ECHM-EDTC Educational and Training Standards for Diving and Hyperbaric Medicine 2011 EDUCATIONAL AND TRAINING STANDARDS FOR PHYSICIANS IN DIVING AND HYPERBARIC MEDICINE Written by Joint Educational Subcommittee of the European Committee for Hyperbaric Medicine (ECHM) and the European Diving Technical Committee (EDTC) List of content: Foreword ..................................................................................................................................................2 1. Introduction...........................................................................................................................................3 2. Definition of jobs...................................................................................................................................4 3. Training programs ................................................................................................................................6 4. Content of modules ..............................................................................................................................7 5. Standards for course organisation and certification.............................................................................9 5.1. Teaching courses..........................................................................................................................9 5.2. Modules and course organisation.................................................................................................9 5.3. Recognition of an expert.............................................................................................................10 6. Certificate of competency and recertification .....................................................................................11 6.1. Audit of training courses and harmonised final assessment ......................................................11 6.2. Logbook ......................................................................................................................................11 6.3. Certification .................................................................................................................................11 6.4. Recertification .............................................................................................................................11 6.5. Summary.....................................................................................................................................13 7. The Joint Medical Subcommittee of ECHM and EDTC .....................................................................14 Appendix 1. Levels of competence ........................................................................................................15 Appendix 2. Training objectives for level 2D .......................................................................................16 Appendix 3. Training objectives for level 2H..........................................................................................51 Appendix 4. Scope of diving...................................................................................................................55 Appendix 5. CME Requirements for Level 2D .......................................................................................56 Appendix 6. CME Requirements for Level 2H .......................................................................................57 Appendix 7. Recognition of Level 3 Expert by ECHM............................................................................58 Approved by ECHM and EDTC on August/September 2011 Page 1 of 62 ECHM-EDTC Educational and Training Standards for Diving and Hyperbaric Medicine 2011 Foreword These educational and training standards are the result of some years of international discussion and extensive educational experience both in diving and hyperbaric medicine. It is based on two main documents: 1. “Educational and Training Standards for the Staff of Hyperbaric Medical Centres” written in 1997 by Jordi Desola, representative of the European Committee for Hyperbaric Medicine (ECHM), and Jurg Wendling, representative of the European Diving Technical Committee (EDTC) for the Joint Educational Subcommittee of the ECHM and EDTC.1 2. “Training Objectives for a Diving Medicine Physician based on current ECHM, EDTC and DMAC sources” prepared by David Elliott with subsequent input from members of the EDTC and DMAC committees and from several non-European members of the Pisa Initiative.2 Those documents have been reviewed by the members of the Joint Educational Subcommittee of the ECHM and the EDTC.3 Training Objectives for a Hyperbaric Medicine Physician were added (initially prepared by Wilhelm Welslau and Jacek Kot). Based on modular structure of the training course, teaching hours which are necessary for fulfil those training objectives were proposed for both level 2D (Diving Medicine) and level 2H (Hyperbaric Medicine). 1 At this time the Joint Educational Subcommittee of the ECHM and EDTC was formed by Jordi Desola (Spain), David Elliott (United Kingdom), Pasquale Longobardi / P. Pelaia (Italy), Francis Wattel (France), and Juerg Wendling (Switzerland). It was chaired by Jordi Desola on behalf of the ECHM and Juerg Wendling on behalf of the EDTC. 2 L’Abbate A, Elliott D. The Pisa inter-university initiative for the medical and physiological support of complex and deeper diving. Diving and Hyperbaric Medicine. 2009; 39: 110-111. 3 At this time the Joint Educational Subcommittee of the ECHM and EDTC had five members: Jordi Desola (Spain), David Elliott (United Kingdom), Juerg Wendling (Switzerland), Pasquale Longobardi (Italy), Alessandro Marroni (Italy), Wilhelm Welslau (Germany) and Jacek Kot (Poland). Approved by ECHM and EDTC on August/September 2011 Page 2 of 62 ECHM-EDTC Educational and Training Standards for Diving and Hyperbaric Medicine 2011 1. Introduction These training standards are the result of some years of international discussion which began prior the 1st European Consensus Conference on Hyperbaric Medicine, Lille, in September 1994 where one session was devoted to "Personnel education and training policies". A comprehensive paper by Jordi Desola and the subsequent debate defined the 5 different personnel categories ideally involved in the staff of a Centre of Hyperbaric Medicine: the medical doctors, including the Medical Director the nurses, the attendants, the chamber operators, and the technicians. The definition, functions, background, academic requirements, dedication, and the continuous education, of each category were agreed (see: www.ECHM.org). A working group has been formed to define the requirements for medical doctors in the fields of diving and hyperbaric medicine. An important feature of this project was the collaboration between the European Committee for Hyperbaric Medicine (ECHM), which is primarily a medical committee, and the European Diving Technology Committee (EDTC) which is a 15-nation committee with not only government, industry and trades union representatives but also with a doctor nominated from each member country. The Goal-setting Principles for Harmonised diving Standards in Europe was published by the EDTC in 1997 and includes a section on the "Qualifications, education and training of medical doctors" (see: www.EDTC.org). This document also defines the different personal categories involved in on-site chambers and bells for diving operations. The version presented here has been edited by the Joint Medical Subcommittee of these two main committees and, from time to time, reports by this Subcommittee have been submitted to and approved by each of the two parent bodies. It is the purpose of this paper to summarise what has been accomplished and to look at the future tasks of a Joint Medical Subcommittee of the ECHM & EDTC. Approved by ECHM and EDTC on August/September 2011 Page 3 of 62 ECHM-EDTC Educational and Training Standards for Diving and Hyperbaric Medicine 2011 2. Definition of jobs Before any consideration of a training programme, the training objectives of each job need to be defined in relation to the competencies that are expected from the incumbent. A number of the jobs in diving and hyperbaric medicine have tasks and objectives in common and so it is possible to optimise the efficiency of the educational program and avoid too much overlap by adopting a modular structure. Thus first we define the jobs which are compatible with the other EDTC and ECHM standards: Level 1. "Medical Examiner of Divers" (MED) Competent to perform the "Fitness to dive assessments" of working and recreational divers and compressed air workers, except the resume diving assessment of after major decompression incidents. Level 2D. "Diving Medicine Physician" (DMP) Competent to perform the initial and all other assessments of working and recreational divers or compressed air workers. Can manage diving accidents and advise diving contractors and others on diving medicine and physiology (with the back-up of a diving medical expert or consultant). Should have knowledge in relevant aspects of occupational health. He or she does not need to be certified specialist in occupational medicine to be in accordance with the standards, but it is recommended also for those of Level 1 who examine commercial divers and compressed air workers. Should have certified skills and basic practical experience in fitness-to-dive assessment, management of diving accidents, safety planning for professional diving operations,