Stoke-on-Trent School of Anaesthesia CCT in Anaesthetics...

Stoke-on-Trent School of Anaesthesia

CCT in Anaesthetics

Intermediate Level Training (ST Years 3 and 4)

Workplace Based Assessments

2010 Curriculum

Stoke-on-Trent School of Anaesthesia. Workplace based assessments ST years 3 and 4 2010 Curriculum

2

Contents:

1. Guidance for using this document 2. Indicative times 3. Essential Units of Training

4. Optional Units of Training

5. Appendix: Completion of Unit of Training Form, Intermediate

Level Training Certificate, List Management Assessment form


3

Guidance for using this document

1. Intermediate level training is divided up into Essential and Optional Units of Training. This document sets out the Index Cases and Skills required for satisfactory completion of each Unit.

2. It is expected that for a Unit to be signed off as ‘satisfactory’ then, as a

minimum, one ACEX, one DOPS and one CBD should be completed unless otherwise stated. A list management assessment should be completed where indicated. In addition a supervising consultant should initial against the Core Clinical Learning Outcomes.

3. At the end of each Unit of Training a ‘Completion of Unit of Training’

form should be signed by the Educational/Clinical Supervisor and the trainee.

4. Evidence in the form of a) a log book summary for that Unit and b) all

completed Anaes CEX, DOPS and CBD forms should be presented to the Educational/Clinical Supervisor.

5. In addition a Multi Source Feedback form should be completed

annually.

Additional Points

1. The Intensive Care Training Summary covers the two three month training periods i.e ST 3/4 and ST 5-7 and should be completed in years 5-7. A Unit of Training Completion form also needs to be signed for each three month period.

2. Copies of all forms required i.e. Anaes CEX, DOPS, CBD, Extended

CBD, MSF and Completion of Unit of Training are attached herewith.

3. It is essential that you attend a Difficult Airway and a Transfer Training course during years ST3 and 4.


4

Indicative Times Listed below are the suggested times allowed to complete training in each unit. A minimum of 20 half day clinical sessions need to be completed for neuro, cardiac, obstetrics, paediatrics and pain medicine. Time in Intensive Care Medicine must be three months. Unit of training Time in months Neuro 2 Cardiac 2 General Duties

Within this Unit: Day surgery General/urol/gynae ENT/Maxfax Trauma and orthopaedics

9 1 2 2 2

Intensive Care Medicine 3 Obstetrics 2 Paediatrics 2 Pain medicine 2


5

Essential Units of Training.

1. Anaesthesia for neurosurgery, neuroradiology and neurocritical care 2. Cardiac/Thoracic 3. General duties

• Airway management • Critical incidents • Day surgery • General, urological and gynaecological surgery • ENT, maxillo-facial and dental surgery • Management of respiratory and cardiac arrest • Non-theatre • Orthopaedic surgery • Regional • Sedation • Transfer medicine • Trauma and stabilisation

4. Intensive care medicine 5. Obstetrics 6. Paediatric 7. Pain medicine


6

Neuro Anaesthesia Core Clinical Learning Outcomes

Achieved Initial

Deliver safe perioperative anaesthetic care to uncomplicated ASA 1-3 adult patients undergoing non-complex elective intracranial and spinal surgery with direct supervision

Deliver safe perioperative anaesthetic care to uncomplicated ASA 1-3 adult patients undergoing non-complex emergency surgery with distant (or indirect) supervision [e.g. insertion of V-P shunt/EVD]

Be an effective team member for resuscitation, stabilisation and transfer of adult patients with brain injury with distant supervision (this could also be completed during an ICM unit – see ICM training summary)

A minimum of 20 clinical sessions must be completed Index Cases: To be supported by Anaes CEX form Index case Date of assessment(s) Craniotomy Index Skills: To be supported by DOPS form Index skill Date of assessment(s) Induction of GA with TCI propofol Case Based Discussion: To be supported by CBD or Extended CBD form Emergency case with indirect supervision Spinal surgery e.g. lumbar microdiscectomy, cervical laminectomy, anterior cervical discectomy

Shunt surgery e.g. insertion of VP shunt, revision of VP shunt, insertion of LP shunt

1CBD/extended CBD as a minimum (choose one of the above categories)


7

Cardiac and Thoracic Anaesthesia Core Clinical Learning Outcome

Achieved Initial

Deliver safe and effective perioperative anaesthetic care to patients undergoing elective coronary artery surgery and minor thoracic investigative procedures under direct supervision

Lung resection under general anaesthesia (lobectomy or pneumonectomy)

Bronchoscopy under general anaesthesia +/- therapeutic intervention

Video assisted thoracoscopic surgery under general anaesthesia

A minimum of 20 clinical sessions must be completed 1 Anaes CEX, 1 DOPS, 1 CBD and a logbook of 10 pump cases to be achieved for a satisfactory cardiac sign off Index Cases: To be supported by Anaes CEX form Index case Date of assessment(s) Coronary artery and/or valve surgery on cardio-pulmonary bypass

Index Skills: To be supported by DOPS form Index skill Date of assessment(s) Establish anaesthesia including invasive arterial and central venous monitoring

Insert a double lumen endo-bronchial tube

Case Based Discussion: To be supported by CBD or Extended CBD form Case description Date of assessment Coronary artery and/or valve surgery on cardio-pulmonary bypass


8

General Duties

1. Airway management 2. Day surgery 3. Critical incidents 4. General, urology and gynaecology 5. ENT, maxillo-facial and dental surgery 6. Management of respiratory and cardiac arrest 7. Non-theatre 8. Orthopaedic surgery 9. Regional 10. Sedation 11. Transfer medicine 12. Trauma and stabilisation


9

Airway Management This may be completed as part of the ENT/Maxfax unit. Core Clinical Learning Outcome

Achieved Initial

To be able to demonstrate the ability to perform elective fibreoptic intubation, either for an awake or an anaesthetised patient, with local supervision

Index Case: To be supported by Anaes CEX form Index case Date of assessment(s) Management of case involving a difficult airway

Index Skill: To be supported by DOPS form Index skill Date of assessment(s) Fibreoptic intubation with patient asleep or awake

Attendance at theoretical Airway Course eg BASDART Course Venue Date Completed


10

Critical Incidents Core Clinical Learning Outcomes

Achieved Initial

To demonstrate leadership in the management of critical incidents as and when they arrive

To provide assistance/leadership to more inexperienced colleagues if called to assist in the management of critical incidents

To demonstrate leadership in ensuring good team work and communication to help reduce the risks of harm from critical incidents

These core learning outcomes can be achieved either with direct clinical experience or by attendance at a suitable simulator course. Index Case: To be supported by Anaes CEX form Index case Date of assessment(s) Management of critical incident Case Based Discussion: To be supported by CBD or Extended CBD form Case description Date of assessment

Attendance at Simulator course Course Venue Date Completed


11

Anaesthesia for Day Case Surgery Core Clinical Learning Outcomes

Achieved Initial

Deliver safe perioperative anaesthetic care to ASA 1-3 patients having more extensive or specialized day surgery procedures with direct supervision

Index Cases: To be supported by Anaes CEX form Index case Date of assessment(s) One of: Knee arthroscopy, excision of lymph node, excision of breast lump, inguinal hernia repair, varicose vein surgery

Case Based Discussion: To be supported by CBD or Extended CBD form Case description Date of assessment

This CBD must involve a patient with significant co-morbidities eg diabetes, obesity In addition a List Management Assessment Form should be completed


12

General surgery/gynaecology/urology Core Clinical Learning Outcomes

Achieved Initial

Deliver safe perioperative anaesthetic care to complex ASA 1-3 adult patients requiring elective and emergency intra-abdominal surgery [both laparoscopic and open] with distant supervision

Manage a list with complex ASA 1-3 adult patients for elective and emergency surgery in all disciplines with distant supervision

Index Cases: To be supported by Anaes CEX form Index case Date of assessment(s) Anaesthesia for colo-rectal surgery Laparoscopic surgery Index Skills: To be supported by DOPS form Index skill Date of assessment(s) Thoracic epidural Case Based Discussion: To be supported by CBD or Extended CBD form Case description Date of assessment

In addition a List Management Assessment Form should be completed


13

ENT and Maxillo-facial Anaesthesia Core Clinical Learning Outcomes

Achieved Initial

Deliver safe perioperative anaesthetic care to ASA 1-3 adult patients requiring routine and emergency non-complex minor/intermediate ENT and maxillo-facial surgery [including list management] under distant supervision

Index Cases: To be supported by Anaes CEX form a minimum of 2 assessments Index case Date of assessment(s) Middle ear surgery inc. hypotensive techniques

Microlaryngoscopy inc. use of LASER

Dental extraction Management of fractured jaw Index Skills: To be supported by DOPS form a minimum of 2 assessments Index skill Date of assessment(s) Manage the airway for laser surgery

Manage the airway for laryngoscopy and micro-laryngeal surgery

Manage induction of anaesthesia for and ENT emergency (bleeding tonsil, foreign body, stridor, abscess etc)

Nasal intubation

Case Based Discussion: To be supported by CBD or Extended CBD form Case description Date of assessment In addition a List Management Assessment Form must be completed Management of respiratory and cardiac arrest in adults and children Core Clinical Learning Outcome

Achieved Initial

Is an effective member of the multi-disciplinary member of the resuscitation team and takes responsibility for the initial airway management


14

In order for this unit to be signed off adult and paediatric life support courses must have been completed and be in date. Course Completion date

ALS

APLS/EPLS


15

Non Theatre Anaesthesia/sedation Core Clinical Learning Outcome

Achieved Initial

To deliver safe peri-procedure anaesthesia/sedation to adult patients outside the operating theatre, but within a hospital setting, for painful or non-painful therapeutic/diagnostic procedures under supervision

Index case: To be supported by Anaes CEX form Index Case Date of Assessment General anaesthesia for adult patient undergoing imaging procedure, ECT or cardioversion


16

Orthopaedic Anaesthesia Core Clinical Learning Outcomes

Achieved Initial

Deliver safe perioperative anaesthetic care to complicated ASA 1-3 adult patients for all elective and emergency orthopaedic/trauma surgery identified at the Basic Level as well as those requiring lower limb primary joint replacement surgery

Manage elective and emergency operating sessions with such patients with distant supervision

Index Cases: To be supported by Anaes CEX form Index case Date of assessment(s) Lower limb joint replacement

Index Skills: To be supported by DOPS form Index skill Date of assessment(s) Positioning of patient in lateral position

Positioning of patient in deck chair position

Case Based Discussion: To be supported by CBD or Extended CBD form Case description Date of assessment For example: Anaesthesia for a patient with Rheumatoid / Osteoarthritis Arthritis.

In addition a List Management Assessment Form must be completed


17

Regional Anaesthesia Core Clinical Learning Outcomes

Achieved Initial

Perform one each of the following blocks satisfactorily under local supervision:

1. Thoracic epidural and/or combined spinal/epidural 2. An upper/lower limb plexus block with peripheral nerve

stimulation or ultrasound guidance

Index Cases: To be supported by Anaes CEX form Index case Date of assessment(s) Management of a patient with regional blockade as sole form of anaesthesia.

Index Skills: To be supported by DOPS form E = essential and must be completed in years 3 and 4 Index skill Date of assessment(s) Brachial Plexus Block (E) Upper Limb Block ( elbow or wrist) Sciatic Nerve Block (E) Femoral Nerve Block (E) Lumbar Plexus Block Popliteal / Ankle Nerve Block Biers Block Epidural (E) Spinal (E) CSE Use of peripheral nerve stimulator Use of ultrasound Case Based Discussion: To be supported by CBD or Extended CBD form Case description Date of assessment For example: Management of a patient with regional blockade combined with a general anaesthetic.


18

Sedation Core Clinical Learning Outcomes

Achieved Initial

To recognise the important principal of minimum intervention, where the simplest and safest technique which is likely to be effective is used to achieve the clinical goal

Provision of safe and effective sedation to any adult patient using multiple drugs if required

Index Case: To be supported by Anaes CEX form Index case Date of assessment(s) Use of sedation in an adult patient Case Based Discussion: To be supported by CBD or Extended CBD form Case description Date of assessment


19

Transfer Medicine Core Clinical Learning Outcomes

Achieved Initial

To deliver safe and efficient transfer [with distant supervision] of: 1. Complex patients for intra-hospital including retrieving a

newly referred ITU patient from A&E or the wards 2. An uncomplicated ventilated patient for inter-hospital

transfer by land [Less than 4 hours]

Attendance at Transfer Training Course Course Location Date

A log book of transfer cases must accompany this unit Index Case: To be supported by Anaes CEX form Index case Date of assessment(s) Inter or intra hospital transfer of adult patient



20

Trauma Anaesthesia Core Clinical Learning Outcomes

Achieved Initial

Be an effective member of the multi-disciplinary trauma team and takes responsibility for the initial airway management of the multiply injured patient with distant supervision

Be able to manage acute life-threatening airway problems safely and effectively with distant supervision. (This can also be assessed in airway or ENT unit.)

Provide safe perioperative anaesthetic care [from arrival in the Emergency Department through to post-operative discharge to the ward from recovery or intensive care] for ASA 1-3 patients with multiple injuries with distant supervision, whilst demonstrating understanding of knowing when to seek senior help

Index Cases: To be supported by Anaes CEX form Index case Date of assessment(s) Anaesthesia for Fractured Neck of Femur

Index Skills: To be supported by DOPS form Index skill Date of assessment(s) Intubation with cervical spine immobilisation

Review neck X rays for the integrity of the cervical spine

Score the Glasgow Coma Scale and decide an appropriate level of care

Insert a chest drain Case Based Discussion: To be supported by CBD or Extended CBD form Case description Date of assessment For example: Management of a multiply injured patient

Attendance at ATLS or equivalent course Course name and location Date


21

Intensive Care Medicine Training Objectives At the completion of Intermediate level ICM training [i.e. after a total of nine months ICM training comprising three months Basic ICM [at CT 1/2] and six months ST training which should normally be completed in two three month blocks one in ST 3/4 and the other in ST 5/6] a trainee should:

• Recognise and manage the factors which may lead to deterioration in sick patients

• Be able to undertake post-resuscitation management and be able to manage the initial resuscitation of more complex specialist patients.

• Have an understanding of the pathology, clinical features and prognosis of the majority of problems presenting to ICU, and be able to initiate management of them, with distant supervision.

• Be able to appropriately request and interpret (in discussion with appropriate specialists) investigations such as CT, ultrasound, and microbiology.

• Be able to make a critical appraisal of the evidence for treatment and investigations.

• Appreciate that ICUs are complex systems which require management and leadership skills.

• Be able to lead a ward round, planning care for the next 24 hours. Please note: The term Anaes CEX is used in the Intensive Care Training Summary for simplicity. This is the same type of assessment as an ICEX i.e a clinical evaluation exercise. The management assessments set out should also be done using the CEX form. Intensive Care Medicine Training Summary ST Years 3 and 4 Date of training


22

Hospital

Unit details Number of beds Casemix

Number of supervised consultant sessions

Number of on call sessions

ST Years 5-7 Date of training

Hospital

Unit details Number of beds Casemix

Number of supervised consultant sessions

Number of on call sessions

Intensive Care Medicine Training Summary Index Cases: To be supported by Anaes CEX form At least 6 completed in 6 months Index case Date of assessment(s)

Pneumonia

Aortic aneurysm

Major trauma/major burns


23

Non traumatic bowel perforation

Acute MI

Septic shock

Acute renal failure

Exacerbation of COPD

Acute pancreatitis

Head injury – resuscitation, stabilisation and transfer. (This is essential for Neuro sign off in years 3/4)

Obstetric ICU admission

Brain stem death testing

Index Skills: To be supported by DOPS form (E = essential) Index skill Date of assessment(s)

Safe establishment of mechanical ventilation E

Fibreoptic bronchoscopy E

Transthoracic pacing

Management of renal replacement therapy

Appropriate use of inotropes with appropriate cardiac output monitoring E

Abdominal paracentesis

Intensive Care Medicine Training Summary Case Based Discussion: To be supported by CBD form Year of training Case description

ST3/4

ST5-7

Management Anaes CEX Date of assessment

Leading daily ward round As a minimum one in years 3/4 and one in years 5-7

Discharge of patients from ICU

Management of treatment withdrawal


24

Discussion with relatives

Practical Procedures Undertaken Procedure ST3/4 total number ST5-7 total number

Arterial line

CVP line Internal Jugular

Subclavian

Femoral

CVVH line

NG tube

Chest drain

Percutaneous tracheostomy

Pulmonary artery catheter

Bronchoscopy

Transvenous pacing

Compliance with local infection control measures: Satisfactory/unsatisfactory Signature (senior nurse on ICU): Name: Intensive Care Medicine Training Summary Transfers Date of transfer Description of case

An ACEX assessment of the transport of a ventilated, critically ill patient outside ICU must also be completed Date of assessment: ICM Syllabus


25

The following aspects of knowledge, skills, attitudes and behaviour should be achieved during the six months of ICM training. Self

assessment (tick)

Resuscitation and initial management of the acutely ill patient Triages and prioritises patients appropriately, including timely admission to ICU

Assesses and provides initial management of the trauma patient Assesses and provides initial management of the patient with burns Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation Obtains a history and performs an accurate clinical examination Undertakes timely and appropriate investigations Performs electrocardiography [ECG / EKG] and interprets the results Obtains appropriate microbiological samples and interprets results Obtains and interprets the results from blood gas samples Interprets imaging studies Monitors and responds to trends in physiological variables Integrates clinical findings with laboratory investigations to form a differential diagnosis

Disease Management Recognises life-threatening maternal peripartum complications and manages care under supervision

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

Initiates, manages and weans patients from renal replacement therapy Practical procedures Performs difficult and failed airway management according to local protocols Performs fibreoptic bronchoscopy and BAL in the intubated patient under supervision

Performs transthoracic cardiac pacing describes transvenous Describes how to perform pericardiocentesis Manages the administration of analgesia via an epidural catheter Performs abdominal paracentesis Describes Sengstaken tube (or equivalent) placement Peri-operative care Manages the care of the patient following craniotomy under supervision Manages the pre- and post-operative care of the trauma patient under supervision

Comfort and recovery Manages the safe and timely discharge of patients from the ICU End of life care Manages the process of withholding or withdrawing treatment with the multidisciplinary team

Manages palliative care of the critically ill patient Performs brain-stem death testing

Manages the physiological support of the organ donor Paediatric care Describes the recognition of the acutely ill child and initial management of paediatric emergencies

Describes national legislation and guidelines relating to child protection and their relevance to critical care

Transport


26

Undertakes transport of the mechanically ventilated critically ill patient outside the ICU

Patient safety and health systems management Leads a daily multidisciplinary ward round Organises a case conference Professionalism Involves patients (or their surrogates if applicable) in decisions about care and treatment

Demonstrates respect of cultural and religious beliefs and an awareness of their impact on decision making

Supports clinical staff outside the ICU to enable the delivery of effective care Appropriately supervises Obstetric Anaesthesia Core Clinical Learning Outcomes

Achieved Initial

Able to provide emergency and non-emergency obstetric anaesthetic care in the majority of patients including those with co-morbidities and obstetric complications with distant supervision

Perform immediate resuscitation of acute obstetric emergencies

A minimum of 20 clinical sessions must be completed Index Cases: To be supported by Anaes CEX form Index case Date of assessment(s) Management of a patient for elective caesarean section

Management of a patient for emergency caesarean section

Index Skills: To be supported by DOPS form Index skill Date of assessment(s) Epidural Analgesia for labour Spinal Anaesthetic CSE (optional) Case Based Discussion: To be supported by CBD or Extended CBD form Case description Date of assessment(s) Management of parturient with post partum haemorrhage

Management of parturient with hypertensive disease of pregnancy

Management of parturient with BMI above 35

Management of parturient with


27

inadvertent dural puncture To do at least 1 CBD/ extended CBD The list above is a guide to possible suitable cases


28

Paediatric Anaesthesia Core Clinical Learning Outcomes

Achieved Initial

Deliver safe perioperative anaesthetic care to ASA 1 and 2 children aged 5 years and over for minor elective and emergency surgery (e.g. inguinal hernia repair, orchidopexy, circumcision, superficial plastic surgery, grommets, manipulation of fractures, appendicectomy) with distant supervision

A minimum of 20 clinical sessions must be completed Index Cases: To be supported by Anaes CEX form One of: Index case Date of assessment(s) Inguinal hernia/PPV ligation/orchidopexy/circumcision/ hypospadias repair

Tonsillectomy/adenotonsillectomy Squint repair Index Skills: To be supported by DOPS form A minimum of 2 need to be completed Index skill Date of assessment(s) Gas induction IV cannulation of the infant/child Use of T-piece and mask to maintain spontaneous ventilation/assisted ventilation

Intubation in child Case Based Discussion: To be supported by CBD or Extended CBD form Case description Date of assessment


29

Pain Medicine Wherever possible this unit should be completed as a dedicated block Core Clinical Learning Outcomes

Achieved Initial

To be competent in the assessment and management of acute surgical and non-surgical pain in most patient groups and circumstances

To be an effective member of the acute pain team

To understand the importance of managing acute on chronic pain in a timely manner

To have knowledge of assessment and management of chronic and cancer pain

Index Cases: To be supported by Anaes CEX form Index case Date of assessment(s) Taking history from chronic pain patient

Management of acute pain round (observed – this may be by pain nurse)

Index Skills: To be supported by DOPS form Index skill Date of assessment(s) Facet joint injection

Chronic pain epidural

Post-op pain relief procedure eg PCA set up


Examples include: treatment for neuropathic pain, difficult post-operative pain case. Pain Medicine contd

Number of chronic pain clinics attended

Number of chronic pain procedure lists attended

Number of acute pain ward rounds attended


30

A minimum of 20 clinical sessions must be completed


31

Optional Units of Training

1. Ophthalmic anaesthesia 2. Plastics/burns 3. Vascular


32

Ophthalmic Anaesthesia Core Clinical Learning Outcomes

Achieved Initial

Deliver safe perioperative anaesthetic care to adults and children requiring routine ophthalmic surgery under direct supervision, and emergency anaesthesia for ASA 1 and 2 patients requiring minor/ intermediate ophthalmic surgery under distant supervision

Demonstrates the ability to provide local anaesthesia for eye surgery with competence in one technique

Index Cases: To be supported by Anaes CEX form Index case Date of assessment(s) Cataract surgery under local anaesthesia

Eye surgery under general anaesthesia

Index Skills: To be supported by DOPS form Index skill Date of assessment(s) Sub-Tenon block (essential) Peribulbar block Case Based Discussion: To be supported by CBD or Extended CBD form Case description Date of assessment


33

Burns and Plastics Anaesthesia Core Clinical Learning Outcomes

Achieved Initial

Delivers safe perioperative anaesthetic care to ASA 1-3 adult patients for minor to intermediate plastic surgery [e.g. tendon repair or split skin grafting] with distant supervision

Index Cases: To be supported by Anaes CEX form One of: Index case Date of assessment(s) Excision & Grafting of major burn (>15% BSA in one session)

SSG to burn Anaesthesia for facial/airway burn Major free-flap repair e. g. DI-EPP flap breast reconstruction

Rotational flap Breast Augmentation Abdominoplasty Index Skills: To be supported by DOPS form Index skill Date of assessment(s) Fluid therapy of the burned patient

Case Based Discussion: To be supported by CBD or Extended CBD form Case description Date of assessment For example: Airway management of facial burn

A List Management Assessment form should accompany this unit Vascular Anaesthesia Core Clinical Learning Outcomes

Achieved Initial

To gain knowledge of the perioperative anaesthetic management of patients undergoing elective and emergency abdominal aortic surgery and newer stenting techniques


34

Index Cases: To be supported by Anaes CEX form One of: Index case Date of assessment(s) Abdominal aortic aneurysm, elective or emergency open repair

EVAR Index Skills: To be supported by DOPS form (not essential for vascular sign off) Index skill Date of assessment(s) CVP line insertion A-line insertion Thoracic epidural Use of cell saver Case Based Discussion: To be supported by CBD or Extended CBD form Case description Date of assessment

Must include either carotid endarterectomy or peripheral vascular graft


35

Appendix

1. RCoA Unit of Training Completion Form 2. Intermediate Level Training Certificate 3. List Management Assessment form

The Royal College of Anaesthetists Completion of Unit of Training Trainee: ______________________________________________________________________ GMC number College Reference Number Unit of Training: ______________________________________________________________

Assessments Has the trainee completed successfully an appropriate number of WPBA? Yes No

Log book Review Is the case mix, complexity and numbers appropriate for the level of training? Yes No

Multi-‐source Feedback

Has a MSF been satisfactorily completed? (Only for units of training requiring MSF) Yes No Minimum clinical learning outcomes

Has the trainee demonstrated achievement of the minimum clinical learning outcomes? Yes No Comments

Signed:____________________________ Name (Print):________________________ Date:____________ (Clinical Supervisor, Educational Supervisor or College Tutor)

Signed:___________________________ Name (Print):_________________________ Date:____________ (Trainee)

The Royal College of Anaesthetists Intermediate Level Training Certificate This is to certify that: ______________________________________________________________________ GMC number College Reference Number • has completed (subject to any units exceptionally deferred to ST year 5) the full intermediate level

competency based programme of training in anaesthesia; • has satisfactorily passed the workplace assessments and demonstrated the minimum clinical learning

outcomes as defined in Annex C to the CCT in Anaesthetics; and • passed the FRCA Final Examination1 on _______________/_______________ (month/year)

He/she has thereby successfully completed intermediate level training (subject to the units listed overleaf that have been exceptionally deferred to ST year 5) and can therefore commence higher level training

from: ________/________/________ (day/month/year).

Signed:____________________________ Name (Print):________________________ Date:____________ (Regional or Deputy Regional Adviser in Anaesthesia)

Signed:___________________________ Name (Print):_________________________ Date:____________ (College Tutor or other designated trainer)2

The Regional or Deputy Regional Adviser and one other designated trainer must sign this certificate2

1 The CARCSI Final Examination is an accepted examination 2 Other designated trainer must be a consultant anaesthetist

The original of this certificate should be kept by the trainee with copies held by the School of Anaesthesia

and/or hospital. A copy should also be sent to the Training Department at the Royal College of Anaesthetists in order to confirm the completion date of intermediate training.

Hospital or department date stamp

Record of intermediate level units of training

Unit of training Completion date Competent Signed/dated

Essential units

Anaesthesia for neurosurgery, neuroradiology and neurocritical care

Cardiac/Thoracic

Intensive care medicine

Obstetrics

Paediatric

Pain medicine

General duties

Airway management

Critical incidents

Day surgery

General, urological and gynaecological surgery

Head, neck, maxillo-‐facial and dental surgery

Management of respiratory and cardiac arrest

Non-‐theatre

Orthopaedic surgery

Regional

Sedation

Transfer medicine

Trauma and stabilisation

Optional units

Ophthalmic

Plastics/burns

Vascular surgery

Higher level units brought forward to ST year 43

Unit of training Completion date Competent Signed/dated

Intermediate level units deferred to ST year 54

Unit of training Deferral Approval Number5

Completion date

Competent Signed/dated

3, 4 Prospective approval required from the RCoA Medical Secretary 5 Approval number issued by the College

This section to be signed when the deferred units of training have been completed. The completed certificate should be kept by the trainee and copies of this page sent to the trainee’s School of Anaesthesia and/or hospital. A copy should also be sent to the Training Department at the Royal College of

Anaesthetists in order to confirm completion of all the essential units of training.

Signed:____________________________ Name (Print):________________________ Date:____________ (Regional or Deputy Regional Adviser in Anaesthesia)

Signed:___________________________ Name (Print):_________________________ Date:____________ (College Tutor or other designated trainer)5

5 Other designated trainer must be a consultant anaesthetist


40

List Management Assessment Form Trainee Name: Date of Assessment: Surgical specialty: Satisfactory Unsatisfactory Comments Pre-operative assessment

Management of bed issues, sending, communication with theatre staff

Preparation for case: equipment, drug checks

Pre-operative checks: WHO guidelines followed

Conduct of anaesthesia; situational awareness, vigilance

Management of patient turnaround

Communication and management in recovery

Overall efficiency and time management

General comments

Consultant Trainer Signature: Trainee signature:

Stoke-on-Trent School of Anaesthesia CCT in Anaesthetics...

Documents

Transcript of Stoke-on-Trent School of Anaesthesia CCT in Anaesthetics...