Foundation programme curriculum

1. 2021 Foundation
Programme Curriculum

2. The Foundation Programme Curriculum 2021
• AIMS
Outcomes of the Foundation Programme
Higher Level Outcomes & Foundation Professional Capabilities
• APPROACH
Learning during the Foundation Programme
Experiential
Direct
Self development
• ASSESSMENT
Evidence to show achievement of the standard required for progression
The ePortfolio and ARCP
Content

3. Aims

4. The Foundation Programme is part of the continuum of medical education
Foundation
Programme
Specialist
Training
GP or
Consultant
Undergraduate
training
F1
F2
FP Certificate of Completion (FPCC)
On completion of Foundation training the
doctor can deliver safe, compassionate care
with indirect supervision.

5. Holistic care and breadth of care
• There is a focus on:
• Physical health
• Mental health
• Social health
• Across a variety of different areas:
• Community or primary care
• Acute and chronic hospital environments
• Mental health settings
• Environments that provide health promotion

6. Three outcomes of the Foundation Programme
Three Higher Level Outcomes (HLOs) of the Foundation Programme.
A professional, responsible for
their own practice and portfolio
development
HLO3: THE PROFESSIONAL
An accountable, capable and
compassionate clinician
THE CLINICIAN
HLO1: THE CLINICIAN
A valuable member of the
healthcare workforce
THE HEALTHCARE WORKER
HLO2: THE HEALTHCARE WORKER

7. The 3 HLOs are broken down into 13 professional capabilities, which form the syllabus:
Professional requirements and
expectations:
11. Ethics and Law
12. Continuing Professional
Development
13. Understanding Medicine
HLO3: THE PROFESSIONAL
Thirteen professional capabilities
Direct and indirect patient care:
1. Clinical Assessment
2. Clinical Prioritisation
3. Holistic Planning
4. Communication and Care
5. Continuity of Care
THE CLINICIAN
HLO1: THE CLINICIAN
Integrating into the healthcare
workforce:
6. Sharing the Vision
7. Fitness to Practise
8. Upholding Values
9. Quality Improvement
10. Teaching the Teacher
THE HEALTHCARE WORKER
HLO2: THE HEALTHCARE WORKER
These capabilities can be demonstrated by behaviour in the workplace during the programme

8. Approach

9. Learning during the foundation programme
Experiential
• Daily experience in the clinical environment with colleagues and patients.
Direct
• Core & non core learning
Self development
• Self directed learning
APPROACH

10. The experiential approach
• Most programmes are 3 x 4 month posts in each year
• Supported by
• Clinical Supervisor
• Educational Supervisor
• Placement Supervision Group
• Clinical and educational supervisor usually the same person
in Scotland

11. Guiding training
• In each placement the Foundation Doctor will have:
• Clinical & Educational Supervisor (Combined Supervisor role)
• Orientate and Combined Supervisor Induction Meeting
• Mid point review
• Guide personal & professional development, and monitors progress against the 3 HLOs / 13 FPCs
• Pastoral Support and contact for concerns
• Combined Supervisor End of Placement Report
• Support from other professionals – a few of these are selected by the Supervisor and form the
Placement Supervision Group (PSG)

12. Direct learning
Teaching/training specific to the Foundation Programme. The ’core learning’ topics are:
• Frailty
• End of life care
• High risk prescribing
• Teaching skills
• Patient safety
• Safeguarding
• Use of new technologies and the
digital agenda
Parity of mental and physical health. Significant increase in mental health topics.
Simulation in now embedded in the curriculum.
• Mental health including mental illness
• Health promotion and public health
• Simulation
• Leadership
• Quality improvement methodology
• Appraisal of evidence
• Careers guidance
• Integration of acute illness into chronic disease
management and multiple comorbidities

13. Other professional activities in the clinical environment are important learning
opportunities too and include:
• Departmental teaching sessions
• M&M and peer review meetings
• Journal clubs
• Grand rounds and Schwartz rounds
• Balint groups
• Multiprofessional meetings, including practice meetings and those with social care
Expansive list of non core learning activities on Scottish Foundation School website
• Experiential “on the job” learning is not included in non-core learning
Non-core learning

14. Self development
• FDs will develop their practice in
different ways
• Online learning, reading,
reflection, non-core teaching
• All FDs will soon be given time
for self development

15. Assessment

16. • A record of clinical and professional behaviours
demonstrated in the workplace.
• Maintained in online TURAS portfolio – the
Foundation ePortfolio.
• Evidence recorded in portfolio - from
experiential learning, direct training and self-
development
• Should demonstrate proficiency in the 13
Foundation Professional Capabilities
Gathering Evidence: The ePortfolio
on, anger
Supervised
learning events
(SLEs)
Multisource
feedback
(MSF)
Placement
Supervision
Group (PSG)
feedback
Clinical
Supervisor
reports (CSRs)
Record of
core learning
Record of self
development
Reflection
on progress
eportfolio

17. Hierarchy of evidence
• HLO 1&2 - Performance in the
clinical environment (SLEs) should
form the majority of evidence
• HLO 3 - largely evidenced by
teaching records and reflection.
Knows
(knowledge)
Does
(observation)
Shows how
(demonstration of skills)
Knows how
(application of knowledge)
Experiential
(SLEs)
Simulation
Learning /
reflection
HLO1: An accountable, capable and
compassionate clinician
HLO2: A valuable member of the healthcare
workforce
HLO3: A professional, responsible for their
own practice and portfolio development Millers pyramid – Hierarchy of Evidence

18. Types of assessment
• Supervised Learning Events
• Placement Supervision Group
• Multisource Feedback (TAB)
• The Personal Learning Log
• The Summary Narrative
• Portfolio Evidence (Curriculum Linkage)
Formative assessment
• Combined (Clinical & Educational)
Supervisor Reports
• Prescribing Safety Assessment (F1 only)
Summative assessment

19. Supervised learning events (SLEs)
SLEs
• MiniCEX - mini clinical encounter - direct observation of a clinical interaction
• DOPS – direct observation of procedure
• CBD – case-based discussion
• LEARN – Learning encounter and reflection note – a form for recording the above and other forms of
evidence such as performance in simulation
• LEADER - for recording feedback following an event where the FD has shown leadership skills
• Developing the Clinical Teacher – feedback on delivered formal teaching session or presentation
No minimum number or mix of SLEs

20. • The 2021 curriculum requires an equity of mental and physical health evidence
• For clinical FPCs - provide SLEs that demonstrate both physical and mental health
• For example FPC2 - management of the acutely unwell patient
• Physical health - an SLE covering acute cardiovascular deterioration eg MI/ arrythmia
• Mental health - an SLE covering delirium or acute confusional state
• For FPCs 1-5 it is expected that more than 1 SLE will be required to demonstrate competence.
• Both physical and mental health should be underpinned with reflections and learning logs
Balancing physical and mental health

21. Placement supervision group (PSG)
• Feeds back to FD on a daily basis (eg. Doctor,
senior nurse, pharmacist, social worker,
dietician)
• Will feed back to CS for end of placement rpt
• At least one report each year should include a
satisfactory PSG (min 3 members)
• PSG form is generated by Supervisor at initial
meeting
• Supervisor sends tickets at appropriate time
to group members

22. Placement Supervision Group

23. Multisource feedback (MSF) / team assessment of behaviour (TAB)
• Feedback on attitudes, behaviours and
professional skills
• Minimum of 1 per year

24. Personal Learning Log: Core and non-core learning
Minimum of 30 hours of self development /
non-core learning (or extra core hours).
Minimum of 30 hours core learning per year.
Min
30 hours
30 hours

25. The summary narrative
• The main form of reflection required by FDs.
• A written reflection cataloguing journey
through the programme
• 1 per HLO – 3 per year total.
• Reflect on progress against the HLOs
• Explain the rationale for evidence selected to
demonstrate each HLO
• Should select from hierarchy of evidence
• SLEs (does)
• Simulation (shows)
• Learning (knows)
• Reflections

26. The Summary Narrative
• Training to reflect on learning and progress
• May identify HLOs requiring better evidence (eg mental health)
• Will help plan PDP for following post
• Start process of self development, train for appraisal & revalidation
• Formative assessment
• Supervisor should review each post
• Give advice and rate progress “ES progress rating”
• The FPD will review before ARCP

27. The Summary Narrative

28. Supervisor Progress Rating

29. Summary Narrative and Curriculum

30. Mandatory FPC2 Requirements

31. Evidence for Higher Level Outcomes
HLO 1 The Clinician
SLEs, simulation,
knowledge reflection
HLO 2 The Healthcare
Worker
TAB, PSG, DCT, LEADER
HLO 3 The Professional
Portfolio development,
core & non-core
learning, careers

32. • Review of
• PDP
• Summary narrative
• TAB &/or PSG (1 each per year)
• Evidence linked to curriculum
• Engagement with learning (SLEs, core / non core learning)
• Gather info from multidisciplinary team
• Summative assessment
• 3rd block report by 31st May to allow time for:
• FPD review, End of Year Report, ARCP
• GMC full registration and Post ARCP reviews
Combined Supervisor End of Placement Reports

33. Other specifics for assessment
Prescribing Safety Assessment
•Must have passed within the 2 years
preceding Foundation
•Or pass prior to completion of F1

34. Foundation Programme Director End of Year Report
•A summative assessment to make
recommendation to the ARCP panel.
•In 3rd post, Educational supervisor completes
Combined Supervisor End of Placement Report
•Same form as for other posts
•FPD does end of year rpt
ARCP panel
• TAB
• PSG
• Other evidence
• Curriculum coverage
• Evidence of learning
• Combined Supervisor rpts
• Summary narratives
EoYR

35. • The ARCP panel make decision based on feedback & evidence
selected by FD from the ePortfolio, put forward for summative
assessment
• ie evidence linked to their curriculum
• There is no fixed number of pieces of evidence required for each FPC,
only that the FD will provide sufficient evidence to demonstrate each.
ARCP

36. ARCP requirements
Provisional registration and a licence to practise with the GMC (F1 only)
Full registration and a licence to practise with the GMC
(F2 only)
To undertake the first year of the foundation programme, doctors must be provisionally registered with the GMC and hold a
licence to practise. In exceptional circumstances (e.g. refugees), a fully registered doctor with a licence to practise may be
appointed to the first year of a foundation programme.
To undertake the second year of the foundation programme, doctors must be fully registered with the GMC and hold a licence to
practise.
Completion of 12 months (WTE) training (taking account of allowable absence) The maximum permitted absence from training, other than annual leave, is 20 days (when the doctor would normally be at work)
within each 12 month (WTE) period of the foundation programme.
Where a doctor’s absence goes above 20 days, this will trigger a review of whether they need to have an extra period of training
(see GMC position statement on absences from training in the foundation programme – June 2013).
A satisfactory Foundation Programme Director’s End of Year Report The report should draw upon all required evidence listed below.
If the FD has not satisfactorily completed one placement but has been making good progress in other respects, it may still be
appropriate to confirm that the FD has met the requirements for progression.
Satisfactory Educational Supervisor’s End of Placement Reports An Educational Supervisor’s End of Placement Report is required for all FD placements.
Satisfactory Clinical Supervisor’s End of Placement Reports A Clinical Supervisor’s End of Placement Report is required for ALL placements. At least one CSR in each level of training must
make use of PSG feedback. All of the clinical supervisor’s end of placement reports must be completed before the doctor’s
Annual Review of Competence Progression (ARCP).
Satisfactory Combined Supervisor’s End of Placement Report A combined report can be submitted at the end of each placement when a senior Clinician holds both ES and CS roles for the FD
Satisfactory Team Assessment of Behaviour (TAB) Minimum of one per level of training
Satisfactory Placement Supervision Group report (PSG) Minimum of one per level of training
Satisfactory completion of all curriculum outcomes The FD should provide evidence that they have met the 13 foundation professional capabilities, recorded in the eportfolio.
Evidence to satisfy FPC1-5 must include direct observation of at least 5 clinical encounters in the form of SLEs and the specific
life support capabilities specified in FPC2.
Satisfactory engagement with the programme Learning log of core/non-core teaching and other learning
Reflection including summary narrative
Contemporaneously developed portfolio
Engagement with feedback on training programme
Completion of relevant probity / health declarations including Form R / SOAR or equivalent
Successful completion of the Prescribing Safety Assessment (PSA) - (F1 only) The F1 doctor must provide evidence that they have passed the PSA within two years prior to entry to the programme or on
completion of the programme.

37. Summary of changes to the 2021 FP curriculum
• New HLOs and FPCs
• More formal hierarchy of evidence
• Highlights the importance of mental health
• No minimum number of SLEs
• 1 PSG & 1 TAB mandatory
• Summary narrative mandatory
• Core Procedures removed
• ILS / ALS courses not mandated
• Specific skills still require to be evidenced (FPC2, F1 Behaviours)

38. • 3 x 4 month placements
• Supervisor initial, midpoint & final meetings
• Prescribing Safety Assessment (PSA) to complete F1
• 60 hours of learning (core & non core)
• QI requirements
..and what remains unchanged

39. • UKFPO website
• https://foundationprogramme.nhs.uk/curriculum/new-uk-foundation-
programme-curriculum-2021/
• Scottish Foundation School Website
• https://www.scotlanddeanery.nhs.scot/trainee-information/scottish-
foundation-school/current-trainees/
Further information