel Devadass¹
1 Laerdal Medical India

COVID outbreak diminished the traditional opportunities for training of health professionals. There was need to adapt conventional healthcare simulationbased training into distance learning modalities. Virtual simulation training - SPAN-T was designed using Sim Capture (SC) Platform for training healthcare professionals on management of Pediatric & Neonatal Emergencies 

Objective
To test efficacy of using virtual platform in building competence of health professionals 

Methodology
SC is a unique digital platform for recording, annotating, debriefing, and reportingofskillspractice,OSCEsandsimulation. FordeliveryofSPANT,oneweektraining program was developed.The selected pediatric/neonatal scenarios were recorded with experts and used for training. Participants attempted pre-test & went through knowledge material. They watched the pre-recorded scenario videos and annotated and reflected on them using SC. From gathered data, experts prepared Plus Delta Plus Chart. Faculty and participants came together for virtual debriefing. Post debriefing, participants attempted post-test and feedback. 

Results
sixteen trainings were delivered with 232 participants from 219 hospitals in 87 cities of India. Comparison between pre- post results of scenarios showed positive gains ranging between 20%(for Asthma) to 65%(OP poisoning). Verbatim responses highlighted that they felt engaged during discussion and had learning points to apply in clinical settings. Participants reported gain in confidence in managing case scenarios discussed during the training. They found SC user friendly and interesting to navigate. The concept of using innovative method to deliver high quality simulation was well appreciated. 

Discussion
The use of SC has facilitated in delivering the virtual simulation trainings effectively and generated robust data base as evidence for efficacy of virtual trainings. SC can positively catalyze teaching, evaluating and mentoring participants in gaining and maintaining knowledge and skills. Also, virtual simulation trainings have proved to be equally effective in transfer of learning and have potential for wide and far reach audience. 

References (maximum three) 

Judy L. LeFlore, Debra A. Sansoucie, Carolyn L. Cason, Amy Aaron, Patricia E. Thomas, Mindi Anderson, Remote-Controlled Distance Simulation Assessing Neonatal Provider Competence: A Feasibility Testing, Clinical Simulation in Nursing, Volume 10, Issue 8, 2014, Pages 419-424, ISSN 1876-1399, https://doi.org/10.1016/j.ecns.2014.04.004. (http://www.sciencedirect.com/science/article/pii/S1876139914000693) 

Gaba, David M. MD The Future Vision of Simulation in Healthcare, Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare: July 2007 - Volume 2 - Issue 2 - p 126-135 doi: 10.1097/01.SIH.0000258411.38212.32 

Yang, T., Buck, S., Evans, L., & Auerbach, M. (2020). A Telesimulation Elective to Provide Medical Students with Pediatric Patient Care Experiences During the COVID Pandemic. Pediatric emergency care, 10.1097/PEC.0000000000002311. Advance online publication. https://doi.org/10.1097/PEC.0000000000002311 

MD Ridwanur Rahman¹
Md. Abul Faiz2, Syed Atiqul Haq¹, jamal abm³, Shohael Mahmud Arafat¹, Akhlak Ahmed¹, Mohammad Masud Karim¹ and Fatema Rahman¹
1 Bangladesh College of Physicians and Surgeons, Bangladesh
2 BCPS
3 Society of Surgeons of Bangladesh, Society of Endo Laparoscopic Surgeons of Bangladesh

Background:
Needs assessment activities are exercised to understand the various needs of a population. This study was done to assess the training need, perform a gap analysis and develop recommendations for prioritizing the training contents in any future re-organizing the training process in Bangladesh. The study was planned as a mixed-method cross-sectional study, using both the quantitative and qualitative approaches. A quantitative survey was conducted March to June 2021, using a structured close-ended self-administered modified Hennessy Hicks Training Needs Analysis Questionnaire. Postgraduate trainees were recruited from both Public and Private Training Institutions. The development of the recommendations to address the gap were developed through a stakeholder workshop. 

Results: 
The questionnaire was administered to 702 trainees, 680 responded (response rate 97%). The mean age was 32 (± 3.9) years, 61% males, 49% were in training for >1 year, and 71% were working with Public Health Care Services. About 33% considered that they currently perform this activity very well. The respondents observed a scope of improving performance in each subcategory of the tasks, clinical skill (92%), management and administrative skills (90%), research skill (89%) and communication skill (89%). 

The qualitative approach identified weakness’ in the undergraduate education system, lack of uniformity between Institutions, little scope for learning research, lack of incentives, disincentives, funds, inspiration and motivation for research. The potential solutions suggested were improving the undergraduate medical education, the introduction of Research Methodology courses, improving motivation of trainers. 

Conclusion:
The recommendation workshop identified significant gaps in the provision of the Post-Graduate Medical Training Scheme in Bangladesh in all the 5 skill domains evaluated. Potential major solutions recommended were to improve ‘undergraduate medical education’, ‘performance supervision’, ‘periodic targeted skill training’ and ‘wider exposure of the trainees to research and clinical situations. It would be urgent to re-structure the post-graduate training curriculum in Bangladesh. 

References (maximum three) 

1. WHO | HENNESSY-HICKS TRAINING NEEDS ANALYSIS QUESTIONNAIRE AND MANUAL. WHO. 2011 

2. Carolyn Hicks P. HENNESSY-HICKS TRAINING NEEDS ANALYSIS QUESTIONNAIRE AND MANUAL For use at a local level to identify training and development needs. 

Belinda Balhatchet¹
Heike Schutze¹, Nicole Williams^2,3 and Bruce Ashford⁴
1 University of New South Wales
2 University of Adelaide
3 Women & Children's Hospital Adelaide
4 Illawarra Shoalhaven Local Health District

Background
Burnout and poor psychological wellbeing are common in postgraduate medical trainees. However, data relating to Australian trainees are lacking. This systematic review aimed to identify and synthesise relevant research on the factors that influence burnout and psychological wellbeing in Australian postgraduate medical trainees. 

Methods
A systematic PRISMA search was conducted across eight databases from January 2000 to September 2021. Empirical peer-reviewed studies were included if they focused on one or more factors influencing burnout and psychological wellbeing in Australian postgraduate medical trainees. Screening was independently conducted by two reviewers at each stage of the process. Results were synthesised and analysed using a convergent qualitative synthesis process structured according to the Job Demands-Resources model of occupational stress. 

Results
Forty-eight papers were included in the final review. Factors impacting burnout and/or wellbeing (job demands) fell under four themes: (i) working hours and workload; (ii) the work and learning environment; (iii) inappropriate behaviour; and (iv) examinations and academic stress. A small number of job resources were identified.


Conclusion
Burnout and poor psychological wellbeing in Australian postgraduate medical trainees are most associated with long working hours and poor work and learning environments. There is limited research into resources that can protect against burnout and promote wellbeing. More longitudinal and qualitative research is needed to support systemic, long-term interventions that will improve the wellbeing of trainees, reduce the prevalence of burnout and ensure optimal patient care. 

N/A 

Daniel Anderson¹
1 The Christie NHS Foundation Trust 

The Paterson Programme (Professional Advancement in Training and Education: Reflection and Supervision in ONcology) is an innovative postgraduate professional supervision experience for doctors in training at all grades and in all specialties based in a UK regional cancer hospital. Created and led by a psychiatrist and psychotherapist with a background in medical education, the programme uses action learning sets (Paterson groups) to provide monthly peer coaching and mentoring in groups. Using techniques from the field of psychotherapy, the programme can also provide as required confidential 1-2-1 supervision to doctors in training and to educational and clinical supervisors who need extra support in their roles. The programme has been created to facilitate professional awareness in preparation for becoming a consultant and focusses on the creation of reflective and enquiring self- and peer- assessed attitudinal development alongside didactic teaching of relevant leadership and management skills. 

The Paterson programme was initially developed in response to the impact of the Covid-19 pandemic on education from the perspectives of learners, supervisors, and institutions, focusing on both active support and career retention. For doctors within training posts particularly, significant changes to service requirements, curtailed exposure to non-Covid presentations and directed day-day management disrupted norms. Burnout and moral injury are increasingly recognised amongst doctors in training. Whilst we have seen the return to learning alongside working, there has been little opportunity for our trainees to consider their learning needs, especially during important transitions moving from the relative independence of basic training to the relative interdependence of higher training (especially in highly specialist fields such as oncology). 

The best model that could apply to this experience comes the pedagogic and professional practice of psychotherapy (and specifically group analytic psychotherapy) whereby the group analytic model of supervision provides a third space sitting in between roles and helps to bridge gaps in professional and personal experience. It is often the interface between these various identities where problems start to generate and become difficulties preventing professionals from satisfactorily performing their professional roles. The programme also centres around organisational culture and values and is underpinned by the question: ‘What sort of values will be important to you as a consultant?’. In this regard the programme provides neither a clinical space, nor a managerial space, and is solely educational by providing to bridge various gaps that trainees may experience during professional transitions that may affect their sense of well- being and development. 

This workshop is suitable for up to 15 attendees at an intermediate/advanced level (and especially those responsible for the delivery of health education at an organisational level). The format will briefly describe the curriculum and structure of the programme and its early outcomes to date. There will be the opportunity to experience a ‘Paterson group’ using attendee participation to give a real sense of the experience of learning and self-assessment in this highly reflective format. There will be time at the end of the group to reflect on the experience. 

References (maximum three) 

Boud, D. & Soler, R.(2016)Sustainable assessment revisited.Assessment & Evaluation in Higher Education,41(3),400-413. 

Kilminster, S. et al (2011). Preparedness is not enough: understanding transitions as critically intensive learning periods. Medical Education, 45: 1006–1015. 

Wenger, E. (1998). Communities of Practice: Learning, Meaning and Identity. Cambridge, CUP. 

Dhanushi Abeygunawardena¹
Bronwyn Terrill^2,3,4
1 The School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW, Australia
2 Australian Genomics, Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
3 Sydney Children’s Hospitals Network, Randwick, NSW, Australia
4 Clinical Translation and Engagement Platform, Garvan Institute of Medical Research, Sydney, NSW, Australia

Incorporating genomic information to guide disease diagnosis and management decisions is an increasingly important part of healthcare delivery. However, healthcare professionals report low confidence, knowledge, and skills in this area[1]. A short continuing professional development (CPD) course in practical medical genomics was developed at UNSW Sydney, Australia, to address this growing area of need.


Summary of work 
The summative course assessment requires participants to submit a self-development action plan describing how they intend to apply knowledge and skills gained during the course to improve a specific genetics/genomics-related policy or procedure in their current practice. The assessment follows pre- and post-course questionnaires that encourage learner reflection on steps of the genetic testing process relevant to their role, and existing barriers to and potential opportunities for incorporating genomics. The Capability, Opportunity and Motivation Model for Behaviour change (COM-B) [2,3] underpinned the design of the questionnaires and the assessment task which were also data collection points for the evaluation of course effectiveness. The course has been offered to a total of 96 participants to date. 

Results and discussion 
The assessment task allows participants to reflect on their improved capabilities, gauge perceived confidence and competence in practising genomic medicine, and formulate and obtain feedback on a process to improve or incorporate genomics into practice. Qualitative evaluation of participant assessment submissions (n=53) revealed enablers and barriers to practising genomic medicine post-course completion. Our analysis also identified areas where further training is required and provided insights for improving the effectiveness of future iterations of the course. 

Conclusions and take-home messages/implications for further research or practice 
This assessment approach is suitable for authentic asynchronous assessment of continuing professional development informing both of participant performance against learning outcomes as well as course effectiveness, and can be adapted for evaluating both immediate and long-term outcomes of training. 

References (maximum three) 

Marika Wrzosek1
 Kathleen Beckmann1, Leslie Ruffalo1, MaryAnn Gilligan1, Carley Sauter1, Cynthia Kay1, Ashley Pavlic1, Sarah Vepraskas1, Hari Paudel1 and Heather Aschoff1
 1 Medical College of Wisconsin 

Background:
Professional development is critical to student success, yet there is no generally accepted model to best integrate this task in the medical school curriculum. In response, our institution implemented the Continuous Professional Development (CPD) course. We present the course structure and learners’ assessment regarding CPD’s impact. 

Summary:
The CPD course spans years three and four of medical school with the goal of ensuring students’ eventual attainment of global competencies. Each third-year student is assigned a CPD faculty director who monitors student progression along competencies, rotation evaluations, and OSCE performance, and provides specialty advising. At the end of the academic year, students complete a summative evaluation of CPD and its components, including their relationship with their director. We used statistical software and content analysis techniques to analyze quantitative data and open-ended questions, respectively. 

Results:
Of the 1,203 evaluation reports submitted since 2016, 828 (70%) students indicated that they “strongly agreed” or “agreed” that their CPD director’s feedback was useful. 908 (75%) of students “strongly agreed” or “agreed” that their CPD director was accessible during times of need. 986 (82%) students rated their CPD director as “outstanding” or “very good.” Given the robust learner response, in the spring 2023, the course was expanded to include select second-year learners. 

Discussion:
The success of the CPD course prompted expansion into preclinical years, wherein learners who have struggled may receive earlier CPD intervention before their formal advising in the third year. 

Conclusions:
Professional development requires the use of innovative strategies. Our CPD course highlighted the value of one-on-one mentoring and feedback on competency progression and individualized advice on meeting students’ career goals. 

Take home:
Students are amenable to data-driven advising as they progress through medical school. CPD faculty are uniquely positioned to notice trends among student cohorts that may drive institutional change. 

ORHUE ODARO¹
1 The University of Texas MD Anderson Cancer Center 

Clinician Educator (CE) pathways provide an alternative avenue for academic advancement, for faculty engaged in significant educational pursuits (1). This study assessed faculty opinions of educational effort as a means of career advancement, and elicited input for measures crucial to the development of a CE pathway, at an academic research institution. 

Following institutional review board approval, an anonymous survey was delivered to faculty to elicit opinions on concepts pertaining to educational effort and career advancement. The author examined responses regarding barriers to, and perceptions of educational effort as a pathway to promotion, by clinician educators (CEs). 

Of the 103 CEs, only 26% saw a clear path for career advancement. Most faculty agreed that a CE pathway would aid their advancement (58%). The majority rated 3 areas as very important to implementing a successful CE pathway: development of promotion criteria (62%), allocating time for medical education (62%), and developing a means to document and quantify educational effort (58%). 

The barriers to CE advancement were categorized into 3 themes: lack of recognition for educational effort; heavy clinical burden; and lack of criteria to assess educational effort. 

Faculty showed lower levels of agreement in questions related to their advancement as CEs. The results suggest key areas to consider in implementing a CE pathway, including developing a rubric to assess educational effort. Educator portfolios can decrease the promotion gap for CEs by providing an objective measure to assess the quality of educational effort (2). 

CEs need and value a rubric such as an educator portfolio, to document and quantify their educational effort. 

Further research should address the impact of educator portfolios on the number of CE promotions at academic research institutions. 

References (maximum three) 

1. Rushing GD, Mokadam NA. Faculty Development: Using Education for Career Advancement. Thoracic Surgery Clinics. 2019;29(3):321-328. doi:https://dx.doi.org/10.1016/j.thorsurg.2019.03.009 

2. Gill AC, Singhal G, Schutze GE, Turner TL. Educational Coaches: Facilitating Academic Vitality and a Pathway to Promotion for Clinician-Educators. J Pediatr. 2021;235:3-5.e3. doi:https://dx.doi.org/10.1016/j.jpeds.2020.11.042