View source for MANAGEMENT AND LEADERSHIP (ML)

== Health service organisation ==

==== Learning Outcome Overview ====
{| class="wikitable"
| colspan="2" |'''MANAGEMENT AND LEADERSHIP (ML)'''
|-
|'''Learning Outcome'''
|'''Health Service Organisation'''
|-
|Code
|ML1
|-
|Description
|Trainees must understand the organisation of  the healthcare system, so as to appreciate the political and economic context  of patient care.
|-
|Assessment
| 

'''MSF, portfolio/logbook  and  end of year   2-3/4 review/COECSA exam''' 
|-
|Target Year of Achievement
|Year 2 with annual reviews
|-
|Related Learning Outcomes
|ML1 – ML12
|-
|Other Links
|Study Guide  3.10.1.2 below
|}

==== HEALTH SERVICE ORGANIsation Study Guide . ====
The ophthalmologist needs a good level of understanding of the way in which the Health Service is organized and managed, to include the interaction between major organizations such as the Department of ophthalmology ,Ministry of health, National council of dental and health practitioners, the various Colleges, and the primary , secondary and tertiary healthcare delivery organizations.

'''Think:'''

* Who is ultimately responsible for the     running of the Health Service?
* What are the roles and responsibilities of     the Department of Health/Ministry of health?
* How do Primary and Secondary Care relate to     the District hospital/regional/referral hospitals and MOH, and how is     health care "purchased"?
* What do I know about Ministry of health?     Targets and how should I respond?
* What are the roles and responsibilities of     the professional societies, ministry of health and the various Colleges?
* Which regulatory agencies are involved in     the licensing and use of drugs and instruments, and what are their roles?
* How do doctors, nurses, managers and     patients have an input into the running of the National Health System?
* What are the differences in health     legislation between the different countries and how does that affect my     patient?
* How does teaching fit into the role of the     ministry of health, professional societies and what other institutions are     involved?

'''Activity:'''

* Read up from the study resources below.

'''Resources:'''

* Websites of local ministries of health and     other relevant organizations in various countries.
* Websites of, professional societies,     teaching hospitals and colleges

== Clinical Governance ==

==== Learning Outcome Overview ====
{| class="wikitable"
| colspan="2" |'''MANAGEMENT AND LEADERSHIP (ML)'''
|-
|'''Learning Outcome'''
| 

'''Clinical Governance'''
|-
|Code
|ML2
|-
|Description
|Trainees must understand and play an active role  in local clinical governance processes, and ensure that patient safety is  paramount in all they do.
|-
|Assessment
| 

'''MSF, portfolio/logbook  and  end of year   2-3/4 review/COECSA exam''' 
|-
|Target Year of Achievement
|Year 2 with annual reviews
|-
|Related Learning Outcomes
|ML1 – ML12
|-
|Other Links
|Study  Guide  3.10.2.2 below
|}

==== UNDERSTANDing THE PRINCIPLES OF CLINICAL GOVERNANCE Study Guide ====
The ophthalmologist needs a good level of understanding of the principles of clinical governance. The ophthalmologist must have an appreciation of the application of clinical governance principles to their own practice.

'''Think:'''

* What is Clinical     Governance?
* How is the quality of the     delivery of clinical care assured?
* How do Clinical     Governance principles respond when quality of clinical care is found to be     below standard?
* What are the principles     of risk assessment and risk management?
* How can patient     management pathways be best organised to ensure a failsafe system?
* What is my role in     ensuring that correct site procedures are performed?
* What is my responsibility     regarding others in the healthcare team whom I perceive to be a cause for     concern?
* In practice, what does a     "no-blame culture" mean to me?
* What is the mechanism in     my hospital and ministry of health for reporting of Critical Incidents and     Serious Untoward Events?
* What is a never event?
* When should I     "whistle blow" when I see evidence of seriously unsafe practice,     and from whom should I seek advice before doing so?

'''Activity:'''

* Read up from the study     resources below.
* Make sure you attend, and     actively contribute to, your department's audit/clinical     governance/mortality and morbidity meetings.
* Ask to be actively     involved in the assessment and management of a Critical Incident or a     Serious Untoward Event in your department and reflect on this in your     e/hard copy-portfolio diary.
* Ensure you are a member     of a medical defence society and be prepared to seek advice from them when     potentially serious matters come to your attention

'''Resources:'''

* www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/Clinical     Governance/fs/en<u></u>
* Medical Defence Union     (MDU) at www.themdu.com<u></u>
* Website for national     Medical and dental Associations<u></u>
* Medical Protection     Society (MPS) at www.medicalprotection.org/uk<u></u>
* General Medical Council     website <nowiki>http://www.gmc-uk.org/guidance/good_medical_practice.asp</nowiki><u></u>  

== Cooperation with other services ==

==== Learning Outcome Overview ====
{| class="wikitable"
| colspan="2" |'''MANAGEMENT AND LEADERSHIP (ML)'''
|-
|'''Learning Outcome'''
| 

'''Cooperation with other services'''
|-
|Code
|ML3
|-
|Description
|Trainees must accept the responsibilities of  an ophthalmologist in relation to other tertiary, secondary and primary care  services. They must develop good clinical networks with colleagues in other  disciplines that will benefit patient care.
|-
|Assessment
| 

'''MSF, Case based discussion, portfolio/logbook  and   end of year  2-3/4 review/COECSA  exam''' 
|-
|Target Year of Achievement
|Year 2 with annual reviews
|-
|Related Learning Outcomes
|ML1 – ML12
|-
|Other Links
|Study  Guide  3.10.3.2
|}

==== CO-OPERATION WITH OTHER SERVICEs Study Guide   ====
The ophthalmologist should understand the importance of maintaining effective professional relationships with all other health professionals where there might be shared care of a patient's clinical problem. These relationships extend to other medical, nursing and paramedical colleagues, as well as to members of lay bodies, where those bodies have a legitimate interest in a patient's medical care.

'''Think:'''

* What other medical,     nursing, paramedical and lay persons/bodies have a role in the delivery of     care to my patient?
* How best can I actively     seek the views of other professionals?
* How should I best     maintain the professional relationships between us to optimise the     treatment of my patient?
* What do I do if that     relationship fails or breaks down?
* Who is responsible for     restoring clinical and other links between the various interested parties?
* How can I best give other     professionals and lay bodies the benefit of my knowledge and expertise as     a doctor?

'''Activity:'''

* Read up from the study     resources below.

'''Resources:'''

* www.gmc-uk.org/guidance/good_medical_practice/index.asp#Wor     king%20with%20Colleagues
* websites of the national health     professional councils and associations

== Role as a Leader ==

==== Learning Outcome Overview ====
{| class="wikitable"
| colspan="2" |'''MANAGEMENT AND LEADERSHIP (ML)'''
|-
|'''Learning Outcome'''
| 

'''Role as a Leader'''
|-
|Code
|ML4
|-
|Description
|Trainees must be able to work as part of a  multi-professional clinical team. They must accept, where appropriate, the  role of the leader of the team. 
|-
|Assessment
| 

'''MSF, portfolio/logbook  and  end of year   2-3/4 review/COECSA exam''' 
|-
|Target Year of Achievement
|Year 2 with annual reviews
|-
|Related Learning Outcomes
|ML1 – ML12
|-
|Other Links
|Study  Guide  3.10.4.2 Below
|}

==== Leader/Team working STUDY GUIDE ====
The ophthalmologist should understand their role as the leader of a clinical team, including nursing, paramedical and other workers involved in the clinical management of a patient under his care. He or she should acknowledge his part in multidisciplinary medical management, and be aware of and sensitive to the priorities of sometimes conflicting management strategies in the treatment of patients with multisystem disease.

'''Think:'''

** What are the      responsibilities of a clinical team leader?
** What are my      responsibilities as patient advocate in relation to the team?
** How do I ensure the      cohesion and efficient functioning of the team?
** In particular, how can I      encourage good team dynamics, especially ensuring that all members      contribute, and build and maintain good relationships within the team?
** How can I demonstrate      that I am ready to take on a leadership role within the team?
** As the leader, how can I      ensure that I am accessible to team members?
** How do I identify and      remedy breakdowns in team effectiveness sensitively and assertively?      Especially in regard to unprofessional behaviour, bullying and/or      harassment, and conflict management.
** Am I aware of national      and local regulations and protocols that govern our action in the health      service, not just as an individual but within a team?
** How can I actively      promote professional activities and values?

'''Think:'''

** In what circumstances      should I accept that the team has different opinions to mine and what      attitude should I take on such occasions?
** How can I appropriately      praise staff when they do well?
** How can I best identify      when other team members are struggling or failing, or under stress (e.g.      with patients receiving bad news), and how can I best support them?
** How can I encourage a      whole-team approach to patient safety?
** How do I ensure that new      staffs are properly inducted and that no-one practices beyond their      capabilities?

'''Activity:'''

** Explore leadership      styles and prejudices with colleagues and trainers in a peer-learning      environment, and discuss these where relevant in CbD.
** Seek opportunities to      act in a leadership role under the supervision of more senior colleagues      e.g. running a theatre list, chairing a meeting, organising a teaching      session
** Reviewing or introducing      a change in practice in your team/unit
** Read up from the study      resources below.

'''Resources:'''

* <nowiki>http://www.bristol-inquiry.org.uk/final_report/report/sec2chap22_10.htm</nowiki><u></u>
* <nowiki>http://www.cehjournal.org/wp-content/uploads/teamwork-for-eye-care.pdf</nowiki><u></u>
* <nowiki>http://www.hrhresourcecenter.org/HRH_Info_Teamwork</nowiki>

'''Assessment:''' 

* Case Based Discussion
* <nowiki>https://www.nwpgmd.nhs.uk/medical-leadership/leadership-development-tools</nowiki>


== Role as a community/clinical researcher ==

==== Learning Outcome Overview ====
{| class="wikitable"
| colspan="2" |'''MANAGEMENT AND LEADERSHIP (ML)'''
|-
|'''Learning Outcome'''
| 

'''Role as a community/clinical researcher'''
|-
|Code
|ML5
|-
|Description
|Trainees must be able to contribute to  research in medicine and appreciate the value of research in clinical care  and in particular understand how to carry out a community clinical trial.
|-
|Assessment
| 

'''MSF, portfolio/logbook  and  end of year   2-3/4 review/COECSA exam''' 
|-
|Target Year of Achievement
|Year 2 with annual reviews
|-
|Related Learning Outcomes
|ML1 – ML12
|-
|Other Links
|Study  Guide  3.10.5.2 below
|}

==== Role as a community/clinical researcher Study Guide ====


The ophthalmologist should understand the importance of research in the field of ophthalmology, and seek to promote it wherever possible.

'''Think:'''

* What is research?
* Do I need to obtain some research skills in     order to understand research publications?
* What sort of research can I do?
* Where do I get ideas for research from?
* What do I know about research ethics and     the law in relation to research?

'''Activity:'''

* Attend a research skills course
* Contact your local research ethics     committee.
* Contact your Trust/institutional R&D     department
* Read published research
* Attend journal clubs
* Ask others if there are any projects you     can join
* Discuss research ideas with your trainers
* Seek opportunities to contribute to     clinical trials through ophthalmology Clinical research networks in     various  centres during your     training

'''Resource:'''

* <nowiki>http://www.dh.gov.uk/en/Managingyourorganisation/Informationpolicy/Patientconfidentialityandcaldicottguardians/DH_4100563</nowiki> <u></u>
* International Conference     on Harmonisation - Good Clinical Practice (ICH-GCP) training, which can be     done online
* Websites of National     research institutes 

'''Reflect:'''

* How could that published     research project have been carried out differently?
* What sort of research     questions have been left unanswered?

'''Assessment:'''

* Research proposal     presentation and dissertation defence


== Role as a Teacher ==

==== Learning Outcome Overview ====
{| class="wikitable"
| colspan="2" |'''MANAGEMENT AND LEADERSHIP (ML)'''
|-
|'''Learning Outcome'''
| 

'''Role as a Teacher'''
|-
|Code
|ML6
|-
|Description
|Trainees must be able to contribute to the  teaching and training of students and other healthcare colleagues
|-
|Assessment
| 

'''MSF, portfolio/logbook  and   end of year  2-3/4 review/COECSA  exam''' 
|-
|Target Year of Achievement
|Year 2 with annual reviews
|-
|


Related Learning Outcomes
|


ML1 – ML12
|-
|


Other Links
|


Study Guide  3.10.6.2 below
|}

==== Role as a teacher Study Guide ====
The ophthalmologist should understand the importance of teaching and be able to make a positive contribution to the undergraduate and postgraduate development of doctors, nurses and paramedical staff in the field of ophthalmology.

'''Think:'''

* How do I learn to best     effect?
* What opportunities are     there for teaching others?
* How can I optimise the     teaching of others in different settings?
* What is the optimum way     of teaching others?
* What teaching aids do I     need, and where can I source them from?
* What skills do I need to     be a good trainer?
* Are there any     "training the trainer" courses I could attend?
* How can I ensure that     patient safety if maintained as I teach others?
* What are the forms of     assessment (formative, summative) and what are their roles in medical     education? (especially work-place based assessment)
* How can I contribute to     the organisation of teaching and training in my unit?
* What should I do if I     become aware of a trainee in difficulty?
* How should the needs of     service and training be balanced?
* How can I receive     feedback on my teaching and training? 

'''Activity:'''

* Seek opportunities to     teach junior colleagues, students and allied professionals
* Contribute to the     organisation of training in your unit
* Seek opportunities to act     as a mentor e.g. to medical students
* Speak to your College     Tutor about taking on the role of Associate College Tutor

'''Resources:'''

* www.rcophth.ac.uk/trainingthetrainers<u></u>
* Attend teaching     methodology courses<u></u>

'''Assessment:'''

* Direct observation form
* Students feedback forms

== Role as a manager ==

==== Learning Outcome Overview ====
{| class="wikitable"
| colspan="2" |'''MANAGEMENT AND LEADERSHIP (ML)'''
|-
|'''Learning Outcome'''
| 

'''Role as a manager'''
|-
|Code
|ML7
|-
|Description
|Trainees need to recognize the role of an  ophthalmologist as a clinical manager who needs to be able to plan in order  to achieve service goals. The trainee must understand the importance of  efficient utilization of resources as self appraisal and accountability for  service outcomes.  The  trainee  must understand that, as a  manager, the ophthalmologist needs to be able to provide support, direction  and motivation to others involved with service delivery and the need to  foster an environment of improving service delivery paying due attention to  patient safety.
|-
|Assessment
| 

'''MSF, portfolio/logbook  and  end of year   2-3/4 review/COECSA exam''' 
|-
|Target Year of Achievement
|Year 2 with annual reviews
|-
|Related Learning Outcomes
|ML1 – ML12
|-
|Other Links
|Study Guide  3.10.7.2 below
|}

==== Role as a manager Study Guide ====
The ophthalmologist should acknowledge the role of medical staff in medical management, and should be able, where necessary and where called upon, to make a positive contribution to the management of departments, Trusts and the wider community for the better delivery of ophthalmic health care.

'''Think:'''

* What are the objectives     and roles of medical managers in my trust?
* Why is it important for     me to be involved?
* Where can I obtain     training in medical management techniques?
* What is my responsibility     and role in ensuring efficient and effective use of resources?
* What role can I play in     appraising other staff and ensuring they are playing their full role in     meeting service objectives?
* Should I consider a     higher qualification in medical management? If not, how involved should I     be?
* What sort of risks does a     service face on a day-to-day basis?
* What techniques can be     used to assess risks associated with a proposed change in service     provision and modification of clinical services?
* How can risk be reduced?

'''Think:'''

* Where can I obtain human     factors or patient safety training?
* What are my     responsibilities in regard to the development and maintenance of a safe     environment for patients and staff?
* When should I consider     involving medical regulatory bodies?
* Do I know how to report     serious issues within my institution?
* What regulations cover     statutory rest periods and what part can I play in ensuring they are     satisfied?
* How can I ensure that     there is appropriate involvement of patients and the public in the     management of my department?

'''Activity:'''

* Seek opportunities to     work with a manager to identify risks associated with a proposed change in     service provision
* Discuss with colleagues     how procedures and processes can be modified to improve patient and staff     safety
* Try and attend management     meetings e.g. subspecialty or unit service meetings and contribute

'''Resources:'''

* <nowiki>http://www.gmc-uk.org/publications/gmc_today/gmc_today_june08/management_matters.asp</nowiki><u></u>
* <nowiki>http://www.gmc-uk.org/guidance/current/library/management_for_doctors.asp</nowiki><u></u>

'''Assessment:'''

* Case based Discussion

== Apply clinical reasoning using an evidence based approach ==

==== Learning Outcome Overview ====
{| class="wikitable"
| colspan="2" |'''MANAGEMENT AND LEADERSHIP (ML)'''
|-
|'''Learning Outcome'''
| 

'''Apply clinical reasoning using an evidence based approach'''
|-
|Code
|ML8
|-
|Description
|Trainees must be able to demonstrate that they  can make decisions by applying appropriate and clear clinical reasoning. They  must be able to apply the principles of evidence based practice.
|-
|Assessment
| 

'''MSF, portfolio/logbook , case based discussion and  end of year   2-3/4 review/COECSA exam''' 
|-
|Target Year of Achievement
|Year 2 with annual reviews
|-
|Related Learning Outcomes
|ML1 – ML12
|-
|Other Links
|Study Guide  3.10.8.2 below
|}

==== Clinical reasoning using an evidence based approach STUDY GUIDE ====
The ophthalmologist needs to make decisions by applying appropriate and clear clinical reasoning using evidence based approach


'''Think:'''

* How can I apply critique     and analytical methods to published research?
* How best can I keep     myself up-to-date with relevant clinical evidence?

'''Activity:'''

* Ensure you discuss     evidence for your decisions informally with trainers and fellow trainees,     and especially when undertaking CbD assessments
* Make use of hospital and     departmental library
* Make use of e-learning     resources available for you
* Arrange and participate     in journal clubs

'''Resources:'''

* Textbook of Evidence based     Ophthalmology- available in hardcopy, PDA and PC (PDF)
* BMJ Clinical Evidence
* Cochrane Library<u></u>
* Evidence based medicine-     How to Practice and Teach EBM. David L Sackett, et al
* Cogni-Q-     PDA based data updated frequently www.unboundmedicine.com

== Departmental audit ==

==== Learning Outcome Overview ====
{| class="wikitable"
| colspan="2" |'''MANAGEMENT AND LEADERSHIP (ML)'''
|-
|'''Learning Outcome'''
| 

'''Departmental audit'''
|-
|Code
|ML9
|-
|Description
|All trainees must participate in departmental  audit. They must understand how audit can contribute to improvement in  clinical practice. They must be prepared to implement the changes recommended  by an appropriately conducted departmental audit.
|-
|Assessment
| 

'''MSF, portfolio/logbook  and  end of year   2-3/4 review/COECSA exam''' 
|-
|Target Year of Achievement
|Year 2 with annual reviews
|-
|Related Learning Outcomes
|ML1 – ML12
|-
|Other Links
|Study  Guide  3.10.9.2 below
|}

==== Departmental audit Study Guide ====
Audit is an essential component of clinical governance. All ophthalmology departments are required to undertake a review of the clinical services they provide. The review should compare these clinical services to a defined standard. The standards used might be published by international and national bodies, commissioners, the Trust or agreed as best practice in the department. 


'''Think:'''

* Which audit standards can     be applied to clinical practice in your department?
* What were the results of     any audits carried out in your department?
* Were the recommendations     identified from the audit implemented?
* Which areas of clinical     practice lend themselves to audit?
* How can I ensure that     patient feedback on service provision is obtained and incorporated into     departmental processes?
* What methods of data     collection are available to me?
* How can audit improve     practice?
* What is the "audit     cycle"?

'''Activity:'''

* Approach and discuss     ideas with supervising Consultant and local audit department
* Read about the principles     of audit
* Identify the clinical     lead for audit in your department
* Get involved in any     current audits that are taking place
* Present a departmental     audit to the clinical team and upload your presentation to your     e-portfolio (your educational supervisor, programme director or clinical     audit lead must validate this)
* Organize the introduction     of recommendations from an audit
* Complete the audit loop     by reviewing changes in practice that have occurred as a result of the     last audit
* Submit a poster of your     audit to a local or national conference e.g. the annual Congress/ COECSA     CONGRESS
* Upload an audit to your     e-portfolio describing your contribution to the process (no more than 3     trainees can claim a significant contribution to an audit (your     educational supervisor, programme director or clinical audit lead must     validate the audit document)

'''Resources''':

* Websites for  national      societies
* Websites for ministries     and research institutions

== Personal audit ==

==== Learning Outcome Overview ====
{| class="wikitable"
| colspan="2" |'''MANAGEMENT AND LEADERSHIP (ML)'''
|-
|'''Learning Outcome'''
| 

'''Personal audit'''
|-
|Code
|ML10
|-
|Description
|All trainees must participate in personal  audit. They must understand how audit can contribute to improvement in their  own clinical practice. They must maintain appropriate audits according to  national policy
|-
|Assessment
| 

'''MSF, portfolio/logbook  and  end of year   2-3/4 review/COECSA exam''' 
|-
|Target Year of Achievement
|Year 2 with annual reviews
|-
|Related Learning Outcomes
|ML1 – ML12
|-
|Other Links
|Study Guide  3.10.10.2 below
|}

==== Personal audit Study Guide ====
Audit of your own clinical practice is an important part of annual appraisal and will provide evidence of good medical practice for revalidation. Paragraph 14 of Good Medial Practice (2006) includes guidance on maintaining and improving performance that includes audit. You are expected to maintain a logbook of surgical practice that contains details of the results and complications of your performance with cataract surgery.

Throughout your training, you MUST perform a continuous ongoing audit of any of your cataract surgery cases in which significant complications occur. The synopsis must include details of the final outcome of these cases, including the final visual acuity and (where available) refraction, and details of any further complications which arise. All these in a log book and portfolio

'''Think:'''

* Which parts of your     clinical practice would you like to review?
* Are there any standards     that you can use or will you have to agree your own standards with your     clinical supervisor?
* How will you plan the     audit so that the results are easily obtained, reliable and relevant?
* How will you respond if     the audit identifies areas of your practice that need to be improved?
* How may my own poor     performance have an impact on patient care and on the service as a whole?

'''Activity:'''

* Identify an area of your     clinical practice that you can review.
* Track down or agree your     own standards.
* Get advice from your     clinical audit department or clinical audit lead.
* Plan and write an audit     protocol.

'''How might you be assessed on this learning outcome?'''

Your log book and portfolio should contain at least an audit of your cataract surgery (a minimum of 50 consecutive cases) to satisfy the mentors that you will be able perform and practice to the highest quality surgery that responds to community needs. The complication rate of ALL your cataract surgery must be documented and available for the mentor to assess throughout the training years.

The structured viva part of the part 2 COECSA examination will assess your understanding and your surgical experience of audit

'''Resources:'''

* Clinical audit support     centre: <nowiki>http://www.clinicalauditsupport.com/</nowiki><u></u>
* Audit and clinical effectiveness     information for ophthalmologists: <nowiki>http://www.rcophth.ac.uk/docs/profstands/ophthalmic-services/AuditandClinicalEffectivenessApril2008.pdf</nowiki><u></u>
* NICE guidance on audit:
* <nowiki>http://www.nice.org.uk/usingguidance/implementationtools/auditadvice/audit_advice.jsp</nowiki><u></u>
* Good Medical Practice: <nowiki>http://www.gmc-uk.org/guidance/good_medical_practice/index.asp</nowiki><u></u>

'''Assessment''':

* Personal audit forms

== Health economics/Managing resources ==

==== Learning Outcome Overview ====
{| class="wikitable"
| colspan="2" |'''MANAGEMENT AND LEADERSHIP (ML)'''
|-
|'''Learning Outcome'''
| 

'''Health economics/Managing resources'''
|-
|Code
|ML11
|-
|Description
|Trainees must understand and apply knowledge  of health economics relevant to eye care. They must understand how ophthalmic  services are planned and managed within the health service system and must be  aware of financial regulation
|-
|Assessment
| 

'''MSF, portfolio/logbook, case based discussion and  end of year   2-3/4 review/COECSA exam''' 
|-
|Target Year of Achievement
|Year 2 with annual reviews
|-
|Related Learning Outcomes
|ML1 – ML12
|-
|Other Links
|Study Guide  3.10.11.2 below
|}

==== Health economics/Managing resources Study Guide ====
The ophthalmologist should acknowledge the fact that resources  for services are not always unlimited and should therefore be able, where necessary and where called upon, to make a positive contribution to the cost evaluation of services , planning and budgeting for resources in departments, Institutions and the wider community for the better delivery of ophthalmic health care.

'''Think:'''

* What is health economics and what is the     value of eye health?
* What is the demand of eye health and what     is the supply of eye health?
* Am I in a position to cost the ophthalmic     services offered in my unit?
* Am I in a position to adequately plan and     budget for the resources and services in my unit?
* Can I do a cost analysis (cost effectiveness,     cost benefit and cost utility)?

'''Activity:'''

* Consider taking basic health economics     course
* Seek opportunities to work with a manager     to see how the ophthalmic services are costed
* Try and attend planning and budgeting     meetings 

'''Resources:'''

* Culyer, Anthony J., and Adam Wagstaff.     "Equity and equality in health and health     care." ''Journal     of health economics'' 12.4 (1993): 431-457.
* Rawlins, Michael D., and Anthony J. Culyer.     "National Institute for Clinical Excellence     and its value judgments." ''BMJ: British Medical Journal'' 329.7459     (2004): 224.
* Alastair M. Gray, Philip M. Clarke, Jane     Wolstenholme, Sarah Wordsworth (2010) Applied Methods of Cost-effectiveness Analysis in Healthcare,     Oxford University Press. Preview <nowiki>ISBN 0-19-922728-4</nowiki>
<u></u>
* Arrow, K. (December 1963), "Uncertainty and the welfare economics     of medical care" , ''American Economic Review'' 53 (5): 941–973
* Drummond, Michael F. (2005) Methods for the Economic Evaluation of     Health Care Programmes, Oxford University Press. Preview. <nowiki>ISBN 0-19-852945-7</nowiki><u></u>
* Whittington, Ruth (2008). ''Introduction to Health Economics: A     Beginners Guide'' Preview. <nowiki>ISBN 978-0-9545494-5-9</nowiki>.
* A.J. Culyer and J.P. Newhouse, ed. (2000). Handbook of Health Economics,     Elsevier. 1A''.Description. Elsevier.''

== Prepare monitoring and evaluation tools of projects ==

==== Learning Outcome Overview ====
{| class="wikitable"
| colspan="2" |'''MANAGEMENT AND LEADERSHIP (ML)'''
|-
|'''Learning Outcome'''
|'''Prepare monitoring and evaluation tools of  projects'''
|-
|Code
|ML12
|-
|Description
|Trainees must be actively involved in  preparing monitoring and evaluation tools. They must understand the  principles of and participate actively with the monitoring and evaluation of  projects.
|-
|Assessment
| 

'''MSF, portfolio/logbook  and  end of year   2-3/4 review/COECSA exam''' 
|-
|Target Year of Achievement
|Year 2 with annual reviews
|-
|Related Learning Outcomes
|ML1 – ML12
|-
|Other Links
|Study  Guide 3.10.12.2 below
|}

==== Prepare monitoring and evaluation tools of projects STUDY GUIDE   ====
Government officials, development managers and civil society are increasingly getting aware of the value of monitoring and evaluation (M&E) of development activities. M&E provides a better means of learning from past experience, improving service delivery, planning and allocating resources, and demonstrating results as part of accountability to key stakeholders. It is therefore important for the ophthalmologist to get familiar with the concepts of monitoring and evaluation, the tools used and how to prepare such tools for projects

'''Think:'''

* What is the difference between monitoring     and evaluation?
* What is the importance of monitoring and     evaluation?
* What are the different tools used in     monitoring and evaluation and when are they used?
* Who does monitoring and evaluation?
* Do I clearly understand the terms used in     M&E and the logical framework?
* For me to prepare the M&E tools, am I     in position to identify the key performance indicators to be evaluated.

'''Activity''':

* Consider attending a short course in     monitoring and evaluation
* Try and identify M&E personnel to get     acquainted with how M&E is conducted particularly taking note of the     types of tools used and how they were prepared. 

'''Resources:'''

* Handbook on Monitoring and Evaluating for     Results, Evaluation Office, UNDP, 2002
* Advancing Results-Based Programming and     Simplification of Programme Procedures UNDP/PROG/01/02 16 November 2001
* Louisa Goslin and Mike Edwards (2007); ''A practical Guide to     Planning, Monitoring, Evaluation and Impact Assessment, Save the Children''
* New Country Programme Format, Review and     Approval Process UNDP/PROG/01/03. 28 November 2001
* Capacity Assessment and Development In a     Systems and Strategic Management Context Guidelines, MDGD/January1998
* ''Civicus; Monitoring and Evaluation Toolkit; www.civicus.org<u><span lang="EN-GB"></span></u>''

'''Assessment:'''

·        Case based discussions