Dear Louise,

My name is Ramesh Mehay and I am a GP Trainer on the Bradford GP Training Scheme.  I’ve been a trainer for 15+ years and I’m delighted to hear that I will be your mentor for the next 6 months or so.    I hope you are enjoying your start to becoming a new GP Trainer.  It is indeed a fabulous journey and you will learn things that will transform the way you think and work both at home and in the surgery.    And I am honoured to be part of that journey.

I was wondering if you could write back to me with a few dates to arrange the first meeting.  Any suggestions of where?   Somewhere nice would be good.   In the meantime, I’d be grateful if you would look at the 3 items below before we meet.  Both of these things will help with our mentoring sessions.

1. Ram’s Top Ten Educational Pearls
   Have a read of this first document to refresh your mind about some basic educational theory.     Please read it at your own pace.  Perhaps one pearl per day for the next 10 days?   Please highlight anything that you find enlightening,difficult to understand or confusing.   
2. Preparing to be mentored video: 
   This video is only 8 minutes long.  It tells you what mentoring is about and how you can prepare to being mentored.   (If any difficulties, this is the website link:  https://youtu.be/PKtobSOtqcg )
3. New or Intending Trainers Learning Needs
   The second and more important one is a questionnairre which I would like you not to rush through but spend some good time thinking about it before your write things down.  This document helps me truly understand your particular learning needs and in so doing will help me tailor a plan specifically for you. 

Any questions, please get in touch.

Ramesh

My mobile number is…

Homework

I’d be grateful if you would look at the two items below before we meet.  Both of these things will help with our mentoring sessions.

• Ram’s Top Ten Educational Pearls : Have a read of this first document to refresh your mind about some basic educational theory.     Please read it at your own pace.  Perhaps one pearl per day for the next 10 days?   Please highlight anything that you find enlightening,difficult to understand or confusing.   
• New or Intending Trainers Learning Needs : This second and more important one is a questionnairre which I would like you not to rush through but spend some good time thinking about it before your write things down.  This document helps me truly understand your particular learning needs and in so doing will help me tailor a plan specifically for you. 

The Session

Session 1 is incredibly important.  Things you do here lay the foundation for all other sessions.    So, it’s important to get this session right.    Here are some things worth doing.

1. Introductions
   It is so incredibly important that you and your mentee (the new or intending GP trainer in this case) develop a really good natural educational relationship.     This starts of in session 1 but don’t think it ends there.   In gardening, you have to initially sow a seed and water it for it to flower into something beautiful.  But in order to maintain that beauty of that flower, you need to continue to water, nourish and look after it.    The mentor-mentee relationship is the same.   You start by getting to know each other at the first session but then it continues in a naturally occuring fashion throughout other sessions.   For example, at the next meeting, your mentee might have beeing going through a hard time with their mother or had taken a well earn’t holiday to Australia.   Your natural curiosity and genuine interest in the mentee as a person should trigger you to explore a bit more. 
2. Setting objectives –within the available timescales
   This usually involves some sort of educational needs assessment of the mentee.  I usually ask the new/intending trainer to come up with a list of things they have difficulty with and bring them to the first sessions.  There are of course many other ways to do an educational needs assessment.  In doing this you can then effortlessly develop objectives and then determine what can be done within the time you have together.    As an experienced Mentor for new and intending GP trainees, I find that there educational needs usually fall within what I have outlined in sessions 2-6 below.   If not, adapt it!
3. Ground rules, contract, framework for working together
   I don’t do this at the beginning of session 1 but rather towards the second half or at the end.  Why?  Because it’s all the rule-based stuff and I don’t want to come across as a mentor who is rigid and uptight.    And if  I am trying my hardest to create an Educational Environment which is based on creating an atmosphere of openness, honesty and kindness, then doing Ground Rules right at the start would ruin it.    Here’s some of the areas I cover…
   • • Time: Agree when the mentor relationship will end.  For mentoring a new/intending GP trainer, I would suggest that 4-6 months would be a reasonable length of time but it could be shorter or longer.  You can extend the relationship if you both wish or just continue as friends.  Agree how often and how long you’ll meet: e.g. once or twice a month?   Set some preliminary dates for future sessions.
     • How you plan to work together:   
       • 1. Actually, it’s best to discuss this collaboratively with your mentee and come up with a joint plan rather than enforce one upon them.   They need to feel as if they too have contributed to how the sessions should run because then it is less likely they will be disheartened with them. 
         2. Agree on “homework” between sessions.
         3. “I would like you to write reflective learning notes after each session for your appraisal.   I’d be grateful if you could send me a copy of your write up because it helps me to understand what you’re really getting out of the sessions and how I might want to tweak or modify them.    But it is up to you.  How do you feel about that?”
     • Flexibility: Agree whether it is ok to be phoned up or called on if the person you are mentoring has a particular question. Since part of the role is to reassure, it is a good idea to agree to this initially and re-negotiate if it gets out of hand.
     • Confidentiality: Agree that you will not disclose to anyone else what you discuss with the person you are mentoring unless with their agreement. Agree how you will describe the partnership to others, including the head of institution if they ask.
     • Boundaries: You are not responsible for the person you are mentoring, nor for their formal induction. But you can answer questions, fill in the gaps, allay anxieties and give friendly guidance. It isn’t your job to fill in all the gaps left by the formal induction process or to cover everything about GP training possible.
4. A bit of educational stuff
   • • To make sure the new/intending trainer has got something out of today’s session more than just planning, I usually do a bit of GP training stuff at the end.  This usually involves covering The GP Trainee’s Training Map to ensure that they understand exactly how GP training works and their roles and responsibilities before we dive in and look at any of the sub-components in more detail.   Click here to see The GP Trainee’s Training Map webpage.
     • Or I might just browse through the ePortfolio – showing them around and how it differs from the trainee view that they might have been familiar beforehand.    Or I might do both if I am particularly on form.
5. Set homework for the next session
   • • Please send me a copy of your reflective learning notes from this session if you feel comfortable to do so.  Remember, the purpose is to help me provide better mentoring sessions for you as a person.
     • Click on the next session below to see the homework.

Homework:

First of all, please could you send me a copy of your reflective learning notes from last week’s session if you feel comfortable to do so.  Remember, the purpose of this is to help me provide better future mentoring sessions tailored to your needs.

As for the next session, I would like you to read up about Case Based Discussions (CBDs) and have a go at doing one. 

1. There is plenty of reading material on BradfordVTS: www.bradfordvts.co.uk/mrcgp/cbd
2. In particular, have a look that the CBD Question Maker for Trainers.
3. And then have a go at doing several CBDs with a trainee in the practice (or borrow one or even use a recently qualified GP in your surgery to play the trainee).
4. Then as you become more well versed in doing them, video record yourself doing a CBD with a trainee, and bring that video to our next session.

Try not to worry about the videos.  A lot of people get flustered when video work is mentioned.   I hope it reassures you that the video does not need to be perfect and I am not looking for perfection.  We are simply using it as a tool to learn and develop.   So, that means making mistakes or not doing things perfectly is absolutely fine.   In fact, just do what you think you would do.  

The Session

1. What is a CBD?   
   • • What’s it purpose?  What is it trying to measure?
2. In terms of doing some CBDs
   • • How did it go?
     • Did the CBD Question Maker help? 
     • Are there any criteria that you struggle with that you would like us to explore now?
     • How did you find the rating scale?
     • What bits of a CBD do you like?
     • What bits of a CBD do you find difficulty with?
3. Let’s watch your video.   
   • • Watch the video either ALOBA style to using the stop-start method (where you perodically stop the tape to discuss good and not so good bits).
     • We will use your difficulties as the Agenda and add anything else that we see whilst watching.
     • Don’t forget rehearsal of skills.   Get your new/intending trainer to practise some microskills with you acting as the trainee.
     • Practise new trainer giving feedback skills (and educational theory on feedback where necessary)
4. Summarise
   • • A written summary – written as you go along.
     • Done by you or the trainee (the latter is better and get them to email you a copy)
5. Set homework for the next session
   1. • Please send me a copy of your reflective learning notes from this session if you feel comfortable to do so.  
      • Click on the next session below to see the homework

Homework:

First of all, please could you send me a copy of your reflective learning notes from last week’s session if you feel comfortable to do so.  Remember, the purpose of this is to help me provide better future mentoring sessions tailored to your needs.

As for the next session, I would like you to read up about the Constulation Observation Tool (COT) and have a go at doing one. 

1. There is plenty of reading material on BradfordVTS: www.bradfordvts.co.uk/mrcgp/cot
2. In particular, have a look that the COT marking crib – try and understand what each criterion means.   Read the COT criteria – detailed guidance on the above link (under the Downloads section).
3. And then have a go at doing several COTs with a trainee in the practice (or borrow one or even use a recently qualified GP in your surgery to play the trainee).
4. Then as you become more well versed in doing them, video record yourself doing a COT with a trainee, and bring that video to our next session.

Again, remember not to worry too much about the videos.; I understand how worked up people get.    But again, to reassure you that you that  I am not looking for perfection.  We are simply using it as a tool to learn and develop.   This is the ideal place to make mistakes and learn from them.  So, if it doesn’t go well, great!   The more material we have for your learning and development.  

The Session

1. What is a COT?   
   • • What’s it purpose?  What is it trying to measure?
2. In terms of doing some COTs
   • • How did it go?
     • Did the COT criteria detailed guidance document help? 
     • Are there any criteria that you struggle with that you would like us to explore now?
     • How did you find the rating scale?
     • What bits of a COT do you like?
     • What bits of a COT do you find difficulty with?
3. Let’s watch your video.   
   • • Watch the video either ALOBA style to using the stop-start method (where you perodically stop the tape to discuss good and not so good bits).
     • We will use your difficulties as the Agenda and add anything else that we see whilst watching.
     • Don’t forget rehearsal of skills.   Get your new/intending trainer to practise some microskills with you acting as the trainee.
     • Practise new trainer giving feedback skills (and educational theory on feedback where necessary) – often trainers just go through the COT marking crib – giving feedback on every single item starting from the beginning to the end.   Explore different ways of offering this feedback.   For instance, could just focus on the areas to improve if the trainee would like that.  Or just focus on the areas that are part of the trainee’s agenda.  There are lots of ways.
     • Also look at ways of using COT to help the trainee with the CSA.   Consider doing two assessments – COT and CSA.   CSA is simple – Data Gathering (DG), Clinical Skills (CS), IPS (InterPersonal Skills) – and give a mark from 0-3.  [0:Clear Fail; 1:Fail; 2:Pass; 3:Clear Pass].   Compare the marks from the two.   Compare the feedback from the two – do they align?   Do they both pick up the same difficulties?
4. Summarise
   • • A written summary – written as you go along.
     • Done by you or the trainee (the latter is better and get them to email you a copy)
5. Set homework for the next session
   1. • Please send me a copy of your reflective learning notes from this session if you feel comfortable to do so.  
      • Click on the next session below to see the homework

Homework:

First of all, please could you send me a copy of your reflective learning notes from last week’s session if you feel comfortable to do so.  Remember, the purpose of this is to help me provide better future mentoring sessions tailored to your needs.

As for the next session, I would like you to read up about the Random Case Review (which are sometimes called Random Case Analysis), Problem Case Analysis and Debriefs and have a go at doing these with a trainee. 

1. There is plenty of reading material on BradfordVTS:
   • • www.bradfordvts.co.uk/teaching-learning/random-case-analysis
     • www.bradfordvts.co.uk/teaching-learning/debriefs
2. In particular, have a look that the following documents:
   1. • Random Case Analysis – theory and mechanics – try and understand the process.  Also look at the RCGP pages on Random Case Review.   
      • As for debriefs, the powerpoint called Getting you head around debriefing.
3. And then have a go at doing several Random Cases and Debriefs with a trainee in the practice (or borrow one or even use a recently qualified GP in your surgery to play the trainee).
4. Then as you become more well versed in doing them, video record yourself doing a Random Case Review and a Debrief – no more than 20 mins for each.Bring these two videos to our next session.

Again, remember what I said about videos:  I am not looking for perfection!   Rough and ready is absolutely fine!

The Session

1. What is a Random Case Review? 
   • • What’s it purpose?  What is it trying to do or measure?
     • How does it work?
     • What is a Problem Case Review?  
     • What’s the difference between a Random Case and Problem Case analysis/review?  (Think Johari’s window and the blind spot!)
2. In terms of doing some Random Case Reviews
   • • How did it go?  How do you find the process of doing one?
     • What bits of a Random Case do you like?
     • What bits of a Random Case do you find difficulty with?
3. Let’s watch your video.
   • • Watch the video either ALOBA style to using the stop-start method (where you perodically stop the tape to discuss good and not so good bits).
     • We will use your difficulties as the Agenda and add anything else that we see whilst watching.
     • Don’t forget rehearsal of skills.   Get your new/intending trainer to practise some microskills with you acting as the trainee.
     • Practise new trainer giving feedback skills (and educational theory on giving feedback where necessary).

1. What is a Debrief? 
   • • What’s it purpose?  What is it trying to do or measure?
     • How does it work? What is the process of doing a debrief?
     • Debriefing can be done by any qualified GP.   How do you encourage other doctors in the surgery to do debriefs.   What debrief training do you provide for them?
2. In terms of doing some Debriefs
   • • How did it go?
     • What bits of a Debrief do you like?
     • What bits of a Debrief do you find difficulty with?
3. Let’s watch your video.
   • • Watch the video either ALOBA style to using the stop-start method (where you perodically stop the tape to discuss good and not so good bits).
     • We will use your difficulties as the Agenda and add anything else that we see whilst watching.
     • Don’t forget rehearsal of skills.   Get your new/intending trainer to practise some microskills with you acting as the trainee.
     • Practise new trainer giving feedback skills (and educational theory on feedback where necessary)
4. Summarise
   • • A written summary – written as you go along.
     • Done by you or the trainee (the latter is better and get them to email you a copy)
5. Set homework for the next session
   1. • Please send me a copy of your reflective learning notes from this session if you feel comfortable to do so.  
      • Click on the next session below to see the homework

Homework:

First of all, please could you send me a copy of your reflective learning notes from last week’s session if you feel comfortable to do so.  Remember, the purpose of this is to help me provide better future mentoring sessions tailored to your needs.

As for the next session, I would like you to read up about Educational Supervision (ES) and have try and map out what you have to do.  I don’t expect you to do one unless you already have a trainee.

1. There is plenty of reading material on BradfordVTS:
   1. • For an introduction: www.bradfordvts.co.uk/edsupervision
      • For Training for Educational Supervisors: www.bradfordvts.co.uk/edsupervision/es-training
2. In particular, have a look that the ES checklist bradford – try and follow it through and see if it makes sense to you and what you are meant to be doing at each stage of the review.   
3. You will probably need to have a look at a trainee’s ePortfolio too – the ES section – to see how the electronic documentation brings it all together.
4. Write down some of your thoughts and things you want help with and email them to me.  

On the Bradford VTS pages, there is a lot of downloadable resources about Educational Supervision.   I don’t expect you to know all of this stuff from the start.  You will cover all of it as your become a more established trainer.  For now, I just want you to focus on the basics which is outlined on the written section of these pages.   I want you to get to a position where you know something about: -What is ES all about?  What are the components?  What do you have do as an ES?   And how does it fit into the ePortfolio?   That will enable us to focus on the difficult bits when we meet. I hope that sounds like a good plan.   Let me know otherwise. 

The Session

1. What is a ES? 
   • • What’s it purpose?  What is it trying to measure?
     • How does it differ from Clinical Supervision?  Do you know the difference?
2. In terms of doing some ES
   • • Do you understand the step-by-step process of doing an ES review (ESR)?   
     • Did the ES checklist bradford help?
     • Are there any subsections of ES that you struggle with that you would like us to explore now?
     • How did you find the trainee and trainer rating scales?
     • What bits of ES do you like?
     • What bits of ES do you find difficulty with?
3. Discuss feedback skills if needs be
   
   • • How do give the trainee feedback in a way that it is accepted by them rather than rejected
     • Defining outcomes – being SMART (eg for their PDP, the capabilities)
4. Summarise
   • • A written summary – written as you go along.
     • Done by you or the trainee (the latter is better and get them to email you a copy)
5. Set homework for the next session
   1. • Please send me a copy of your reflective learning notes from this session if you feel comfortable to do so.  
      • Click on the next session below to see the homework

Homework:

First of all, please could you send me a copy of your reflective learning notes from last week’s session if you feel comfortable to do so.  Remember, the purpose of this is to help me provide better future mentoring sessions tailored to your needs.

As for the next session, this will be our final session.   Yes, hasn’t the time gone fast.   Do remember though, you can still contact me via phone, email or in person and I would be happy to other discuss things further down the line.   Now, for the next session, I simply want you to think about what we haven’t covered and pick things that you would like us to focus on.  

This is what we have covered so far

• CBDs
• COTS
• Random Case Reviews, Problem Cases
• Debriefs
• Educational Supervision
• Feedback skills

Here are some things you might want us to focus on 

• Navigating the ePorfolio
• Helping trainees with AKT
• Doing CSA practice
• Topic-based Tutorials
• Teaching QIA & SEAs (and the QI project)
• The Practice as a Learning Organisation
• HDR and Trainers’ Workshops
• Trainees in Difficulty
• Preparation for the interview 

Of course, there may be other things not on this list.   Please write down a list of things and send me a copy via email.  I will do my best to make our last session complete the whole process nicely.

The Session

1. Make an Agenda for the session
   • • Use the trainee’s list.
     • Is there anything else you have thought of which will help this new/intending trainer?
     • Pick what is achievable in the next 3 hours.   
     • It is better to cover a few areas in depth rather than lots of areas superficially (in my opinion).
2. List of things
   • • Navigating the ePorfolio
     • Helping trainees with AKT
     • Doing CSA practice
     • Topic-based Tutorials
     • Teaching QIA & SEAs (and the QI project)
     • The Practice as a Learning Organisation
     • HDR and Trainers’ Workshops
     • Trainees in Difficulty
3. Things definately worth covering
   
   • • Preparing for the interview – please see Bradford VTS New & Intending Trainer’s page – some good downloads under “Trainer Interview”
     • Is the practice ready? 
       • • How to get others involved in GP training.
         • Protecting the new GP Trainer:
           • •  Making sure the GP Trainer gets protected time to do debriefs.     
             • Also 1.5h weekly admin time per trainee.
             • Doing the work there and then e.g. Don’t write up COTs, CBDs etc when you get home.  Do it there and there STRAIGHT AFTER or even DURING the assessment.
         • Where to go now?   Developing a future Educational PDP that is dynamically evolving.
4. Feedback on yourself  as Mentor
   1. • What has been helpful.
      • What has not been so helpful.
      • What should I do more of?
      • What should I do less of?
      • What hasn’t been covered that should have been?
5. Summarise
   • • A written summary – written as you go along.
     • Done by you or the trainee (the latter is better and get them to email you a copy)
6. Closing the session
   • • Please send me a copy of your reflective learning notes from this session if you feel comfortable to do so.  
     • Hug, and close.   (coffee and cake?  lunch? evening meal?)
     • Submit your invoice for Mentoring to your local HEE GP School.