2021 Faculty Expression of Interest Difficult Conversations*

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* 1. RACS ID

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* 2. First Name

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* 3. Surname

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* 4. Specialty

Cardiovascular

General

Neurosurgery

Otolaryngology Head and Neck

Orthopaedic

Paediatric

Plastic and Reconstructive

Urology

Vascular

Other (please specify)

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* 5. Are you a Fellow of RACS (FRACS)?

Yes

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* 6. If required, are you willing to travel?

Yes

Other (please specify)

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* 7. Have you been faculty before with RACS? If so which course(s)?

Australia and New Zealand Surgical Skills Education and Training (ASSET)

Bioethics Forum

Care of the Critically Ill Surgical Patient (CCrISP®)

CLEAR Course for Consultants

Clinical Decision Making (CDM)

Conflict and You

Early Management of Severe Trauma (EMST)

Foundation Skills for Surgical Educators (FSSE)

Keeping Trainees on Track Face-to-Face (KTOT)

Leading out of Drama

Non-Technical Skills for Surgeons (NOTSS)

Operating with Respect (OWR)

Process Communication Model

Promoting Advanced Surgical Education (PrASE)

Safer Surgical Teamwork (SST)

Supervisors and Trainers for SET (SAT SET) Face-to-Face

Surgeons As Leaders in Everyday Practice (SAL)

The Academy Educator Studio Sessions

The Academy of Surgical Educators Forum

Training in Professional Skills (TIPS)

Writing Medico Legal Reports

Younger Fellows Forum (YFF)

Other (please specify)

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* 8. Have you completed the Operating With Respect face to face Course?

Yes

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* 9. Have you completed the Foundation Skills for Surgical Educators Course?

Yes

Exempt

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* 10. Are you a current/recent (last 5 years) Surgical Supervisor?

Yes

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* 11. If yes, please detail experience (max 500 words):

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* 12. Are you a current/recent (last 10 years) Board chair?

Yes

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* 13. If yes, please detail experience (max 500 words):

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* 14. Why are you interested in joining the Faculty of the Difficult Conversations with Underperforming Trainees course? (max 500 words)

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* 15. What qualities do you think are important for Surgical Faculty teaching the Difficult Conversations with Underperforming Trainees course? (max 500 words)

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* 16. Please outline your experience in managing underperforming Trainees? (max 500 words)

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* 17. Please read the following compulsory RACS policies:

RACS Faculty Charter (PDF 35.71KB)

Responsible Approach to Alcohol (PDF 98.51KB)

RACS Workforce Conduct Policy (PDF 178.9KB)

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* 18. Your Privacy: RACS is collecting the information on this form for the purpose of processing your course registration. This information may be disclosed to those responsible for the administration and conduct of the course including external parties who provide administrative and organisational support. The College may also need to verify the information provided on this form with external institutions or individuals, and gather additional information in order to process your registration. We may also disclose personal information where we are required to do so by law. If you fail to provide this information the College will be unable to process your registration. You may gain access to the personal information you have provided on this form and other personal information we hold about you by contacting the College’s Privacy Officer on 03 9249 1200. You also have the right to update and correct any personal information we hold about you.

I agree

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* 19. By completing this form you are agreeing:
- To be a RACS Faculty for the above mentioned course/training for the agreed term of 1 year;
- That you have read the relevant policies
- That you agree with the privacy information in Q18
and you wish to proceed with your EOI.

Yes

2021 Faculty Expression of Interest Difficult Conversations*

Question Title

* 1. RACS ID

Question Title

* 2. First Name

Question Title

* 3. Surname

Question Title

* 4. Specialty

Question Title

* 5. Are you a Fellow of RACS (FRACS)?

Question Title

* 6. If required, are you willing to travel?

Question Title

* 7. Have you been faculty before with RACS? If so which course(s)?

Question Title

* 8. Have you completed the Operating With Respect face to face Course?

Question Title

* 9. Have you completed the Foundation Skills for Surgical Educators Course?

Question Title

* 10. Are you a current/recent (last 5 years) Surgical Supervisor?

Question Title

* 11. If yes, please detail experience (max 500 words):

Question Title

* 12. Are you a current/recent (last 10 years) Board chair?

Question Title

* 13. If yes, please detail experience (max 500 words):

Question Title

* 14. Why are you interested in joining the Faculty of the Difficult Conversations with Underperforming Trainees course? (max 500 words)

Question Title

* 15. What qualities do you think are important for Surgical Faculty teaching the Difficult Conversations with Underperforming Trainees course? (max 500 words)

Question Title

* 16. Please outline your experience in managing underperforming Trainees? (max 500 words)

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* 17. Please read the following compulsory RACS policies:

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* 19. By completing this form you are agreeing: - To be a RACS Faculty for the above mentioned course/training for the agreed term of 1 year; - That you have read the relevant policies - That you agree with the privacy information in Q18 and you wish to proceed with your EOI.

* 19. By completing this form you are agreeing:
- To be a RACS Faculty for the above mentioned course/training for the agreed term of 1 year;
- That you have read the relevant policies
- That you agree with the privacy information in Q18
and you wish to proceed with your EOI.