Teaching on the run tips 6: determining competence.

University of Western Australia, First Floor N Block, QEII Medical Centre, Nedlands, WA. Fiona R Lake, MD, FRACP, Associate Professor in Medicine and Medical Education, Education Centre, Faculty of Medicine and Dentistry; Jeffrey M Hamdorf, PhD, FRACS, Associate Professor in Surgical Education, School of Surgery and Pathology. Reprints will not be available from the authors. Correspondence: Associate Professor Fiona R Lake, University of Western Australia, 1st Floor N Block, QEII Medical Centre, Verdun Street, Nedlands, WA 6009. [email protected] The Medical Journal of Australia ISSN: 0025729X 1 November 2004 181 9 502-503 ©The Medical Journal of Australia 2004 www.mja.com.au Teaching on the run doctor or trainee to perform either independently observation, to let them know and to give them needed. As many hospitals or training programs n tured training for common simple skills (eg, sutur sive training and testing of competency for infreque but life-saving skills (eg, intubation), it is initially im out what training junior doctors have had in such s octors in training need to practise to improve, and, whether we like it or not, practice often involves patients. While learning, it is possible that errors will occur. It is our responsibility as senior doctors to ensure that our trainees provide safe and good care and receive support in the learning environment. At a certain point, we also need to decide whether they are good enough to work alone. This involves assessing knowledge, skills, communication skills and professional behaviour. Often we rely on our “gut feeling” about whether they are capable. Is this sufficient? The focus of this teaching tips article is on how to decide when trainees are capable of carrying out procedural skills on patients.