Prevocational Supervision Training Package Video 1 - Understanding the Framework

Summary

The 2024 update to Australia's National Framework for Prevocational Medical Training introduces major changes, emphasizing a broad range of clinical experiences and cultural safety. The revised program aims to improve health outcomes by increasing exposure to underrepresented groups, particularly Aboriginal and Torres Strait Islander communities. With a shift from time-based training to competency-focused assessments, including Entrustable Professional Activities (EPAs), the new framework supports both professional development and well-being. Enhanced supervision, clear role definitions, and a focus on culturally safe practice ensure a more inclusive, flexible, and supportive training environment for future doctors.

Takeaways

• 😀 The National Framework for Prevocational Medical Training in Australia will undergo significant changes in 2024, affecting both PGY1 and PGY2 doctors.
• 😀 The revised framework emphasizes breadth of clinical experience over core specialty terms, with a focus on safe and high-quality care for patients.
• 😀 Key goals of the framework include aligning training with community health needs and improving outcomes for underrepresented groups, particularly Aboriginal and Torres Strait Islander populations.
• 😀 PGY1 doctors will complete a year of training culminating in General Registration, while PGY2 doctors will receive a Certificate of Completion.
• 😀 The framework introduces four categories of clinical experience: undifferentiated illness, chronic illness, acute and critical illness, and periprocedural care, ensuring broad clinical exposure.
• 😀 Cultural safety is a core component, with a focus on ensuring culturally safe practice for Aboriginal and Torres Strait Islander patients throughout both PGY1 and PGY2.
• 😀 New assessment methods will include entrustable professional activities (EPAs), which will be formally implemented in 2025, covering tasks like clinical assessment, acute care, prescribing, and team communication.
• 😀 Supervisors in the new system have clearly defined roles, including term supervisors, primary clinical supervisors, and day-to-day clinical supervisors, all of whom support the social and emotional well-being of prevocational doctors.
• 😀 Longitudinal training emphasizes competency and outcomes, with assessments focusing on real-world clinical performance rather than time-based training.
• 😀 The framework promotes consistent, nationally implemented standards to ensure that prevocational doctors are trained in environments that are free from bullying, harassment, and discrimination.

Q & A

What is the most significant change to Australian prevocational medical training in 2024?

The most significant change is the revised National Framework for Prevocational Medical Training, which includes updated standards for both PGY1 and PGY2 doctors, with a stronger focus on broad clinical experiences rather than core specialty terms.

What is the primary distinction between PGY1 and PGY2 years in the new framework?

PGY1 concludes with the granting of General Registration, while PGY2 concludes with the granting of a Certificate of Completion. The revised framework emphasizes the breadth of clinical experiences over the two years, instead of focusing on core specialty terms.

What are the key goals of the revised National Framework for Prevocational Medical Training?

The key goals include aligning training with community health needs, improving health outcomes for underrepresented groups (especially Aboriginal and Torres Strait Islander communities), promoting cultural safety, enhancing supervision, and fostering a competency-based training approach.

How does the revised framework aim to support Aboriginal and Torres Strait Islander health?

The framework increases exposure to community health settings, promotes culturally safe practices, and addresses issues like racism and discrimination. It also includes specific programs and supports for Aboriginal and Torres Strait Islander people.

What are the four domains included in the new outcome statements for prevocational doctors?

The four domains are: 1) Practitioner, focusing on patient care; 2) Professional and Leader, emphasizing ethical behavior and teamwork; 3) Health Advocate, focusing on holistic care and partnership with patients; and 4) Scientist and Scholar, related to evidence-based practice and expanding medical knowledge.

What are the four categories of clinical experiences introduced in the revised framework?

The four categories are: A) Undifferentiated illness patient care, B) Chronic illness patient care, C) Acute and critical illness patient care, and D) Perioperative or periprocedural patient care.

How does the framework incorporate cultural safety into medical training?

Cultural safety is integrated through reflection on personal biases, understanding the needs of Aboriginal and Torres Strait Islander patients, and practicing culturally safe and anti-racist care. This is emphasized across all clinical experience categories.

What are Entrustable Professional Activities (EPAs) and how are they assessed?

EPAs are core tasks that prevocational doctors perform in their daily work. They are assessed to determine how much supervision is required for the doctor to complete these tasks. The EPAs focus on clinical assessment, recognition and care of acutely unwell patients, prescribing, and team communication.

What changes are made to the assessment process in the revised framework?

The revised assessment process includes mid-term and end-of-term assessments, with a focus on progressing towards independent practice. From 2025, all assessments will be recorded in an e-portfolio, which tracks the doctor's progress over time.

How are supervisors categorized in the revised framework?

Supervisors are categorized as term supervisors (who provide overall guidance), primary clinical supervisors (consultants or senior doctors), and day-to-day clinical supervisors (doctors at least PGY3 or above who manage daily patient care).