Continuing medical education for consultants.

education for consultants In March 2002 we ran the first of hopefully many courses aimed at the continuing educational needs of A&E consultants. The motivation for setting up such a course came from an acute awareness of our own educational needs which were not being fulfilled by courses we had attended around the country purporting to keep us up-to-date. Sue Mason, Alan Fletcher, and I attempted to create a tailor-made course for A&E consultants. We believed that there were four main components that we would like to incorporate in such a course. The first of these was a form of assessment. We felt that it was vital that candidates were challenged throughout the course and not allowed to become passive spectators. We were very much aware of the vulnerabilities and insecurities that we all have and it was therefore vital that this assessment was non-threatening, and the best way we felt to achieve this was to make the course self assessment. The course therefore started with an OSCE where candidates were asked to answer 30 questions and then they were provided with the answers. At the end of the course there was a similar OSCE that was designed to show candidates that the knowledge base had improved, reinforcing the value of the course. The second principle was that consultants should not feel embarrassed or exposed in the environment that we created either because they were having to compete with more knowledgeable/ confident registrars or by an over enthusiastic and domineering faculty menber with a point to prove. We were very fortunate in attracting high profile individuals with a good track record of teaching who had no problem in adopting the approach of facilitators rather than teachers. With regard to the content we clearly couldn’t cover the whole range of conditions that make up emergency medicine but decided to focus upon aspects of cardiorespiratory illness and the interpretation of the chest x ray, ECG, and blood gases. This approach not only gave us adequate material for the self assessment quizzes but these are some of the core skills required in the management of all sick patients. The final consideration was that the course should be enjoyable, not overtaxing, and with more than adequate time for networking. The course was therefore limited to two days and ran from 9.30 to 5.00 pm. Sandwiched between the self assessment quizzes were five lectures and five workshops. The lectures covered topics such as oxygen therapy in patients with COPD, venous thromboembolic disease, and the management of acute coronary syndromes. Each lecturer was asked to pose 10 questions to the audience throughout their presentation. The audience had the opportunity of “voting” for the correct answer using a digivote system. We believe this was an essential component and given that the voting was anonymous candidates could participate without feeling threatened. The workshops covered topics such as chest x ray interpretation skills, arrhythmia management, and acid base disturbance. Having agreed the format of the course, it wasn’t difficult to attract an appropriate faculty. It was more difficult attracting candidates. We first advertised the course with a flyer at the Spring Conference in Bournemouth 2001. Three hundred flyers were distributed giving a telephone number for further details. It was surprising that not one phone call was received. We then advertised the course on the Acad.A&E web site which provoked about six inquiries. A letter to every A&E department in the country produced slightly more inquiries, though still less than 20. It wasn’t until a personalised letter was sent to every A&E consultant in the country that an appropriate response was obtained. We received over 100 inquiries to this method of advertising, which may well have had sometime to do with the rather desperate plea of “please come” at the bottom of the letter. The venue was the purpose built Postgraduate Medical Education Centre at the Northern General Hospital in Sheffield and the first course attracted 36 A&E consultants. The faculty consisted of A&E consultants, cardiologists, radiologists, and a chest physician. The course appeared to hit many of the right notes if we are to believe the feedback and appraisal forms. However, there are 36 A&E consultants out there who would be able to give you an unbiased view. There is clearly scope for similar courses covering different issues—for example, neurological emergencies, aspects of trauma management, and soft tissue problems. It wouldn’t be too SUPPLEMENT