People

Educational supervisor (ES) – this is the senior doctor (usually Consultant or Associate Specialist) who is responsible for day to day supervision and management of a trainee. An ES may have a few trainees to supervise, but a trainee must have only one overall ES for that particular phase of training (i.e. ACCS, ST3 or ST4-6). It is possible (and preferential) for a trainee to have the same ES for the whole training programme. However this may not be possible for geographical reasons and this role would then have to be delegated to the local Clinical Tutor. The ES is responsible for meeting with the training and completing a structured training report for that phase of training. However it is up to the trainee to proactively arrange these meeting and provide the information for the STR.

Clinical Tutor (CT) – this is an individual (usually Consultant or Associate Specialist) who has been delegated the responsibility for the day to day management of a trainee where, for geographical reasons, it would be difficult for the trainees ES to continue this role. The CT is responsible for meeting with the training and completing a structured training report for that phase of training. However it is up to the trainee to proactively arrange these meeting and provide the information for the STR.

Clinical supervisor (CS) – this is the term used to describe an individual, almost invariably a senior doctor, who is responsible for overseeing the trainees WPBAs and providing feedback.

TPD – A training programme director (TPD) is a deanery appointment to either a School of Emergency medicine or STC, who has responsibility for managing the EM speciality training programme. They contribute to the placement of trainees, the annual assessment process and support ES and CT.

Processes

ARCP – The Annual review of Competence Progression has replaced the former RITA. The panel will assess the trainees portfolio of evidence, STRs and any other documented assessments provided and make a judgment as to the trainee’s suitability to progress to the next stage of training (or confirm that training has been completed to a satisfactory standard). Most ARCP will require the trainee to be present, but this is not always required particularly if no problems have been identified. Successful completely of the ARCP will allow the trainee to plan their next phase of training with the TPD.

STR - Structured Training Report – This is vital part of the trainee portfolio of evidence and summarises the trainee’s progress in that particular phase of training. The STR is completed by the ES (or CT) and trainee and must include evidence of completion of the required WPBAs. Each STR will be review by the ARCP and will provide strong evidence of satisfactory progression to the next stage of training.

Assessment tools

Mini CEX – A mini clinical examination exercise this is a snap shot of the doctor patient relationship, designed to assess the knowledge skills and attitudes of the trainee. A specified number of Mini CEXs are required for each stage of training and must be assessed by an appropriate CS. These will initially be kept in hard copy (in the trainee’s portfolio) and a copy retained by the CS.

DOPS – A direct observation of procedural skills (DOPs) is designed to assess the procedural skills of the trainee. A specified number of DOPs are required for each stage of training and must be assessed by an appropriate CS. These will initially be kept in hard copy (in the trainee’s portfolio) and a copy retained by the CS.

CBD – Case-based discussion is designed to enable the CS to provide structured feedback on a recently seen case. The trainee will proved the ED notes of several recently seen cases, relevant to that stage of training. The CS will choose the case for discussion and start by reviewing the record in the notes, the assessment and then the medical management plan. A specified number of CBDs are required for each stage of training and must be assessed by an appropriate CS. These will initially be kept in hard copy (in the trainee’s portfolio) and a copy retained by the CS.

Mini PAT and MSF – Mini peer assessment tools (Mini PAT) and multi-source feedback (MSF) are designed to collage the view of co workers for 360 degree appraisal. Each trainee will need to recruit 8 assessors from amongst supervising consultants, SAS, ST, FTSTAs, Foundation Drs and experienced nursing or Allied Health Professional Colleagues to complete a questionnaire. The trainee will also complete a self-assessment using the same questionnaire. These questionnaire are then returned either to the ES or deanery and presented (ideally in ‘bar chart’ format) to show the trainees strengths and weaknesses. Individual regions may have their own type of validated 360 degree feedback which is perfectly acceptable to use. 

Educational principles

Competence – is the ability to effectively perform the activities of a particular occupation (or role) to the standards expected.

WPBA – Work-based placed assessment (WPBA) is the assessment of working practices based on what they actually do in the workplace and is (predominantly) carried out in the workplace itself.

Formative assessment – is used as part of an ongoing learning or development process. It checks of the trainee’s progress but doesn’t contribute to a pass or fail decision, but rather informs about the strengths and weaknesses of that individual. The process always involves feed back to the trainee.

Summative assessment – is usually a test that takes place after a specified training period. Other sources of information may contribute to this decision (i.e. it may be modular). Summative assessment is used to decide whether the trainee has reached a standard to proceed to the next level or training or can be awarded a CCT.

Definitions

MSK – Musculoskeletal medicine is the component of ST3 training that has a trauma and musculoskeletal focus. This can be completed in the ED with a dedicated focus in MSK or in another suitable learning environment (e.g. trauma ward and clinic). There is no specific period of time allocated for this training, but its completion is marked by the achievement of the competencies outlined in the MSK section in ST3. It is possible that the trainee may not have achieved all of these competencies during ST3 and if this is the case it will need to be agreed (at the ARCP) as to how these competencies will be gained during the remaining training period.

PEM – Paediatric Emergency Medicine (PEM) training is deliverable at two levels. Firstly all trainee’s who wish to get on the specialist register in EM will need to demonstrate that they have gained the competencies outlined in the PEM part of ST3 training. This can be completed in a general ED (that sees a minimum of 16K children) with a dedicated focus in seeing paediatric cases or in another suitable learning environment (e.g. a PED or Paeds ward). There is no specific period of time allocated for this training, but its completion is marked by the achievement of the competencies outlined in the PEM section in ST3. It is possible that the trainee may not have achieved all of these competencies during ST3 and if this is the case it will need to be agreed (at the ARCP) as to how these competencies will be gained during the remaining training period.

The second level of training is at ST6, with the aim of obtaining a sub speciality interest in Paeds Emergency Medicine. For details of this training see CEM - Curriculum - Paediatric EM This level of training can only be completed in approved PED as lit of which can be found here.