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Facing the challenge of training to be a trainer

Dr Neil Brownlee didn't really know what to expect when he decided to train to become a trainer ­ here he outlines why he did it and what is involved

octors become trainers for varied reasons. Personally, I had always enjoyed the half-day release as a registrar. I had experience of training in my last practice and felt that I would like to bring the challenge of training to my new practice. I don't feel as if I have suddenly turned into the type of doctor who thinks that a knife-wielding heroin addict just needs someone to talk to. I simply enjoy teaching, happen to believe that we should be proud of general practice and would like to do my bit to recruit and train new GPs.

A GP trainer has to be approved by the JCPTGP based on evidence from the associate director of postgraduate GP education. In my case the northern deanery sent me a rather formal but practical form to fill out. I made contact with the local VTS and applied for the course.

Pre-course preparation included preparing a video of myself consulting, collecting problem and random cases and reading. The course was divided into four modules (all non-residential). The first two included:

 · The attributes of a good teacher

 · Learner-centred learning

 · The anatomy of the tutorial

 · Teaching the consultation

 · Teaching random and problem case analysis

 · Summative assessment

 · Preparing for the MRCGP examination.

It was a cathartic experience wearing jeans and trainers, throwing myself into role-play and generally having a good time on weekday mornings. I feel that all aspects were taught well and in great detail.

General practice training is certainly a world away from the old hospital 'give me 20 causes of a large spleen' style. That is refreshing. But training also involves a lot more paperwork than expected. I can see why this is necessary but my hope is that tutorials don't become like one of those consultations where you spend more time filling in forms than talking to the patient.

Module 3 involves supervised teaching practice. This lasted for six months during which time I had to give six one-hour tutorials to a registrar under the supervision of an established trainer. We soon established a good relationship, the sessions were recorded on video and feedback was very helpful.

The emphasis was on assessing learning needs, planning tutorials well in advance and summarising learning points at the end of each session.

Module 4 was a one-day course during which we all met up again and discussed our individual experiences. We also had some further guidance on curriculum planning and preparing for our interviews.

A bit of a culture shock

The last stages of trainer selection involve preparing the practice for training, performing an audit of our records and performing my own audit to MRCGP standard. This was a bit of a culture shock but there are well-written guidelines and an internet search gave me useful information.

The practice visit was looming and this meant meeting with the partners and staff to discuss the duties of a training practice. Everybody in a practice needs to be happy about the reasons to train and the commitment involved.

The time, effort and financial costs need to be emphasised. Although one partner has the main responsibility for a registrar, all partners must be willing to train and provide cover when necessary.

We needed to convert part of the reception area into a registrar's room. Funding for this was available from deaneries after an approval process.

The practice had already had an informal visit from the associate director for general practice. This was the prelude to his formal practice visit, which also included the VTS scheme organiser and a course organiser. The premises were inspected and our practice library and electronic library were examined and sets of notes reviewed.

This was also an opportunity for the visiting team to speak to our staff and my other partners. The latter then sat back, ate cakes and apparently enjoyed watching me get 'a good hard viva'.

The visit was a two-way process and lots of helpful advice was given about training, curriculum planning and common problems we may face.

The final step was an interview several weeks later. Again I was quizzed on several topics such as preparations for future registrars, ways to help a 'difficult registrar', and my views on the demise of community health councils. The atmosphere of the interview summed up the whole course: formal but friendly.

Training to be a trainer is a drawn-out process. It takes several months and there are many tasks to perform. But each step is relatively simple, support is on offer at every stage and financial support for intending training practices is now available.

Useful resources

·Middleton P, Field S. The GP Trainer's Handbook. Oxford: Radcliffe Medical Press, 2000

·Fraser RC. Clinical method: A General Practice Approach. Oxford: Butterworth-Heinemann 1999

·www.gptrainers.co.uk

Contains links to all the deaneries with websites

·www.wellclosesquare.co.uk

This is a practice website which has deservedly won many awards ­ it has a detailed section on GP training with many resources

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