Medical intern training - where does the future lie?

Medical intern training - where does the future lie?

“The (current) assessment process is largely focussed on identifying the very few instances of serious underperformance, and provides little meaningful feedback for the majority.” 

Review of Medical Intern Training (Australian Healthcare Ministers' Advisory Committee, 2015)


The Australian Taxpayer makes a considerable investment in the future of the healthcare system.  Nationally, over $300M is invested per year to train interns, yet there is little qualitative or quantitative evidence that they currently meet the training objectives set for them.

Osler partners with the Intensive Care Foundation

The Intensive Care Foundation and Osler have announced they will partner to provide a special offer to CICM fellows and trainees.

The partnership, which allows all new subscribers to access the Clinical Portfolio at a substantial discount, will also see Osler donate $60 per subscription to the Foundation.

“We’re delighted to be able to partner with the Foundation.  The chance to give something back to the ICU community is really important to us, particularly as Osler has its origins in the critical care environment”, says Osler co-founder and Intensivist, Dr Todd Fraser

Osler enables users to capture data related to their education, training, continuing professional development, patients and procedural activity, and will soon launch patient and peer feedback portals and a personal performance development planner.

“The Intensive Care Foundation is happy to partner with Osler Technology given its strong mantra to increasing training quality standards within the Intensive Care environment,” says Foundation Executive Director David Brennan.  

"Osler have agreed to generously donate to the Foundation for every subscription they receive, which we hope you may consider. We look forward to working closely with Osler in the future and growing our partnership with such a dedicated, community-minded organisation.”

For more information on the partnership, visit http://osler.community/icf

The Bawa-Garba Case : what will healthcare learn from this experience?

The recent case of Dr Hadiza Bawa-Garba has created a fire storm across the globe's healthcare community.

Dr Bawa-Garba has been convicted of manslaughter and removed from the UK medical register for her role in the tragic death of a 6 year old boy, Jack Adcock.  While it appears that her actions contributed to Jack's death, it is also clear that factors such as staff shortages, poor orientation to workplace, a lack of supervision, locum nursing staff and the administration of a non-prescribed medication have also played a major role.  A review of the case is presented here

This case is awful on so many levels.  One can only imagine the gut-wrenching grief of a family, not only devastated by the loss of their son, but by the disintegration of their faith in a system they thought was supposed to protect him.

I'm sure Hadiza Bawa-Garba feels the same.

Incredibly, despite all the system failures, and the multitude of clinicians involved (including those supposed to be supervising her practice), she is the only one to face official consequences.

The case ultimately boils down to three main issues :

  1. The contribution of system failures to the ultimate outcome versus individual responsibility
  2. The decision to ignore system failures and place blame solely on the individual
  3. The apparent injustice in the treatment of the individual

The last of these will be dealt with in due course by the courts as Hadiza launches her appeal.

The UK Health Minister, Mr Jeremy Hunt has signalled his intent to address the second.

But will healthcare ever address the first?   

High risk industries create environments to reduce the impact of inevitable human error.  Healthcare could not sit further from this paradigm, with understaffing, poor orientation processes, migratory staff and under-resourcing contributing to mistakes.

But our processes are letting us down too.  Take procedural medicine for example.  In many cases, our junior staff are denied the opportunity to learn properly, are then expected to perform these skills without supervision, and the inevitable errors occur.

Blaming a lack of funding is an all-to-easy out, a case made by no less an agency than the Organisation for Economic Co-operation and Development (OECD), which has called for investment in patient safety initiatives as their cost is dwarfed by the unfathomable costs of mistakes.

It's time for health to stop making excuses and start taking action.  

But will it learn its lessons from this tragic case? 

Happy Birthday Osler!

HAPPY BIRTHDAY OSLER!

3 years ago today, in a rotunda in a park in Peregian Beach, Osler was born.

We've come a long way in that time, with over 1200 users, thousands of assessments and procedures performed, an international e-learning prize, CPD approval from 4 colleges, and 3 government grants under our belts.

But we could not have done so without the hard work and dedication of our wonderful team, past and present. So here's to Dean, Genelle, Phebe, Cameron, James, Jo, Mara, Madhava, Tim, Vaughan and Ian who have helped us bring this fantastic project to life.

And most importantly, thanks to you, our fantastic user community, for whom we strive so hard to produce a world class platform.

Cheers!

Osler receives Ignite Ideas grant for Patient Feedback platform

Osler Technology has recently been granted funding to complete it's Patient Feedback portal.

The Advance Queensland Ignite Ideas program awarded Osler Technology $100,000 to add the important metric to it's ever-expanding suite of Professional Development Tools.

"Patient feedback is critical to the ongoing professional development of healthcare staff, and we're delighted that the Queensland Government has supported the commercialisation of this feature," says Osler co-founder, Dr Todd Fraser.

Junior doctors trial app to enhance education

Junior doctors trial app to enhance education

The Osler Clinical Performance Platform is now being trialled with junior doctors at Mackay Base Hospital, aimed at further enhancing their educational experience.

Osler is an online portal that provides a consistent framework for recording, analysing, monitoring and benchmarking the performance of clinical staff.

Executive Director Research and Innovation Associate Professor Dr David Farlow said Mackay Base Hospital is the only Queensland Health facility to trial the platform with junior doctors.

Competency in practice - a podcast with Dr Chris Farmer

Dr Chris Farmer is a career intensivist and a former president of the Society of Critical Care Medicine in the US, so he knows a thing or two about competency in ICU.

In this broad ranging interview, he chats to me about his interest in the area, how we can measure and define competency, and where the future lies in this important topic

Here's the interview

How many of these have you done?

How many of these have you done?

A recent opinion piece in the Journal of the American Medical Association drew attention to the issue of procedural experience in healthcare.

Titled “How many have you done?”, the piece described the experience of a doctor who required a procedure herself, in this case, an amniocentesis.

Of course, what the patient was really asking is, “How can I be reassured you know what you are doing?”

Skills decline - a problem on the rise

Skills decline - a problem on the rise

In the 2-year course of our Osler journey, my business partner Jeff has said to many time who in the hospital he’d want looking after him if he needed a procedure performed : the senior registrar.

As Jeff sees it, senior registrars are about as sharp skills-wise as they are ever going to get.  They do the most procedures, they learned the most recently and they are yet to be cloaked by an air of invincibility.

And he’s not far off the mark.

// End of salesforce stuff