1 The supervision during the formative moments: a continuous formation f or practitioners in Italy. Carmela Zotta MD and Diego Sabbi MD Family Physicians - AIMEF ( Italian Association of Family Physicians) Italy 2nd annual meeting of GP/FM teachers in Europe -Assessment in FP/GP Kranjska Gora September 2005

2 The supervision during the formative moments: a continuous formation for practitioners in Italy. In Italy the continuous formation postgraduate of medicine family’s phisicians is obligatory for law; nevertheless precise rules don't exist for the disbursement of the contents. Historically, until the operativeness bylow about Continuous Education in Medicine (ECM-2002), the assignement to organize courses of scientific updating and professional formation has been developed by the Medical Societies. The fragmentation of various Scientific Societes didn’t permit to formulate objectives and shared didactic methodologies. __________________________________________________________

3 The supervision during the formative moments: a continuous formation for practitioners in Italy. They are still currently the Scientific Societies, with private and public provider, to organize the formative appointments, that after recording on special form internet of the Health’s Ministery, is appraised, with the attribution of a score (ECM credits), by 3 referees divided for the various medical specialties. The score estimates the methodologies of teaching, the hours used in classroom and the availability of didactic materials etc. The weight of the pharmaceutical industry is notable and this makes unbalanced the formative offer toward sectors that the business marketing makes more desirable. __________________________________________________________

4 The supervision during the formative moments: a continuous formation for practitioners in Italy. The physicians are forced, as by law enacted, to reach a number of annual credits, for now thirty and subsequently fifty. All the costs of professional formation burden on the physician.,because are not anticipated for contract abstentions from the job for updating __________________________________________________________

5 The supervision during the formative moments: a continuous formation for practitioners in Italy. In the courses of the family’s medicine one or more facilitator (GPs graduated in the various Scientific Societies ) manage the event with the contribution of experts of the medical specialties dealt. Not always the formation meets the interest of all sharers : indeed an ample knapsack of colleagues without motivation is interested only in the attainment of the credits necessary. __________________________________________________________ The didactic materials are often "formative packets" self made in the respect of the active pedagogy.

6 The supervision during the formative moments: a continuous formation for practitioners in Italy. The experience of formation that AIMEF has developed in the last years has brought to the elaboration of a new figure: The Supervisor It derives from the necessity to transfer also methodological contained to experts of the medical specialties devoid of didactics and to check in progress the activity of the facilitators of our scientific society. __________________________________________________________

7 The supervision during the formative moments: a continuous formation for practitioners in Italy. The supervisor is an experienced GP of didactics and formation who observes,without directly participating, a formative event. Using special evaluation’s grates he expresses a judgment and he writes possible suggestions for the improvement of the following events.

8 The supervision during the formative moments: a continuous formation for practitioners in Italy. The grates appraise the logistic organization, the teachers and the classroom. The judgment so formulated allows to check the event in its entirety with a considered, repeatable and comparable system.

9 The supervision during the formative moments: a continuous formation for practitioners in Italy. Example of supervision (La Thuile, february 2003)

10 Before: score The teacher appears quite Then: score When the lesson is completed the teacher gives bibliographic guidelines of concern and updating Evaluation about Score 0 Score 1 Score 2 Score 3 Score 4 Introduction nothing not much partiallyvery much fully Si presenta ai discenti Favorisce la comunicazione tra i discenti Crea un atmosfera adeguata Illustra i metodi e le tecniche didattiche Forma i gruppi di lavoro Raccoglie aspettativa ed esigenze dei discenti Lesson Inquadra la lezione all’interno del corso Utilizza un linguaggio pertinente chiaro e preciso Descrive logicamente le fasi del modello formativo Sceglie le tecniche educative ed adegua il linguaggio tenendo conto del contesto Mantiene lucidità e disponibilità nonostante le interruzioni Utilizza la mimica e la gestualità per mettersi in contatto con i discenti Model Descrive i materiali in modo esauriente Illustra adeguatamente le manovre da compiere Organizza esercitazioni di gruppo Esegue una valutazione sui singoli stimolandoli a far meglio Mantiene un atteggiamento paritetico con il discente durante la spiegazione Ripone i materiali al termine della simulazione He offer to participants He encourages the message among the participants He creates a confortable atmosphere He shows the educational metods ed tecniques He consitutes the work’s groups He gets in prospects and demands of participants He frames the lesson into the course He uses a properly and intelligible language He describes logically the steps of formative example He choose the educational techniques and adjusts the language esteeming the framework He is mindful and receptive although the breakings He uses the pantomime and motions to network the participants He describes the materials in exhaustive way He shows propery the handlings to observe He organizes the group’s exercises He accomplishes an evaluation about singles exciting them to make better He keeps an equal attitude toward the participant through the lesson He puts back the materials after the model

11 The supervision during the formative moments: a continuous formation for practitioners in Italy. As regards to the experts of the medical specialties this has allowed the Scientific Society to understand better personal motivations, didactic ability and knowledges of the single professionals and to begin to word a list of the most suitable colleagues to intervene in our formative moments.

12 The supervision during the formative moments: a continuous formation for practitioners in Italy. I thank for your attention and let you work

13 Evaluation about Score 0 Score 1 Score 2 Score 3 Score 4 Introduction nothingnot much partiallyvery much fully Il materiale di autoapprendimento mi è sembrato utile e ben congegnato Il facilitatore ha illustrato i metodi e le tecniche didattiche Il facilitatore ha formato i gruppi di lavoro Il facilitatore ha raccolto aspettativa ed esigenze dei discenti Il docente ha creato un atmosfera adeguata Il docente ha favorito la comunicazione tra i discenti Knoledgment 7. Il docente ha inquadrato la lezione all’interno del corso Il docente ha utilizzato un linguaggio pertinente chiaro e preciso Il docente ha descritto logicamente le fasi del modello formativo Il docente ha scelto le tecniche educative ed adeguato il linguaggio tenendo conto del contesto Il tempo dedicato all’apprendimento delle conoscenze è stato congruo Il docente ha risposto alle domande che gli sono state rivolte in modo chiaro ed esauriente Ability Il facilitatore ha descritto i materiali utilizzati in modo esauriente Il docente ha illustrato adeguatamente le manovre tecniche o le fasi della simulazione clinica da compiere Il facilitatore ha supportato i gruppi risolvendo i problemi e richiamando l’attenzione del docente sulle problematiche tipicamente del medico di medicina generale Il docente ha eseguito una valutazione sui singoli stimolandoli a far meglio Il docente ha mantenuto un atteggiamento paritetico con il discente durante la spiegazione Il tempo dedicato alle abilità pratiche è stato congruo Please before the evaluation say your satisfaction about the organization 1) The atmosphere used for the knowledge was warm and appropriate? Yes Not Why? 2) The hotel’s treatment was ad just? Yes Not Why? The self-knoledge’s material appeared useful and workmanlike The facilitator showed educational methods and techniques The facilitator created some bevy for work The facilitator gathered furloughs and needs of participants The teacher created an adjust atmosphere The teacher countenanced the communication between the partecipants The teacher placet the lesson into the meeting. The teacher used a suitable,clear and accurate language The teacher logical decribed the steps of pedagogy The teacher choosed the pedagogical tecniques and adjusted the language seeing the setting The time devoted to learning of skills was congruent The teacher answered plain and exhaustive The facilitator exhaustive described the used materials The teacher adeguately showed the tecniques or the steps of a clinic simulation to complete The facilitator supported the groups finding a solution to the troubles and refering the teacher about the typical problems of family phisician The teacher evaluated a singles encouraging them to make better The teacher had an equal conduct with the partecipants during the oral interpretation The time devoted to practice abilities was congruent

14 The supervision during the formative moments: a continuous formation for practitioners in Italy.