1. ACCS ROTATION STRUCTURE and CURRICULUM

ACCS TRAINEE HANDBOOK

2017 v3

WEST OF SCOTLAND DEANERY

AUGUST 2017 CONTENTS

1. ACCS ROTATION STRUCTURE and CURRICULUM

2. CT1 ACCS ACUTE MEDICINE PLACEMENT

3. CT1 ACCS EMERGENCY MEDICINE PLACEMENT

4. CT2 ANAESTHETIC PLACEMENT

5. ADDITIONAL INFORMATION FOR ACCS ACUTE MEDICINE PARENT TRAINEES

6. ADDITIONAL INFORMATION FOR ACCS EMERGENCY MEDICINE PARENT TRAINEES

7 ADDITIONAL INFORMATION FOR ACCS ANAESTHESIA PARENT TRAINEES

8. CT2 INTENSIVE CARE MEDICINE PLACEMENT

9. INTENSIVE CARE MEDICINE EDUCATIONAL SUPERVISOR FORM

10. ACCS EM STRUCTURED TRAINING REPORT PAPER FORM

11. ST1/CT1 & ST2 ARCP CHECKLISTS

12. ACCS CONTACTS & FURTHER TRAINING INFORMATION

2 Section 1

ACCS STRUCTURE

In the West of Scotland, the ACCS training programme is currently arranged as follows:

Year 1: 6 month Emergency Medicine placement, 6 month Acute Medicine placement (these can be arranged in either order)

Year 2: 12 month Anaesthesia and Intensive Care Medicine placement, as a general rule this will be 6 months Anaesthesia and 6 months ICM (these can be arranged in either order). The curriculum rules allow a 3/9 month split either way. A 6/6 month split is the most common occurrence.

Required rate of progression through ACCS year 2: We would expect you to achieve an Initial Assessment of Competency [IAC] certificate after 3-4 months of anaesthetic training. On occasion some trainees are slow to acquire anaesthetic competencies, only finally achieving an IAC certificate after 6-9 months of training. This in turn impacts on the time available to achieve ICM competencies within the ACCS CT2 year. Trainees who fail to achieve the IAC and are judged unable to take part in on call rota activity after 6 months of anaesthetic training should expect to require an extension to ACCS CT2 training time.

The curriculum The most up to date source of information is the ACCS website – https://www.rcoa.ac.uk/accs The current curriculum is from 2012. It is easily found on the ACCS website; and is also available here - http://www.rcoa.ac.uk/node/1455.

Trainees need to read the ACCS curriculum. It will explain the competencies you need to demonstrate over the 2 years. It is a miserable thing to read but persist with it to get to grips with ARCP requirements. The requirements for workplace based assessments are onerous and it even explicitly says at one point – expect to do at least one a week.

All trainees are required to use an e-Portfolio to record the required competencies. Sadly there is no single ACCS e-Portfolio. Emergency Medicine and Acute Medicine trainees should use the e-Portfolios provided by the Royal College of Emergency Medicine and the JRCPTB respectively. They are similar in design. Anaesthesia trainees should use the e-Portfolio provided by the RCOA, which is not similar in design.

Where it is not possible to use your e-Portfolio to complete assessments, you should complete paper copies of these and upload them to the Personal Library section of your e-Portfolio. Generally when in EM and AM anaesthetic trainees will need to use paper copies of the EM and AM WPBA’s and scan them in to their anaesthetic eportfolio, and when in anaesthesia EM and AM trainees will need to use paper copies of anaesthetic forms and scan them into their eportfolio’s. Paper versions of the WPBA’s can be found through the ACCS site or directly from the respective College/Faculty webs sites. Documents should be labelled clearly in order to avoid any problems at your ARCP review. The file names of documents taken from the WOSSA website should not be altered.

3 However….it is not quite that ‘simple’……

1. The West of Scotland School of Anaesthesia [WOSSA] expects certain documents which are available on the WOSSA website to be filled out and uploaded to eportfolio as PDFs, so even anaesthetists will not be entirely “paperless” whilst in Anaesthetics – see Anaesthesia section.

2. ICM does not have an eportfolio for CT level trainees. In addition clarity on ICM ARCP requirements is hard to come by. Certain official ACCS documents say slightly different things. In the West of Scotland to simplify this issue please use and fulfil the guidance found below in the ICM section of the handbook. Every year trainees fail to read the handbook and thus end up with bad ARCP outcomes

4 Section 2

CT1 ACCS ACUTE MEDICINE PLACEMENT (6 MONTHS)

In your six months of Acute Medicine, not everyone will be in an acute medical unit for the full time of their placement, but you will be in an acute medical specialty with time in acute receiving.

Educational Supervision You will be allocated an educational supervisor, but if you are having issues being allocated with one, please email [email protected] and this will be remedied. You should meet your supervisor early and complete a learning agreement and plan what you need to do in this block. You should also have a mid placement and end of placement meeting. Try to do your assessments in a timely fashion and do not leave them to the last minute, as your supervisor needs to be able to review these to complete your training report.

Study Leave Apply for study leave in advance to allow the unit to plan their staffing. There will be four ACCS training afternoons throughout the year and the dates for these will be confirmed with you.

Numbers of required Workplace Based Assessments

Mini-CEX 3 ACAT 3 DOPs 5 CBD 3 Supervisor Report 1 MSF (minimum of 12 responses, 3 of which 1 (to be done in AM or EM placement) must be consultants, including Supervisor)

Generic information on curriculum and assessment

Major and Acute Presentations (in Curriculum)  2 of the 6 Major Presentations must be covered by Mini-CEX or CBD  10 of the Acute Presentations with ACAT, mini-CEX or CbD.  Further 8-10 with ACAT, E-learning, teaching, reflective entries, etc.  Complete 5 practical procedures from the curriculum using DOPS

Due to the differences in the e-Portfolios, there is a difference in the way to access the forms for assessments.

Both AM and EM trainees will be able to use the e-Portfolio to complete the WPBAs and the Educational Supervisors Report (Structured Training Report in the EM e-Portfolio). You should link assessments to the Major and Acute presentations and reflections on learning events and e-learning can also be linked.

Anaesthetics trainees will need to use paper forms for WPBAs and upload these to the RCOA e-Portfolio. These forms are available through the JRCPTB website and then searching for 5 the specific WPBA required. The Structured Training Report that follows should be used at the final meeting and uploaded. Please ensure that forms are clearly labelled as this allows them to be readily identified at the time of ARCP.

The ARCP checklist should be completed and uploaded to the e-Portfolio.

AM trainees should also keep a procedure and clinic logbook available though the JRCPTB, https://www.jrcptb.org.uk/documents/cmt-procedure-logbook-2015. As this will help for CT3

6 Structured Training Report for Acute Medicine Module

The modular (clinical) supervisor must complete this STR, having reviewed the trainee’s learning portfolio and WPBAs. ACCS-AM trainees should also have a clinical supervisors report completed in their e-Portfolio.

Current Placement

Base Hospital/Department

Dates

Clinical supervisor

WPBAs in Current Placement Assessment Number Comments

Mini-CEXs

(min 3 in 6 months)

DOPs (List of Procedures and Outcome)

(min 5 in 6 months)

CBDs

(min 3 in 6 months)

ACATs

(min 3 in 6 months)

7 MSF Number of respondents:

(min 1 in 12 months)

Summary of experience

Activity Details / comments

Log book - numbers and case mix

Clinical governance, audit

Progress against PDP

Management, leadership

Exams, educational achievements

Courses, study days

Teaching experience

Plaudits, thanks

Other achievements

Periods of absence

Concerns, complaints, investigations: Are you aware if this trainee has been involved in any conduct, capability or Serious Yes1 / No Untoward Incidents/ Significant Event investigation, or named in any complaint? If so, are you aware that the issue(s) has/have been resolved satisfactorily, with no Yes1 /No / NA unresolved concerns about the trainee’s fitness to practice or conduct? Details:

1 If there is an unresolved concern or conduct, capability/ SUI investigation or a complaint for this trainee please complete the Exception Exit Report, and notify the Deanery and TPD/Head of school.

8 Summary of Trainees Assessment Please attach supporting evidence if available or give examples of behaviours.

Clinical knowledge and skills

Professionalism and attitudes

Communication and relationships

Academic endeavour and learning

Overall strengths of Trainee

Areas for improvement

Supervisor signature: Trainee signature:

Date: Date:

9 Section 3

CT1 ACCS EMERGENCY MEDICINE PLACEMENT (6 MONTHS)

All ACCS trainees will have 6 months in Emergency Department. Trainees should ensure exposure to all streams of patients i.e. Resus, Minors and Majors o=in order to gain the breadth of knowledge and skills.

Educational Supervision During your 6 months in EM, you will be allocated an educational supervisor/clinical Supervisor, but if you are having issues being allocated with one, please email [email protected] and this will be remedied. You should meet your supervisor early and complete a learning agreement and plan what you need to do in this block. You should also have a mid placement and end of placement meeting. Try to do your assessments in a timely fashion and do not leave them to the last minute, as your supervisor needs to be able to review these to complete your training report at the end of your placement. EM trainees should continue to liaise with their EM Education Supervisor or ACCS EM lead for EM career progression, exams and any other issues.

Workplace Based Assessments

Numbers of required Workplace Based Assessments

Mini-CEX 4 ACAT EM 1 DOPs 5 CBD 3 Supervisor’s Structured Training Report 1 MSF (minimum of 12 responses, including 1 for the year (done in AM or EM) Supervisor and 3 consultants)

Please note the above numbers are the minimum WPBA required. Your Supervisor must verify that the minimum number of assessments have been satisfactorily completed when they complete their Structured training Report (STR) at the end of each block. Further details and links are list in following section. You should link your WPBAs to relevant section of RCEM curriculum covered in that assessment.

Generic information on curriculum and assessment

During Emergency Medicine 6 months - the trainee must undertake:  Summative assessment (Mini-CEX or CbD) in two of the following Major presentations: o CMP1 - Anaphylaxis o CMP2 - Cardiorespiratory arrest o CMP3 - Major Trauma 10 o CMP4 - Septic patient o CMP5 - Shocked patient o CMP6 - Unconscious patient  Summative assessment (Mini-CEX or CbD) in all of the following Acute presentations: o CAP7 - Chest pain o CAP1 - Abdominal pain o CAP6 - Breathlessness o CAP30 - Mental health o CAP18 - Head injury  Formative assessments (ACAT-EM) in 5 additional acute presentations  10 additional assessments of acute presentations using a combination or o e-learning o Reflective entries o Teaching and audit assessments o Additional ACAT-EMs  Assessment of practical procedures including: o Airway management o Primary survey o Wound care o Fracture reduction joint reduction o Plus one other from the list using generic DOPs

Guidance for ACCS Acute Medicine trainees

 Use e-Portfolio to complete WPBA.  Link the WPBAs with the ACCS 2010 Curriculum found on e-portfolio. ACAT assessments are especially useful in allowing you to link one assessment to a variety of major and acute presentations.  Log on teaching sessions and courses attended under ‘Reflective Logs’ that can also be linked to the curriculum. This is especially useful to link various acute presentations to the curriculum, which you might not have covered via WPBAs.

Guidance for ACCS Emergency Medicine trainees

Guidance for ACCS Anaesthesia trainees

 Use paper forms from the ACCS website. Scan and upload these to the Personal Library section of your RCOA e-Portfolio.  RCEM Paper form are available at http://www.rcem.ac.uk/docs/Training/2015%20Curriculum%20-%20Appendix %202%20(Oct%202016%20update)%20-%20for%20website.pdf 

11 Section 4

CT2 ACCS ANAESTHETICS PLACEMENT (1 YEAR)

Numbers of required Workplace Based Assessments

Mini-CEX 5 Anaes CEX ACAT - DOPs 6 CBD 8 Supervisor Report 1 MSF (minimum of 12 responses, including Consultant feedback Supervisor)

Generic information on curriculum and assessment

Information about the Initial Assessment of Competencies is available at: http://www.rcoa.ac.uk/training-and-the-training-programme/initial-assessment-of- competencies-iac [accessed 12.8.16]

Guidance for ACCS Acute Medicine trainees

 You should use the assessment forms from the RCOA and WOSSA website, scan and upload these to your e-Portfolio.  Note that you will be required to keep a Logbook of all theatre cases you have participated in during your Anaesthetic rotation. A suitable iPhone or android app can be used for this (e.g. iGasLog) or a Logbook can be downloaded from the RCOA website.

Guidance for ACCS Emergency Medicine trainees

Guidance for ACCS Anaesthesia trainees

 You should complete Workplace Based Assessments on your e-Portfolio, but use WOSSA files for the Clinical Experience & Logbook, Portfolios(of Research & Audit, Education &Teaching and Administration & Management), Trainee Evaluation of Post and Educational Supervisor Reports. These should be completed electronically then uploaded into Library or Activities in your e-Portfolio, using the same file names as those found on the WOSSA website. http://www.jet5.com/wossa [accessed 12.8.16]

12 Section 5

ADDITIONAL INFORMATION FOR ACCS ACUTE MEDICINE PARENT TRAINEES

You must register as a trainee member of the JRCPTB (Joint Royal Colleges of Physicians Training Board) (http://www.jrcptb.org.uk). Once you have returned your Form R and conditions form to NES, your details will then be forwarded to the JRCPTB, who should then contact you regarding registration.

ACCS ACUTE MEDICINE YEAR 3 The third year will be spent in acute medical specialties. This allows additional time to achieve equivalent competencies and experience to CMT trainees. You should have the CMT curriculum added to your e-portfolio at the beginning of the training year and should cross link with this curriculum. By the end of the third year you should have completed the MRCP and will be eligible to apply to higher specialist training.

ACCS 1 ARCP Requirements Educational Supervisor’s Structured Reports from ACUTE MEDICINE and EMERGENCY MEDICINE rotations. Completed ACCS Record of Training Form

ACCS 2 ARCP Requirements

Anaesthesia

Educational Supervisor Report from Anaesthesia

Clinical Experience – Logbook & Portfolios files should be uploaded onto e-portfolio

Initial Assessment of Competence in Anaesthesia and CUT forms for Basis of Anaesthetic Practice. Once you obtain the IAC you should use any remaining general anaesthesia time to start to gain the WPBAs required for core anaesthesia training.

Consultant Feedback from Anaesthesia scanned into e-portfolio

ICM requirements are as below in CT2 ACCS INTENSIVE CARE MEDICINE

Trainee Evaluation of Posts from Anaesthesia & Intensive Care Medicine should be uploaded onto e-portfolio

Additional yearly ARCP Requirements

At the end of each training year you will also be asked to submit Deanery Forms which include:

SOAR Absence Declaration Form – Deanery need a paper copy even if you also put this on your eportfolio Exam Information Annual Update Form Flexible Training Form

In January of each year these forms will be sent to you by the Deanery along with your ARCP letter detailing the ARCP requirements and deadlines. 13 ------

ARCP checklists attached at the end of the Handbook.

Section 6

ADDITIONAL INFORMATION FOR ACCS EMERGENCY MEDICINE PARENT TRAINEES

You must register as a trainee member of the Royal College of Emergency Medicine (RCEM) http://www.rcem.ac.uk . Once you have returned your Form R and conditions form to NES, your details will then be forwarded to the Royal College of Emergency Medicine, who should then contact you regarding registration and eportfolio access.

RCEM advice regarding registration of trainees is as following;

 Trainees who have been issued with National Training Numbers (NTNs); run-through trainees and higher specialty trainees must enrol with the Training Standards Committee (TSC). Enrolment will enable the College to, in due course, confirm eligibility for the FRCEM examination and make a recommendation to the GMC for inclusion on the specialist register.

 Trainees who have not been issued with a National Training Number; core trainees, those in Fixed Term Specialty Training Appointments (FTSTA) or Locum Appointment for Training (LAT) posts must register with the Training Standards Committee (TSC). As part of this process the TSC will advise on the recognition of previous training and the training required to complete the programme.

EDUCATIONAL SUPERVISORS Meet with your Educational Supervisor early and complete a Learning Agreement. You should have initial, midpoint and endpoint reviews. Plan the end of block review in plenty of time to give them time to provide an Educational Supervisor’s Report. They can provide you with information about research/audit and teaching opportunities. An Educational supervisor will be a consultant in the Speciality you are currently in.

You should aim to keep in contact with your Emergency Medicine Educational Supervisor when you move into other specialty placements.

You can also contact ACCS EM lead through NES for further training related queries and issues.

STUDY LEAVE Ask for study leave in advance. There should be 4 ACCS training days in the year, and details will be forwarded to you as early as possible.

EXAMS The GMC have approved the changes to the College’s examination structure, with effect from August 2016. The existing MRCEM and FRCEM examinations will therefore be replaced with a suite of examinations that will lead to the award of Fellowship of the College (FRCEM).

14 A number of these changes will be introduced with effect from August 2016 whilst others will be phased in over the next two years to permit trainees and other examination candidates the opportunity to complete the existing suite of examinations. Please see the regulation and information packs on RCEM website, http://www.rcem.ac.uk/RCREM/Exams_Training/UK_Trainees/RCEM/Exams_Training/UK_Tr ainees/UK_Trainees.aspx?hkey=e088081a-9f1a-4aec-84a7-eda53a9a8ca9

ACCS 1 ARCP Requirements

Educational Supervisor Reports from Emergency Medicine & Acute Medicine: ensure that your supervisors have acknowledged a satisfactory MSF for each block and that you have completed a satisfactory number of WPBAs.

ACCS 2 ARCP Requirements

Anaesthesia

Educational Supervisor Report from Anaesthesia

Clinical Experience – Logbook & Portfolios files should be uploaded onto e-portfolio

Consultant Feedback from Anaesthesia scanned into e-portfolio

ICM requirements are as below in CT2 ACCS INTENSIVE CARE MEDICINE

Trainee Evaluation of Posts from Anaesthesia & Intensive Care Medicine should be uploaded onto e-portfolio

Additional yearly ARCP Requirements

At the end of each training year you will also be asked to submit Deanery Forms which include:

Form R Absence Declaration Form - Deanery need a paper copy even if you also put this on your eportfolio Exam Information Annual Update Form Flexible Training Form SOAR declaration

In January of each year these forms will be sent to you by the Deanery along with your ARCP letter detailing the ARCP requirements and deadlines.

15 ARCP checklists attached at the end of the Handbook.

Section 7

ADDITIONAL INFORMATION FOR ACCS ANAESTHESIA PARENT TRAINEES

You must register as a trainee member of the RCoA. On registering you will receive Login details. Go to the RCOA website for instructions on what to do once you have your login details (http://www.rcoa.ac.uk/trainee-e- portfolio/joining-instructions). If you have any problems, contact [email protected]. PROGRESSION Successful completion of each component of the first two years of the ACCS programme (http://www.rcoa.ac.uk/careers-training/training-anaesthesia/anaesthesia-programme- structure/acute-care-common-stem-accs) is required for direct entry into CT2 Anaesthesia. By the end of CT2 Anaesthesia, you must successfully have completed the Royal College of Anaesthetists (RCoA) 2010 Curriculum-Basic Level Training and have passed the Primary FRCA in order to apply for an ST3 post in Anaesthesia.

EDUCATIONAL SUPERVISORS

Meet with your Clinical/Educational Supervisor early and complete a Learning Agreement. You should have initial, midpoint and endpoint reviews. Plan the end of block review in plenty of time to give them time to provide an Educational Supervisor’s Report. They can provide you with information about research/audit and teaching opportunities. ANAESTHETIC COLLEGE TUTORS There is an RCoA College Tutor in every hospital, who can help with any Anaesthetic related questions. It is helpful to make contact with them to plan your anaesthetic career and exam preparation. STUDY LEAVE Ask for study leave in advance. There will be 4 ACCS training days in the year. Details will be available early in the year. Consider applying for IMPACT, ATLS, PILS/APLS, SICS meetings, RCPSG events. ACCS1 ARCP Requirements

16 Educational Supervisor Reports from Emergency Medicine & Acute Medicine scanned into e- portfolio: ensure that your supervisors have acknowledged a satisfactory MSF for each block and that you have completed a satisfactory number of WPBAs.

Portfolios file (as above) should be uploaded onto e-portfolio.

Trainee Evaluation of Posts from Emergency Medicine & Acute Medicine should be uploaded onto e-portfolio.

ACCS2 ARCP Requirements

Anaesthesia

Educational Supervisor Report from Anaesthesia

Clinical Experience – Logbook & Portfolios files should be uploaded onto e-portfolio

Consultant Feedback from Anaesthesia scanned into e-portfolio

ICM requirements are as below in CT2 ACCS INTENSIVE CARE MEDICINE

Trainee Evaluation of Posts from Anaesthesia & Intensive Care Medicine should be uploaded onto e-portfolio.

Additional yearly ARCP Requirements

At the end of each training year you will also be asked to submit Deanery Forms which include:

Form R Absence Declaration Form - Deanery need a paper copy even if you also put this on your eportfolio Exam Information Annual Update Form Flexible Training Form SOAR declaration

In January of each year these forms will be sent to you by the Deanery along with your ARCP letter detailing the ARCP requirements and deadlines. ------

ARCP checklists attached at the end of the Handbook.

17 Section 8

CT2 ACCS INTENSIVE CARE MEDICINE – info applies to all trainees – EM, AM and Anaesthesia

Educational Supervision for ICM

Each anaesthetic dept. has a Royal College of Anaesthetists Tutor [the College Tutor] and they will assign to you an Anaesthetic Educational Supervisor for the anaesthetic component of your year. If this doctor also does ICM it is likely they will remain your supervisor during your ICM block. If they do not do ICM then you need a separate Educational Supervisor who is an ICM consultant during your ICM block. Every intensive care unit has a Faculty of Intensive Care Tutor and it is their duty to assign to you an ICM consultant to fulfil this role. Your Intensive Care Ed. Sup. should check up on your ICM WPBA’s and compile your ICM Educational Supervisor report.

18 Meet with your ICM educational supervisor early in your block to discuss an educational framework for the block, plan a mid block review date and another meeting just prior to the Deanery paperwork submission deadline and if required a further final end of block meeting.

ICM related Assessment requirements

There is a discrepancy between the required number of WPBA’s as found on the ICM section of the ACCS website and the curriculum. You will be pleased to note in the WoS we use the lower numbers as dictated by the ACCS website, not the vast numbers suggested by the 2012 curriculum document.

The table below shows all the assessments needed during your time in ICM.

Competency needs to be demonstrated using WPBA’s in all 25 elements of ‘Annexe F’. Annexe F can be found at- https://www.rcoa.ac.uk/CCT/AnnexF [accessed 24.7.2017]. A single WPBA assessment can be used to attest to competence in several domains of Annexe F but generally you will need to do more than the minimum number of WPBA’s to complete Annexe F.

Elements required for ARCP + Minimum number of WPBA’s required for ARCP If ICM block 3 months If ICM block 4-6 months Mini-CEX 1 2 DOPs 1 2 CBD 1 2 ACAT 1 2 NOTE – 2 of the 6 major presentations must be covered, one must be ‘treatment of the septic patient’ – as per ACCS curriculum Demonstrate ability [through WPBA] Required by all trainees in the 25 competencies found for Basic level ICM training in Annexe F Completion of Unit of Training (CUT) Required by all trainees. form in Intensive Care Medicine

MSF (minimum of 12 responses, at Required by all trainees least 3 from Consultants) Educational Supervisor Report - Required by all trainees – use form below. needs to be completed in detail including a dated review of all the above elements, use the local form below

All of the elements in the table above need to be clearly labelled and scanned into eportfolio in time for your ARCP.

In addition you should comply with any further base specialty requirements for documentation of clinical experience gained in ICM e.g. if your College requires a logbook keep one. etc.

Should you need to use the Faculty WPBA’s and MSF forms they are available on the Faculty website at - https://www.ficm.ac.uk/curriculum-assessment-training/assessment-forms [accessed 24.7.17]

The local ICM Educational Supervisor form

19 Use the locally generated ICM Educational Supervisor report form [below]. This is the most important piece of paperwork and it must be completed in detail clearly indicating that all the appropriate assessments have been seen and judged satisfactory by your supervisor.

To help you and your Educational Supervisor an exemplar completed Educational Supervisor form can also be found below.

About the ARCP submission deadline and ICM paperwork completion – problems in particular for doctors starting a 3 month block of ICM in May

The Deanery has a tight deadline to complete the formal paperwork requirements. This means your end of year ARCP needs to be in June. In turn your paperwork submission deadline will be late May or very early June. This gives a tight timeline for submitting all the required ICM related paperwork if your ICM block starts at the back end of the CT2 year.

If you start ICM in August, November or February you are expected to have completed all the required WPBA’s by the Deanery paperwork submission deadline including an MSF and a fully completed Ed. Sup. Report. [even if your block does not finish until end July]

If you end up doing a 3 month ICM block that starts in May it is unrealistic to expect all the paperwork to be completed by the end of May/early June Deanery ARCP paperwork submission deadline. It is however still expected that all required WPBAs except the MSF are done by the Deanery deadline.

Even if you start in May an Educational Supervisor report is required for the Deanery deadline. This will be a truncated report as you may not have done an MSF but it will give the ARCP panel information on your progress. A partially filled in Ed. Sup. Report form should be signed by both parties and submitted by the Deanery deadline. Thereafter by a later deadline which will be given to you after the first ARCP date a fully completed Ed. Sup. Report should be submitted. This will be re-examined by the ACCS ARCP committee and an appropriate outcome for the year given prior to the end of July.

------

West of Scotland ICM Educational Supervisor report for ACCS doctors

Trainee - name and GMC number:

Supervisor:

Attachment: Hospital & ICU:

Dates and duration of attachment:

REVIEW OF WPBA

Assessments to be completed:

20 If ICM block 3 months the required minimum number of satisfactory assessments is DOPS x1, CEX x1, CBD x1, ACAT x1, MSF x1 If ICM block 4-6 months the required minimum number of satisfactory assessments is DOPS x2, CEX x2, CBD x2, ACAT x2, MSF x1

Programme Date of Satisfactory Comments [expand as necessary] Component assessment Yes/No

DOPS 1 DOPS 2 DOPS 3 DOPS 4 ACAT 1 ACAT 2 ACAT 3 CEX1 CEX 2 CEX 3 CBD 1 CBD 2 CBD 3 MSF

Please comment on –

General clinical ability:

Competence at practical procedures:

Examinations:

Audit, research, presentations:

Teaching:

Any suggested areas for development:

Advice to trainee:

------Supervisors are asked to complete an Ed. Sup. Report for all trainees in time for the Deanery ARCP paperwork submission deadline [usually end May/early June]

21 One realises the Deanery ARCP deadline may be too early for a full judgement if the ICM block only started in May. If so please sign and fill in this form as much as possible, your trainee should then sign and submit it for the ARCP process. A further completed form will thereafter be required by the end of the 2nd week of July.

Has your trainee completed successfully an appropriate number of WPBA? Does this include 2 of the 6 major presentations? [answer yes/no] Has a MSF been satisfactorily completed? Does this include 12 responses, with at least 3 from consultants [answer yes/no] Is consultant feedback satisfactory?

Has the trainee demonstrated satisfactory progress and in your judgement achieved the minimum clinical learning outcomes? [answer yes/no] Has Annexe F been completed [answer yes/no]

Planned date of review should the above areas be incomplete/unsatisfactory

Overall assessment of trainee [free text]

Signature Trainee: …………………………………. Date: ………………

Signature Trainer: ………………………………….. Date: ………………..

------

West of Scotland ICM Educational Supervisor report for ACCS doctors- EXAMPLE of how to do it

Trainee - name and GMC number: Dr ACCS ICM trainee GMC. xxxxxxx

Supervisor: Dr Ed Sup

Attachment - Hospital & ICU: ICU at Monklands

Dates and duration of attachment: 2.17-7.17 inc. - 6 months in total

REVIEW OF WPBA

Assessments to be completed: If ICM block 4-6 months the required minimum number of satisfactory assessments is DOPS x2, CEX x2, CBD x2, ACAT x2, MSF x1 If ICM block 3 months the required minimum number of satisfactory assessments is DOPS x1, CEX x1, CBD x2, ACAT x1, MSF x1 22 Programme Date of Satisfactory Comments Component assessment Yes/No

DOPS 1 15.2.17 yes Insert art line DOPS 2 20.2.17 yes Insert central line DOPS 3 1.3.17 yes Attach patient to ventilator DOPS 4 15.3.17 yes Safely intubate critically unwell patient ACAT 1 18.3.17 yes Good teamwork on ward round ACAT 2 21.4.17 yes Good multitasking on ward round ACAT 3 CEX1 20.2.17 yes Safe use sedative drugs CEX 2 23.3.17 yes Safe use of inotropes CEX 3 15.3.17 yes Management of the unconscious patient [major presentation] CBD 1 24.2.17 yes Management of septic patient [major pres] CBD 2 24.2.17 yes Management of massive blood loss CBD 3 20.4.17 yes Management of CAP MSF 1.6.17 yes A very good MSF, included feedback from 4 consultants

Please comment on –

General clinical ability: At a high level for stage in training

Competence at practical procedures: Progressing well

Examinations: Has recently passed part 1 FRCA

Audit, research, presentations: Initial audit performed and presented to dept, change instituted and currently repeat audit underway

Teaching: Actively participated

Any suggested areas for development: None, continue as at present

Advice to trainee: Continue as at present ------Supervisors are asked to complete an ed. Sup. Report for all trainees in time for the Deanery ARCP paperwork submission deadline [usually end May/early June] One realises the Deanery ARCP deadline may be too early for a full judgement if the ICM block only started in May. If so please sign and fill in this form as much as possible, your trainee should then sign and submit it for the ARCP process. A further completed form will thereafter be required by the end of the 2nd week of July.

23 Has your trainee completed successfully an appropriate number of WPBA? yes Does this include 2 of the 6 major presentations? [answer yes/no] Has a MSF been satisfactorily completed? Does this include 12 responses, with yes at least 3 from consultants [answer yes/no] Is consultant feedback satisfactory? yes

Has the trainee demonstrated satisfactory progress and in your judgement yes achieved the minimum clinical learning outcomes? [answer yes/no] Has Annexe F been completed [answer yes/no] yes

Planned date of review should the above areas be incomplete/unsatisfactory N/A

Overall assessment of trainee [free text] A very good trainee

Signature Trainee: Dr ACCS ICM trainee Date: 3.6.17 Signature Trainer: Dr Ed Sup Date: 3.6.17

This is available in electronic form on ePortfolio.

The Royal College of Emergency Medicine

Structured Training Report for ACCS EM

The educational supervisor must complete this STR, having reviewed the trainees learning portfolio and WPBAs

Trainees Name

Educational Supervisor name

Position & GMC number

Training Unit

National Training Number

Training number (if applicable)

Previous annual assessments

Dates Outcome

24 1

Previous placements in ACCS programme

Clinical supervisor Dates

Acute medicine

Anaesthetics

ICM

Emergency Medicine

Current placement

Clinical supervisor Dates

Emergency Medicine

Acute Medicine

Anaesthetics

ICM

WPBA in current placements (only successful WPBAs should be included here)

Assessment Dates and number Outcome Comments

Mini-CEX

(Min x 4)

DOPs

(Min x 5)

CBD

(Min x3)

MSF

(Min x1 a year)

ACAT

(Min x 1)

Other

25 Experiential outcomes (please review evidence in learning portfolio)

Activity Date Outcome Comments

Log book

CG activity

PDP

Educational achievements

Management

Short courses

ALS

ATLS

Other evidence

Other outcome to be considered that may not be in the learning portfolio

Activity Date Outcome Comments

Critical incidents

Complaints

26 Other

Summary of Trainees Asssessment

Educational Supervisor to complete. Please attach evidence if available to support opinions or give examples of behaviours.

Strengths of Trainee

Weaknesses of Trainee

Suggestions for improvement

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

portfolio and WPBA, covering the period from ………………..to ……………….

ES Name and Signature Trainee Signature

Date: Date:

Annual Review of Competence Progression Checklist for Work Place Based Assessments in ACCS CT/ST1

Trainee Name: DRN/NTN:

Emergency Medicine

Summative assessments by a consultant in at least 2 Major Date of Assessor’s Presentations assessment name

 CMP1 Anaphylaxis Date Name  CMP2 Cardio-respiratory arrest (or current ALS certification) Date Name  CMP3 Major Trauma Date Name  CMP4 Septic patient Date Name  CMP5 Shocked patient Date Name  CMP6 Unconscious patient Date Name Summative assessments by a consultant in each of the following 5 Acute Presentations:  CAP1 Abdominal Pain Date Name  CAP6 Breathlessness Date Name  CAP7 Chest Pain Date Name  CAP18 Head Injury Date Name

28  CAP30 Mental Health Date Name Formative assessments in at least 5 further Acute Presentations using a variety of assessment tools including ACAT(EM) which can cover up to 5 acute presentations 1. Date 2. Date 3. Date 4. Date 5. Date Name Name Name Name Name 10 other Acute Presentations covered by: Teaching delivered / Audit / E-learning modules / Reflective practice / Additional WPBAs

1. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 2. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 3. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 4. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 5. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 6. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 7. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 8. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 9. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 10. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name

Practical procedures as DOPS in each of the following 5 domains:  Airway Maintenance Date Name  Primary Survey Date Name  Wound Care Date Name  Fracture/Joint manipulation Date Name  Any 1 other procedure Date Name

Acute Medicine

Formative assessments in 2 Major Presentations not yet covered:  CMP1 Anaphylaxis Date Name  CMP2 Cardio-respiratory arrest Date Name  CMP3 Major Trauma Date Name  CMP4 Septic patient Date Name  CMP5 Shocked patient Date Name  CMP6 Unconscious patient Date Name Formative assessments in at least 10 Further Acute presentations using a variety of assessment tools including ACAT(GIM) 1. Date 2. Date 3. Date 4. Date 5. Date Name Name Name Name Name 6. Date 7. Date 8. Date 9. Date 10. Date 29 Name Name Name Name Name 10 other Acute Presentations covered by: Teaching delivered / Audit / E-learning modules / Reflective practice / Additional WPBAs 1. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 2. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 3. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 4. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 5. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 6. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 7. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 8. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 9. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name 10. Teaching / Audit / E-learning / Reflective / WPBA (Please circle) Date Name Practical procedures as 5 DOPS 11. Date 12. Date 13. Date 14. Date 15. Date Name Name Name Name Name

Overview by end of CT/ST1

Structured Training Report x2 (one for each placement) YES / NO (please circle)

MSF – minimum of 12 responses (annual) Date with spread of participants as agreed with Educational Supervisor ACCS AM trainees only - Multi Consultant Review x 4 YES / NO (please circle) Evidence of Audit or Quality Improvement Project (one YES / NO every 12 months) (please circle) Progress in relevant post graduate examinations: Exams achieved ALS or equivalent (upload certificate to ePortfolio) Date Safeguarding Children Level 2 (upload certificate to ePortfolio) Date Progress toward achieving level 2 common competences confirmed by YES / NO supervisor and trainee (red and blue man symbols) (please circle) Number of core training days attended (upload certificates to ePortfolio) Number Survey monkey feedback completed for each placement (if a requirement in YES / NO region) (please circle)

To be completed by trainee and countersigned by Educational Supervisor

30 Trainee signature: Date:

Education Supervisor signature: Date:

Education Supervisor name PLEASE PRINT

Annual Review of Competence Progression

Checklist for Work Place Based Assessments in

ACCS CT/ST2

Trainee Name: DRN/NTN:

Initial Anaesthetic Competences – if in 3 month post

Formative assessment of 5 Anaesthetic-CEX: Date of Assessor’s assessment name  IAC A01 Preoperative assessment Date Name  IAC A02 Management of the spontaneously breathing patient Date Name  IAC A03 Anaesthesia for laparotomy Date Name  IAC A04 Rapid Sequence Induction Date Name  IAC A05 Recovery Date Name Formative assessment of 8 Specific Anaesthetic CbDs:  IAC C01 Patient identification Date Name  IAC C02 Post op nausea & vomiting Date Name

31  IAC C03 Airway assessment Date Name  IAC C04 Choice of muscle relaxants & induction agents Date Name  IAC C05 Post op analgesia Date Name  IAC C06 Post op oxygen therapy Date Name  IAC C07 Emergency surgery Date Name  IAC C08 Failed Intubation Date Name Formative assessment of 6 further anaesthetic DOPS:  IAC Basic and advanced life support Date Name  IAC D01 Demonstrate function of anaesthetic machine Date Name  IAC D02 Transfer and positioning of patient on operating table Date Name  IAC D03 Demonstrate CPR on a manikin Date Name  IAC D04 Technique of scrubbing up, gown & gloves Date Name  IAC D05 Competences for pain management including PCA Date Name  IAC D06 Failed Intubation practical drill on manikin Date Name

PLUS - the Basis of Anaesthetic Practice - if in 6 month post  Pre-operative assessment Date Name  Pre-medication Date Name  Induction of GA Date Name  Intra-operative care Date Name  Post-operative recovery Date Name  Anaesthesia for emergency surgery Date Name  Management of cardio-respiratory arrest (adult and children) Date Name  Infection Control Date Name Optional modules if in 9 month block  Sedation Date Name  Regional block Date Name  Emergency surgery Date Name  Safe Transfers Date Name

Intensive Care Medicine

Formative assessments in 2 missing Major Presentations:  CMP1 Anaphylaxis Date Name  CMP2 Cardio-respiratory arrest Date Name  CMP3 Major Trauma Date Name  CMP4 Septic patient (ideally assessed in ICM) Date Name  CMP5 Shocked patient Date Name

32  CMP6 Unconscious patient Date Name Formative assessment of any Acute Presentations not yet covered 1. Date 2. Date 3. Date 4. Date 5. Date Name Name Name Name Name Formative assessment of 13 practical procedures as DOPS (may be assessed as Mini CEX or CbD if indicated), including:  ICM 1 Peripheral venous cannulation Date Name  ICM 2 Arterial cannulation Date Name  ICM 3 ABG sampling & interpretation Date Name  ICM 4 Central venous cannulation Date Name  ICM 5 Connection to ventilator Date Name  ICM 6 Safe use of drugs to facilitate mechanical ventilation Date Name  ICM 7 Monitoring respiratory function Date Name  ICM 8 Managing the patient fighting the ventilator Date Name  ICM 9 Safe use of vasoactive drugs and electrolytes Date Name  ICM 10 Fluid challenge in an acutely unwell patient (CbD) Date Name  ICM 11 Accidental displacement ETT / tracheostomy Date Name  Any other Date Name  Any other Date Name

Overview by end of CT/ST2

All 6 Major Presentations completed Date

All 38 Acute Presentations completed Date

All 45 Practical procedures completed Date

Structured Training Report x2 (one for each placement) YES / NO (please circle) MSF – minimum of 12 responses (annual) with spread of participants as YES / NO agreed with Educational Supervisor (please circle) ACCS AM trainees only - Multi Consultant Review x 4 YES / NO (please circle) Evidence of Audit or Quality Improvement Project (one every 12 months) YES / NO (please circle) Progress in relevant post graduate examinations: Exams achieved

Resuscitation courses relevant to specialty (ALS, ATLS, APLS or equiv.) Date

Safeguarding Children Level 2 (upload certificate to ePortfolio) Date

33 Progress toward achieving level 2 common competences confirmed by YES / NO supervisor and trainee (red and blue man symbols) (please circle) Number of core training days attended (upload certificates to ePortfolio) Number

Survey monkey feedback completed for each placement (if a requirement in YES / NO region) (please circle)

To be completed by trainee and countersigned by Educational Supervisor

Trainee signature: Date:

Education Supervisor signature: Date:

Education Supervisor name PLEASE PRINT

ACCS CONTACTS & FURTHER TRAINING INFORMATION

USEFUL WEBSITES

 JRCPTB (Joint Royal College of Physicians Training Board)- http://www.jrcptb.org.uk

 College of Emergency Medicine- http://www.rcem.ac.uk

 West of Scotland School of Anaesthesia- http://www.jet5.com/wossa/

 ACCS UK website- http://www.rcoa.ac.uk/accs

 Royal College of Anaesthetists website- http://www.rcoa.ac.uk

 Faculty of Intensive Care Medicine - http://www.ficm.ac.uk

CONTACTS

 Acute Medicine: Dr Christine Aiken - [email protected]

34  Emergency Medicine: Dr Shabhir Ahmad - [email protected]

 Anaesthesia: Dr Scott Marshall - [email protected]

 ICM: Dr Gregor Imrie - [email protected]

 Deanery Admin: Anand Ferguson - [email protected]