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Next on our agenda is MS Kirsty Modzelewski and she'll be speaking on acid curriculum survey. Mismos Arlovski is an estate in Colorectal in general surgery and she sits on the RCs Edinburgh trainees committee and Asset Council. She has a clinical interest in robotics and pelvic floor surgery with an in research interest in surgical education and training. Thank you very much. And so, yeah, really grateful to come and present this really exciting bit of work and they were going to be launching today on behalf of assets. So I think before we start talking about the new curriculum, we probably need to talk a little bit about the old curriculum, what it was and why we needed to change it. So the old curriculum came about in about 2007 following the modernizing medical careers. And there was a cry for kind of a more defined curriculum with structure feedback and a more standardized approach uh training trainees across the whole country. But there's a lot of criticism of the old curriculum. People felt it was to tick box E and there was a high volume of feedback required work base place assessments were asked for. But that didn't really translate as high quality feedback. One of the major criticisms, the lack of the holistic approach, the old curriculum wasn't flexible enough to meet the differing trainee needs because, you know, we're all very different individuals and it wasn't flexible of to treat to manage those needs whether it was personal, professional, technical. So there was a call for change first with the Greenaway report, the shape of training report in 2013 followed by excellence by design, the GM sees publication and these were calling for a change in in postgraduate chaining across the board across the board. So everyone sat down and decided that we should start trying to come up with a bit of a new curriculum. And and the working point for the the new surgical curriculum was very much to start at point of that, the end of training will be reached when the supervisors and the trainee agree that the training is performing at the level of the day one consultant. So you start at that point and then you take a foundation program, graduate or or another doctor coming into the system and they had to then work out how to get them from that point to this point. They wanted to do it in such a way mostly in the Greenway reports suggest that we should be doing in such a way that these, these trainees are doctor first, a generalist first and then a specialist later and following on from a lot of the work out of North America and trustable professional activities, they wanted to, uh, indicate a level of, of indicative of, of their level of training by the level of supervision. So what skills, what activities could a trainee do at? What level of supervision? And that would indicate where they were in their, their training progression. So, I've popped up the general surgery curriculum because that's what I'm most familiar with. All of the new curriculum's were sort of based around this, this, this process which wasn't dissimilar to the old process. There's a few differences, the G pcs that we've heard about, these were generic professional capabilities, um mostly from the G M C document and they were for all specialties, medical and surgical and they encompass things like uh professionalism, leadership, um as well as, you know, evidence based practice. Then there was the more specialty specific capabilities in practice. So these were more specific activities that were such as war drones, emergency theaters, outpatient clinics. It would be more specific to your specialty. The main focus of the assessment for the new curriculum is going to be the multi consultant report. Okay. That is kind of harks back to the old pre 2007 way of doing things where everyone was assessed by all the consultants getting in a room and saying, well, you know, he's a good chap. We'll let him progress on to the next level and I stress the word chap there. The difference is that the new M C R s are much more structured. So they bring in that objective assessment that wasn't there in the pre 2007 system. There's also some trainee self assessment in there, which is very important because that is compared to where the supervisors, I think a trainee is, is. Um and to see where discrepancies lie because of the N C R work based placed assessments were gonna be what they call rebalanced I reduced. And the focus we're going to be made taken away from those quantitative numbers over to more specific needs. So the critical conditions varies from specialty specialty, but we focus more on attaining specialty specific critical conditions than literally obtaining thousands of work based placed assessments with variable feedback. The main thing about the new curriculum was though is its flexibility you'll see over on the side here that each phase has an indicative number of years. It's similar to what we do already. But that flexibility that was built into the system and that trainees depending on their personal professional circumstances could take more or less time to get through each phase as required. And that might change as they went through. The other aspect of flexibility that was built in was that the tick boxes were still there a little bit. It was much more flexibility in how you presented the evidence to prove that you would tick those boxes. So the new surgical curriculum is due to be launched in 2020. But as with a lot of things that happened in 2020 it all went a bit pear shaped and it was delayed for a year. I have to praise the G C S T, the amount of and, and we saw it with Keith, the amount of information webinars, Q and A's um data on like everything was there. If you wanted a question answered, if you had a concern about the new curriculum, they had it covered, they did so well and they had the engagement with trainees and trainers was huge so I can really commend them on that. However, as with everything that any new thing, what works on paper doesn't necessarily work in real life. And so there was inevitable teething problems and we started to in asset, we started to hear about these from our fantastic regional representatives feeding back to council. Some of these teething problems were based around unfamiliarity with the new system. We heard about a consultant that spent 30 minutes trying to find the literal button to launch the M C R and we knew that these would improve with time and a bit of kind of experience with the systems. But one big area that we kept hearing over and over again was about variations and how the curriculum was being implemented. Okay. Now you say, well, hang on, isn't, isn't that what we wanted. Don't we want it to be variable? Depending on the trainees need flexibility is built into the system. And I use a picture of myself here. Unfortunately, it wasn't quite as flexible as we expected. And we were hearing cases of where minimum number of work based placed assessments were still happening. In fact, sometimes the number had actually gone up from previously in the old curriculum, critical conditions. Nobody quite knew how many critical conditions they had to get or how many work based place assessment they had to get for each work critical condition. And at what level and by what stage? And M crs, well, how many M CRS you need to get for? Well, a six month placement, a 12 month placement, two and six months and a two week window, that means pretty tight turnaround on these things. And trainers were telling trainees that they were now spending more time on administration of training, which would mean leaving less time for what they really wanted to do, which was give good quality, meaningful feedback to trainees and trainees were feeling this. But the J C S T and I SCP were listening and they were listening to some of the criticisms and the concerns that we all had. And this is why it's so important that we get this data and information continually fed back to us. And in June this year or June last year, they reduced the emcee our window from two weeks to 40 hours, which may or may not have been a good thing. So why are we doing this survey? Well, the fact is with a bit of data, we, we can help identify where problems are, where good practices. Um and we need that. Did we need to know what's happening on the ground? So we developed the asset or we established an asset curriculum steering group and with support from the J C S T, we decided that we were gonna talk to not just trainees but trainers to find out what was actually going on on the ground. We get some quantitative data but also qualitative data so that we can actually see what the lived experience is of those you accessing this curriculum. And like I said, the aim was to identify various in practice between Dean Aries specialties and also levels from higher surgical to court surgical training. We want to highlight good practice but identify those areas that we need to target for development. So here it is the new surgical curriculum implementation and user feedback study, not the catchiest name. I apologize. And there's two surveys, obviously one target is as trainees and one at trainer. So I encourage you all to get your phones out today. Scan the QR code that's relevant to yourself. But also please share these surveys. I'll put the QR codes up at the end again, the survey closed on the fifth of May I want you pleased to send this out to your fellow trainees and trainers that will be available in the asset website and through social media platforms. Um If you forget it, then please get in touch with your regional reps and they'll be able to give you a link to it. It's really important to get this data because I'm going to steal a line from our former present of my college. Um without it, we can't make it better for the trainees that come after us. But more importantly for the trainees that are in program at the moment. So thank you very much to ask it and J C S T for supporting this. But more importantly, thank you to all my colleagues in asset curriculum steering group who have helped us get this off the ground again, if you want to scan the codes and like I say, share them as freely and widely as you can with all of your colleagues. Thank you very much for taking the time to talk to us about the new curriculum and the rationale behind that, please again, do fill out the survey. If you've got a minute, we'd really appreciate it.