Training the trainers

The significant challenges and opportunities for medical training in Ireland were outlined during the second RCPI Annual Trainer Conference

Improving our training programmes to meet the evolving needs of the doctors and patients of tomorrow is fundamental to the mission of the RCPI.

Our core and higher specialist training programmes enable and empower physicians to deal with the growing complexities of medicine so that all healthcare professionals can be confident their training equips them with the skills to meet the needs of the 21^st Century patient.

As our learning and innovation evolves, training is reviewed, optimised, and benchmarked to the highest of international standards, providing up-to-date skills and training to clinicians, healthcare leaders, and other healthcare professionals for decades to come.

On Friday 3 November 2023, we welcomed over 200 RCPI trainers to No 6 Kildare Street and online to address some of the significant challenges and opportunities for medical training in Ireland, during the second RCPI Annual Trainer Conference.

The agenda, designed by RCPI Dean of Education, Dr Maeve Doyle and her team, highlighted some of the improvements underway to better support our trainers and trainees.

Workplace learning

The conference focused on three crucial themes: Workplace learning for trainers; experience-based learning; and delivering training in your hospital with an emphasis on enhanced induction and simulation.

Prof Tim Dornan, Emeritus Professor at the School of Medicine, Queen’s University Belfast, kicked off the event with his presentation, ‘Clinical trainers in the age of patient safety – Atop the arch of Janus.’ Likening our College to the keys of Janus, he explained how training is about transitions, from education to practice. He explained that we must pass through the arch of assessments before becoming independent practitioners.

Participating in training allows doctors to acquire the skills and tools to become a good doctor focused on patient safety and outcomes. Workplace learning, despite the competing complexities of service provision and societal expectations, is a key component to this.

Doctors acquire new skills and experience through what is known as ‘mimetic learning’ – learning on the job. As Prof Dornan pointed out – just being there, doing it, receiving guidance and feedback are the cornerstones of this learning. This allows our doctors in training to equip themselves with the tools to provide the highest quality and standards of patient care, and, in turn, create rewarding careers for themselves.

We all understand that being a doctor is about capability and excellence.

And we do this in a complex environment, where a blame culture, allied to societal expectation and pressure on outcomes, has the potential to adversely affect the doctor and, in turn, the decisions they make for their patients.

Building trust in yourself, confidence in your decision-making and pride in how you do what you do are all qualities doctors acquire on our world-class training programmes, and over the course of their career as a doctor through lifelong learning and continuous professional development.

Feedback literacy

The conference delegates also heard from Dr Richard Conn, Consultant Paediatrician and Clinical Senior Lecturer at Ulster School of Medicine, and Dr Muirne Spooner, Senior Lecturer, RCSI, who discussed experiential learning. They introduced the concept of ‘feedback literacy’ – a term I had not heard before. They explained the importance of both trainers and trainees understanding and recognising that feedback is being given, and that during times of formal and informal feedback, both may need to manage their emotions. Most importantly feedback must be acted upon.

As trainers, we must appreciate that feedback is a two-way thing.

We heard an account of ‘the future trainer’ fromDr Consilia Walsh, Consultant Psychiatrist and Clinical Lead, HSE National Doctors Training and Planning (NDTP), who spoke about workforce planning for the future. Dr Anna Clarke, Elected Fellow, RCPI Council, and Ms Cliodhna Martin, RCPI Global Training and Partnerships Manager, described the international opportunities at the College. Dr Lorraine O’Neill, Consultant Rheumatologist, University Hospital Kerry, spoke about enhancing induction for all trainees, with a focus on international trainees. We have a community of doctors and an international network of close to 13,000 alumni working in around 90 countries across the globe. This is something we must tap into, harness and nurture.

Dr Maeve Doyle provided an overview of the evidence-based change underway at RCPI to train the medical workforce for the future, as well as the important role the new Irish Clinician Educator Track will play in this. She highlighted the need for protected time for doctors in educational leadership and supervision roles. She also outlined the changes the College is making to support trainers, such as the trainers’ hub, trainers’ training day, trainers’ refresher course, and our Annual Trainer Conference.

The meeting concluded with an interactive discussion on ‘achievable simulation’ with Prof Dara Byrne, RCPI and HSE National Clinical Lead for Simulation, and Dr Paul O’Hara, Consultant Physician and Nephrologist in Saolta University Health Care Group.

Expansion of training places

In my role as RCPI President, I am committed to ensuring that the environment in which we train and work catches up and keeps pace with the needs of doctors and our patients. It is important that medicine, in its broadest sense, is a more attractive option – one that doctors in training and those who have completed their training abroad are keen to pursue in Ireland after their travels.

Building the capacity of our healthcare professionals to meet the growing needs of our ageing population will require all of us working together, and events such as this uncover the forward thinking and innovation across our membership.

Expansion of numbers in medical schools and places in training will be required to meet the growing workforce planning needs. Provision of funding must match the planned expansion in these numbers. Training and education delivery will need to adapt to meet these growing numbers.

Working collaboratively with each other, the HSE, the Forum of Irish Postgraduate Medical Training Bodies, NDTP, the Department of Health, the Irish Medical Council and others, we have a shared responsibility to deliver on improved training, recruitment and retention, as well as our own and the wellbeing of each other. The RCPI has always played a leading role in this regard.