A Guide to Remote Medic CPD learning on the Job
At Medilink, we give high priority to ensuring our remote medical staff have the support and opportunities to foster their Continuing Professional Development (CPD), pre, during and post their assignments. We realise that however prepared you are on paper, your first time in the field may prove the most difficult to plan for and cope with.
At the outset, for example, it can be difficult to differentiate among the various roles and responsibilities of your topside clinical team members. However, unlike working in a hospital or an ambulance service, you will always know where your clinical supervisor is, round the clock. That will be immensely reassuring as you carry out your duties.
It is important to get the most out of every day during your stint on rotation. The trick is to be proactive, get involved, keep up with the pace and learn how to make the most of your colleagues’ expertise as an educational resource.
With some planning, every deployment, and each part of your daily routine on a remote site, can be to your advantage. For example, morning clinics are excellent opportunities to keep up to date with medical histories and perform examinations for a whole set of occupational screenings.
On a remote site, you can maximise learning opportunities by making a daily plan with the other onsite medics. If you are left with some slack time while on clinic duty, you could tactfully ask your colleagues to discuss their patient medical histories. This extra homework will pay off: patients are often more open when talking to a remote medic that is thorough, and this makes you a vital member of the team.
Create a Culture of Learning
Early on in a rotation, you must consider when, what, and how you are going to learn. Many remote medics expect to learn by osmosis. You may be motivated initially, but without an impetus such as setting specific time aside to read up on patients’ notes or the commitment of signing up for an online course, you may find your motivation to learn wanes rapidly. When you adapt, however, you may find that the new, interactive learning style suits you better.
Be Inventive in Finding Learning Opportunities
The benefits of learning in a clinical environment is that you can make your own learning plans and can structure your own time, which is ultimately the way you’ll be learning for the rest of your life.
As a remote medic, your main aim is to gain confidence in the clinical practice, however, it can be difficult to structure your learning, and you will need to be creative in searching for learning opportunities. Many new remote medics spend time revising courses such as ACLS or PHTLS, covering areas such as “chest pain” or “blunt trauma”, but be aware that trying to find even a slightly similar case when working on a remote site may prove difficult.
Occupational health screenings of indigenous workers at start of a project are theoretically ideal learning opportunities, but, in reality, can be pressured and not conducive to quality patient discussion.
Good places to gain greater insights into patients’ needs on site can be the smoking, weight loss or well-man clinics. Here, the slower turnover of patients means you should be able to find what you are looking for.
Develop Clinical Skills
Apart from daily practise in the clinic, try occasional muster drills with willing patients and a “study buddy”. Give yourself the same amount of time for history taking and examination as in your ACLS or PHTLS moulages; this will ensure that you become comfortable with the rather limited and inflexible structure of these assessments.
If it feels strange to be examining outside of the given specialty you are studying under, it is probably because you are not confident enough. Persevere with pushing yourself outside your comfort zone.
The step between practising skills on a medical manikin and treating a patient is a big one, and you need to bridge the gap with someone who has the tacit knowledge and experience of working on a remote site.
It is important to remember that your role is to learn all the time. If you have not yet proved your competence to the client on site, offer to observe or assist on emergency drills; in this way, you can familiarise yourself with the equipment and techniques and can ask questions to clarify your understanding. Don’t worry if you fail at performing a skill. Sometimes the only way to learn is by making mistakes, and these are best made when you have the excuse of being an active member of the emergency response drills.
Keep Your Knowledge Up to Date
Companies providing remote medics which demonstrate a lack of educational direction are not acceptable in today’s market. However, you must remember that clinical experience is your responsibility. It is though more than acceptable to request supportive CPD from your employer to ensure you are current with their protocols and procedures.
Finding the time and energy to factor in book or online learning can be hard after a long, busy day. Some remote medics find their skills slipping as they enter their second or third year of rotation and by the time they do their offshore medics refresher, ACLS or PHTLS, they may feel less than confident.
As soon as you rotate into a new remote site, your topside provider will begin to test your knowledge. Do not get upset if you cannot answer all their questions. The reason topside doctors ask tough questions is to assess whether you are studying at a basic level and whether you will be safe as a remote medic.
Try to keep a running list of unfamiliar drugs, questions you couldn’t answer, and conditions you should read up on. It is also a good idea to keep shorthand notes if another remote medic teaches you a trick of the trade; these hands me down tips are invaluable. Use the time travelling home to review your running list from the past rotation, consolidate your learning, and prepare for the next period of duty.
Document Your Remote Medic CPD
If you are also a registered healthcare professional, creating a portfolio is a must. Now is an ideal time to explore potential career options and to improve your curriculum vitae. Make the most of downtime time by writing up a case that interested you, working on an audit project, or updating your portfolio.
However, do not overplay your portfolio; most of the projects and presentations done as a remote medic will not count towards your registration. Ensure you make enough to progress, but try not to spend all your free time logging patient encounters and writing reflective reports.
Aim high: try to get published as a remote medic, this will impress your client and potential employers.
Your Priorities at a Remote Site
Patients come before secondary duties but, conversely, it can feel inappropriate to make your feelings known if you are not busy clinically. However, it is worth voicing concerns if you are to make the most of your limited patient time on your rotations. Some CPD sessions may be your only chance to learn about a specific area of medicine.
Your progression in remote medicine is difficult to anticipate, and remote medics making the transition can become frustrated by their new learning environment. But, remember the positives: for the first time, you can tailor your medical education to suit your learning style.
Remind yourself of the opportunities you have been given in becoming a remote healthcare practitioner, and that you are still training; practice makes perfect. If you have any issues with your rotation, let your topside team know and they will try to assist you. Topside doctors remember how it feels to be in your shoes, but sometimes they need to be reminded.
Suggested Learning Resources
Self-directed learning is a start. As a guide, we list some of the most salient print and online resources to start with.
The ECG Made Easy by John R Hampton, Churchill-Livingston, 2008
Oxford Handbook of Clinical Medicine by Murray Longmore et al, Oxford University Press, 2010
The Oxford Handbook of your current specialty (from the library)
The BNF iPhone app
Kumar and Clark’s Clinical Medicine by Parveen Kumar and Michael Clark, Saunders, 2009
A good revision book on objective structured clinical exams, for example: Macleod’s Clinical Examination by Graham Douglas et al, Churchill-Livingston, 2009 (comes with a demonstrative DVD)
Pocket Prescriber by Timothy Nicholson, Ashan Gunarathne and Donald Singer, Hodder Arnold, 2010