LOP | ENG

The GP training largely consist of learning on the job.

Prerequisite for a future-proof education.

Links to document in Dutch.

Links to document in Dutch.

Prerequisite for a future-proof education.

The GP training programme prepares the GP's of tomorrow.

Self-directed learning is the process of planning and consciously adjusting learning.

GP supervisors, internship supervisors and teachers play a central role...

Seeing each other at work, asking questions and giving feedback is essential.

Balans tussen ruimte en kaders

Progress meetings as a moment for reflection, assessment and planning.

Balance between room and frameworks.

Do you want to use this dialogue poster? Do you have any suggestions?

Topics for discussion

Teacher

• What does the slogan 'Responsible Trust' mean to you?
• How do you give trust?
• How do you experience trust?
• You are part of the triangle. What does that mean for you? What do you need to be a part?
• How visible are you to the GP trainee and supervisor/other supervisors?
• How is the GP trainee visible to you?
• How do you create room for the development of the GP trainee in the academic programme during the release days?

Topics for discussion

GP trainee

• What does the slogan 'Responsible Trust' mean to you?
• You are part of 'the triangle'. What does that mean for you? What do you need to be a part?
• How much room do you experience in your education?
• How do you make choices in your education and what helps you to do so?
• What challenges you?
• How visible are you to your GP-supervisor, other supervisors and/or teachers?

The GP training programme consists (in time) of approximately 80% practice learning; approximately 20% of the time is course education, organised by the training centre. Trainees learn with and from each other, with and from their supervisors and teachers, and through self-study. The specific care and knowledge networks in which those involved (trainees, supervisors, teachers, patients, etc.) learn, work and collaborate determine the possibilities for learning. Topics for discussion:

• What happens where in your training programme regarding learning and working?
• How are learning and working in different places in your training programme connected? The supporting role of technology should also be considered.
• What is needed to work and learn in the care and learning networks within your training programme?
• How do you ensure continuity, patient safety and patient comfort?

STARTING POINT

The practice and GP Training Centre are hubs in a larger network.

Zie LOP H3, par 3.1

Self-directed learning is the process of planning and consciously adjusting learning during the development of a GP. Strong positioning of self-directed learning within the training programme contributes to intrinsic motivation for the trainee's active and in-depth development, even after the training programme.Self-directed learning takes place within the framework of the training programme. Self-direction within the training programme occurs in interaction with others: co-regulation of learning. Topics for discussion:

• What room for self-direction does your programme offer? Is there enough room?

• What promotes your intrinsic motivation? What not?
• How do you differentiate between co-regulation, external steering and control?

STARTING POINT

Self-directed contributes to the trainee's development into a future-proof GP.

Zie LOP H3, par 3.3

A balance between room and frameworksWe strive for a programme where trainees experience a balance between clear frameworks on the one hand, and sufficient room to become responsible members of the profession in their own way on the other, to contribute to the qualification, socialisation and subjectification of trainees. In this NEP, we call that balance 'Responsible Trust':

• Trust in the motivation and responsibility of the trainee to become a GP.
• Trust in the programme conditions that challenge trainees.

Trust is responsible because...

• … we continuously work on the professionalisation of all stakeholders
• … we continuously work on constructive training relationships and on developing an environment in which it is impossible not to learn
• … we provide development-oriented and normative progress interviews

Responsible Trust

GP supervisors, internship supervisors and teachers are key players in ensuring a development-oriented learning environment. The professional development of GP supervisors, internship supervisors and teachers is based on self-direction (similar to trainees) within a learning organisation. The competence profiles of supervisors and teacher provide the frameworks. In the context of the starting points of the National Education Programme (NEP), topics for the professional development plans of supervisors and teachers are defined. Topics for discussion:

• How do you get a picture of your own competencies based on the profile of supervisor/teacher?
• What topics would you like to address in your professional development?

• What suggestions do you have for professional development of and with others?

STARTING POINT

Skilled supervisors and teachers ensure a good education.

Zie LOP H3, par 3.5

To achieve the desired and necessary diversity of healthcare providers, we must ensure that physicians with all possible backgrounds want to and can become GPs. This requires a welcoming, inclusive training programme with equal opportunities for all GP trainees. Therefore, people who work in the GP training programme need to be more aware of implicit assumptions and unintentional exclusion. A greater diversity of trainees, supervisors and teachers, increases the quality of the training programme by learning with and from each other to provide appropriate care to a diverse group of patients. Topics for discussion:

• How do you and your training centre promote inclusivity, diversity and equity of opportunity?
• Are you familiar with the 'Implementation Plan - Innovations for an inclusive learning climate in the Dutch general practitioner training'? It can be requested from Dutch Specialty Training Amsterdam UMC, location AMC, by sending an email to:info.huisartsgeneeskunde@amc.uva.nl

Inclusiveness, diversity and equity of opportunities

Zie LOP H2

The GP training programme educates tomorrow's GPs: GPs who are flexible, resilient and take charge of their work. At the end of the programme, the trainee can independently provide GP care in a dynamic society. This requires the trainee to develop broadly.To contribute to this broad development, we need a wide vision on our training programme. We find such vision in the work of the leading contemporary educational philosopher Biesta. According to Biesta, every programme contributes to three target domains: qualification, socialisation and subjectification.Competencies and Themes are the frameworks within which the trainee grows as a professional, a member of the profession and an individual. All three target domains can fully develop, if we create the right conditions. Therefore, in the NEP, the target domains are shaped and elaborated in the five starting points of the training programme.

The end point: The GP

Zie LOP H2

Seeing each other at work, mutual questioning, and feedback are indispensable for training. The National Education Programme (NEP) defines this as 'mutual visibility within constructive training relationships'. To appear visible in constructive training relationships requires both challenges and security from the trainee, supervisor and teacher. In the trainee-supervisor-teacher triangle, the teacher and the supervisor mutually support the trainee and each other. Trainee and supervisor observe each other in their work and learn from each other. In addtion to daily educational meetings, the NEP emphasises the importance of weekly mutually observed consultation hours (taking turns). The trainee also learns by observing and questioning the supervisor, teachers, and peers and by being observed and questioned by - and getting feedback from - the supervisor, teachers and peers. Topics for discussion:

• In your programme, how are roles divided within the triangle?
• How do all involved in your programme balance challenges and safety?
• What do you need to make the consultation hours (taking turns) successful?
• When would you consider the training relationship constructive?

STARTING POINT

Training is based on mutual visibility and dialogue within constructive training relationships.

Zie LOP H3, par 3.2

Balans tussen ruimte en kaders

Om bij te dragen aan de kwalificatie, socialisatie en subjectificatie van aios streven we naar een opleiding waar aios een balans ervaren tussen enerzijds heldere kaders en anderzijds voldoende ruimte om op hun eigen manier een verantwoordelijk lid van de beroepsgroep te worden. In dit LOP noemen we die balans Verantwoord vertrouwen:

• Vertrouwen op motivatie en verantwoordelijkheid van de aios om zicht te ontwikkelen tot huisarts.
• Vertrouwen op opleidingscondities die aios uitdagen.

Vertrouwen is verantwoord omdat…

• … we continu werken aan de professionalisering van alle betrokkenen
• … we continu werken aan aan constructieve opleidingsrelaties en aan de ontwikkeling van een materiële omgeving waarin het onmogelijk is om niet te leren
• … we zorgen voor ontwikkelingsgerichte én normerende voortgangsgesprekken

Do you want to use this dialogue poster?

1. The dialogue poster is also available as a printable PDF

2. Do you want to use elementes/parts of this poster? Please contact: communicatie@huisartsopleiding.nl

3. Do you have any suggestions for challenging or suggestions on how to use this dialogue poster? Please contact: onderwijs@huisartsopleiding.nl

Developments in society and the GP profession have consequences for how we train GPs. An adaptive ability to keep up with the times is required from trainees and the training programme. Within the frameworks of the competency profile and the 10 Themes, there needs to be room for self-direction and freedom of choice. Curriculum development is an ongoing process that requires structural room for current developments and innovation.

Zie LOP H1 en H2

Room for development

• Sustainability and Planetary Health
• Ageing
• Tightness in the labour market/healthcare
• Diversity in healthcare and among healthcare providers
• Technological developments, such as e-health and artificial intelligence
• People-centered care from a broader perspective on health and disease
• Developments in the fiels of individual prevention

Developments that require room in the development of this NEP current training programme (in random order):

Topics for discussion:

• How do new subjects find their way into your training programme?
• What room for self-direction and choice does your training programme offer?
• What room for self-direction and freedom of choice do trainees experience in your training programme?

Topics for discussion

Supervisor

• What does the slogan 'Responsible Trust' mean to you?
• How do you give trust?
• How do you experience trust?
• You are part of the triangle. What does that mean for you? What do you need to be a part?
• How are you visible to trainees and teachers?
• How is the trainee visible to you?
• How do you create room for the development of the trainee in your practice?

Assessing is about making regular statements about the competence level and the pace of competency development. This is a task of supervisors and teachers. Decision-making, as a progress decision, concerns continuation and completion of the training programme. This is the task of the head of the training centre. Key in this decision-making is whether the trainee, in the remaining training time, is expected to develop adequate competencies - within the 10 Themes - to independently provide general medical care at the end of the training programme. The progress decision is based on the expert judgements of supervisors and teachers. Topics for discussion:

• How do you form a picture of yourself/your trainee?

• As an expert, how do you maintain a sound judgment and advice?
• How do you keep your assessment and decision-making development-oriented?
• How can you organise progress interviews as tripartite meetings as much as possible?

STARTING POINT

Assessment and decision-making both have developmental and normative functions.

Zie LOP H3, par 3.4

The 4 pillars

IMAGE OF THE TRAINEE

PROGRESS MEETING

EXPERT JUDGMENT

SAFETY NET

Image of the GP trainee: Trainee, supervisor and teacher make agreements about visibility in practice, with or without targeted observation instruments or tests.

Expert opinion of supervisor, teacher and GP trainee: they express their view upon the trainee based on their own role and expertise.

Safety net: in case of doubt about the level of competence and/or insufficient imaging of this, the GP trainee is asked to substantiate his or her competence development, with the ultimate variant being the intensive supervision trajectory.

Progress meetings in the triangel in which the GP trainee, supervisor and teacher jointly look back on the past period, construct their assessment of the competencies and plan activities for further development.