When using instruments or conducting physical examinations, performs actions in a rational sequence Techniques to adjust your own teaching style to suit the individual as well the subject, being aware that not every individual will learn in the same way Psychosocial, cultural, political, economic and other social determinants affecting evidence-based practice To become an effective and efficient professional learner, it is important to develop the habit of embedding your learning and continuing professional development (CPD) into your daily practice (in all your roles), adapting your approaches to your personal development aims and the context in which you work. Drug switching may be externally recommended (for example, by specialists or Clinical Commissioning Groups) for quality reasons such as efficacy or efficiency. Consider the impact of drug switching in the patient's best interest and the impact of cost saving on the wider system

The main point is to show how real educational needs and their solution can be drawn from everyday practice, and can open out more fields. Once the local librarian is consulted, she will be a recognised resource and probably used again. Showing the application of this way to learning can open the concept of the method as well as demonstrating how the detail of learning needs can be defined. The process of reflective learning Equality and diversity encourages the promotion of inclusion as well as protects employment rights. It is important to be able to raise issues and challenge colleagues should any behaviour lead to discrimination. Safe and effective prescribing also requires an understanding of the organisational systems in place for medication prescribing, issuing, monitoring and review: Working with patients and carers and promoting an organisational culture that allows them and all staff to be honest and raise concerns openly is essential. Some patient groups may be more at risk due to characteristics such as language, literacy, culture and health beliefs. The complete learner possesses the ability to pass through all the stages with equal facility, but most people have a preferred learning style. The style is preferred or dominant not exclusive. We each enter the circle at the point of our own preference and move according to our needs and circumstances. In some instances, the learner just learns in the one style and sees no need to move. In medicine, this would be difficult, but not impossible.

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Chapter Introduction -- chapter 1 Why bother with learning? -- chapter 2 Finding time for learning -- chapter 3 Discovering learning needs with PUNs and DENs -- chapter 4 Examples of reflective learning -- chapter 5 Research to reality -- chapter 6 Sharing PUNs and DENs -- chapter 7 From PUNs and DENs to PDPs And recognition of deficiencies leads to the discovery of Doctors’ Educational Needs DENs. When you discover Patients’ Unmet Needs you have found your first PUN, leading you on to then construct your DEN. Record each PUN in a log showing date, patient age. sex and ID, description of the PUN and the group it falls into. For effective learning to occur, a learner needs to feel comfortable with the method, a personalised plan with the method tailored to the preferred style is likely to achieve this. Leading and managing improvement in healthcare systems is just as important as, and complementary to, acting on behalf of an individual patient.

A comprehensive understanding of local services and patient pathways, to enable timely and appropriate referrals It is important to apply effective strategies for communicating about and reducing the risk of dependency or addiction to medicines where this may occur (for example, opioids, benzodiazepines, GABA drugs) as well as supporting and managing patients who have become dependent on medications, seeking specialist advice and intervention when appropriate It can be harder to carry out quality improvements in secondary care in a short timescale due to the larger scale and complexity of the organisation – but it is possible to become involved with how changes are introduced. If you have the opportunity to speak to or shadow someone introducing a project you can learn from observing how service changes can be carried out even in a large organisation. Self-directed learning and formal learning The GMC Generic Capabilities Framework (2017) included the domain of 'Capabilities in Leadership and Team working'. This requires doctors in training to demonstrate that they can lead and work effectively in teams by: It doesn’t matter what type and volume of work you’ve been doing (whether you’ve been doing telephone triage, OOH only, admin support only, prison work, etc)

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Applicability of population-level studies to individuals and certain groups (for example, groups commonly excluded from clinical trials, disadvantaged groups)

simple (symmetrical, skewed) distributions, scatter diagrams, box plots, forest plots, funnel plots, statistical process control charts, Cates diagrams, decision aids Works in partnership with the patient and carers or relatives, finding common ground to develop a shared management plan Focused history-taking, targeted questioning and examination to obtain sufficient relevant information to diagnose, manage and refer appropriately

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Firstly, the return of appraisal can be looked at as a positive thing, with NHS England and the GMC stating that appraisal this year should be focused on the health and wellbeing of staff, rather than on the usual CPD credits. Testing has indicated that the whole appraisal preparation should take just over 30 minutes to complete, which is a major reduction on the usual time we all dedicate to getting our appraisal up to scratch. At times patients’ needs may not be fully met because, for example. you are unable to tell them the times when the Special Clinic is open, don’t know who is the best surgeon for referral with impotence, don t know whether they can have free prescriptions. This Non-clinical knowledge PUN is best met by asking, delegation or ensuring that information resources are easily available within the practice. Completing the learning style questionnaire enables the learner to select the method most suited to their preferred style. It will also enable them to make the most of that style, and from the basis of success, develop their other styles.