Motivational Questions Flashcards
Why do you want to do anaesthetics?
- Worked with anaesthetists publicly and privately across 3 anaesthetic terms + day Surg as med student. have spent a lot of time in anaesthetics where I loved every minute of it and discussed the career with many anaesthetists so I know what it involves and know the career path is suited to me
C
- Application of physiology and pharmacology to clinical practice.
- Mix of medical knowledge with practical skills.
A
- flexibility - pain, peri-op, expedition/retrieval. MPH&TM done aeromedical and expedition, hope to be involved in future +/- AT
- Cultures supportive of teaching, research and quality improvement, would like to be involved in these in non clinical time, particularly teaching with experience as a tutor/mentor at JCU, UQ associate lecturer and clinical coach. Created instructional videos on procedural skills to teach junior staff. Attended courses on clinical teaching and collect feedback for continuous improvement.
P
- while it doesn’t have the continuity of care of other professions, this provides flexibility allowing for rural work.
From NQ and want to give back to community. 6 months rural last year, discussed pathway - provide service for more complex patients + pain/periop and upskill rural gens (commitment to teaching) + allow leave.
Other reasons
- Evolving technologies, work with many different specialties, opportunities for research and quality improvement
Summary - Done 3 anaesthetic terms + in med school and I know that I enjoy the work. Fit in well with the anaesthetic team and can see myself in the position of the consultants in 10 years time.
Tell us about yourself
- CCSHO at Mater. From Townsville, graduated JCU where I developed an appreciation for rural practice on a number of placements.
Worked at TDS during uni where I spent a lot of time working with anaesthetists in theatre and discovered my passion for the profession
C - Anaesthetics and ED rotations during residency. During this time I developed non-technical skills in communication, teamwork and appropriate escalation, through being involved directly in care of patients and their families, and collaborating with a multidisciplinary team to do this.
A - I am someone who seeks out learning opportunities, done art lines, nerve blocks and tubes during these placements. Also done a number of courses (chest drains, airway skills, BASIC cancelled) to further develop my knowledge. - Research
- Teaching
M - Quality improvement
P - Colleagues see me as level headed, reliable and approachable. Outside of medicine playing volleyball is my main hobby, where I can use my height to make up for a complete lack of skill, as well as practice being a team player and leader. I’m also an amateur cook, enjoy outdoor activities like hiking and rock climbing and am learning mandarin (not the easiest language I could have picked but comes in handy in brisbane)
Why should we give you the job?
Should target selection criteria/rules in practice
I have a skillset which covers the roles in practice
- Understand pathway,
- Motivated to learn and undertake CPD
- Academic history of research, audit and teaching
- From NQ and want to give back to community with rural work
- Communication, collaboration, leadership examples
C - 3 anaesthetics terms, got very involved with department in teaching sessions such as primary teaching, audits and research with department.
- Understand training and TPS, own logbook
- Good fit with the team.
A
- Committed to education with personal study, courses/CPD and good understanding of career pathway
- Commitment to teaching (JCU, UQ), feedback on teaching, research and audit skills from MPH&TM –> Ready for scholar role activities having lead audits myself
M -
P - Passion for rural medicine, rural background, 6 months rural, identified community needs
- Friendly, approachable. Supervisors have commended my hard-working nature, time management and professionalism.
How do you deal with stress/pressure?
Occupational hazards
- Long hours, frequent and irregular overtime
- Alternating low level activity with extremely demanding, precise, procedural duties
- Unexpected, rare and/or stressful crisis situations
- Working to others’ schedules - irregular meal/leisure breaks
- “uncontrolled” work environment
Acute
- recognise
- list and prioritise
- systemic approach (e.g. ABCDE assessment)
- delegate/ask for help
- reassess remaining tasks
Supports Recognition of stress and engagement with supports - Family, friends, partner colleagues - Mentors - GP - SOT, supervisors - Employee assistance program at your hospital - Doctors health advisory service - WOASIG representative - Psychologist/psychiatrist - Lifeline
Self-care
- Active (physically, socially, mentally)
- Physically - sleep, diet, exercise
- Socially - Social groups both medical and non-medical. Involvement in social volleyball
- Mentally - professional organisations/CPD, hobbies (sport, mandarin, cooking)
C
- Don’t arrive HALT (hungry, angry, late, tired)
- I’M SAFE (free from illness, medication, stress, alcohol, fatigue, eating)
- Take breaks
- Take leave when required for holidays to avoid fatigue and have something to look forward to
A
- CPD and courses to upskill and be able to manage work tasks
- Mindfulness - have read books on this topic and incorporated mindfulness strategies into my work/life
e.g. listing 3 things good and non-good, reflecting on these mistakes as learning opportunities for improvement rather than ruminating over events that have occurred.
M
P
- Act, belong, commit (self care)
- Personal health - own GP
- Home organisation - cleaner, food etc. during time poor periods
What are your strengths/skills?
My main strengths lie in my communication, teamwork and leadership skills, and I think these will be of great benefit to me in an anaesthetic career.
Rural resus example covers all of them. Calm because of training and prior resus experience.
Team work - reliable, approachable, safe, needs of team in front of those of myself (vball)
- Fit in well with a variety of teams that I have worked with - Friendly, avoid criticising others make time for others
- Approachable - during ED terms I was commended by nursing staff for being approachable with patient concerns, ensuring they felt these concerns were appropriately understood and addressed, rather than dismissed
- Commended by supervisors for recognising my limits and appropriately escalating, particularly on my rural rotation when doing on call shifts
Communication - patients (breaking bad news/end of life care empathetically), staff clinically (handover), staff conflict resolution (internship Usama mornings)
- I have a strong skillset in communicating with patients, families which I have successfully used to improve patient outcomes in cases of effectively breaking bad news or preventing DAMA by helping patients understand their condition
- I also communicate well with staff, having successfully negotiated with with other teams and managed conflict by being able to understand conflicting perspectives. In one such setting I was required to use a model of graded assertiveness, where I escalated issues to consultant level when patient safety was at risk due to an inpatient team registrar not being able to see a patient in ED within an appropriate timeframe due to other commitments, and was later commended on my management of this scenario by my supervisor.
Leadership - team leader, calm under pressure, delegation
Resilient, Flexible and adaptable to different working environments. I can cope well with changes and look for opportunities that arise from these, such as COVID allowing me to present research virtually at international conferences I otherwise would have struggled to attend. These skills have also allowed me to cope well on rural rotations and will be beneficial in my career as I plan to do more rural work, where I will be exposed to unfamiliar environments with unexpected challenges.
I think my resilience is key to this, which is supported by learning mindfulness techniques which I have incorporated into my day to day life, good lifestyle habits of sleep, diet and exercise and my wide network of strong social supports.
Also commended by supervisors on my hard working nature and professionalism, and for exceeding expectations regarding clinical knowledge and skills.
What are your weaknesses?
Speaking up against a hierarchy.
Mindful of my role as a junior who is still learning and respect for seniors
Quiet nature, had times that I wanted to speak up but didn’t feel comfortable
Pushed myself out of my comfort zone in public speaking roles and learnt graded assertiveness
Have been able to apply this in such situations successfully - urology ED
Diagnostic errors due to focusing in on one diagnosis too early and not considering a broad differential or dismissing minor factors that don’t align with my diagnosis. I improved this significantly across my 9 months of ED time by initially creating a list of red flag differentials to exclude based on the triage note and then again taking a step back and working through a surgical sieve in my mind after reviewing a patient to ensure I had not missed any possible diagnoses. I am still working on finding the best time and way of doing this for anaesthetic cases as I have not experience a many significant intra-operative complications but currently am taking a similar approach before initiating treatment. For example when the heart rate goes up and I presume the patient requires more analgesia, before picking up the syringe I re-review the monitor and surgical situation and again run through a broad mental differential.
What contributions will you make when you become a specialist?
I’m addition to best quality practice
- rural - from NQ and want to give back
- Teaching - pay it forward for those that helped me
- research and quality improvement
C
- rural work, grown up in NQ, give back to underserviced communities there
JCU, MPH&TM, 6 months rurally - identified areas for contribution
- upskill rural generalists, provide leave
- service for comorbid patients and periop and pain
A
- Research - multiple projects including multicentre. Capable of performing projects start to finish. Keen to expand and pass on these skills.
- Audit and quality improvement. Again can perform process start to finish.
M
- Teaching + mentoring - Many anaesthetists taught me, want to pay this forward.
Teaching roles, courses and student feedback. Presented research in clinical simulation.
- Teaching patients and community groups for health education, allowing them to take charge of their health and advocate for themselves on health issues
- Advocate for health of colleagues. Have assisted friends in overcoming mental health issues, know what supports are available for them such as doctors health advisory service. Consider joining WOSIG in order to advocate for my colleagues health
P -
Conclusion - my contributions would be rural practice, teaching and academic tasks, in addition to providing the best quality of practice I can. I am currently doing my best in providing these contributions as a junior doctor and would aim to continue these during my career.
What has been your greatest achievement to date?
OR
What has been the most important thing you have done since graduating?
2 options
Non medical:
- lots of medical achievements e.g. responsibility on rural, team leading
- academic achievements e.g. masters and publications
Most important is finding a group of non-medical friends through our shared hobby of volleyball. Opportunity to practice leadership and collaboration, get focus off medicine, exercise.
Internship was so focused on medicine and career progression, many publications and study.
Finding a life outside of medicine subsequently
I’ve had a number of academic and clinical achievements so far in my career, although the thing that stands out to me as what I am most proud of isn’t so much one specific task but the times that I have exceeded expectations as a clinician.
An example of this is when I stepped up to a PHO role for a rural rotation at longreach hospital. Here I was for the first time in my career expected to see patients independently in ED and more importantly do overnight shifts as the only doctor in the hospital.
Despite some stressful scenarios and feelings of imposter syndrome and, I successfully managed a number of reasonably unwell patients, and received very positive feedback from my supervisors that I had performed well above the expected standard for doctors in this role in relation to my clinical reasoning and appropriately escalating, and that the allied health team had found me to be approachable, professional and a clear communicator.
I was offered by the superintendent of the hospital the opportunity to stay for another term, although unfortunately had to decline this in order to make my anaesthetics term at PA. This feedback, in addition to similar feedback on others terms such as ED, has given me the confidence in my abilities to step up and challenge myself with additional responsibility and the learning opportunities that come with this, while ensure to recognise my limits.
Therefore, while not one specific moment, i am most proud to apply my knowledge and abilities in order to exceed the level that is expected of me, and provide the best patient care I can.
Tell us about your teaching experience
Roles - JCU tutor, small group mentor, OSCE examiner - UQ clinical coach - Mater MEU committee - Invited lectures - Informal teaching Training - UQ how to be a better teacher series - Developed and audited simulated clinic at JCU - Written mock OSCE examinations - Feedback from all students - MPH&TM
- I have extensive teaching experience, having been involved in teaching since early in medical school and have developed my teaching through courses, student feedback and research in medical education.
- At JCU I was employed both through the tutoring program as homegroup program. Tutoring involved assisting lecturers in cohort wide teaching sessions for junior years, while the homegroup program involved weekly small group meetings to facilitate group learning as well as individual mentoring. I did these for 3 years, tutoring a range of different subjects, allowing my to see different lecturer’s teaching styles, in order to develop my teaching style.
- I was also involved in writing and coordinating practice OSCEs in my own time and was appointed as an assessor for the final OSCE. Here I learnt skills in developing assessment and assessing students and providing feedback.
- During this time I became involved with research within the clinical teaching department, performing a literature review, coordinating focus groups and contributing to writing of a mixed methods paper on clinical simulation for students in their first clinical year at JCU. This provided me with skills in conducting qualitative research and a more well developed understanding of the literature regarding teaching and simulation. I presented this paper earlier this year at the international association of medical science educators annual meeting, where I was shortlisted for best presentation, and was able to attend a number of sessions, picking up skills which I have incorporated into my teaching
- Since graduation I have been involved with the UQ program as a clinical coach, where I provide formal weekly bedside teaching, in addition to opportunistically providing teaching to students wherever possible, which I did a lot of during my 9 months in ED.
- This teaching is usually focused around practical skills or assessing patients, rather than textbook based knowledge. I structure this teaching by for example having the student assess a patient, and follow this with a discussion around differentials, investigations and management, with an aim to facilitate students to critically analyse and reflect on their clinical decision making to determine for example why they are selecting a specific test and what are the implications of a positive or negative result - will it change management?
- I have also given invited lectures to the intern cohort and medical students on how to thrive and make the most of their time.
- In recognition of my teaching efforts, the UQ school of medicine has appointed me as an associate lecturer for their program.
- In order to continually improve my teaching, I collected feedback from students, which I have records of with me, which has been overwhelmingly positive particularly in my ability to explain concepts and engage the audience.
In addition to this, I am attending the UQ ‘how to be a better teacher’ lecture series, which consists of monthly lectures, in order to continue developing my skills.
Summary -
Through teaching experience in a number of settings and formats, complemented by continual improvement of my teaching style through research, courses and feedback. I am confident in my abilities based on this feedback and being invited to present and teach on multiple occasions. I have refined my abilities as a teacher and enjoy applying these skills to pass on my knowledge at all opportunities.
C
- JCU tutoring and homegroup - developed style
- UQ clinical coach and associate lecturer - feedback
- Outline structure of bedside teaching (lots in ED) - encourage critical analysis and self reflection
A
- Mock OSCE - assessing and providing feedback
- Research, presentation and conference - literature
- Courses - refined style
M
- Invited presentations
- Feedback for quality improvement
P
- Teach at all opportunities
Do you do any study/reading outside of your job?
OR
What continuing medical education have you participated in?
C
- Read topics I encounter that I am unfamiliar with
- Reading introductory anaesthetics texts such as ‘the first year’ by Lachlan Rathie
- ASA and PVACCS membership - lecture programs
A
- Courses (PLP, online, BASIC)
- Self directed study for primary exam
- MPH&TM
- Teaching - study for teaching sessions which helps keep core medical knowledge up to date. + collect feedback on my teaching and have attended courses to improve this
- Research - literature reviews around topics of research and audit
M
- speaking with good judgement course
P
- Learning mandarin
Who is someone you admire at work and why?
- I admire Steve Fung, one of my mentors as I think he embodies ANZCA roles in practice and as a role model is he part of the reason I am pursuing an anaesthetic career.
1. As a medical expert, he keeps up to date in his interest areas of cardiac and vascular anaesthesia.
He has a well thought out and justifiable reason for all of his decisions, which has significantly helped my understanding of anaesthetics
2&3. He is an excellent communicator and collaborator, being approachable, friendly and always making time for others, and displaying empathy and understanding in all interactions with patients and staff
4. As a leader I’ve seen him manage an anaesthetic crisis calmly and effectively and outside of work had instigated an anaesthetic rock climbing group which I think has been great to help people socialise outside of the workplace
5. As a health advocate he places the needs of his patient first and takes time to ensure their needs are met, negotiating with other staff and advocating to the hospital executive for system issues effecting patient safety, particularly I have seen him escalate issues on staffing ratios and recovery bed numbers. He also displays a commitment to the welfare of other anaesthetists.
6. As a scholar he has made great efforts teach me and other junior doctors, previously taking me between theatres as a duty anaesthetist to practice intubation and has helped me on research and audit projects.
7. As a professional he displays a passion for anaesthetics, inspiring me to become an anaesthetist, always acts in a professional manner and pays attention to ethical issues such as informed consent.
On a personal note, he maintains a work life balance, with hobbies such as rock climbing, and often organises other staff to come to these, fostering a supportive environment where closer relationships can be formed between team members outside of a clinical setting.
What experiences have led to you to decide on a career in anaesthetics?
Med school + 3 terms
- Love the work, fit in well with the team
- understand pathway
- Teaching from department, pay it forward (interest area - qualifications)
- very involved with department in QI and research (interest areas)
Rural
I have spent a significant amount of time working with anaesthetists since medical schooling where I enjoyed the mix of medicine and technical skills, career flexibility with special interest areas and opportunities for rural work, focus on research and education and found that I fit in well with the anaesthetic team.
C
Working in a day surgery as a medical student where I spent a lot of time with anaesthetists, enjoyed developing technical skills such as cannulation and basic airway skills
Anaesthetic rotations as a junior doctor able to develop a better understanding of the clinical decision making in anaesthetics, and enjoyed applying physiology and pharmacology in practice, as well as the mix of technical skills.
During these times I was able to discuss the career with a number of both public and private anaesthetists, developing a good understanding of what the career involves. Very diverse field with many options for special interest areas including types of surgery or pain, periop, allergy, hyperbaric and even retrieval.
During rural rotations I was able to see the flexibility of and demand for this skillset, allowing me options to work rurally in future, given my regional background and interest in rural medicine, with additional challenges but also the rewarding nature of caring for underserviced populations and involvement in the community.
A
- Career with a focus on research, quality improvement and teaching, all of which I have been involved in and want to continue
M
- Opportunities to work with a number of different specialty and multidisciplinary teams
P
- Personality fits in well with the anaesthetic team
What research activities have you participated in?
I have 7 publications and additional projects that I have presented or are awaiting publication. These span various types of papers such as cohort studies, qualitative research, systematic reviews and case reports across fields of critical care, medical specialties, global health and medical education.
- initially involved as a data collected where I learnt the research process
- In my final year of uni I initiated my dissertation for my MPH&TM, a systematic review analysing diagnostic test accuracy of melioidosis rapid diagnostic tests. I’d studied statistical analysis as part of my masters and here applied those skills as well as performing literature searches.
- Also in 6th year published my first first author paper, a case report and letter to the editor
- Involved with the clinical school in a mixed methods study on clinical simulation in teaching, where I coordinated focus groups and learnt how to collect and analyse qualitative data
Since graduation I have presented my research at multiple conferences, learning skills in public speaking and summarising research, and have focused my further research towards my interest area of critical care.
Summary -
I have achieved 7 publications and about 12 oral/poster presentations, developing research skills in a wide array of formats, and supplementing this knowledge with further study through my masters degree. I plan on using these skills to work with like-minded individuals on larger, more impactful studies in critical care.
What quality assurance activities have you participated in?
- Thinkdrink, teleIx
- Anzela
- NOF
- PONV
- TEG
Taken all opportunities for involvement as I believe this is an imperative component of clinical governance to ensure the best quality of care is provided and can effect change beyond on an individual level
9 projects that have been presented, 3 as a data collector and 6 as a presenter, involved in planning, analysis and write up or results
Presenter:
- Features of recurrent chest pain ED presentations at TTH - presented CSANZ ASM 2020
- Inpatient and discharge opiate prescribing amongst junior doctors
- ANZELA national audit at PAH - perioperative risk assessment,
management and outcomes of emergency laparotomy patients
Personally presented the last two at hospital wide meetings including grand rounds.
Through the skills gained by being a co-author on these audits I have gained the skills to initiate the audit process as a leader in collaboration with colleagues and appropriate stakeholders, and have initiated two projects at the PA on perioperative management of #NOFs and cognitive outcomes following emergency anaesthesia of elderly patients, with involvement of a multidisciplinary team of key stakeholders such as the #NOF nurse navigator.
I have also analysed hospital policies, recently having conducted my own systematic review on regional anaesthesia in colorectal surgery, which I am attempting to publish, and presented my findings compared to hospital policies at an anaesthetics departmental meeting and at hospital grand rounds, and am looking to present this at the next ERAS committee meeting to have these guidelines reviewed.
Summary -
I have been involved in all stages of the audit cycle and have collaborated on projects as both in assisting and leading roles. I have initiated projects and collaborated with multidisciplinary teams on these and have presented these at grand rounds, conferences and other appropriate settings to ensure closure of the audit cycle through dissemination of results to appropriate stakeholders to enact change.
What have been your professional interest up to now?
C
- Anaesthesia -
TDS, rotations. Cardiology and CTS during med school, minimal anaesthetics time there yet.
- anaesthesia and ED rotations, publications and quality improvement
- US -
Take opportunities to learn these skills in anaesthetics and ED and through courses for vasc access and nerve blocks
Research on art and central line insertion techniques
- Rural medicine - JCU, rural rotations, MPH&TM
focus on indigenous health - culturally appropriate care
A
- teaching - research in this
- research and audit
M
P
- Safe airway management - airway matters course
