SH RADSC Residency Faculty Repository by LCY

Mission & Vision

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V: We nurture doctors into leaders in medical imaging, always bettering clinical care.

M: A people-first approach to higher medical education, emphasising on:

Accountable competency-based training curriculum though collaborations
Enabling innovations though a conducive learning culture and working environment
Professionalism though role modelling and reflective learning

Rules of Engagement

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Always be attentive to each other’s concerns and doubts
Trust each other’s intentions
Keep an open mind, emphatic to other views
Be non-judgemental, always something to learn
Make the process fun and get to know each other better, keep a positive spirit
Keep the hierarchy flat as much as possible, be inclusive

Structure

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Learning Strategy

Wendy Cheong, Joel Liu, Elizabeth Cheong, May Lim, Gary Gu, Ngoo Yongmin

Learning Environment

Sivashanker Subramaniam, Huang Hian Liang, Thida Win, Kelvin Koh, Wong Hui Lin, Jocelyn Sim

Academic Growth

Tan Min-On, Tang Phua Hwee, Jasmine Chua, Tan Tien Jin, Amanda Liew, Tan Jee Cheng, Sherrie Leong

Faculty Development

Ranu Taneja, Ganti Srujana, Shaun Previn, Charlene Ng

Resident's Exco Committee

CR: Audrey Chia, Martin Wong

Subspecialty CF / SR Teams

ABD - WHL/RTA, BRE - LLF, CTR - TMN, MSK - CLR/SSU, NRL - SPA/KKK, NUC - HHL, PAE - THW, URS - CHL/KSX, VIR - CME, GEN - KSX

Stakeholders

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GME Office

DIO: Prof Tan Hak Koon

RAC Committee
Chair: A/Prof Andrew Tan, other radiology PDs in NHG and NUHS

RADSC ACP
Chair: A/Prof Andrew Tan; Education Vice-Chair: Dr Yu Wai Yung; HODs of all departments
College of Radiologists Singapore
Chair: A/Prof Andrew Tan

Competency Based Education

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Basic Concepts to Outcome and Competency Based Education.

We use the 6 ACGME Core Competencies:

Patient Care (PC)
Medical Knowledge (MK)
System Based Practice (SBP)
Practice Based Learning & Improvement (PBLI)
Professionalism (Prof)
Interpersonal Skills & Communications (ICS)

CMBE = “an outcomes-based approach to the design, implementation, assessment and evaluation of a medical education program using an organizing framework of competencies”.

CBME in PGME

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“In a traditional educational system, the unit of progression is time and it is teacher-centered. In a CBET system, the unit of progression is mastery of specific knowledge and skills and is learner-centered.”

Core Components:

Outcome Competencies: Competencies required for practice are clearly articulated.
Sequenced Progressively: Competencies are arranged progressively.
Tailored Learning Experiences: Learning experiences facilitate the progressive development of competencies.
Competency Focused Instructions: Teaching practices promote the progressive development of competencies.
Programmatic Assessment: Assessment practices support and document the progressive development ofcompetencies.

Radiology Milestones 2.0

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Milestones are simply a significant point in development. They can enable the learner and the program determine individual trajectories of professional development in narrative terms

Radiology Milestones 2.0 Supplementary Guide

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Elaboration of Radiology Milestones

Training Structure Overview

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A. Work Place Learning (Clinical Rotations)

Y1: Foundational Rotations
Y2-3: Intermediate Skills & Early Subspecialty Exposure
Y4-5: Advanced Skills & Deep Subspecialty Exposure

Year 1 -4: 7 x ABD, 4 x NRL, 6 x MSK, 4 x MAM, 3 x PAE, 3 x GEN, 5 x THO, 2 x ENT, 4 x VIR, 4 x ULS, 3 x NUC, 3 x ELE
Year 5: 4 x 3 monthly Subspecialty Rotations including 1 cross cluster

B. Structured Learning

National Didactic Lectures under CRS - R1-4 depending of schedule
Department Learning Events (DLE) - 16 sessions per week as declared by departments

MOH PTT Funding Guidelines

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Each department to designate 16 hours of Department Learning Activities (DLE) per month. Minimum 70% attendance. Residents are free to attend DLEs from any Singhealth site to hit attendance requirement. 1 national didactic session may also count as 1 DLE session.

E-modules hosted on google classroom (code: vyghj73), will NOT count to PTT wet Jul 2023 onwards.

Overview

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Summative Assessments

FRCR Exams
SOEE (expiring)
DXIT(unknown status after APMES)

Formative Assessments

End of Rotation Assessment (E1)
360 Evaluation (E4)
Entrustable Professional Activities (EPAs)
Portfolio / Logbooks

All assessment data to be captured via Medhub and reviewed at 3 monthly CCC meetings. Feedback provided to residents at semi-annual reviews by PD and mid posting reviews by CF.

New E1 End of Rotation Forms

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Data will feed directly to milestone collection.

New E4 (360) Form

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Likert Scale for ease of understanding. 3 monthly to radiographers / nurses / peers.

Appraisal Model

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Capped at 30% outstanding / exceed expectations per cohort
Paper exercise using collected data via E1 forms
2 Stage scoring system

Faculty Scholarly Activities

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All Core Faculty members aim to hit 3 x scholarly activities each year as part of role modelling.

AMEI Educator Develoment Framework

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Videos: https://www.youtube.com/playlist?list=PL3EqS2fXwIhf5qIrCILxkgdBBlVzQl518

Optimising Our CCC

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Basics Nuts & Bolts of EPAs

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Units of Professional Practice (Tasks) that may be entrusted to a learner to execute unsupervised, once he or she has demonstrated required competency.

EPAs: Essential units of professional practice (eg. counselling patient, insertion of central line, resuscitation)
Competencies: Knowledge, skills, attitudes, values (eg. communication skills, medical knowledge)

Entrustment Based Discussions

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5 levels of entrustment:

Observation
Direct Supervision
Indirect Supervision
Oversight / Distant Supervision
Supervise Others

12 Tips of EPA Implementation

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Tips for supervising clinicians:

Talking to learners about trust
Using EPA descriptions to guide learning and teaching
Providing learners with greater ad hoc responsibilities
Using EPAs to identify/create opportunities for assessment and feedback
Including case-based discussions
Acknowledging gut feelings about learner readiness for more autonomy

Tips for curriculum leaders:

Enabling the trust development
Applying trust decisions at all levels of the supervision scale
Employing all available information sources for entrustment
Empowering learner ownership of the assessment process
Using technology for learner tracking
Use aggregate data as metric for program evaluation

Core Components of EPA Implementation

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Performance prediction
Shared local mental model
Workplace assessment
High-stakes entrustment decisions
Outcomes based
Value of the collective
Informed clinical competency committee members
Construct alignment
Qualitative data
Entrustment decision consequences

R2C2 Feedback Model

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R2C2 Instructional Video

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R2CR Tri-fold Handout

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Applying Science of Learning to Health Professions Education

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Overview of Evaluation Parameters

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Resident / Faculty Wellbeing

ACGME-I Well-being Survey

Resident Performance

Promotion / Progression
Scholarly Activities
QI Participation

Faculty Performance

Faculty Scholarly Activities
Faculty Development Participation
Faculty Evaluation by residents (E5)

Graduate Performance

Graduate Survey (Graduates) & (HOD)

Programme Quality

Annual Programme Evaluation by Faculty (E6A) and Residents (E6B)
Rotation Evaluation (E7)
ACGME-I Citations

Annual Programme Evaluation & Improvement (APEI)
Singhealth Internal Review

Term of Reference

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Current TOR
1. Reviewing the Diagnostic Radiology Residency Program quality by monitoring and tracking quality indicators for

a) Resident Performance
Using faculty evaluations of residents, 360 degree evaluations, residents’ scholarly activity, residents’ attendance at various didactic teaching sessions, duty hours monitoring, in training exam results, professional exam (FRCR, MMed) results.

b) Faculty Performance
Using resident evaluations of faculty, faculty scholarly activity, teaching activities, faculty attendance of faculty development courses/conferences.

c) Graduate Performance
Using graduate survey results.

d) Program Quality
Using evaluations of the residency program by the faculty and residents, evaluation of subspecialty rotations by residents, resident survey on national didactic lectures, resident survey on Monday evening didactic teaching, results of internal reviews, GMEC/RAC/ACGME-I communications, and ACGME-I resident survey results if any.

2. Addressing and ensuring that areas of non-compliance with ACGME-I requirements are corrected.

3. Conducting an annual review of program curriculum and overall educational goals of the program.

4. Preparing an annual summative evaluation of the quality of the residency program, and making specific recommendations/action plans as necessary for its improvement.

The committee meets annually.

Proposed New TOR

Contribute to continuous quality control and improvement of residency program by:

Review all available qualitative and qualitative data pertaining to resident performance, faculty performance, graduate performance and external audit (ACGME/GME)
Assess whether the program is meeting educational goals, aligned with mission and vision
Evaluate and advise on the process of program evaluation
Prepare annual evaluation report (program to provide semi-annual progress report to PEC)

PEC Committee Members

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Chair: Education Vice Chair RADSC ACP
Vice-Chair: Tan Tien Jin
Members: All CFs in quality subcommittee, PD/APDs, 5 residents from residency exco, 3 HOD nominated physician faculty

Overview of Meeting Schedules

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4 Faculty Meetings Per Year

Mar - Core Faculty Mini-CCC Meeting (Physical / All CF)
Jun - Combined Faculty CCC Meeting (Virtual / All CF + optional site reps)
Sep - Core Faculty Mini-CCC Meeting (Physical / All CF)
Dec - Combined Faculty CCC Meeting (Virtual / All CF + optional site reps)

2 CF-Site Rep Meetings Per Year

Before Combined Faculty CCC Meeting (Jun & Dec)

Core Faculty Mini-CCC Meetings

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2025 Dates: 25 Mar 2025 and 30 Sep 2025

Time: 2pm-6pm

Venue: Outram Campus Academia

Agenda for Meeting:

Subcommittee Updates
Workplan Management
Strategic Planning
Short CCC Review

Combined Faculty CCC Meeting

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2025 Dates: 27 May 2025 and 2 Dec 2025

Time: 2pm-6pm

Venue: Zoom

Agenda for Meeting:

CCC milestones review
Program updates and feedback
Short followup on important workplaces

CF-Site Rep Meetings

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Date/Time: To be planned by CF, at least 1 week before Combined Faculty CCC Meetings (twice yearly)

Agenda:

Performance of residents in subspecialty rotations for last 6 months
Review of rotation feedback
Update curriculum and SRLE

Approved SG Radiology EPAs

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MOH EPA Resource Guide

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APMES Introduction

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Local program accreditation model replacing ACGME-I in 2023.

Cycle of WBA

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Tentative Posting Roadmap with EPA Schedule

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An Updated Primer on Entrustable Professional Activities (EPAs)

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1st MOH recommended primer on EPAs, good to give general overview to residents and physician faculty.

Ingredients of Rich Entrustment Decision

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Entrustment decisions stem from judgments of a trainee’s competence and include the permission to act with a higher level of responsibility or autonomy and a lower level of supervision.
Making entrustment decisions differs from regular assessment of trainees, which usually has no consequences beyond marking trainee progress.

5 factors for consideration in entrustment decision making:

Capability (specific knowledge, skills, experience, situational awareness)
Integrity (truthful, benevolent, patient-centered)
Reliability (conscientious, predictable, accountable, responsible)
Humility (recognizes limits, asks for help, receptive to feedback)
Agency (proactive toward work, team, safety, personal development)

Recommended Description / Components of an EPA

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Title
Specification and limitations
Risks in case of failure
Most relevant competency domains; knowledge
Skills, attitudes and experiences
Information sources to assess progress and support summative entrustment;
Entrustment/supervision level expected at which stage of training
Time period to expiration if not practiced

Infographics For EPA Implementation in SH Rad Residency

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EPA Schedule Mapped to Rotations

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Core Faculty FTE

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Programmes are required to submit to GME the faculty FTE declaration and supporting documents (i.e. dept rosters) every 6 months.
Prior to submission, we will need to review the dept rosters to ensure that it tallies with the PET and SET hours stated in the declaration file.
All faculty’s FTE declaration will also need to be endorsed by the HODs.
List of PET: Continuity clinics, simulator training, case-based teaching, residency journal club, core lectures, tutorials, workshops, operative simulation, faculty supervising resident performing operation in OT, administrative work related to residency training.
List of SET: Ward rounds, exit rounds, consults, specialty clinics, teaching resident while faculty performs surgery in OT.

R1 Orientation Slides on Structure of Program Curriculum

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Resident Guidebook 2024

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Abdomen Rotation

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Breast Rotation

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Cardiothoracic Rotation

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General Rotation

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Musculoskeletal Rotation

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Neurology & HN Rotation

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Nuclear Med Rotation

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Pediatrics Rotation

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Ultrasound Rotation

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Vascular & IR Rotation

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New Rotation Plan for AY2025

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