There is a general acknowledgement that medical training programmes focus on the clinical aspects of the job. Insight is important in any illness and there is now a recognition that the non-technical and non-clinical aspects of being a consultant in Intensive Care Medicine are often neglected. We are literally exxpected to lead a multidisciplinary team, interact and negotiate with colleagues from across the hospital and from various specialties in often stressful and challenging situation. Businesses especially the multinationals, invest heavily in developing their team and leaders. The NHS through the organisation such as the Faculty of Medical Leadership and Management are also starting to do the same for healthcare professionals.
In Australia and New Zealand, the Consultant Intensivist Transitioning (CIT) course is a compulsory course for all their registrars. This is the inaugural UK CIT course with national and international experts forming the knowledgeable and passionate faculty. Whilst there are other medical management courses in the UK, this is specifically designed for the Intensive Care Consultant.
Aspects and areas covered;
- Legal aspects
- Conflict management
- Managing performances
- Managing and initiating change
The sessions are interactive with almost no didactic lectures.
Segun provides a more personal account (below) but my take-home message would be:
- Decisions are made before the meeting; do your homework and prepare.
- Reinforce what you do well to make yourself indispensable.
- Legal issues can be very daunting – are your processes robust enough for patient safety?
- Work-life balance is a choice.
- By knowing yourself, you are better able to manage yourself and understand others.
In conclusion, this course is merely the starting and provides the foundation for a lifetime of learning and development. By better understanding ourselves and what motivates us, we can form better relationship with those around us; colleagues and most importantly, patients. As mentioned above, there are other medical management courses available, but to my knowledge, this is the only on which is specific for ICM.
Dr James Day and Dr Graham Barker should be congratulated for organising this course in the UK and I whole heartedly recommend it. Thanks to @RoodenburgO @cmoMD @DannytheBaker and the rest of the faculty.
Adrian Wong, Consultant ICM/Anaesthetic (ESTJ)
Reflections from the CIT
St Anne’s college, Oxford. A rainy Tuesday morning.
I’m sitting with a number of intensive care colleagues, intently concentrating on Dr Owen Roodenburg, Consultant Intensivist. He’s travelled all the way from the Alfred Hospital in Melbourne to speak to us.
His hospital specialises in ECMO, Echo, VADs, and recently ran the CHEER trial looking at Intensivist delivered ECMO for in-hospital arrests.
Yet today, he is talking to us about none of those things. He is talking about…change.
Today is the UK’s first Consultant Intensivist Transition (CIT course). 19 delegates are being taken through a series of exercises, introducing them to the “hidden curriculum” of being a consultant.
It’s a varied and exciting bag. Following this introduction to the mechanics and psychology of change, Jonathan Fielden- an intensivist with a long career in health politics and now working in the department of health- talks to us about his approach to meetings. (Having been BMA Consultant head for many years, he’s been to a few).
We take part in a mock meeting. Role playing different team
Members, each with differing agendas, it’s remarkably realistic- and brings up many discussions about how each of us copes in these environments.
It’s easy to think that we’re going to show up as the new sheriff in town, and change everything. In another session on “initiating change” we are reminded how it’s not always the case. Another mock exercise pitching a new service follows.
We break for lunch and network. Dr Helen Higham from OxSTAR takes us through a fascinating session on managing under stress. Situation awareness and cognitive biases continue to dog us as consultants. Simulation training can help this, thankfully- as can being good to your nursing team. Matt Holdaway from Oxford Adult ICU gave plenty of pointers on keeping nurses happy (don’t touch the ventilator without telling them! And it’s THEIR ventilator!)
Day one ended with a lovely session on work-life balance from Jonathan Goodall, and a session on law talking us through complaints, coroners and all in between.
“And this above all, to thine own self be true”
We start by learning about our Myers Briggs personality types, and how different traits interact. This leads nicely into sessions on conflict management (not easy!) leadership (not as straightforward as you’d think!) and negotiation (which is not “getting your own way”).
I had to leave after this session, but left fired up and full of idea.
There’s been nothing like this formally taught in ICM training in the UK before. The faculty were engaging, knowledgeable, and genuine.
Most importantly they reminded us of the highest truth.
Intensive care is about people. Patients are people. Staff are people. All of our interactions involve people. And we, the consultants of the present and future, are people.
We need to care about people. Start with ourselves. Do things we love, in and out of work. Rest. Exercise. Eat well. Manage ourselves in stressful situations.
We need to care about our team mates. Listen to them. Be empathic. Train our emotional intelligence. Negotiate with them to achieve the best outcomes for all
Involved, not just to get our own way.
When we do that, the people that we have been trained to care about- the patients- get the best from us, and from everyone else.