2020 at a Glance
EV continues to work hard to improve our impact on the health of communities within our jurisdiction. We work collaboratively with stakeholders to better serve our practices and their communities whilst delivering high quality outcomes for our registrars. A selection of stakeholders shared their views on EV’s contribution throughout our region and we are grateful for their involvement in this report.
EV’s Response to COVID-19
“Reality is the commonest cause of stress.”
In 2020, Australian general practice and general practice training were forced into a paradigm shift due to the COVID-19 pandemic. Endless Zoom meetings, remote learning, telehealth, fever clinics, working from home, home schooling, patient uncertainty, closed facilities and cancelled events were part of the new landscape occurring on a broader community backdrop of social isolation, fear, loss, sadness and heroism.
Impact of COVID
Changes related to the impact of COVID escalated rapidly for the medical education program and the team involved in its delivery. By mid-March, all face-to-face workshop were cancelled for an initial period of two weeks. On 24 March, EV closed both offices with all staff working from home and all educational activities for registrars and supervisors were to be delivered remotely. This included peer learning workshops (PLWs), external clinical teaching visits (ECTVs), training advisor (TAs) contacts, cluster group meetings, supervisor professional development, workplace based assessments (WBAs) for the Practice Experience Program (PEP), as well as the accreditation and re-accreditation processes. The commitment and innovation demonstrated by all staff (medical and administrative) in continuing to provide support to our stakeholders was amazing. This rapid deployment of resources and functions was facilitated by strategic pre-planning and prompt responses from IT within the organisation.
New models of training
Throughout the year, the Senior Education Portfolio Team (SEPT) continued work on developing new models of training under the guidance of Drs Heather McGarry and Andrew Roberts. Given the window of opportunity that the changing training environment has offered, it is important that this work continue to be developed to the pilot stage in 2021.
Policies and Procedures
During 2020, it was vital that EV maintained regular and detailed discussions with RACGP and ACRRM to ensure that procedures and policies were sufficiently flexible to avoid disadvantaging registrars and practices in the program. This was a generally successful period with appropriate extensions and exemptions being provided. It was extremely disappointing that despite these efforts there were significant technological disruptions to the assessment processes of both Colleges causing delays and stress for all involved.
During the year, EV has continued work on three important research projects – Developing a GP Supervisor Curriculum; Developing a GP Supervision Framework and Developing a Cultural Safety Framework for GP Supervisor Professional Development. Despite significant staff changes, the research team managed to progress these projects that are due for completion in 2021. Late in 2020, EV announced the appointment of Dr Angelo D’Amore as the Research and Evaluation Manager.
Another significant appointment during 2020 was Dr Elisabeth Wearne as Deputy Director of Medical Education and Training – Rural Pathways. Liz’s appointment was greeted with broad acclamation from stakeholders across the region. She joins Dr Carolyn O’Shea, Deputy Director of Medical Education and Training – General Pathway, in providing support and strategic advice in the medical education programs.
In a year of significant change, EV farewelled David Glasson and welcomed Dr Mark Rowe as CEO. Both CEOs have been extremely supportive of the medical education team. The EV Board, through good governance and expertise, continues to provide strategic direction to achieve our organisational aims and objectives.
The impacts of the pandemic, personally and professionally, were inescapable. The whole EV organisation has been remarkable in what has been achieved in these circumstances. The medical education team have demonstrated resilience, innovation, imagination, persistence, patience, dedication and humour, but above all compassion, care and support for our stakeholders, their families, their communities and each other.
At the end of my 2019 report I wrote – It’s better to look back and say: “I can’t believe we did that” than to look back and say: “I wish we did that.” Reflecting on 2020, I can honestly say “I can’t believe we did that.”
Let your dreams be bigger than your fears and your actions be louder than your words.
Professor Neil Spike AM
Director of Medical Education and Training
This RACGP program continued to evolve throughout 2020. As might be expected, many participants had their practice and their program disrupted by COVID during the year. Many participants were granted a COVID-extension by RACGP to allow more time to continue or complete their program without disadvantage.
COVID restrictions required changes to the way our MEs supported participants, including quarterly orientation sessions being on Zoom rather than having an opportunity to meet face-to-face with those entering the program. More significant changes were needed to find a range of alternative methods to direct observation for the workplace-based assessments (WBAs) that are such an important element of the program. A variety of methods were used including electronic remote observation of real consultations with scheduled patients; remote audio of real telehealth consultations and simulated consultations with an actor or the medical educator playing the “patient” role. Such methods relied on technology and stable connections. Unsurprisingly there were initial “teething” problems until everyone became familiar with the technology.
A positive outcome was the less intrusive nature of being remote, which allowed observation of a more natural interaction between the GP and their patient.
Late in 2020, the RACGP released details of a redesign of the PEP program, based on feedback from participants and training organisations delivering PEP on behalf of RACGP. These changes have been widely supported as program improvements. The changes included the controversial Learning Modules no longer being mandatory for completion; an increase in the number of highly valued WBAs from six to twelve per term and the introduction of PEP Exam Preparation (PEPExP).
This unprecedented year has drawn the EV PEP team closer together and all have risen to the challenges of supporting our PEP participants. Our thanks go to Melanie Khan, PEP Administration Coordinator for her compassion and diligence and to our enthusiastic ME team committed to encouraging the participants to be the best they can be.
Professor Neil Spike, AM
Medical Coordinator PEP
2020 Research Projects
During 2020, three major research projects were at various stages of implementation
The National GP Supervisor Professional Development Curriculum project was funded through an RACGP Education Research Grant (ERG) from January 2020 to December 2020, with subsequent COVID extension funding from January 2021 to March 2021. This research project was supported by the Royal Australian College of General Practitioners with funding from the Australian General Practice Training Program: An Australian Government initiative.
The GP Supervisor Professional Development Framework project was funded through an RACGP Special Project Grant (2019-2020) from February 2020 to November 2020. The timeframe for the final report was extended to March 2021 without any further funding available
The Cultural Safety Training project was funded through a grant from the Department of Health. The aim of the project was to develop a cultural safety framework and develop education modules Professor Marlene Drysdale outlines the project in the accompanying video.
Tapley A, Davey AR, van Driel ML, Turnock A, Holliday EG, Morgan S, Mulquiney K, Spike NA, Magin PJ.
Turner RH, Tapley A, Sweeney S, Davey AR, Holliday EG, van Driel ML, Henderson KM, Ball JI, Morgan S, Spike NA, Fitzgerald K, Magin PJ.
Sophia Hill, Amanda Tapley, Mieke L, van Driel, Elizabeth G Holliday, Jean Ball, Andrew Davey, Irena Patsan, Neil Spike, Kristen Fitzgerald, Simon Morgan, Parker Magin
Neil A Spike and Parker J. Magin.
Williames, S., Temple-Smith, M., Chondros, P., Spike, N., Salamone, A., Magin, P., Hiscock, H., Sanci, L.
Aboriginal and Torres Strait Islander
As 2020 presented new challenges to how we delivered our education and training programs at EV, the significant contribution of Aboriginal people to the content, delivery and evaluation of our programs remained core.
Other significant achievements included the introduction of a research project relating to cultural safety training, the launch of our second Innovate Reconciliation Action Plan, and the completion of a suite of cultural protocols that can serve as an educational and capacity building tool for staff and stakeholders.
Aboriginal Health education and training program
Registrars in the early stages of their training program are required to submit a reflective essay based on a review of an approved resource, which are then assessed by our cultural educators.
Registrar feedback that demonstrates the transformation brought about by this activity included:
We acknowledge the significant contribution our small team of cultural advisors and cultural educators have made across many facets of our organisation. We thank Professor Marlene Drysdale, Ms Nicole Cassar and Mr Brian Stevens for their wise counsel, generosity and patience with our ongoing learning, and the subsequent transformation of our lives.
EV successfully applied to the Department of Health for Special Projects Grant funds to conduct research into supervisor cultural safety training. The Project commenced in July and by the end of the year, research for Stage 1—the development of a Cultural Safety Framework—was completed.
The research has led us to the conclusion that Aboriginal lived experience, and Australian and International research, has shown that training alone, while important, will not be enough to achieve cultural safety, equity and EV Reconciliation Action Plan goals or Closing the Gap aspirations and an organisation wide approach to cultural safety attainment for all of us at EV is underway.
Reconciliation Action Plan
EV was proud to launch its second Innovate RAP in September, with staff, Board Directors and guests joining in the virtual celebration. Our 2020 – 2021 RAP includes 16 actions and 70 deliverables and EV has committed additional resources to ensure we achieve this ambitious plan.
Registrar placements in Aboriginal Community Controlled Health Services (ACCHS)
This year’s placement data is consistent with the 2019 training year and the placements continued under an RACGP approved remote supervision model.
We are grateful to our small band of dedicated remote supervisors who enable these placements. We also thank our partner ACCHS who work hard to provide a culturally safe general practice training experience for registrars.
Strengthening rural GP workforce in Eastern Victoria
A significant appointment in 2020 was Dr Elisabeth Wearne as Deputy Director of Medical Education and Training – Rural Pathway. This role builds on our strong history of GP Education in Gippsland where many of EV’s current and previous personnel are highly regarded for their knowledge and expertise in the sector.
This new role encompasses both medical education team leadership, and positive and productive engagement with regional, state and national partners.
EV made it a priority in 2019 to promote the benefits of general practice and in particular, rural general practice by committing and financially investing to develop practice profiles, case studies and promotional videos highlighting Gippsland rural practices and their communities. Throughout 2020, this campaign continued to be cornerstone or promoting the benefits of undertaking training GP training in our Gippsland region. This campaign contributed to EV successfully filling its 2021 rural training quota.
Rural Generalist GPO and GPA State Trainee Workshops
Since 2016, EV have been funded by the Department of Health and Human Services (formerly via RWAV) to co-ordinate and deliver workshops for GP Obstetric (GPO) and GP Anaesthetic (GPA) Trainees State-wide. These workshops commenced in 2013 and have now evolved into a significant component of the trainee’s educational program supported by a highly experienced and knowledgeable faculty spread across Victoria.
EV was fortunate to hold one combined Rural Generalist GPO & GPA Workshop in February 2020 in Warragul prior to the COVID restrictions for all trainees from across Victoria. This was an invaluable experience for all trainees not only from an education
and training perspective but the opportunity to undertake a 3 hour ‘Breaking Bad News’ session lead by Clinical Psychologist, Dr John Reeves and supported by actress, Veronica Porcaro.
The program was moved completely online for the remainder of the year, delivering what was possible to ensure trainees continued to be supported.
A comprehensive GPA program was provided to trainees and supported by a highly skilled and experienced line up of speakers from across the country including, Broome, Ayr and the Northern Territory. This was followed by moving the Pre-Exam Workshop on line as well with registrars rotating through 4 stations in a VIVA format/examination environment.
The GPO Workshop program continued online and covered topics such as Obstetric Emergencies, the Difficult Ceasar, Antenatal Care, Clinical Decision making, Sphincter injury and repair and a very interactive and engaging case-based discussion amongst all trainees and facilitators.
‘Although we were unable to do the practical sessions, it was great to do ‘virtual’ simulation of scenarios by way of discussing our clinical reasoning and plans/actions, with a GP led unit focus. Thank you so much for taking up your Saturday morning to deliver this, I found the session extremely useful.’ (GPO Online Workshop)
Prior to the lockdown we were able to offer the ACRRM registrar workshop F2F in Traralgon, and in March we partnered with MCCC to deliver a mock-StAMPS session in Parkville.
Extended and Advanced Training Skills
EV continues to promote and support ACRRM and RACGP registrars undertaking both extended and advanced procedural skills posts. EV had a number of rural registrars undertaking both extended and advanced skills posts in Obstetrics, Anaesthetics and Emergency Medicine. The Victorian Rural Generalist Program (VRGP) was established during 2020. EV worked collaboratively with VRGP to promote the Rural Generalist pathway to both prospective and existing GP registrars for 2021.
Dr Kelly Seach, Senior Medical Educator continued to provide oversight of the Training Skills portfolio with Drs Patrick Ruane and Antony Wong providing mentoring support for GP registrars undertaking procedural skills in Obstetrics and Anaesthetics.
EV looks forward to continue supporting rural generalist pathways and the VRGP in the future to ensure our registrars have the opportunity to undertake advanced procedural skills in their discipline of choice whilst also meeting the needs of the Gippsland community.
Rural Junior Doctor Training Program
EV (the only RTO and one of 15 organisations nationally) continues to co-ordinate the Rural Junior Doctor Training Innovation fund (RJDTIF). The program offers GP rotations for Interns (PGY1) in the Gippsland Rural Intern Training Program (GRIT) and PGY2s in collaboration with Latrobe Regional Hospital and supported by the Monash Training Hub.
Although impacted by COVID restrictions, all 15 Intern rotations and 4 PGY2 rotations remained filled across Maffra Medical Group, Heyfield Medical Centre, Breed St. Clinic Traralgon and Trafalgar Medical during 2020.
An extension of our contract to deliver this program was provided by the Department of Health and EV looks forward to continuing to support and provide valuable experiences for rural pre-vocational junior doctors across Gippsland in 2021.
People and Culture
One of EV’s key strategic objectives is to have a collaborative and engaged organisation, proactive and responsive in relation to the needs of our stakeholders. To support this objective through the Covid-19 pandemic, we ensured we kept in touch with our staff and stakeholders through electronic platforms. We implemented a COVID-19 response Employee Staff Survey to check in on staff, gain feedback and ensure we were attuned to what the organisational needs were to support engagement, collaboration and success in our programs.
One of the outcomes of the survey was to provide additional support to staff which we did, through additional meetings and support webinars which included topics like dealing with change and uncertainty, looking aft er our mental health, skills for remote working through the pandemic, ergonomic desk training and more. These online forums enabled the exchange of ideas, experiences and supportive strategies and were well received by EV staff . Contributions from each and every staff member were welcomed, including from our very own Medical Educators who presented some valuable insights and information in particular around the importance of sleep and self-care.
EV’s shared values of responsibility, creativity and innovation were certainly demonstrated throughout the year with staff stepping up to the challenge and
making adaptations to work practices which have enabled business continuity and the ongoing delivery of a high quality training program. A notable achievement by EV staff was the remarkably fast adaptation to this new mode of working and the ability to maintain momentum and high performing teams.
Activities like staff recruitment were also effectively conducted remotely with the successful appointment new staff throughout this time. Online inductions have been received positively and have been a supportive aspect of welcoming new EV staff.
EV’s Senior Management Team have provided strong leadership for the organisation through their tireless efforts and initiatives to maintain the connectedness of teams who are collaborating and feel supported and valued. Keeping lines of communication open with our people was more important than ever. The regular online organisational updates by senior managers to all staff have been an important aspect of maintaining a common channel of communication open and have promoted a positive culture by bringing all staff together virtually.
Ensuring staff safety including implementation of a new policy and practices in the COVID-19 response space was also a big focus area for EV and continues to underpin our organisational planning.
The RACGP Awards celebrate the vital contribution GPs make to the health of communities across Australia and recognise the significant achievements of RACGP members.
Victorian GP Supervisor of the Year
Dr Terence Heng
In 2020, Dr Terence Heng was the recipient of the RACGP Victorian GP Supervisor of the Year. Terence is an EV Supervisor and has practices at Vermont and Nunawading.
Terence is a dedicated educator and mentor to both current and past registrars who have worked at his practice. He is an innovative teacher and uses technology platforms to discuss interesting cases and learning points with learners.
He is well respected within his community and much-loved GP to his patients. Through his work, Terence shows both the medical community and the public that General Practitioners are able to manage a wide breadth of presentations to a very high standard, improving the image of General Practice.
Terence plans to join the EV medical education team in 2021.