core trainee portfolio - kss · pdf file3 ct1 appraisal paperwork ... core trainee portfolio...

Core Trainee Portfolio For Anaesthetics & ICM CT1, CT2 & ACCS CT2 & CT2+ Trainees

Trainee Name:

__________________________________________

Date Core training commenced: 4

th August 2010

Training Hospital: Year One

____________________________________

Training Hospital: Year Two

____________________________________

If found can you please return this guide to the Anaesthetic Office

(10/11/10 - Version 2)

Contents NB: single trainee portfolio for 2 years of training.

No ST (Specialty Training) content

Introduction

Section 1 Educational Agreement 2 Record of Training and Appraisals 3 CT1 Appraisal Paperwork - Initial - Interim progress report 3/6/9 month - Final / exit 4 CT2 Appraisal Paperwork - Initial - Interim progress report 3/6/9 month - Final / exit 5 Initial Competency Paperwork & Certificate 6 Workplace Training Objectives Paperwork 7 Obstetric Module Paperwork 8 ICM Module Paperwork 9a CT1 ARCP Review Paperwork Requirements - Insert documents (see Appendix A - Core Trainee Guide Section 6) 9b CT2 ARCP Review Paperwork Requirements - Insert documents (see Appendix A - Core Trainee Guide Section 6)

10 Workplace-Based Assessments - Copy of DOPS’, Anaes-CEXs, CbDs and MSF Summary (included on a CD)

11 Record Teaching Attendance 12 Record Audit Sessions, Publications & Posters 13 Record of Absence from Work or Training Event

Appendices Appendix A – Core Trainee Guide Appendix 1 – Appendix 8

Introduction Core Trainee Portfolio is the KSS Deanery CT1/2 record of Anaesthetic training. This is based on the Royal College of Anaesthetists syllabus (CCT II Basic Level Training and Assessment) and the College guidance for Workplace Based Assessment Tools for use in CT1/2. During a trainee’s first 2 years they must get each of the following ‘Workplace Training Objectives’ signed off by an appropriate Trainer.

This can either be after observation by or discussion with an appropriate Trainer or by satisfactory completion of a DOPS/CEX or CBD. A trainee MUST complete the appropriate number of DOPS/CEX/CPD as detailed below (The ‘Trainee Record’ of completed DOP’s etc. can be found at the within this document). Before being permitted to practice anaesthesia without immediate supervision, all trainees must achieve a satisfactory standard in an assessment of competency involving at least two consultant anaesthetists who meet the criteria to be trainers. The trainee will be assessed in the following areas: a) Preoperative assessment. b) General anaesthesia for ASA I or II patients (including equipment and anaesthetic

machine check.) c) Rapid sequence induction. d) CPR skills.* e) Clinical judgement, attitudes and behaviour *If a trainee has successfully completed an ALS course within the last 12 months (d) can be omitted.

The Certificate of Initial Assessment of Competency is then awarded (usually at around 3/12 training by the College Tutor). During the second year of Anaesthetic training a trainee will also complete an obstetric and module. The ICM module (3 /12) is completed in either CT1 or CT2. After a Trainee has completed all the above and passed the Primary Exam they are awarded the Basic Level Training Certificate (this is downloaded from the RCA website and completed by the College Tutor) and are eligible for a ST3 post.

Please note extracts are taken from IBTICM, RCA, St. George’s SOAN website. The KSS Deanery SOAN would like to thank all the members of the Committee especially Drs Hazel Adams Kirti Mukherjee, Mark Blackmore, Chris Carey & Simon Walton for their contributions & amendments to this (v2 2009) & help with the previous version (v1 2008) of the Core Trainee Portfolio. If you have any general suggestions or additional paperwork you would like to submit please send them to Denise (SOAM MWPO) care of [email protected] and I will add them.

Guidance for Educational Supervisors and Consultants

Trainees must undertake workplace-based assessment (WPBA) for every unit of training. The assessments do not stand alone. They are part of the evidence that the trainee will present at their ARCP. It is the responsibility of the trainee to work with their educational supervisor to plan how many and which WPBAs they should undertake. The minimum number is one each of A-CEX, DOPS, ALMAT and CBD for each unit of training. In addition at the appropriate stage of training the trainee must complete all the assessments that comprise the Initial Assessment of Competence and the Initial Assessment of Competence in Obstetric Anaesthesia. There are also a number of extra compulsory assessments. These are marked with an asterisk. It is the trainee’s responsibility to ask their clinical supervisors to make the assessments - which should be filled in at the time. The trainee’s capacity to get their assessments done on time is a measure of their professionalism and the ARCP panel should take providing incomplete evidence seriously. Consultants should therefore not agree to sign off assessments retrospectively. It is OK to help the trainee if unforeseen complications make this necessary. The trainees’ performance can still be rated satisfactory if they coped appropriately for their experience.

Some assessments can be undertaken in simulation. Commonly these will be DOPS. The critical incidents should be undertaken as simulations. The assessments are intended to sample a cross-section of the trainee’s capabilities and are not to be treated as a detailed competence checking exercise. Trainees should be encouraged to do assessments regularly during placements and not to store them up to the end of placement. The marking of assessments is a professional skill of the consultants. The decision they must make is whether the trainee’s performance is satisfactory or not. There is no fixed pass-mark or criterion because the consultant must make an allowance for the trainees’ stage of training, level of experience, the difficulty of the case and any complicating factors that might influence the progress of the work. The consultant must ask him or herself if the performance they have seen is satisfactory for this trainee given all the relevant circumstances. For instance, ALMATs can be undertaken at any time during training and a performance that is excellent at a year might be judged very erratic in ST7. Consultants should not see this as a problem because their professional skill and knowledge is recognised in asking them to make these judgments. Where performance is rated satisfactory the consultant should give feedback. This should identify good points, recognise deficiencies and where possible give guidance for further progress. There is no necessity for all training to be provided in blocks in order to facilitate these assessments. Some experiences will benefit from consistent allocation of experience whereas others may be absorbed into a more general form of work allocation. Schools of anaesthesia may wish to review their policy of placements in order to facilitate assessment of workplace performance. The annual review of progress will be required to consider progress in each of the categories.

ACCS trainees will need to undertake the Initial Assessment of Competence – whatever their parent specialty. A Certificate of Initial Competence is the minimum requirement for successful completion of an anaesthetic placement, even if the placement is 6 months. ACCS trainees from other specialties should proceed with other WPBAs after the initial test. ACCS trainees may also ask Anaesthetists to observe and assess WPBAs relating to other specialties that are not assessed for non-ACCS anaesthesia trainees. This should be done using the relevant assessment tool from the ACCS curriculum.

Guidance for Trainees

How many WPBAs? The curriculum is divided into sections. Most sections have formal WPBAs identified for them. The minimum standard is to undertake one of each WPBA for each section of training (A-CEX, DOPS, ALMAT, CBD). Some sections such as Cardiac are usually undertaken as specific placements and clearly the assessments must be complete by the end of the block. Other clinical specialties, such as Orthopaedics, are not usually seen as block placements. The trainee must take steps to complete these assessments when suitable work presents. At some stages of training and in some Schools of Anaesthesia there are few block placements and it would be easy to fall into the trap of leaving the assessments until the end of the year. If you do this you will not have the necessary documentation for your ARCP.

It’s the trainees responsibility It is the trainee’s responsibility to organise and undertake their WPBAs. The Educational Supervisor will advise the trainee on how well they are progressing and will complete a regular appraisal of their progress and complete a Structured Report for the Trainee to send to the ARCP Deanery Panel.

Glossary of terms

Abbreviation Term Abbreviation Term

ALI Acute Lung Injury Hb Haemoglobin

ALS Advanced Life Support IAC Initial assessment of competence

APLS Advanced Paediatric Life Support

IPPV Intermittent positive pressure ventilation

ARDS Acute Respiratory Distress Syndrome

IRMER Ionisation Radiation (Medical Exposure) Regulations

ASA American Society of Anesthesiologists

IT Information technology

ASD Atrial septal defect IVRA Intravenous Regional Anaesthesia

BE Base excess LiDCOTM Lithium indicator dilution cardiac output

BIS Bispectral index MAC Minimum alveolar concentration

BP Blood pressure MH Malignant hyperpyrexia BMI Body mass index MRI Magnetic resonance imaging BNF British national formulary NAI Non-accidental Injury

CFAM Cerebral function analysis monitor

NCEPOD National Confidential Enquiry into Perioperative Deaths

CFM Cerebral function monitor NICE National Institute for Health and Clinical Excellence

CO2 Carbon dioxide NO Nitric oxide

CPEX Cardiopulmonary exercise testing

NSAID Non-steroid anti-inflammatory drug

CSE Combined Spinal Epidural PCA Patient Controlled Analgesia CSF Cerebro spinal fluid PEA Pulseless Electrical Activity CSM Committee on Safety of

Medicines PFO Patent foramen ovale

CT Computerised tomograms PONV Postoperative nausea and vomiting

CVP Central venous pressure PSI Ponds per square inch ECG Electrocardiogram Ref Reference EEG Electroeucephalogram RS Respiratory system EMG Electromyogram RSI Rapid sequence induction ENT Ear, Nose and Throat SpO2 Saturation of haemoglobin with

oxygen EPLS European Paediatric Life

Support SVP Saturated vapour pressure

ERPC Evacuation of Retained Products of Conception

TCI Target Controlled Infusions

GCS Glasgow Coma Score VSD Ventricular septal defect GMC General Medical Council WCC White cell count

Educational Agreement

KSS Deanery Trainee Name: _________________________________ Trainee KSS Deanery Reference Number: ________________________ GMC Number: _______________________ Educational Supervisor name CT1 Year: ____________________________ Educational Supervisor name CT2 Year: ____________________________

CT 1 SYLLABUS Educational Agreement

On the following pages you will find the WPA /competence and knowledge requirements for CT 1. These start after initial competence training. It is the responsibility of the trainee to ensure that over the year all training of the elements is completed. It is the responsibility of Clinical and Educational Supervisors to provide an environment for this to be achieved.

Signed (Trainee) ------------------------------------------- Date ----------------

Signed (Educational Sup) --------------------------------- Date ---------------

CT 2 SYLLABUS Educational Agreement On the following pages you will find the WPA /competence and knowledge requirements for CT 2. It is the responsibility of the trainee to ensure that over the year all training of the elements is completed. It is the responsibility of Clinical and Educational Supervisors to provide an environment for this to be achieved.

Signed (Trainee) ------------------------------------------- Date ----------------

Signed (Educational Sup) --------------------------------- Date ---------------

1

Record of Training and Appraisals

Date of Initial Test of Competency: _______________________ Date Primary Exam Achieved MCQ _______________________ OSCE ______________________ SOE_______________________

Audit Activity (Date Signed by Ed Sup) CT1 Audit 1 Title _________________________________ Date ___________ Audit 2 Title _________________________________ Date ___________ CT2 Audit 1 Title _________________________________ Date ___________ Audit 2 Title _________________________________ Date ___________

2

3. CT1 Appraisal forms

Appraisal Records (Trainee to insert completed appraisal forms after this page)

Initial Appraisal Signature _________________ Date _________

Three Month Appraisal Signature _________________ Date _________

Six Month Appraisal Signature _________________ Date _________

Nine Month Appraisal Signature _________________ Date _________

Educational Supervisor Structured Report completed (Appendix 2 & on CD): Signature _________________ Date _________

Please Note: you must show the Structured Report to the ARCP Deanery Panel

After your ARCP you must discuss your ‘ARCP Outcome’, plus any other documents you signed at your ARCP with your Educational Supervisor at your final Appraisal: Final Exit Appraisal Signature _________________ Date _________

After this Appraisal you must show the ‘CT1 ARCP Outcome’, plus any other documents you signed at your ARCP to your new Educational Supervisor at your ‘initial CT2 appraisal’

3

__________________________Trust

CT1 - Initial Anaesthetic Appraisal

Trainee Name: __________________________________________ Date: ___________ (Trainee to bring their portfolio to this appraisal meeting) Educational Supervisor (ES): ____________________________________ Grade: CT____ Previous Post : ____________________________________ Career Aims: Length of time post at Trust: months Site: ____________________________________ Training Modules: Other Training Objectives: Audit Exam Taken / Results Study Leave Planned Issues Arising from previous ARCP? Weaknesses to address? Signed by trainee: ____________________________________ Signed by ES: ____________________________________

__________________________Trust

CT1 - Anaesthetic Interim Report (after 3 months)

Trainee Name: __________________________________________ Date: ___________ (Trainee to bring their portfolio to this appraisal meeting) Educational Supervisor (ES): ____________________________________ Modules Completed MSF Report Completed for ICM/Anaesthetics? Y / N (ES to attach summary) RCA Logbook Completed? Y / N (Trainee to attach summary) ICM Logbook Completed? Y / N (Trainee to attach summary) WBA’s Completed? Y / N (if yes (Y) please list, if no (N) please state what is outstanding) Study Leave Taken? Y / N Sick, Parental, Carers or Maternity/Paternity Leave Taken? Y / N if Y please state how many ________ days

Teaching Attendance Satisfactory Y/N Total CPD Points awarded: ______________ Please note: 50 points per year required (half external and half internal) Audit Undertaken Y/N Issues Arising from previous Appraisal / Unmet objectives? Weaknesses to address? Action (KSS SOAN ARCP Action Plan may be attached) Goals for future training Signed by trainee: _____________________________ Signed by ES: _____________________________

__________________________Trust

CT1 - Anaesthetic Progress Report (after 6 months) (Completed for Interim Review)

Trainee Name: __________________________________________ Date: ___________ (Trainee to bring their portfolio to this appraisal meeting) Educational Supervisor (ES): ____________________________________ Modules Completed MSF Report Completed? Y / N (ES to attach summary) RCA Logbook Completed? Y / N (Trainee to attach summary) ICM Logbook Completed? Y / N (Trainee to attach summary) WBA’s Completed? Y / N (if yes (Y) please list, if no (N) please state what is outstanding) Study Leave Taken? Y / N Sick, Parental, Carers or Maternity/Paternity Leave Taken? Y / N if Y please state how many ________ days

Teaching Attendance Satisfactory Y/N Total CPD Points awarded: ______________ Please note: 50 points per year required (half external and half internal) Audit Undertaken Y/N Issues Arising from previous Appraisal / Unmet objectives? Weaknesses to address? Action (KSS SOAN ARCP Action Plan may be attached) Goals for future training Signed by trainee: _____________________________ Signed by ES:____________________________

__________________________Trust


Trainee Name: __________________________________________ Date: ___________ (Trainee to bring their portfolio to this appraisal meeting) Educational Supervisor (ES): ____________________________________ Modules Completed MSF Report Completed? Y / N (ES to attach summary) RCA Logbook Completed? Y / N (Trainee to attach summary) ICM Logbook Completed? Y / N (Trainee to attach summary) Educational Supervisor’s Final Structured Report completed? Y/N IBTICM End of Attachment Trainee Assessment completed (if applicable)? Y/N (If ‘N’ this must be completed for the trainee’s ARCP at your next meeting) WBA’s Completed? Y / N (if yes (Y) please list, if no (N) please state what is outstanding) Study Leave Taken? Y / N Sick, Parental, Carers or Maternity/Paternity Leave Taken? Y / N if Y please state how many ________ days


__________________________Trust

CT1 - Final Anaesthetic Appraisal

Trainee Name: _______________________________________ Date: __________ (Trainee to bring their portfolio to this appraisal meeting) Educational Supervisor (ES): ____________________________________ Modules Completed & Initial Certificate Signed? Y/N (if ‘N’ please state what is not completed) Study Leave Taken? Y/N RCA Logbook Completed? Y/N (attach summary) ICM Logbook Completed? Y/N (attach summary) Educational Supervisor’s Final Structured Report completed? Y/N IBTICM End of Attachment Trainee Assessment completed (if applicable)? Y/N (This must be completed for the ARCP/RITA in addition to the final appraisal report) Teaching Attendance Satisfactory Y/N

Total CPD Points awarded: _________________ Please note: 50 points per year required (half external and half internal)

Audit Undertaken? Y/N Primary Exams Undertaken Y/N if ‘Y’ Pass/Fail (Please note: not essential for CT1 but advisable) ARCP Outcome? Satisfactory/Unsatisfactory Issues Arising from latest ARCP / Unmet objectives / Weaknesses to address? (KSS SOAN ARCP Action Plan may be attached) Objectives Achieved Objectives to be Completed? Trainee Transfer of Information Form Completed: Y/N Goals for future training Signed by trainee: _____________________________ Signed by ES: _____________________________

4. CT2 Appraisal forms

Appraisal Records (Trainee to insert completed appraisal forms after this page)

Initial Appraisal Signature _________________ Date _________

Three Month Appraisal Signature _________________ Date _________

Six Month Appraisal Signature _________________ Date _________

Nine Month Appraisal Signature _________________ Date _________

Educational Supervisor Structured Report completed (see Appendix 2 or CD):

Signature _________________ Date _________

Please Note: you must show the Structured Report to ARCP Deanery Panel

After your ARCP you must discuss your ‘ARCP Outcome’, plus any other documents you signed at your ARCP with your Educational Supervisor at your final Appraisal: Final Exit Appraisal Signature _________________ Date _________

After this Appraisal you must show the ‘CT2 ARCP Outcome’, plus any other documents you signed at your ARCP to your new Educational Supervisor at your ‘initial appraisal’

4

__________________________Trust

CT2 - Initial Anaesthetic Appraisal

Trainee Name: __________________________________________ Date: ___________ (Trainee to bring their portfolio to this appraisal meeting) Educational Supervisor (ES): ____________________________________ Grade: CT____ Previous Post : ____________________________________ Career Aims: Length of time post at Trust: months Site: ____________________________________ Training Modules: Other Training Objectives: Audit Exam Taken / Results Study Leave Planned Issues Arising from previous ARCP? Weaknesses to address? Signed by trainee: ____________________________________ Signed by ES: ____________________________________

__________________________Trust


Trainee Name: __________________________________________ Date: ___________ (Trainee to bring their portfolio to this appraisal meeting) Educational Supervisor (ES): ____________________________________ Modules Completed MSF Report Completed? Y / N (ES to attach summary) RCA Logbook Completed? Y / N (Trainee to attach summary) ICM Logbook Completed? Y / N (Trainee to attach summary) WBA’s Completed? Y / N (if yes (Y) please list, if no (N) please state what is outstanding) Study Leave Taken? Y / N Sick, Parental, Carers or Maternity/Paternity Leave Taken? Y / N if Y please state how many ________ days

Teaching Attendance Satisfactory Y/N Total CPD Points awarded: ______________ Please note: 50 points per year required (half external and half internal) Audit Undertaken Y/N Issues Arising from previous Appraisal / Unmet objectives? Weaknesses to address? Action (KSS SOAN ARCP Action Plan may be attached) Goals for future training Signed by trainee: _____________________________ Signed by ES: ___________________________

__________________________Trust

CT2 - Anaesthetic Progress Report (after 6 months) (Completed for Interim Review)

Trainee Name: __________________________________________ Date: ___________ (Trainee to bring their portfolio to this appraisal meeting) Educational Supervisor Name (ES): ____________________________________ Modules Completed? MSF Report Completed? Y / N (ES to attach summary if undertaken) RCA Logbook Completed? Y / N (Trainee to attach summary) ICM Logbook Completed? Y / N (Trainee to attach summary) WBA’s Completed? Y / N (if yes (Y) please list, if no (N) please state what is outstanding) Study Leave Taken Y / N Sick, Parental, Carers or Maternity/Paternity Leave Taken? Y / N if Y please state how many ________ days

Teaching Attendance Satisfactory Y/N Total CPD Points awarded: ______________ Please note: 50 points per year required (half external and half internal) Audit Undertaken Y/N Primary Exams Undertaken Y / N, if ‘Y’ Pass / Fail Issues Arising from previous Appraisal / Unmet objectives / Weaknesses to address? Objectives Achieved Objectives to be Completed Action (KSS SOAN ARCP Action Plan may be attached) Goals for future training Signed by trainee: _____________________________ Signed by ES: _____________________________

__________________________Trust


Trainee Name: __________________________________________ Date: ___________ (Trainee to bring their portfolio to this appraisal meeting) Educational Supervisor (ES): ____________________________________ Modules Completed MSF Report Completed? Y / N (ES to attach summary) RCA Logbook Completed? Y / N (Trainee to attach summary) ICM Logbook Completed? Y / N (Trainee to attach summary) Educational Supervisor’s Final Structured Report completed? Y/N IBTICM End of Attachment Trainee Assessment completed (if applicable)? Y/N (If ‘N’ this must be completed for the trainee’s ARCP at your next meeting) WBA’s Completed? Y / N (if yes (Y) please list, if no (N) please state what is outstanding) Study Leave Taken? Y / N Sick, Parental, Carers or Maternity/Paternity Leave Taken? Y / N if Y please state how many ________ days


__________________________Trust

CT2 - Final Anaesthetic Appraisal

Trainee Name: _______________________________________ Date: __________ (Trainee to bring their portfolio to this appraisal meeting) Educational Supervisor (ES): ____________________________________ Modules Completed & Basic Certificates Signed? Y/N (if ‘N’ please state what is not completed) Study Leave Taken? Y/N RCA Logbook Completed? Y/N (attach summary) ICM Logbook Completed? Y/N (attach summary) Educational Supervisor’s Final Structured Report completed? Y/N IBTICM End of Attachment Trainee Assessment completed (if applicable)? Y/N (This must have been completed for the trainee’s ARCP the final appraisal report is in addition) Teaching Attendance Satisfactory Y/N Total CPD Points awarded: ______________ Please note: 50 points per year required (half external and half internal) Audit Undertaken? Y/N Primary Exams Undertaken Y/N if ‘Y’ Pass/Fail (Please note: Essential for CT2) ARCP Outcome? Satisfactory/Unsatisfactory Issues Arising from latest ARCP / Unmet objectives / Weaknesses to address? (KSS SOAN ARCP Action Plan may be attached) Objectives Achieved Objectives to be Completed? Trainee Transfer of Information Form Completed: Y/N Goals for future training Signed by trainee: _____________________________ Signed by ES: _____________________________

5. Initial Competency

Paperwork

Domains of Good Medical Practice (GMP) Code Descriptor

1 Knowledge, Skills and Performance

2 Safety and Quality

3 Communication, Partnership and Teamwork

4 Maintaining Trust

Anaesthetic: Assessment Tools Key

Code Workplace Based Assessment Tools

A Anaesthesia Clinical Evaluation Exercise [A-CEX]

C Case Based Discussion [CBD]

D Direct Observation of Procedural Skills [DOPS]

E Examination

I Intensive Care Medicine Clinical Evaluation Exercise [I-CEX]

L Anaesthesia List Management Assessment Tool [ALMAT]

M Multi-source Feedback [MSF]

S Simulation

T Acute Care Assessment Tool [ACAT]

5

Basic Level [CT1 and 2] Initial Assessment of Competence

A-CEX Assessment Code

Assessment Completed? Please ��

IAC_A01 Preoperative assessment of a patient who is scheduled for a routine operating list [not urgent or emergency] [0-3 months]

IAC_A02 Manage anaesthesia for a patient who is not intubated and is breathing spontaneously [0-3 months]

IAC_A03 Administer anaesthesia for laparotomy [0-3 months]

IAC_A04 Demonstrate Rapid Sequence Induction [0-3 months]

IAC_A05 Recover a patient from anaesthesia [0-3 months]

DOPS Assessment Code


IAC_D01 Demonstrate functions of the anaesthetic machine [0-3 months]

IAC_D02 Transfer a patient onto the operating table and position them for surgery [lateral, Lloyd Davis or lithotomy position] [0-3 months]

IAC_D03 Demonstrate cardio-pulmonary resuscitation on a manikin. [0-3 months]

IAC_D04 Demonstrates technique of scrubbing up and donning gown and gloves. [0-3 months]

IAC_D05 Basic Competencies for Pain Management – manages PCA including prescription and adjustment of machinery [0-3 months]

IAC_D06 Demonstrates the routine for dealing with failed intubation on a manikin

CBD Examine the case-notes. Discuss how the anaesthetic plan was developed. Ask the trainee to explain their approach to preop preparation, choice of induction, maintenance, and post op care. Select one of the following topics and discuss the trainees understanding of the issues in context.

Assessment Code


IAC_C01 Discuss the steps taken to ensure correct identification of the patient, the operation and the side of operation

IAC _C02 Discuss how the need to minimise postoperative nausea and vomiting influenced the conduct of the anaesthetic

IAC _C03 Discuss how the airway was assessed and how difficult intubation can be predicted

IAC _C04 Discuss how the choice of muscle relaxants and induction agents was made

IAC _C05 Discuss how the trainee’s choice of post-operative analgesics was made

IAC _C06 Discuss how the trainee’s choice of post-operative oxygen therapy was made

IAC _C07 Discuss the problems emergency intra-abdominal surgery causes for the anaesthetist and how the trainee dealt with these

IAC _C08 Discuss the routine to be followed in the case of failed intubation

The Initial Assessment of Competence Certificate is available for download from the secure area of the College website. Please make sure to complete the form and send a copy to the School Office. Please Note: This page amended 10th November 2010

Certificate of Completion of Initial Assessment of Competence in Anaesthesia: I have reviewed this trainee’s logbook and WPBAs and believe he/she has achieved a level of competence and knowledge in the above criteria that I would expect of this level of trainee.

Trainee name College Tutor / Ed Supervisor Name Signature Date

6. Workplace Training Objectives Paperwork

Please see Appendix 8 for more information





4 Maintaining Trust






E Examination




S Simulation


6

Anaesthesia in General – Assessments A-CEX Assessment Code


AGB_A01 Administer anaesthesia for laparoscopy [3-6 months]

AGB_A02 Administer anaesthesia for a shared airway procedure [3-6 months if suitable cases are available]

AGB_A03 Administer anaesthesia for eye surgery [12-24 months]

AGB_A04 Administer anaesthesia to a diabetic patient on insulin [3-6 months]

AGB_A05 Administer anaesthesia to an asthmatic or COPD patient [3-6 months]

AGB_A06 Administer anaesthesia to a patient with ischaemic heart disease [6-12 months]

AGB_A07 Administer anaesthesia to an elderly patient [> 80 years] [6-12 months]

AGB_A08 Conduct regional anaesthesia for surgery [12-24 months]

AGB_A09 Transfer an unconscious, ventilated patient within the hospital or to another hospital [6-12 months]



AGB_D01 Basic Anaesthetic Competences – Demonstrate use of the nerve stimulator to evaluate neuromuscular block [3-6 months]

AGB_D02 Basic Anaesthetic Competences – Assess a patient’s Glasgow Coma Scale rating and advise appropriate safe levels of monitoring and care [3-6 months]

AGB_D03 Basic Anaesthetic Competences – Perform a primary and secondary survey of an injured patient [may be done in simulator] [6-12 months]

AGB_D04 Basic Competencies for Pain Management – manages epidural analgesia by continuous infusion [6-12 months]

ALMAT

Assessment Code


AGB_L01 Conduct an appropriate routine general surgical operating list [12-24 months]

AGB_L02 Conduct an appropriate orthopaedic operating list [12-24 months]

AGB_L03 Manage an emergency theatre session

Anaesthesia in General - Assessments (continued) CBD Examine the case-notes. Discuss how the anaesthetic plan was developed. Ask the trainee to explain their approach to preop preparation, choice of induction, maintenance, and post op care. Select one of the following topics and discuss the trainees understanding of the issues in context.

Assessment Code


AGB_C01 Discuss how the trainee understands the patients likely feelings and apprehensions as they face surgery and how these factors influenced their management

AGB_C02 Discuss how did the trainee dealt with anticipated problems where surgeon and anaesthetist shared the airway.

AGB_C03 Discuss the trainees choice of post-operative fluids

AGB_C04 Discuss the trainee’s choice and use of sedatives and tranquillisers

AGB_C05 Discuss the effects and hazards of the pneumo-peritoneum induced for laparoscopic surgery

AGB_C06 Discuss what additional monitoring can be used for sick patients

AGB_C07 Discuss how the trainee decided between inhalation and intravenous induction

AGB_C08 Discuss the choice of agents and conduct of inhalation induction

AGB_C09 Discuss how massive haemorrhage was managed [volume expansion, blood transfusion, hazards including incompatibility reaction]

AGB_C10 Discuss the management of anaesthesia in the presence of common inter-current diseases e.g. Asthma , COPD, Hypertension, IHD, Rheumatoid arthritis, Jaundice, Steroid therapy, and diabetes

AGB_C11 Discuss whether awareness was a potential problem. Explore the factors predisposing to awareness and the manoeuvres available to reduce the risks

AGB_C12 Discuss any difficulties in restoring spontaneous ventilation at the end of the anaesthetic

AGB_C13 Discuss why this patient failed to breathe and how it is possible to distinguish between opiate excess, continued anaesthetic effect and/or residual paralysis.

AGB_C14 Discuss the management of any cyanosis, hypo- and hypertension, shivering or stridor in recovery

AGB_C15 Discuss how the trainee chose a regime for post operative pain relief and how they judged its adequacy

AGB_C16 Discuss the factors influencing the occurrence of any post-operative confusion seen

AGB_C17 Discuss how the patients obesity affected their management

AGB_C18 Discuss how the possibility of post-operative atelactasis and pulmonary embolism influenced the anaesthetic choices

AGB_C19 Discuss how the trainee decided that a day patient was fit for discharge home

AGB_C20 Discuss any concerns the trainee had regarding their anaesthetic affecting intraocular pressure

AGB_C21 How did the trainee recognise and manage hypovolaemic shock

AGB_C22 What effect did the trainee expect trauma to have on gastric emptying and how did this affect their anaesthetic plan

AGB_C23 Discuss how the trainee planned anaesthesia in the presence of a recent head injury

AGB_C24 Discuss the management of cervical spine injuries

AGB_C25 Discuss how the trainee recognised and managed dilutional -coagulopathy

AGB_C26 Discuss how factors relating to an elderly patient’s age influenced the conduct of anaesthesia

Certificate of Completion of Anaesthesia in General Assessment Module: I have reviewed this trainee’s logbook and WPBAs and believe he/she has achieved a level of competence and knowledge in the above criteria that I would expect of this level of trainee.


Paediatric Assessments A-CEX Assessment Code

Assessment Once completed please ��

PAB_A01

Basic Competences in Paediatric Anaesthesia – make preoperative assessment of a fit child [12-24 months]

PAB_A02 Administer anaesthesia to a child age>5 spontaneous ventilation [12-24 months]

PAB_A03 Administer anaesthesia to a child age>5 controlled ventilation [12-24 months]


Assessment Completed Please ��

PAB_D01 Basic Competences in Paediatric Anaesthesia – Conduct IV Induction in a fit child [12-24 months]

PAB_D02 Basic Competences in Paediatric Anaesthesia – Conduct inhalation induction of fit child [12-24 months]

CBD Examine the case-notes. Discuss how the anaesthetic plan was developed. Ask the trainee to explain their approach to pre-op preparation, choice of induction, maintenance, post op care. Select one of the following topics and discuss the trainees understanding of the issues in context

Assessment Code


PAB_C01 Examine the case notes of a child the trainee has anaesthetised and discuss how differences in anatomy from the adult influenced the conduct of the anaesthetic

PAB_C02 Discuss how the choice of drugs and drug doses differs from the adult.

PAB_C03 Discuss airway management and the choice of suitable anaesthetic circuits for a child

PAB_C04 Discuss the problems of detecting and reporting child abuse in relation to the case records of a patient that the trainee has dealt with. [Child abuse need not be an issue with the patient but their history and examination should form the basis for the discussion]

Certificate of Completion of Paediatric Assessment Module: I have reviewed this trainee’s logbook and WPBAs and believe he/she has achieved a level of competence and knowledge in the above criteria that I would expect of this level of trainee.


Regional Anaesthesia - Assessments A-CEX

Assessment Code


RAB_A01

Conduct anaesthesia for surgery using spinal or epidural anaesthesia

RAB_A02 Manage the sedative regime of a patient undergoing surgery using regional anaesthesia

DOPS

Assessment Code


RAB_D01 Establish a peripheral nerve block


Assessment Code


RAB_C01 Discuss the choice of local anaesthetics & spinal opioids in the context of regional anaesthesia

RAB_C02 Discuss the innervation an spinal dermatomes of any regional anaesthetic block the trainee has used

RAB_C03 Discuss the management of the complications of spinal and epidural (including caudal) analgesia [associated hypotension, shivering, nausea & anxiety]

RAB_C04 Discuss the absolute and relative contraindications to regional blockade

Certificate of Completion of Regional Anaesthesia Assessment Module: I have reviewed this trainee’s logbook and WPBAs and believe he/she has achieved a level of competence and knowledge in the above criteria that I would expect of this level of trainee.


Critical Incidents - Assessments DOPS Assessment Code


CIB_D01

Basic Competences for Critical Incidents – Demonstrates the emergency management of the following critical incidents in simulation: 1. Cardiac and / or respiratory arrest 2. Unexpected Hypoxia with or without cyanosis 3. Unexpected increase in peak airway pressure 4. Progressive fall in minute volume during spontaneous respiration or IPPV 5. Fall in end tidal CO2 6. Rise in end tidal CO2 7. Rise in inspired CO2 8. Unexpected hypotension 9. Unexpected hypertension 10. Sinus Tachycardia 11. Arrhythmias [ST segment changes; sudden tachydysrhythmia; sudden bradycardia; Ventricular Ectopics – Ventricular tachycardia – Ventricular Fibrillation] 12. Convulsions Demonstrate the management of the following specific conditions in simulation: 1. Aspiration of vomit 2. Laryngospasm 3. Bronchospasm 4. Tension Pneumothorax 5. Gas / Fat / Pulmonary embolus 6. Adverse drug reactions 7. Anaphylaxis 8. Transfusion of miss-matched blood or blood products 9. Malignant hyperpyrexia 10. Inadvertent intra-arterial injection of irritant fluids 11. High spinal block 12. Local Anaesthetic toxicity 13. Failed intubation 14. Difficulty with IPPV and sudden or progressive loss of minute volume It is not expected that trainees will formally demonstrate simulated management of more than a small number of these specific events but they must know the steps in managing all.

Certificate of Completion of Critical Incident Assessment Module: I have reviewed this trainee’s logbook and WPBAs and believe he/she has achieved a level of competence and knowledge in the above criteria that I would expect of this level of trainee.


Control of Infection - Assessments A-CEX

Assessment Code


IFB_A01

Undertake a sterile procedure with proper attention to asepsis

DOPS

Assessment Code


IFB_D01 Demonstrate proper technique in scrubbing up to perform a neuraxial block


Assessment Code


IFB_C01 Discuss how the trainees anaesthetic management was influenced by the precautions taken to prevent cross-infection with healthcare associated infections

IFB_C02 Discuss how the trainees anaesthetic management was influenced by the precautions taken to control blood-borne infections

Certificate of Completion of Control of Infection Assessment Module:

I have reviewed this trainee’s logbook and WPBAs and believe he/she has achieved a level of competence and knowledge in the above criteria that I would expect of this level of trainee.


7. Obstetric Module Paperwork





4 Maintaining Trust






E Examination




S Simulation


7

Assessment of Basic Competency in Obstetric Anaesthesia

Introduction

Before being allowed to work in an obstetric unit without direct supervision trainees must be formally assessed as competent in the basic obstetric anaesthetic skills. The initial training in obstetric anaesthesia for a novice CT2 should consist of a minimum of 20 directly supervised obstetric anaesthesia sessions taken within a 4 month period, in a reasonably busy unit. At least 50% of these sessions should be supervised by a consultant specialist in obstetric anaesthesia. Trainees will normally undertake the basic assessment in their second year of training, and must have passed it by the end of their CT2 training. More experienced trainees may be assessed after a relatively short period of supervision.

• If the trainee fails the assessment then they may need targeted instruction before a re-test. Whether the whole assessment is to be repeated or targeted at deficient areas is a decision to be taken locally, with regard to local circumstances, and is left to the discretion of the trainee’s supervisor.

• If a trainee repeatedly fails to pass the assessment of basic competency they may still be signed off for the competencies listed on the next page, but such a trainee must not work on an obstetric unit without immediate supervision.

• Before progressing to indirect supervision CT2s must successfully complete the workplace assessment of the basic competencies

Obstetrics Module Wherever possible, this Basic Level unit of training should occur in a dedicated block. The use of simulators may assist in the teaching and assessment of some aspects of this section e.g. general anaesthesia for Caesarean section Learning outcome:

� To gain knowledge, skills and experience of the treatment of the healthy pregnant woman

Core clinical learning outcomes: � To pass the formal practical initial assessment of competence in obstetric anaesthesia

and, having achieved this, be able to provide analgesia and anaesthesia as required for the majority of the women in the delivery suite

� To understand the management of common obstetric emergencies and be capable of performing immediate resuscitation and care of acute obstetric emergencies [e.g. eclampsia; pre-eclampsia; haemorrhage], under distant supervision but recognising when additional help is required

NB: All competencies annotated with the letter ‘E’ can be examined in any of the components of the Primary examination identified in the FRCA examination blueprint (see Appendix 8).

OBSTETRIC KNOWLEDGE Competence Description Assessment

Methods GMP Once

completed please ��

OB_BK_01 Recalls/describes the anatomy, physiology and pharmacology related to pregnancy and labour [cross ref basic sciences]

A,C,E 1

OB_BK_02 Lists common obstetric indications for anaesthetic intervention on the delivery suite

A,C,E 1

OB_BK_03 Describes the effects of aortocaval compression and how to avoid it

A,C,E 1,2

OB_BK_04 Recalls/describes how to assess fetal well being in utero A,C,E 1,2

OB_BK_05 Discusses the management of pre-eclampsia and eclampsia C,E 1,2

OB_BK_06 Lists risk factors and describes the management of major obstetric haemorrhage

C,E 1,2

OB_BK_07 Explains local feeding / starvation policies and the reasons behind them

A,C,E 1,2

OB_BK_08 Explains the thromboprophylaxis requirements in pregnancy A,C,E 1,2

OB_BK_09 Describes the grading of urgency of Caesarean section A,C,E 1,2

OB_BK_10 Explains why anaesthetic techniques must be modified in the pregnant patient

A,C,E 1,2

OB_BK_11 Lists methods of analgesia during labour and discusses their indications and contraindications

A,C,E 1,2

OB_BK_12 Describes epidural or CSE analgesia in labour and recalls/discusses the indications, contraindications and complications

A,C,E 1,2

OB_BK_13 Explains how to provide regional anaesthesia for operative delivery

A,C,E 1

OB_OK_14 Understands the need to call for assistance after several attempts at placement of regional blocks proves unsuccessful

A,C,E 1,2,3

OB_OK_15 Describes the immediate management of accidental dural puncture

A,C,E 1

OB_BK_16 Recalls/describes maternal and basic neonatal resuscitation A,C,E 1,2

OB_BK_17 Describes how to access local maternity guidelines and the value of having these guidelines

A,C,E 1,2

OBSTETRIC SKILLS Competence Description Assessment

Methods GMP Once

completed please ��

OB_BS_01 Undertakes satisfactory preoperative assessment of the pregnant patient

A,D 1

OB_BS_02 Demonstrates the ability to clearly explain and prepare an obstetric patient for surgery

A,C,D 1,3,4

OB_BS_03 Demonstrates the use of techniques to avoid aorto-caval compression

D 1

OB_BS_04 Demonstrates the ability to provide epidural analgesia in labour

A,D,M 1

OB_BS_05 Demonstrates the ability to provide spinal anaesthesia for caesarean section

A,D 1

OB_BS_06 Demonstrates the ability to convert epidural analgesia to epidural anaesthesia for surgical intervention

A,C,D 1

OB_BS_07 Demonstrates the ability to provide general anaesthesia for caesarean section [S]

A,C,D,S 1

OB_BS_08 Demonstrates an appropriate choice of anaesthesia/analgesia for instrumental delivery

C 1

OB_BS_09 Demonstrates an appropriate choice of anaesthesia for retained placenta

C 1,2

OB_BS_10 Demonstrates safe and effective management of post-delivery pain relief

C,M 1

OB_BS_11 Demonstrates ability to recognise when an obstetric patient is sick and the need for urgent assistance

C,M 1

OB_BS_12 Demonstrates the ability to provide advanced life support for a pregnant patient [S]

D,S 1

OB_BS_13 Demonstrates the ability to provide basic neonatal life support [S]

D,S 1

OB_BS_14 Obtains the Initial Assessment of Competence in Obstetric Anaesthesia

A,C,D 1,2,3,4

Initial Assessment for Competence in Obstetric Anaesthesia A-CEX Assessment Code


OB_BTC_A01 Basic Competencies for Obstetric Anaesthesia – conduct epidural analgesia for labour [12-24 months]

OB_BTC_A02 Basic Competencies for Obstetric Anaesthesia – conduct regional anaesthesia for caesarean section [12-24 months]

OB_BTC_A03 Basic Competencies for Obstetric Anaesthesia – conduct general anaesthesia for caesarean section [12-24 months][S]



OB_BTC_D01 Basic Competencies for Obstetric Anaesthesia – top up epidural for labour analgesia [12-24 months]

OB_BTC_D02 Basic Competencies for Obstetric Anaesthesia – top up epidural for caesarean section [12-24 months]

OB_BTC_D03 Basic Competencies for Obstetric Anaesthesia – Perform spinal anaesthesia [12-24 months]


Assessment Code


OB_BTC_C01 Discuss how changes in the anatomy and physiology due to pregnancy influenced the conduct of anaesthesia

OB_BTC_C02 Discuss whether pregnancy influenced the choice of drugs used during anaesthesia

OB_BTC_C03 Discuss how the conduct of general anaesthesia is affected by late pregnancy

OB_BTC_C04 Examine the case records of a patient that the trainee has anaesthetised for operative delivery in a situation where major haemorrhage might be expected. Discuss the factors that influence the likelihood of major obstetric haemorrhage, the precautions that should be taken to deal with it and the principles of its management.

OB_BTC_C05 Examine the case records of a patient with pregnancy associated hypertension that the trainee has treated. Discuss how this influences anaesthetic management.

OB_BTC_C06 Examine the case records of a patient for whom the trainee provided extradural analgesia for normal labour. Discuss the methods of pain relief available for normal delivery.

RECORD of OBSTETRIC ANAESTHESIA SESSIONS

Name /grade of Supervisor

Date of Session Signature of Supervisor

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

Certificate of Completion of ‘Obstetric Anaesthesia’ Module Taking into account the workplace assessments and the knowledge & skills assessment documented above; and with reference to a summary assessment of the knowledge, skills and attitudes displayed over a period of not less than 3 months working supervised in obstetric anaesthesia: I have reviewed this trainee’s record of workplace assessment and log book and confirm they have attained the required competencies to complete this ‘unit of training’.

This assessment has been completed satisfactorily.

Trainee Signed ……………………………..…………… Print name……………………..........…..…………………………………. Lead Trainer / Module Director signed………………………………………. Print name……… ……………..........…... Appointment: …………………………………………….……………….. Date: …..……….………….

Please note: If the assessment is not completed satisfactorily, details of the reasons why and plans for remedial action must be documented below or attached.

Assessor’s comments:

8. Intensive Care Medicine Module Paperwork





4 Maintaining Trust






E Examination




S Simulation

8

ICM – Basic Level Objectives

Training objectives: During Basic training in ICM the trainee will be working under direct supervision for the majority of the time, being introduced to the knowledge and skills required for ICM. A broad-based outline knowledge of the wide range of problems which are seen in ICM is necessary at Basic level. Greater understanding and expertise can be built upon this during higher stages of training so the trainee can become a progressively more autonomous practitioner. The composite competencies for Basic level ICM are outlined here by Domain, mapped to the relevant assessment tools and Good Medical Practice. The components that make up each competence are listed in the full syllabus below. After Basic level training (i.e. after 3 months of post-Foundation training) a trainee should:

� Appreciate the factors involved in the decision to admit to the ICU � Identify a sick patient at an early stage � Be able to undertake immediate resuscitation of patients with cardiac arrest and sepsis � Have an outline understanding of the pathology, clinical features and the management of

common problems which present to ICU � Understand the principles and place of the common monitoring and interventions in ICU � Be able to follow a management plan for common ICU problems and recognise developing

abnormalities, but appreciate that they will need assistance in deciding on an appropriate action.

� Be able to continue the management, with distant supervision, of, for example: - a resuscitated patient - a stable post-operative patient - a patient established on non-invasive ventilation

Please see Schedule of Assessments for the Joint CCT in IBTICM link: http://www.ibticm.org/_assets/pdf/assessments/schedule_of_assessments_for_the_joint_cct_in_icm.pdf

Schedule of BASIC Assessments Required for Training in Anaes/ICM

Type of WBA Basic ICM 3 months

DOPS 3

CBD 2

Mini-CEX 1

MSF 1

Grand Total 7

ICM – Basic Level Competences Each competence is mapped to the relevant assessment tools as follows:

Competence Description Assessment Methods

GMP

Completed please ��

Domain 1: Resuscitation and initial management of the acutely ill patient

1.1 Triages and prioritises patients appropriately, including timely admission to ICU

I, C, M, T, S

1

1.2 Manages cardiopulmonary resuscitation

I, M, T, S 1

1.3 Manages the patient post resuscitation I, M, T 1

Domain 2: Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation

2. 1 Obtains a history and performs an accurate clinical examination

I, M 1

2.2 Undertakes timely and appropriate investigations I, C, M 1

2.3 Performs electrocardiography (ECG / EKG) and interprets the results

D, I, C 1

2.4 Obtains appropriate microbiological samples and interprets results

D, C 1

2.5 Obtains and interprets the results from blood gas samples D, C 1

2.6 Interprets imaging studies I, C 1

2.7 Monitors and responds to trends in physiological variables I, T 1

2.8 Integrates clinical findings with laboratory investigations to form a differential diagnosis

I, C, T 1

Domain 3: Disease Management

3.1 Manages the care of the critically ill patient with specific acute medical conditions

D, I, C, M, T 1

3.2 Identifies the implications of chronic and co-morbid disease in the acutely ill patient

C. E 1

3.3 Recognises and manages the patient with circulatory failure

I, C, T 1

3.4 Recognises and manages the patient with, or at risk of, acute renal failure

I, C, T 1

3.5 Recognises and manages the patient with, or at risk of, acute liver failure

I, C, T 1

3.6 Recognises and manages the patient with neurological impairment

I, C, T 1

3.7 Recognises and manages the patient with acute gastrointestinal failure

I, C, T 1

3.8 Recognises and manages the patient with acute lung injury syndromes (ALI / ARDS)

I, C, T 1

3.9 Recognises and manages the septic patient I, C, T 1

3.10 Recognises and manages the patient following intoxication with drugs or environmental toxins

I, C 1

Domain 4: Therapeutic interventions / Organ system support in single or multiple organ failure

4.1 Prescribes drugs and therapies safely D, C, M 1

4.2 Manages antimicrobial drug therapy I, C, M 1

4.3 Administers blood and blood products safely D, C, M 1

4.4 Uses fluids and vasoactive / inotropic drugs to support the circulation

I, C 1

4.6 Initiates, manages, and weans patients from invasive and non-invasive ventilatory support

D, C, T 1

4.8 Recognises and manages electrolyte, glucose and acid-base disturbances

I, C, T 1

4.9 Co-ordinates and provides nutritional assessment and support

D, C, M 1

Domain 5: Practical procedures

5.1 Administers oxygen using a variety of administration devices

D 1

5.2 Performs emergency airway management D 1

5.4 Performs endotracheal suction D 1, 4

5.7 Performs chest drain insertion D 1, 4

5.8 Performs arterial catheterisation D 1, 4

5.9 Performs ultrasound techniques for vascular localisation

D 1, 4

5.10 Performs central venous catheterization D 1, 4

5.11 Performs defibrillation and cardioversion D 1, 4

5.14 Demonstrates a method for measuring cardiac output and derived haemodynamic variables

D 1

5.15 Performs lumbar puncture (intradural / 'spinal') under supervision

D 1, 4

5.19 Performs nasogastric tube placement in the intubated patient

D 1, 4

5.20 Performs urinary catheterization D 1

Domain 6: Peri-operative care

6.1 Manages the pre- and post-operative care of the high risk surgical patient

C, M, T 1

Domain 7: Comfort and recovery

7.1 Identifies and attempts to minimise the physical and psychosocial consequences of critical illness for patients and families

C, M 1, 3

7.2 Manages the assessment, prevention and treatment of pain and delirium

D,I C, M, T

1

7.3 Manages sedation and neuromuscular blockade D,I C, M, T

1

7.4 Communicates the continuing care requirements of patients at ICU discharge to health care professionals, patients and relatives

M, T 3

Domain 8: End of life care

8.2 Discusses end of life care with patients and their families / surrogates

D, C, M

3, 4

Domain 9: Paediatric care

See Intermediate level competencies, Section 6

Domain 10: Transport

See Intermediate level competencies, Section 6

Domain 11: Patient safety and health systems management

11.2 Complies with local infection control measures C, M 2

11.3 Identifies environmental hazards and promotes safety for patients and staff

C, M 2

11.4 Identifies and minimises risk of critical incidents and adverse events, including complications of critical illness

C, M 2

11.6 Critically appraises and applies guidelines, protocols and care bundles

C 1

11.7 Describes commonly used scoring systems for assessment of severity of illness, case mix and workload

C 1

Domain 12: Professionalism

12.1 Communicates effectively with patients and relatives D, M, T 3

12.2 Communicates effectively with members of the health care team

D, M 3

12.3 Maintains accurate and legible records / documentation D, M, T 1

12.6 Respects privacy, dignity, confidentiality and legal constraints on the use of patient data

C, M 1, 4

12.7 Collaborates and consults; promotes team-working M 3

12.8 Ensures continuity of care through effective hand-over of clinical information

C, M, T 1

12.11 Takes responsibility for safe patient care D, C, M, T

1,3

12.13 Seeks learning opportunities and integrates new knowledge into clinical practice

M 1

12.14 Participates in multidisciplinary teaching

M 1

12.15 Participates in research or audit under supervision

M 1, 4

Completion of IBTICM Basic Training Taking into account the workplace assessments and the knowledge & skills assessment documented above; and with reference to a summary assessment of the knowledge, skills and attitudes displayed over a period of not less than 3 months working supervised in Intensive Care Medicine: I have reviewed this trainee’s record of workplace assessment and log book and confirm they have attained the required competencies to complete this ‘unit of training’.

This assessment has been completed satisfactorily. Trainee Signed ……………………………..…………… Print name……………………..........…..…………………………………. Lead Trainer / Module Director signed………………………………………. Print name……… ……………..........…... Appointment: …………………………………………….……………….. Date: …..……….………….

Please note: If the assessment is not completed satisfactorily, details of the reasons why and plans for remedial action must be documented below or attached.

Assessor’s comments:

9a. ARCP Review Requirements for CT1: Insert the following documents

The documents listed below can remain where they are in this portfolio: a) ALS Certificate b) Your work place based assessment record, with DOPS, CBD’s &

Anaes-CEX’s, c) A summary sheet listing courses/meetings attended during the year d) A summary of any publications, posters advertised, or

audit/research projects undertaken e) List of Sick, Parental, Carers or Maternity Leave taken over the

year

a) FORM R – completed with amendments and signed. (Please find another one attached if any amendments are necessary)

b) 2 copies Educational Supervisor’s Structured Report (signed by your Educational Supervisor and College Tutor confirming that you have met all your competencies) Please Note: This report is different from an appraisal report.

c) A current curriculum vitae (dated)

d) GMC Certificate / Licence

e) Proof of College Registration / Letter from RCOA

f) Multisource feedback summary to be undertaken in CT1. (You will also be required to distribute 15 copies of the ‘Multi-source feedback’ form and the covering letter. MSF forms are in Appendix 4 which you can photocopy)

g) A summary of your log books is downloadable from the RCOA for anaesthesia and the intercollegiate board for ICM. This must include summaries (but no patient details or raw

data) for each module completed.

h) Letter of thanks/commendation/complaints/grievances

i) Evidence of Completion of Trainee PMETB Survey

9a

CT1 Trainee to insert Primary FRCA Exam Certificates here:

Assessment: I have seen this trainee’s Primary FRCA Exam Certificate and they will be able to apply for an

ST3 RTG post as long as they also have a successful outcome at their ARCP review.


Please find 2010/11 Primary FRCA Exam dates listed in Appendix 6

- CT1 ICM Trainee Logbook (Trainee: please insert a completed copy of your ICM logbook summary for each year here)

Assessment: I have reviewed this trainee’s logbook and believe he/she has achieved a level of competence and knowledge in the above criteria that I would expect of this level of trainee.


- CT1 RCOA Trainee Logbook (Trainee: please insert a completed copy of your RCOA logbook summary here)



- Insert the completed ARCP Outcome for each CT1 training Year (Trainee please insert a completed & signed copy of your ARCP

Outcomes here. Please make sure the Educational Supervisor at each new attachment is able to go through the latest one with you at your initial appraisal)

9b. ARCP Review Requirements for CT2: Insert the following documents

The documents listed below can remain where they are in this portfolio: f) ALS Certificate g) Your work place based assessment record, with DOPS, CBD’s &

Anaes-CEX’s, h) A summary sheet listing courses/meetings attended during the year i) A summary of any publications, posters advertised, or

audit/research projects undertaken j) List of Sick, Parental, Carers or Maternity Leave taken over the

year

a) FORM R – completed with amendments and signed. (Please find another one attached if any amendments are necessary)

b) 2 copies Educational Supervisor’s Structured Report (signed by your Educational Supervisor and College Tutor confirming that you have met all your competencies)

Please Note: This report is different from an appraisal report. c) A current curriculum vitae (dated)

d) GMC Certificate / Licence

e) Proof of College Registration / Letter from RCOA

f) Multisource feedback summary to be undertaken in CT1. (You will also be required to distribute 15 copies of the ‘Multi-source feedback’ form and the covering letter. MSF forms are in Appendix 4 which you can photocopy)

g) A summary of your log books is downloadable from the RCOA for anaesthesia and the intercollegiate board for ICM. This must include summaries (but no patient details or raw data)

for each module completed.

h) Letter of thanks/commendation/complaints/grievances

i) Evidence of Completion of Trainee PMETB Survey

9b

CT2 Trainee to insert Primary FRCA Exam Certificates here:

Assessment: I have seen this trainee’s Primary FRCA Exam Certificate and they will be able to apply for an

ST3 RTG post as long as they also have a successful outcome at their ARCP review.


Please find 2010/11 Primary FRCA Exam dates listed in Appendix 6

- CT2 ICM Trainee Logbook (Trainee: please insert a completed copy of your ICM logbook summary for each year here)



- CT2 RCOA Trainee Logbook (Trainee: please insert a completed copy of your RCOA logbook summary here)



- Insert the completed ARCP Outcome for CT2 training Year (Trainee please insert a completed & signed copy of your ARCP Outcomes here.

Please make sure the Educational Supervisor at each new attachment is able to go through the latest one with you at your initial appraisal)

10. Workplace-Based Assessments - Insert Completed WBA’s

(Templates can be found in Appendix 3)

- Insert Completed MSF Summary (Templates can be found in Appendix 4)

10

11. Record of Teaching - Complete Record and add up CPD points

- Insert Attendance Certificates

11

KSS School of Anaesthesia

Record of Continuing Professional Development (CPD) Activity

Name Period Covered from to

Record of CPD Activity CPD Points

Date Venue Activity Internal External

Total Points

External CPD Activity Points

Courses 2 half day/5 day

Meetings or Conferences 2 half day/5 day

Diploma or Degree 5

Speaking at a regional/national meeting 5

Publication in a peer reviewed journal 10

Letter in a peer reviewed journal 2

Poster presentation at regional/national meeting 5

Internal CPD Activity Points

Departmental meeting 1 per hour

Completing audit project 5

School based study day 2 half day/5 day

Simulator session 2 half day/5 day

You will be expected to acquire 25 internal

and 25 external CPD points every 12 months.

12. Record of Audit Sessions Publications & Posters

12

Record of Audit Sessions, Publications & Posters

Name: ………………………..……………… Period Covered: …………..… to ……………

Date Subject of

Audit/Publication/Poster Detail

Signature of

Supervisor

13. Record of Absences from Work or Training Event

13

RECORD OF ABSENCE FROM – Work or Training Days (please make a special note of unplanned leave)

Date from

Date to / expected to return

REASON FOR ABSENCE FROM WORK (WK) / TRAINING DAY (Regional - RTD Study Day - SD or Simulator STD) – please indicate which type of absence

Date / Signature of when the ED SUP / College Tutor / CS was informed

Date: Trust HR Department were informed

Notes:

The only acceptable reasons for non-attendance to educational training & study days are sickness (SL), annual leave (AL) or study leave (ST). You may photocopy and use the Trust Record of your absences.

Core Trainee Appendices

For Anaesthetics & ICM CT1, CT2 & ACCS CT2 & CT2+ Trainees

2010 - 2012

Appendices

Appendix 1: Form R for CT1/2 Appendix 2a: ES Structured Report Template for CT1 Year

Appendix 2b: ES Structured Report Template for CT2 Year Appendix 2c: ICM End of Attachment Trainee Assessment Form Appendix 3a: DOPS template

Appendix 3b: CbD template

Appendix 3c: Anaes-CEX template Appendix 3d: ICM DOPS template

Appendix 3e: ICM CbD template

Appendix 3f: ICM-CEX template Appendix 4a: MSF Anaes Letter Appendix 4b: MSF Anaes 360 degree TAB

Appendix 4c: MSF Summary Appendix 4d: MSF ICM 360 degree TAB

Appendix 4e: MSF ICM Summary Appendix 5: RCOA Membership Information & Form

Appendix 6: Primary FRCA Information & Exam Schedule

Appendix 7: Blueprint of the Primary FRCA Examination Mapped Against the Basic Level Units of Training Appendix 8: Action Plan

APPENDIX 1

FORM R for

CT1 Year 2010/2011 and

CT2 Year 2011/2012

1

Training Year: 2010/11 SHA/Commissioner: South East Coast Deanery: Kent, Surrey & Sussex

Forename (s): Surname:

Date of Birth:

Medical School awarding primary qualification: (name and country)

GMC/GDC Reg No.:

Primary Qualification and date awarded:

Gender:

Attach Passport Size Photo

Work Address: Work Phone: Email:

Home/Other Address: Home Phone: Mobile Phone: Email:

Immigration Status: (e.g. resident, settled, work permit required)

Post Type or Appointment: (e.g. LAT, Run Through, FTSTA etc.)

Core Trainee

GMC Programme Approval Number: (to be completed by Postgraduate Dean)

KSS/SRT540 Deanery Reference Number: 10/ANA/C /KS Specialty: Anaesthetics

National Training Number: (to be completed by Postgraduate Dean on first registration) N/A I confirm that I have been appointed to a programme leading to award of a CCT subject to satisfactory progress �

Specialty 1 for Award of CCT: Specialty 2 for Award of CCT:

I confirm that I will be seeking specialist registration by application for a CESR �

I confirm that I will be seeking specialist registration by application for a CEGPR �

Provisional Date for Core CCT/CESR/CEGPR Award: August 2012

Royal College/Faculty assessing training for the award of CCT (if undertaking full prospectively approved programme): Royal College of Anaesthetists

Initial Appointment to Programme: (Full time or % of Full time Training)

Date of Entry to Grade/Programme: (Substantive date started in Programme of appointment)

4th

August 2010

I confirm that information recorded above is correct Core Trainee signature: ______________________________ Date: _________ Postgraduate Dean/Head of School/ STC Chair/TPD print name: ______________________________ Postgraduate Dean/Head of School/ STC Chair/TPD signature: ______________________________ Date: _________ (to be confirmed on appointment to/on entering core training and before a Deanery Reference Number (DRN) is issued. Must be updated and submitted annually with the Postgraduate Dean in order to renew registration for specialty training).

Form R:

Registering for Postgraduate Core Training

Conditions of joining core training programme (Training Year: 2010/11- Note: this is NOT an offer of appointment)

Dear Postgraduate Dean

On accepting an offer to take up a training post in the KSS Deanery, I agree to meet the following conditions throughout the duration of the programme:

• to always have at the forefront of my clinical and professional practice the principles of Good Medical Practice for the benefit of safe patient care. Trainees should be aware that Good Medical Practice (2006) requires doctors to keep their knowledge and skill up to date throughout their working life, and to regularly take part in educational activities that maintain and further develop their competence and performance

• to ensure that the care I give to patients is responsive to their needs, that it is equitable, respects human rights, challenges discrimination, promotes equality, and maintains the dignity of patients and carers

• to acknowledge that as an employee within a healthcare organisation I accept the responsibility to abide by and work effectively as an employee for that organisation;

• this includes participating in workplace based appraisal as well as educational appraisal and acknowledging and agreeing to the need to share information about my performance as a doctor in training with other employers involved in my training and with the Postgraduate Dean on a regular basis

• to maintain regular contact with my Training Programme Director (TPD) and the Deanery by responding promptly to communications from them, usually through email correspondence

• to participate proactively in the appraisal, assessment and programme planning process, including providing documentation which will be required to the prescribed timescales

• to ensure that I develop and keep up to date my learning portfolio which underpins the training process and documents my progress through the programme

• to use training resources available optimally to develop my competences to the standards set by the specialty curriculum

• to support the development and evaluation of this training programme by participating actively in the national annual GMC trainee survey and any other activities that contribute to the quality improvement of training

• to agree that KSS Deanery may make some or all of the information above available to other relevant third parties e.g. Deanery / Trust administrative staff, other Deanery Specialty Schools, Colleges, Department of Health and e-Portfolio providers

I acknowledge the importance of these responsibilities. If I fail to meet them I understand that the Postgraduate Dean may require me to meet with him/her to discuss why I have failed to comply with these conditions. I understand that this document does not constitute an offer of employment.

Yours sincerely

Trainee’s signature Trainee’s name (printed) Date Please return this form to: Denise Chukwu School of Anaesthesia Medical Workforce Projects Officer KSS Deanery Suite 4.2 Providian House 16-18 Monument St, London EC3R 8AJ Tel/Fax: (0)20 7415 3406 / 0207 868 5155

Training Year: 2011/12 SHA/Commissioner: Deanery: Kent, Surrey & Sussex

Forename (s): Surname:

Date of Birth:

Medical School awarding primary qualification: (name and country)

GMC/GDC Reg No.:

Primary Qualification and date awarded:

Gender:

Attach Passport Size Photo

Work Address: Work Phone: Email:

Home/Other Address: Home Phone: Mobile Phone: Email:

Immigration Status: (e.g. resident, settled, work permit required)

Post Type or Appointment: (e.g. LAT, Run Through, FTSTA etc.)

Core Trainee

GMC Programme Approval Number: (to be completed by Postgraduate Dean)

KSS/SRT540 Deanery Reference Number: 10/ANA/C /KS Specialty: Anaesthetics

National Training Number: (to be completed by Postgraduate Dean on first registration) N/A I confirm that I have been appointed to a programme leading to award of a CCT subject to satisfactory progress �

Specialty 1 for Award of CCT: Specialty 2 for Award of CCT:

I confirm that I will be seeking specialist registration by application for a CESR �

I confirm that I will be seeking specialist registration by application for a CEGPR �

Provisional Date for Core CCT/CESR/CEGPR Award: August 2012

Royal College/Faculty assessing training for the award of CCT (if undertaking full prospectively approved programme): Royal College of Anaesthetists

Initial Appointment to Programme: (Full time or % of Full time Training)

Date of Entry to Grade/Programme: (Substantive date started in Programme of appointment)

4th

August 2010

I confirm that information recorded above is correct CoreTrainee signature: ______________________________ Date: _________ Postgraduate Dean/Head of School/ STC Chair/TPD print name: ______________________________ Postgraduate Dean/Head of School/ STC Chair/TPD signature: ______________________________ Date: _________ (to be confirmed on appointment to/on entering core training and before a Deanery Reference Number (DRN) is issued. Must be updated and submitted annually with the Postgraduate Dean in order to renew registration for specialty training).

Form R:

Registering for Postgraduate Core Training

Conditions of joining core training programme (Training Year: 2011/12- Note: this is NOT an offer of appointment)

Dear Postgraduate Dean

On accepting an offer to take up a training post in the KSS Deanery, I agree to meet the following conditions throughout the duration of the programme:

• to always have at the forefront of my clinical and professional practice the principles of Good Medical Practice for the benefit of safe patient care. Trainees should be aware that Good Medical Practice (2006) requires doctors to keep their knowledge and skill up to date throughout their working life, and to regularly take part in educational activities that maintain and further develop their competence and performance

• to ensure that the care I give to patients is responsive to their needs, that it is equitable, respects human rights, challenges discrimination, promotes equality, and maintains the dignity of patients and carers

• to acknowledge that as an employee within a healthcare organisation I accept the responsibility to abide by and work effectively as an employee for that organisation;

• this includes participating in workplace based appraisal as well as educational appraisal and acknowledging and agreeing to the need to share information about my performance as a doctor in training with other employers involved in my training and with the Postgraduate Dean on a regular basis

• to maintain regular contact with my Training Programme Director (TPD) and the Deanery by responding promptly to communications from them, usually through email correspondence

• to participate proactively in the appraisal, assessment and programme planning process, including providing documentation which will be required to the prescribed timescales

• to ensure that I develop and keep up to date my learning portfolio which underpins the training process and documents my progress through the programme

• to use training resources available optimally to develop my competences to the standards set by the specialty curriculum

• to support the development and evaluation of this training programme by participating actively in the national annual GMC trainee survey and any other activities that contribute to the quality improvement of training

• to agree that KSS Deanery may make some or all of the information above available to other relevant third parties e.g. Deanery / Trust administrative staff, other Deanery Specialty Schools, Colleges, Department of Health and e-Portfolio providers

I acknowledge the importance of these responsibilities. If I fail to meet them I understand that the Postgraduate Dean may require me to meet with him/her to discuss why I have failed to comply with these conditions. I understand that this document does not constitute an offer of employment. Yours sincerely

Trainee’s signature Trainee’s name (printed) Date (2011/12) Please return this form to: Denise Chukwu School of Anaesthesia Medical Workforce Projects Officer KSS Deanery Suite 4.2 Providian House 16-18 Monument St, London EC3R 8AJ Tel/Fax: (0)20 7415 3406 / 0207 868 5155

Appendix 2a – 2c

Appendix 2a: CT1 Year 2010/2011 Educational Supervisor / College Tutor

Structured Report Template

Appendix 2b: CT2 Year 2011/2012 Educational Supervisor / College Tutor

Structured Report Template

Appendix 2c: ICM Core CT1/2 Educational Supervisor / College Tutor End of Attachment

Trainee Assessment Form Template for

2

Name of person submitting report:

Position (ie, College Tutor)

From To

Training unit (Hospital): Placement

Dates Aug 2010

Aug 2011

Trainee’s name: GMC

number

Training number

Workplace based assessments (WPBAs) in current placement (only successful WPBAs should be included here) Anaesthetic Clinical Evaluation Exercise (Anaes-CEX) Mean overall

Frequency: 4 every 6 months Number rating Summary of comments

General anaesthesia with spontaneous respiration

General anaesthesia with controlled ventilation

Anaesthesia for a patient with a full stomach

Shared airway

Paediatric case

Anaesthesia for an elderly patient

Obstetric case

Regional anaesthesia case

ICU Case

Directly Observed Procedural Skills (DOPS) Mean overall


Cardiopulmonary resuscitation (manikin-based)

Rapid sequence induction

Central venous cannulation

Insertion of arterial line

Spinal anaesthesia

Epidural anaesthesia

Assessment & management of patient with a

reduced level of consciousness

Regional anaesthesia for caesarean section

Educational Supervisor / College Tutor Structured Report For submission to the Annual Review of Competence Progression

panel – Core Training Year (Appendix 2a)

General anaesthesia for caesarean section

Inhalational induction

Management of postoperative pain (PCA/morphine infusion/epidural)

Simple peripheral nerve block

Case Based Discussion (CBD)

Frequency: 2 every 6 months Mean overall

Number Rating

Anaesthesia for a patient with a full stomach Summary of comments

Shared airway

Paediatric case


Obstetric case


ICU Case

Difficult intubation

Major haemorrhage

Multi-Source Feedback (MSF) (Compulsory at CT1 & ST6)

Number ICM / Anaes reviewed: /

Maintaining trust/professional relationships with patients

Summary of comments (including comment on range of sources)

Average Score (assessor) Self assessment score

Verbal communication skills



Team-working/working with colleagues



Accessibility



Patient survey Number reviewed:

Summary of comments

Experiential outcomes

Activity Outcomes (delete as appropriate)

log-book: expected activity achieved / not achieved

subject/title

Audits (see attendance record in trainee portfolio)

1 completed / not completed / had impact / no impact



research 1 work in progress / completed

projects 2 work in progress / completed

3 work in progress / completed

publications 1 work in progress / submitted / accepted / published

2 work in progress / submitted / accepted / published


Teaching - (see attendance record in trainee portfolio)

management development

presentations 1 (see attendance record in trainee portfolio)

2

3

4

courses / meetings 1 relevant / not relevant / impact / no impact

Attended (see attendance record in trainee portfolio)

2

3

4

5

Other outcomes Date/s Outcome

1. reported adverse incidents resolved/pending no case to find/accountable

2. complaints resolved/pending no case to find/accountable

3. other

any further comments/observations

Leave days taken during this placement:

Annual Study Sickness

Basic Level Competences completed during this placement Completed Date

Initial test of competency

Preoperative assessment

Premedication

Anaesthesia and HDU and ICU equipment: monitoring and safety

Induction of general anaesthesia

Intraoperative care (including sedation)

Post operative and recovery care

Intensive & high dependency care

Regional anaesthesia

Management of trauma, stabilisation and transfer of patients

Obstetric anaesthesia and analgesia

Paediatric anaesthesia

Anaesthesia and the elderly

Pain management

Infection control

Critical incidents

Management of respiratory and cardiac arrest

Emergency anaesthesia

Intermediate Level Competences completed during this placement Completed Date

I confirm that this is an accurate description/summary of this trainee’s learning portfolio,

covering the time period from _____/_____/________ to _____/_____/________

Signed by Date

(educational supervisor)

Signed by Date

(trainee)

Name of person submitting report:

Position (ie, College Tutor)

From To

Training unit (Hospital): Placement

Dates Aug 2011

Aug 2012

Trainee’s name: GMC

number

Training number

Workplace based assessments (WPBAs) in current placement (only successful WPBAs should be included here) Anaesthetic Clinical Evaluation Exercise (Anaes-CEX)

Mean overall


General anaesthesia with spontaneous respiration

General anaesthesia with controlled ventilation

Anaesthesia for a patient with a full stomach

Shared airway

Paediatric case


Obstetric case


ICU Case

Directly Observed Procedural Skills (DOPS)

Mean overall


Cardiopulmonary resuscitation (manikin-based)

Rapid sequence induction

Central venous cannulation

Insertion of arterial line

Spinal anaesthesia

Epidural anaesthesia

Assessment & management of patient with a

reduced level of consciousness

Educational Supervisor / College Tutor Structured Report For submission to the Annual Review of Competence Progression panel – Core Training Year 2

Regional anaesthesia for caesarean section

General anaesthesia for caesarean section

Inhalational induction

Management of postoperative pain (PCA/morphine infusion/epidural)

Simple peripheral nerve block

Case Based Discussion (CBD)

Frequency: 2 every 6 months Mean

overall

Number Rating

Anaesthesia for a patient with a full stomach Summary of comments

Shared airway

Paediatric case


Obstetric case


ICU Case

Difficult intubation

Major haemorrhage

Multi-Source Feedback (MSF) (Compulsory at CT1 & ST6)

Number reviewed:










Accessibility



Patient survey Number reviewed:

Summary of comments

Experiential outcomes

Activity Outcomes (delete as appropriate)

log-book: expected activity achieved / not achieved

subject/title

Audits (see attendance record in trainee portfolio)




research 1 work in progress / completed

projects 2 work in progress / completed

3 work in progress / completed

publications 1 work in progress / submitted / accepted / published



Teaching - (see attendance record in trainee portfolio)

management development

presentations 1 (see attendance record in trainee portfolio)

2

3

4

courses / meetings 1 relevant / not relevant / impact / no impact

Attended (see attendance record in trainee portfolio)

2

3

4

5

Other outcomes

Date/s Outcome

1. reported adverse incidents resolved/pending no case to find/accountable

2. complaints resolved/pending no case to find/accountable

3. other

any further comments/observations

Leave days taken during this placement:

Annual Study Sickness

Basic Level Competences completed during this CT2 placement Completed Date

Initial test of competency

Preoperative assessment

Premedication

Anaesthesia and HDU and ICU equipment: monitoring and safety

Induction of general anaesthesia

Intraoperative care (including sedation)

Post operative and recovery care

Intensive & high dependency care

Regional anaesthesia

Management of trauma, stabilisation and transfer of patients

Obstetric anaesthesia and analgesia

Paediatric anaesthesia

Anaesthesia and the elderly

Pain management

Infection control

Critical incidents

Management of respiratory and cardiac arrest

Emergency anaesthesia

Intermediate Level Competences completed during this placement Completed Date

I confirm that this is an accurate description/summary of this trainee’s learning portfolio,

covering the time period from _____/_____/________ to _____/_____/________

Signed by Date

(educational supervisor)

Signed by Date

(trainee)

KSS School Of Anaesthetics Intensive Care Medicine END OF ATTACHMENT Trainee Assessment

Trainee Name: __________________________________________ Date: ___________ (Trainee to use this form for an appraisal meeting at the end of a 3 month attachment)

Educational Supervisor (ES): ____________________________________ Attachment (Trust/Hospital): _______________________________________________________ ST Year: ………………..……… Duration of attachment: …..…… /…..…… /……..… to …..…… /…..…… /……..…

ETR Review Achievements during attachment:

i) Competencies: Please sign domains achieved in table below WBA’s Completed? Y / N (if yes (Y) please list, if no (N) please state what is outstanding)

ii) Audit, research, presentations, Case Summary Y / N: if Y please state how many case summaries _____ iii) Other:

iv) Critical Incidents: v) Sick, Parental, Carers or Maternity/Paternity Leave Taken? Y / N if Y please state how many ________ days

Overall assessment of trainee:

� MSF Report Completed for ICM? Y / N (ES to attach summary if applicable) � ICM Logbook Completed? Y / N (Trainee to attach summary) � Study Leave Taken? Y / N if Y please state how many ________ days � Teaching Attendance Satisfactory Y/N Total KSS SOAN CPD Points awarded: _______ Please note: Below 40 points = unsatisfactory, 40- 50 points = fair, 50 points = average, 50 – 60 points good, 60 upwards excellent

Areas for development during next attachment: Advice to trainee: Recommendation to ARCP panel: …………………………………………………………………………………………………………....

Signed by trainee: _____________________________ Signed by ES: _____________________________ (Appendix 2c)

KSS School Of Anaesthetics Intensive Care Medicine COMPETENCY DOMAINS SUCCESSFULLY ACHIEVED

Used in Conjunction with the ‘End Of Attachment Trainee Assessment’ Form

Domain No.

Competency Domain

Basic Level ICM

Intermediate Level ICM

Advanced Level ICM

1 Resuscitation and initial management of the acutely ill patient

Sign Sign Sign

2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation

Sign Sign Sign

3 Disease Management

Sign Sign Sign

4 Therapeutic interventions / Organ system support in single or multiple organ failure

Sign Sign Sign

5 Practical procedures

Sign Sign Sign

6 Perioperative care

Sign Sign Sign

7 Comfort and recovery

Sign Sign Sign

8 End of life care

Sign Sign Sign

9 Paediatric care

Sign Sign Sign

10 Transport

Sign Sign Sign

11 Patient safety and health systems management

Sign Sign Sign

12 Professionalism

Sign Sign Sign

(Appendix 2c)

Appendices 3a – 3f

Appendix 3a: Anaes DOPS template

Appendix 3b: Anaes CbD template

Appendix 3c: Anaes-CEX template

Appendix 3d: ICM DOPS template

Appendix 3e: ICM CbD template

Appendix 3f: ICM-CEX template

3

Appendix 3a – 3c

Anaes WBA’s

DIRECT OBSERVATION OF PROCEDURAL SKILLS (DOPS) - Anaesthetics

Please complete this form in BLOCK CAPITALS and BLACK ink - (Appendix 3a)

Trainee’s Surname

Trainee’s Forename(s)

GMC Number GMC NUMBER MUST BE COMPLETED

Procedure

Code Number

Observed by


Date

Signature of observing doctor

Assessment:

Practice was satisfactory Assessor’s signature

Practice was unsatisfactory Assessor’s signature

If the performance was judged to be unsatisfactory, you must tick the boxes on the reverse of this form to indicate which areas of performance they were.

Example of good practice were:

Areas of practice requiring improvement were:

Further learning and experience should focus on:

DIRECT OBSERVATION OF PROCEDURAL SKILLS (DOPS) - Anaesthetics

If you have rated the performance unsatisfactory please indicate which elements were unsatisfactory:

Did not understand the indications and contraindications to the procedure.

Tick Comments

Did not properly explain the procedure to the patient.

Tick Comments

Does not understand the relevant anatomy. Tick Comments

Failed to prepare properly for the procedure. Tick Comments

Did not communicate appropriately with the patient or staff.

Tick Comments

Aseptic precautions were inadequate. Tick Comments

Did not perform the technical aspects of the procedure correctly.

Tick Comments

Failed to adapt to unexpected problems in the procedure

Tick Comments

Failed to demonstrate adequate skill and practical fluency

Tick Comments

Was unable to properly complete the procedure Tick Comments

Did not properly complete relevant documentation Tick Comments

Did not issue clear post-procedure instructions to patient and/or staff

Tick Comments

Did not maintain an appropriate professional demeanor

Tick Comments

Did not understand the indications and contraindications to the procedure.

Tick Comments

CASE BASED DISCUSSION (CBD) ANAESTHETICS

Please complete this form in BLOCK CAPITALS and BLACK ink - (Appendix 3b)

Trainee’s Surname



Procedure

Code Number

Observed by


Date


Clinical setting:

Theatre ICU A&E Delivery Suite Pain Clinic Other

Case category: ASA Class: 1 2 3 4 5

Elective Scheduled Urgent Emergency

Assessment:



If the performance was judged to be unsatisfactory, you must tick the boxes on the reverse of this form to indicate which areas of performance you judged to be unsatisfactory.




CASE BASED DISCUSSION (CBD) ANAESTHETICS Special focus of discussion:

Please grade the following areas:

(Please see domain descriptors)

Belo

w y

our

expecta

tion for th

eir

gra

de a

nd e

xperience

Appro

priate

for gra

de

and e

xperience

Above y

our expecta

tion

for th

eir g

rade a

nd

experience

Not obse

rved o

r not

applicable

1. Record keeping:

2. Assessment and review of Investigations:

3. Identification of potential problems and difficulties:

4. Understanding of clinical alternatives:

6. Justification of clinical decisions shows understanding of risks and benefits

7. Planning for future care:

8. Quality of written instructions for future care:

9. Overall clinical care:

5. Understanding of the issues surrounding the clinical focus chosen by the assessor

Please complete this form in BLOCK CAPITALS and BLACK ink - (Appendix 3b)

ANAES-CLINICAL EVALUATION EXERCISE (CEX) ANAESTHETICS

Please complete this form in BLOCK CAPITALS and BLACK ink - (Appendix 3c)

Trainee’s Surname



Procedure

Code Number

Observed by


Date


Clinical Setting:

Theatre ICU A&E Delivery Suite Pain Clinic Other

Assessment:






If the performance was judged to be unsatisfactory, you must tick the boxes on the reverse of this form to indicate which areas of performance you judged to be unsatisfactory.

ANAES-CLINICAL EVALUATION EXERCISE (CEX) ANAESTHETICS Domains

Tick Unacceptable

Did not plan and prepare satisfactorily

Did not make a clear plan for the patients care

Is unaware of the particular hazards and problems of this procedure

Did not consider all the important relevant information or fails to organise additional appropriate investigation

Did not modify plans to avoid problems or mitigate their effects

Did not prepare necessary drugs and equipment before starting the case

Did not consider some important management options Did not recognise the potential hazards

Did not request necessary additional equipment and resources in advance

Did not request appropriate assistance

Did not make satisfactory clinical decisions

Decisions did not reflect a clear understanding of underlying principles of medical science and practice

Did not initiate monitoring and observation appropriate to the clinical situation

Did not reassess the options as the patient‘s condition changes

Did not attend to critical events in the patient’s progress

Did not take into account the urgency of the situation in responding to events

Did not know how to correctly operate the equipment

Did not anticipate the need for interventions and slow to respond to the need for intervention

Did not recognise obvious hazards

Slow to review the effects of interventions

Did not seek all relevant data before formulating responses

Did not respond to incipient difficulty by increasing the intensity of monitoring and observation

Did not focus sufficiently on safe practice

Careless of patient identification, correct procedure (and site of surgery) and formal record of risk factors

Did not abide by published standards, guidelines and protocols

Did not abide by protocols for checking drugs and equipment and critical actions

Breached procedures for avoiding healthcare associated infections

Did not record having encountered difficulties

Did not keep timely, accurate comprehensive records

Exhibited poor standards of professional behaviour

Insensitive to the patients opinions, hopes and fears

Did not respect confidentiality

Did not protect patients dignity

Knowledge was below expectation

Did not clearly explain plans and risks in a way that the patient could understand

Poor team working was observed

Did not discuss potential problems with the team

Did not understand the importance of the concerns expressed by other team members

Fails to demonstrate necessary leadership

Fails to follow the lead of others when appropriate

Made assumptions about capability of team members and did not act upon any poor performance

Acts without consideration of the affects on others and fails to co-operate to achieve joint goals

Displays panic and anxiety. Did not inspire confidence

Did not give clear timely instructions

Is rude to colleagues

Practical work was poorly carried out

Was clumsy

Handled tissues and uses instruments roughly

Did not follow an appropriate sequence in practical procedure

Procedure failed due to the operators lack of skill

Cannot explain how to operate equipment or makes mistakes

Appendix 3d -3f

ICM WBA’s

Intensive Care Medicine

Direct Observation of Procedural Skills (DOPS) Assessment Form

Please complete this form in BLOCK CAPITALS and BLACK ink - (Appendix 3d)

Trainee’s Surname



Procedure

Code Number

Observed by


Date


Assessment:

Practice was satisfactory

Tick one

Assessor’s signature

Practice was unsatisfactory

Tick one


Expand on areas of good practice. You MUST expand on areas for improvement for each unsatisfactory score given.





If you have rated the performance unsatisfactory, you MUST indicate which elements were unsatisfactory:

Performance YES NO Comments

Understands indications and contraindications for the procedure

Tick Tick Comments

Explained procedure to patient Tick Tick Comments

Understands relevant anatomy Tick Tick Comments

Satisfactory preparation for procedure Tick Tick Comments

Communicated appropriately with patient and staff

Tick Tick Comments

Full aseptic technique Tick Tick Comments

Satisfactory technical performance of procedure Tick Tick Comments

Adapted to unexpected problems during procedure

Tick Tick Comments

Demonstrated adequate skill and practical fluency

Tick Tick Comments

Maintained Safe practice Tick Tick Comments

Completed procedure Tick Tick Comments

Satisfactory documentation of procedure Tick Tick Comments

Issued clear post-procedure instructions to patient and staff

Tick Tick Comments

Maintained professional demeanour throughout procedure

Tick Tick Comments


Case based Discussion (CbD) Assessment Form

Trainee’s Surname


GMC Number GMC NUMBER MUST BE COMPLETED Please complete this form in BLOCK CAPITALS and BLACK ink - (Appendix 3e)

Code Number or Description of Case

Observed by


Date

Signature of supervising doctor

Clinical Setting:

ICU HDU A&E Ward Transfer Other Assessment:


Tick one



Tick one


Expand on areas of good practice. You MUST expand on areas for improvement for each unsatisfactory score given overleaf.

Examples of good practice were:



Special focus of discussion:


(Please see Domain Descriptors)

Satisfactory

Unsatisfactory

1. History taking and information gathering Tick Tick

2. Assessment and differential diagnosis Tick Tick

3. Immediate management and stabilisation Tick Tick

4. Further management and clinical judgement Tick Tick

5. Identification of potential problems and difficulties Tick Tick

6. Communication with patient, staff and colleagues Tick Tick

7. Record keeping Tick Tick

8. Overall clinical care Tick Tick

9. Understanding of the issues surrounding the clinical focus chosen by the assessor

Tick Tick



Clinical Evaluation Exercise (ICM-CEX) Assessment Form

Please complete this form in BLOCK CAPITALS and BLACK ink - (Appendix 3e)

Trainee’s Surname



Observation

Code Number

Observed by


Date

Signature of supervising doctor

Clinical Setting:

ICU HDU A&E Ward Transfer Other Assessment:


Tick one



Tick one


Expand on areas of good practice. You MUST expand on areas for improvement for each unsatisfactory score given.

Examples of good practice were:




Clinical Evaluation Exercise (ICM-CEX) Assessment Form


(Please see Domain Descriptors)

Satisfactory

Unsatisfactory

1. History taking and information gathering Tick Tick

2. Assessment and differential diagnosis Tick Tick

3. Immediate management and stabilisation Tick Tick

4. Further management and clinical judgement Tick Tick

5. Identification of potential problems and difficulties Tick Tick

6. Maintain safe practice for patient, trainee & staff Tick Tick

7. Communication with patient, staff and colleagues Tick Tick

8. Record keeping Tick Tick

9. Overall clinical care Tick Tick

Appendix 3e

Appendix 4a – 4f:

MSF Form templates Appendix 4a: MSF Anaes Letter

Appendix 4b: MSF Anaes 360 degree TAB Appendix 4c: MSF Anaes Summary Appendix 4d: MSF ICM Letter

Appendix 4e: MSF ICM 360 degree TAB Appendix 4f: MSF ICM Summary

4 - MSF

Appendix 4a – 4c

Anaes MSF

COVERING LETTER FOR MULTI-SOURCE FEEDBACK DATE: Dear Colleague, RE: Core trainees in Anaesthesia / Intensive Care Medicine – Multi-Source Feedback 360o Team Assessment of Behaviour (TAB) Multi-source feedback is now a required part of the assessment process for core trainees in anaesthesia and we would be grateful if you would take a few minutes to complete the attached form. The form is anonymous but I ask that you complete a limited number of personal details to enable us to check that a suitable cross-section of people have been asked to comment on the trainee’s performance. Please return the MSF form TO: …………………………….……………………………… (Educational Supervisor / College Tutor In the envelope provided by the date indicated below) DATE: ……………… Thank you for agreeing to complete this multi-source feedback form. Yours faithfully, __________________ Trainee Name:_______________________________ KSS Deanery School of Anaesthetics

Appendix 4a

Appendix 4b

KSS Deanery School of Anaesthesia

Multi-source feedback: 360o team assessment of behaviour (TAB)

Trainees name

GMC number

Current post

Date started present post 4h August 2010

Assessor’s details

Gender Male Female

Specialty & Location Consultant Anaesthetics

Nurse Theatre/Recovery

ODP Administration/Secretarial staff

SAS Grade ICU/HDU

SpR 3–5/StR 3–7

Ward

StR 1/2 Other

FY / Other

Areas of concern Behaviour and attitudes evidenced by behaviour

None Some Major

Comments


• Listens

• Is polite and caring

• Shows respect for

patients’ opinions, dignity and confidentiality

• Is unprejudiced and dresses appropriately


None Some Major

Comments


• Gives understandable information

• Speaks good English, at the appropriate level for patients


• Respects others’ roles and works constructively in the team

• Hands over effectively and communicates well

• Is unprejudiced, supportive and fair

Accessibility

• Is accessible

• Takes proper

responsibility

• Only delegates

appropriately

• Does not shirk duty

• Responds when

called

• Arranges cover for

absence

Assessor’s Signature

Thank you for completing this form.

Appendix 4b

Appendix 4c

KSS Deanery School of Anaesthesia

Anaesthetic MSF Summary form for Feedback to the trainee

Trainees name

Trainee’s GMC number

Current post

Date started present post

Name of the Educational Supervisor

Year of CT / SpR / StR training

Form to be completed by the staff member responsible for

feedback before the meeting with the trainee

Areas of concern Behaviour and attitudes evidenced by behaviour Number of

raters No Concern

Some Concern

Major Concern


• Listens


• Shows respect for patients’ opinions, dignity and confidentiality


Comments:




Comments:


Number of raters

No Concern Some Concern

Major Concern




Comments:

Accessibility

• Is accessible

• Takes proper responsibility

• Only delegates appropriately


• Responds when called

• Arranges cover for absence

Comments:

Future recommendations for training:

After completing this form, please can the Educational Supervisor meet with the trainee to discuss it and

make one copy for the trainee’s portfolio and one for your records? Thank you.

Appendix 4c

Educational Supervisor’s Signature

Date

Trainee’s signature

Appendix 4d -4f

ICM MSF

IBTICM

Multi-source feedback (ICM MSF)

Appendix 4d

IBTICM Multi-source feedback (ICM MSF) Date Dear Colleague Trainees in Intensive Care Medicine – Multi–source feedback Multi–source feedback is now a required part of the assessment process for trainees in intensive care medicine and we would be grateful if you would take a few minutes to complete the attached form. The form is anonymous but we ask that you complete a limited number of personal details to enable us to check that a suitable cross-section of people have been asked to comment on the trainees’ performance. Please return the form to ------------------------------------- (Educational Supervisor) in the envelope provided by (add date)-------------------------. Thanks you for agreeing to complete this multi-source feedback form. Yours faithfully, ----------------------------------------------------------- IBTICM Trainee (add name)

IBTICM

Multi-source feedback (ICM MSF)

Appendix 4e

Name of trainee: Year of Training:

Assessor details Male Female GMC No:

Doctor specialty Date / /

Consultant

Nurse (Theatres/PACU)

SAS Grade Nurse (ICU/HDU)

SpR 4-5 (StR 6-7) Nurse (Ward)

SpR 1-3 (StR 3-5) ODP

StR 1-2 (CT 1-2) Admin/Secretarial

FY 1-2 Other

• Please use the free text part of this form to comment on particularly good behaviour or any behaviour causing concern

• If you want to comment on attitude please provide evidence of behaviour. This should reflect the trainee’s behaviour over time – not usually a single incident.

• The trainee will receive private feedback, but you will not identified

• If enough observers regard a trainee as giving cause for concern they will be offered help and support

Areas of concern

Please TICK to indicate the standard of the trainee’s performance in each area

None

Some Major Cannot comment


• Listens






• Speaks good English, at an appropriate level for the patient

Team working/working with colleagues


• Hands over effectively and communicates well. Is unprejudiced, supportive and fair

Accessibility • Is accessible • Takes proper responsibility • Only delegates appropriately • Does not shirk duty • Responds when called • Arranges cover for absences

Comments

IBTICM

MSF Summary Form

(for Feedback to the trainee) Appendix 4f

Trainees name

Trainee’s GMC number

Current post

Date started present post

Name of the Educational Supervisor

Year of CT / SpR / StR training

Form to be completed by the staff member responsible for

feedback before the meeting with the trainee

Areas of concern Behaviour and attitudes evidenced by behaviour Number of

raters No Concern

Some Concern

Major Concern


• Listens




Comments:




Comments:


Number of raters

No Concern Some Concern

Major Concern




Comments:

Accessibility

• Is accessible

• Takes proper responsibility

• Only delegates appropriately


• Responds when called

• Arranges cover for absence

Comments:

Future recommendations for training:

After completing this form, please can the Educational Supervisor meet with the trainee to discuss it and

make one copy for the trainee’s portfolio and one for your records? Thank you.

Appendix 4f

Educational Supervisor’s Signature

Date

Trainee’s signature

Appendix 5:

RCOA Membership - Information

- Insert Form

5

Registration with the Royal College of Anaesthetists It is a mandatory requirement for all trainees to be registered with the appropriate Royal College, therefore Core Anaesthetics Training Trainees must be registered with the RCoA. If you are not registered the School of Anaesthetics will not complete your Annual Review of Competence Progression (ARCP). How to enrol: You will require the following codes: KSS Deanery SOAN: GMC Approval code: KSS/SRT540 Training Number: RTG trainees – should use the Training Number allocated to them

Core Trainees on one or two year contracts: 10/ANAE/Cnnnn/KSS Where nnnn is a four digit number which identifies an individual trainee Core Trainees should be aware that whilst this number resembles a National Training Number it is not one it is your KSS Deanery Reference Number and should only be used for registration with the RCoA. Step One: Register with the RCoA You are firstly required to register for an account by going to http://www.rcoa.ac.uk/docs/Registration.pdf Step Two: Registration Once the registration form has been successfully completed and signed by you, your Training Programme Director or College Tutor and a Regional Adviser post the application form to: Training Department The Royal College of Anaesthetists Churchill House 35 Red Lion Square London WC1R 4SG Please note: Dr Claire Shannon is currently the Regional Advisor for South Coast region and she will be able to provide her signature to your application form if required. You will need to post your application form to her with a stamped addressed envelope at the following address: SESA Step Three: Enrol Once step two is completed you should be able to view ‘My RCoA’. This section of the website will only become visible and accessible to you once you have logged in. Step Four: Make payment You are required to pay your fee Queries: Please contact the Enrolments Department at the RCoA at [email protected] For exam queries please contact: [email protected]

Appendix 6:

- Primary FRCA Exam Schedule

6

Appendix 7:

Blueprint of the Primary FRCA Examination Mapped Against

the Basic Level Units of Training

7

APPENDIX 7

Blueprint of the Primary FRCA examination mapped against the basic level units of training

Unit of Training MCQ OSCE SOE 1 SOE 2

Preoperative assessment √ √ √** √ Premedication √ √ √ √ Induction of general anaesthesia √ √ √ √ Intra-operative care including sedation √ √ √ √ Postoperative and recovery room care √ √ √ √ Introduction to anaesthesia for emergency surgery √ √ √ √ Transfer medicine √ √ Management of respiratory and cardiac arrest √ √ √ √ Control of infection √ √ √ √*** Academic and research √* Airway management √ √ √ Critical incidents √ √ √ Day surgery √ √ √ √ General, urological and gynaecological surgery √ √ √ ENT, maxillo-facial and dental surgery √ √ √ Intensive care medicine √ √ √ √ Non-theatre √ √ √ Obstetrics √ √ √ √ Orthopaedic surgery √ √ √ Sedation √ √ √ √ Paediatrics including child protection √ √ √ √ Pain medicine √ √ √ √ Regional √ √ √ √ Trauma and stabilisation √ √ √ Anatomy √ √ Physiology and biochemistry √ √ √ √*** Pharmacology √ √ √ √*** Physics and Clinical measurement √ √ √ Statistical methods √ √ OSCE: * Communicates risk information, and risk-benefit trade-offs, in ways appropriate for individual patients. SOE1: ** All the drugs patients may be on preoperatively. SOE2: *** Partially covered

Appendix 8:

Action Plan Template

8

School of Anaesthetics - SPECIALTY TRAINING – TRAINEE ACTION PLAN

First Name of Trainee Grade

Last Name of Trainee

Specialty ANAESTHETICS ARCP due date

Knowledge to Gain/Skills to Build/Attitudes to Develop

Proof Development Activities

Potential Mentors

Target Completion

Date 1.

2.

3.

4.

Continue overleaf if additional areas identified. Please cross through all unfilled boxes

Agreed further review date To be reviewed by

Progression date to next level of training

TPD/Educational Supervisor Agreement:- Name of TPD/Educational Supervisor

Signature of TPD/Educational Supervisor Date

Signature of Trainee I am signing that I understand the skills/attitudes and knowledge identified that need further development and have agreed the timeframe with the TPD/Educational Supervisor. I have had explained and understand the consequences should these not be achieved.

Date

Please return this form to the Specialty Workforce Team at:- Suite 4.2, Providian House, 16-18 Monument Street, London EC3R 8AJ

Additional requirements (if needed)

Knowledge to Gain/Skills to Build/Attitudes to Develop

Proof

Development Activities

Potential Mentors

Target Completion

Date

5.

6.

7.

8.

Please cross through all unfilled boxes

Office use only:- Copy in Trainee file and Trainee Support Group Copy to Educational Supervisor & DME

core trainee portfolio - kss · pdf file3 ct1 appraisal paperwork ... core trainee portfolio...

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