Many many years
ago when you were trained as a doctor you were given information, it was called
training and you spent time in different areas of medicine in order to see how
different specialties worked and in doing so you learned. This is not a
difficult concept for it is a simple system which worked
once and amazingly continues to do so.
There are, however, those who benefited from
this simple system but who now practice self colonoscopy the process by
which by staring deeply into your own dark black hole full of Sierra Hotel
India Tango you gain enlightenment by completely ignoring the wider world. As a
result of such practices they change medical education not for the better but
for the worse as we hope a recent experience will illustrate.
An email from
one of our doctors in training has prompted we elderly grunts to pass comment
for many years ago we did something called audit.
It was not
called audit then it was called good medical care and analysis. As a junior
grunt we were once asked by a very learned Professor to keep a record of all
their patients admitted over a 3 month period either as an emergency or a
routine admission and to record every procedure done and every complication a
patient had so that they could see how well they were doing (or not).
We were then
asked to analyze this information which we did and discussed this with our
seniors called registrars who suggested ways that we could present this
information.
We did so to a
group of fellow medical teams at our first world university and it generated
loads of discussion regarding the results. What followed was a discussion
between professionals, not managers, regarding the results and the team we were
on did rather well and it led to changes for the better.
We did this
because we were asked to and it was to our and to our future patients'
benefit(s). We still have this presentation and its results.
We did this
because it was right. The paper records and acetate slides could form part of a
historical record of medical practice at that time and we guard them well for there is
the issue of patient confidentiality of the cases presented. Please note
patient, not commercial, confidentiality.
Fast forward to
the "new" NHS training of junior doctors and we have been asked to
complete an electronic template for an audit, not an analysis, presented at a
meeting we were not present at in order to satisfy an electronic tick box
exercise that achieves what?
We did not do
that decades ago so what has changed? Do an audit present and learn from it then
move on. Now do an audit present and learn from it then move on but ask everyone
at the audit (or not) to waste time filling in an electronic tick box. Is this
for the better or for the worse?
What matters is
the analysis of the data not collecting a load of electronic ticks on an
e-portfolio afterwards. Afterwards one should be concentrating on the results
and looking for improvement in patient care not looking up a dark passage at an
e-portfolio.
And worse we
were not present at the presented audit. So if we complete the template how
good is the e-portfolio at representing that doctor's medical "training"?
Tripadviser medical education anyone?
Praise be to the
Party for continuing to improve medical standards by training new doctors to
tick boxes and ignore patients. A complete waste of time and a useless exercise
of no benefit to the doctor to be or their patients.
Still it is
cheaper than treating patients or teaching doctors face to face. And you can be
assured that if the box is ticked that the doctor will be a good one won't they?
1 comment:
The trouble is that they ae applying the tick box principle to the Liverpool Care Pathway.
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