The Clinical Training and Evaluation Centre, known simply as CTEC, was visionary when it was opened by the Queen 17 years ago on the UWA campus. There was rightly a lot of fanfare then – the facility was the first of its kind in Australia that even today pushes the boundaries of surgical and trauma training both nationally and internationally.
Last year it held just over 260 educational workshops and events and trained 2639 health professionals – 76% of them from WA with the rest coming from various states and New Zealand. While simulation centres have sprung up in other places since, CTEC manages to stay ahead through smart innovation. Locally, it is playing an increasingly important role in the training of junior doctors in the state.
Its director Professor Jeff Hamdorf and senior lecturer Dr Ruth Blackham are set on giving that training real academic and professional clout. Jeff told Medical Forum that he and Ruth were the only funded clinicians at CTEC, while workshops were often run by clinicians on an honorary basis..
“We have been borrowing their expertise for the past 17 years. It’s a very generous thing about our community of doctors. Since Ruth began working at CTEC we have benefited from her academic insight and we’re hoping to break new ground in the next couple of years,” he said.
Training with rigour
“Now, if you go on a course anywhere in the world, you will receive a certificate of participation but that is not a test of your competency or proficiency in any way. So we are developing a platform for academic proficiency in all of our courses. It’s an exciting and certainly challenging process.
“It’s not a simple case of here’s a test – it has to be a validated test that holds meaning to the statutory bodies and others. It must have third party confirmation.”
This certification process began at CTEC a couple of years ago for courses in which the junior doctors considering a surgical career would attend.
“These courses help them apply for surgical training; help give them basic and intermediate skills and we have some validation metrics showing they are competent and proficient in various areas. My aim over the next four years is to promulgate that proficiency assessment through all of our core skills courses.”
“We will be doing this in parallel – each time we review a course we will add that proficiency assessment. It’s a big job but it is good work.”
Medical Forum has reported over the past months on the difficulties interns are experiencing in acquiring the necessary skills to launch them into the next phase of their careers. We have also heard from young doctors who feel vulnerable because they don’t feel they possess the right skills to do their job well.
Support for juniors
Jeff said one response to this was ‘boot camp’, a three-day intensive skills course to prepare brand new interns for life on the wards and CTEC is looking to host this for the first time this year involving academics from other universities.
The JDocs suite of courses is for those looking at a career in surgery. The Royal Australian College of Surgeons has a formidable pre-application checklist of skills and knowledge expected and JDocs works through those items preparing applicants for their best shot at entry.
CTEC has designed a package to meet the need with four skills courses, a professional development day and an exam preparation course. Those courses are booked out in advance and are no walk in the park. The exam preparation alone involves two evening sessions a week over 22 weeks but, as Jeff says, “that’s what you have to do”.
“It doesn’t matter how good our education system or how good the training, it doesn’t seem enough to satisfy the appetite,” Jeff said.
CTEC runs as a not-for-profit with about $1m in funding from the WA Department of Health, registration fees and donations from industry, usually in kind.
“We meet regularly with WA Health on training issues for junior hospital staff, who are predominately its employees. Almost every course we run is subsidised by WA Health, which is strongly supportive of our vision. We are now producing outcomes and some proficiency data, which is fantastic for us and for WA Health because we can go to them and say, ‘here’s proof’.”
Jeff said while the data is useful locally, its effects can be felt more widely. Medicine is a mobile profession, particularly among its junior ranks, and CTEC is a useful recruitment strategy for the Department of Health.
Looking to the future, CTEC is looking at developing a curriculum to help young doctors approach one of the fasting growing operations in the world – a sleeve gastrectomy.
“In 2008 there were 18,000 sleeve gastrectomies performed worldwide, in 2013 there were 172,000 all without a training curriculum or a systematic way of looking at how it is taught. So we are developing our own model so we can teach it in the lab before people learn it on people,” Jeff said.
“Ruth and I have engaged a number of key academics around the world as thoughts leaders and we hope to develop a curriculum and promulgate that through CTEC as a training platform but I don’t want to get the cart too far in front of the horse. This is Ruth’s PhD but to be involved in something that leads to international change and safer practice is just fantastic.”