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  1. 1. Foundation Training Programme - Educational Supervisors Pack Contents Section 1 Guidance Notes for Educational Supervisors Section 2 Foundation Programme Organisational Structure Foundation Programme Contact Details Section 3 - Aug 2005 F1 House Letter from Carol King RE: Aug 2005 House Details of Posts Details of Rotations/Allocations Details of Induction & EPR Training Details of Intermediate Life Support (ILS) Training Details of Simulation Training F1 Teaching programme Details of Half-Day Teaching Workshops Section 4 Teaching Guidance Section 5 Job Description for F1 Trainee Job Description for F2 Trainee - Draft Job Description for Educational Supervisor Job Description for Clinical Supervisor Section 6 Careers Advice Section 7 Curriculum for the Foundation Years in Postgraduate Education & Training Section 8 Operational Framework for Foundation Training Section 9 Foundation Learning Portfolio Section 10 Foundation Programme Rough Guide
  2. 2. Section 1 Guidance Notes for Educational Supervisors 1. Roles & Responsibilities Please refer to both the 'Educational & Clinical Supervisors' job descriptions for a comprehensive list of responsibilities and duties. 2. Assessments Trainees need to undertake the following assessments, spread out over different posts: Assessment Tool No. During F1 Year No. During F2 Year Notes Mini-PAT (TAB) 1 or 2 if concerns with the first 1 or 2 if concerns with the first 12 different healthcare professionals (for Mini PAT) and 10 different healthcare professionals (for TAB) including the Educational Supervisor Mini-CEX 6 6 different clinicians for each DOBS 6 6 different healthcare professionals for each CBD 6 6 different clinicians for each 3. Meetings with Trainees You need to meet with each trainee 3 times during a rotation, at the beginning, mid-point and at the end. Initial Meeting (all page numbers refer to the learning portfolio) a) check the trainee has received a local induction, all documentation, including clinical competency checklists have been completed and induction recorded on STARS b) discuss the trainees self-appraisal form (p 9) career intentions, learning needs, how these will be developed and agree the personal development plan - PDP(p 11) c) Agree and sign the educational agreement (p17) c) discuss the types of evidence the trainee might collect for their portfolio to demonstrate they have achieved competency. Agree what assessment methods will be used to evaluate whether the trainee is achieving the competencies (i.e. DOPS, Mimi-CEX, Mini- PAT, CBD) and write this up on the induction meeting form (p18). Mid-Point Meeting a) provide support to the trainee. b) review the trainees progress and provide support to them for the development of their portfolio. c) ensure trainees are engaging in the assessments process, have completed an appropriate number and range of assessments and they are achieving the competencies. d) Check attendance at educational opportunities e) complete the mid-point review form (p19) Final Review Meeting a) examine the assessments undertaken and reflective practice recorded (p22) and compare against the PDP. b) Re-visit the self-appraisal form (p9), self-appraisal of learning form (p23) and discuss how competence has developed. c) Discuss any concerns and areas for further development .e. additional work and assessment to address shortcomings in performance in next placement, including any additional assessment required. d) Inform the FTP Director if any concerns have been highlighted. e) Complete the end of placement final review form (p20) 4. 4. Doctors in Difficulty If you have any concerns about trainees, please discuss these with the Foundation Training Programme Director(s).
  3. 3. Section 2 - Foundation Programme Organisational Structure KSS DEANERY FOUNDATION SCHOOL Dr Jan Welch DIRECTOR of PGME CLINICAL TUTOR Tunji Lasoye Foundation Training Programme Director Matthew Bowles Deputy Director of PGME Vacant Manager of PGME Jo Hiley F1 Educational Supervisors (1 to approximately 5 trainees) F2 Educational Supervisors (1 to approximately 5 trainees Clinical Supervisors (Several) Clinical Supervisors (Several) FTP Co-ordinator Sheinaz Mahomedally FTP Clinical Facilitator Carol King Study Leave Co-ordinator/PGME Administrator Madeleine Carlisle
  4. 4. Foundation Training Programme Contacts PGME Team Name Title Foundation Role Contact information Jan Welch Director of PGME/Clinical Tutor/PG Dean Overall responsibility for the implementation, delivery and evaluation of the foundation training programmes at King's e-mail: jan.welch@kingch.nhs.uk Matthew Bowles Deputy Director of PGME/ Foundation Training Programme Director - F1 Lead Responsible for strategy & planning in relation to F1 programme Ext: 4437 Sec. Ext 4801 Pager: KH4801 matthew.bowles@kingsch.nhs.uk Tj Lasoye Foundation Training Programme Director - F2 Lead Responsible for strategy & planning in relation to F2 programme development Ext:3518 Sec Ext 1584 KH3943 tj.lasoye@kingsch.nhs.uk Steve Mowle GP Postgraduate Sub Dean Responsibility for strategy & planning in relation to training in General Practice steve.mowle@kcl.ac.uk Carol King Clinical Facilitator Clinical training & 1st point of contact regarding everyday problems/difficulties 72 5634 KH5642 carol.king@kingsch.nhs.uk Joanne Hiley Manager of PGME Overseeing managerial and administrative aspects of foundation programme 72 5642 joanne.Hiley@kingsch.nhs.uk Vacant Foundation Training Programme Co- ordinator Responsible for administration for the 2 year foundation programme Madeleine Carlisle PGME Administrator Some admin support for the F1 year Ext 72 5764 madeleine.carlisle@kingsch.nhs.uk
  5. 5. Educational Supervisors Name Specialty Foundation Role Contact information Paul Baskerville Surgery - Firms 1 to5 Overall responsibility for the education and development of foundation trainees allocated to the specialty. Ext 4370 / Sec. Ext 3519 paul.baskerville@kingsch.nhs.uk Matthew Bowles Surgery - Firms 1 to5 As above Ext 4437 / Sec Ext 4801 Pager: KH4801 matthew.bowles@kingsch.nhs.uk Keith Jones Surgery - Firms 1 to5 As above Ext 4428 / Sec Ext 3339 keith.jones@kingsch.nhs.uk Sarah Phillips Orthopaedics As above Sec Ext 1306 sarah.Phillips@kingsch.nhs.uk Kilian Walsh Urology As above Sec Ext 1728 KH4856 kilian.walsh@kingsch.nhs.uk Stefanie Quast ITU As above KH1697 Stefanie.quast@kingsch.nhs.uk Prof. Anne Greenough Paediatrics As above Sec Ext: 3037 anne.greenough@kingsch.nhs.uk Catherine Bryant Medicine Firm 1 As above Ext 6142 / Sec Ext 6058 KH6142 catherine.byrant@kingsch.nhs.uk Liam Cormican Medicine Firm 1 As above liam.cormican@kingsch.nhs.uk Jane Evans Medicine Firm 1 As above Sec Ext 6085 jane.evans@kingsch.nhs.uk Prof. A McGregor Medicine Firm 2 As above alison.langley@kcl.ac.uk Simon Aylwin Medicine Firm 2 As above Ext 4585 / Sec Ext 2997 KH4585 simon.aylwin@kingsch.nhs.uk Carol Gayle Medicine Firm 2 As above Ext 1352 / Sec Ext 1735 carol.gayle@kingsch.nhs.uk Kate Hopkins- Jones General Practice As above katiemars@yahoo.com Yvonne Doyle Public Health As above Tel No: 020 7716 7060 yvonne.doyle@selondon.nhs.uk Muriel Buxton- Thomas Nuclear Medicine As above Ext 3440 muriel.buxton-thomas@kcl.ac.uk
  6. 6. Modernising Medical Careers - Foundation Training Programme Guidance for Speakers Background ‘Modernising Medical Careers’ begins across the country in August this year. Doctors coming out of medical school will take part in a two year Foundation Programme; the first year, equivalent to the PRHO year, will to be called F1 and the second, F2. The Foundation Programme has a Curriculum (www.mmc.nhs.uk) which has much to commend it and gives trainees and their trainers a pretty clear picture of what the trainees should know and be able to do by the end of F1 and then F2. Regular assessment of trainees’ competences is a key feature of the Foundation Programme. Teaching for Foundation Year 1 The Tuesday lunchtime teaching programme for the coming year has been specifically drawn from the Foundation curriculum. The principal objectives of the F1 year are care of the acutely ill patient and generic skills. The focus of acute care is symptom based rather than disease based; this seems appropriate as on the whole PRHO’s are bleeped to “please see this patient with chest pain, confusion etc.” rather than “please manage this patient’s asthma, bowel obstruction etc.”. Preparing your Teaching Session We are very keen the teaching sessions should be as interactive as possible and not too lecture-like; in theory they should have had plenty of those at medical school. We would tentatively suggest the use of real or imaginary scenarios that you could go through with the whole group (38 F1s in total) or ask them to discuss the scenarios in small groups initially and then open it up for whole group discussion. Prescribing is a vital task for PRHO’s and we would ask you to include basic drugs and their doses whenever appropriate in your teaching session. Include relevant bits of generic knowledge and skills from the curriculum which apply generally to acute care (see overleaf).
  7. 7. GENERIC KNOWLEDGE AND SKILLS FOR ACUTE CARE (from section 7.1 of the Foundation Curriculum) Knowledge Common presenting symptoms and signs of acute illness including breathlessness, hypoxaemia, hypotension, oliguria, chest or abdominal pain, nausea, vomiting, headache, and confusion or coma. Frequently occurring causes of the above. Clinical interpretation of acutely abnormal physiology with a clear understanding of the boundaries of normality. Skills Identify, assess, and initiate treatment in critically ill patients appropriate to the site of care (e.g. hospital, home, GP surgery). Promptly assess the airway, breathing and circulation in the collapsed patient. Establish venous access with attention to infection control measures. Deliver a fluid challenge safely to acutely ill patients to optimise cardiac output. Document acutely abnormal physiology. Reassess acutely ill patients within an appropriate period following initiation of treatment. Undertake a focused history and examination to establish a differential diagnosis including difficult circumstances. Select appropriate initial investigations to explore the differential diagnosis. Request senior or more experienced help when appropriate. Succinctly present the relevant clinical details of an acutely ill patient to a senior doctor. Communicate effectively with other specialties when appropriate. Ensure own safety and that of team members as well as the patient when dealing with disturbed patients.
  8. 8. JOB DESCRIPTION Post Title: Pre-Registration House Officer (12 Month Rotation Post) Grade: F1 Doctor Rotations: 3 x 4 Month Rotation ( GP attachment only) or 4 x 3 Month Rotation Departments: General Medicine (Firm M1 & M2) General Surgery (Firms S1, S2, S3, S4 & S5) Paediatrics ICU Urology Orthopaedics General Practice Location: King's College Hospital NHS Trust Hours/Rota: Banding as at start date of contract King's College Hospital NHS Trust (www.kingsch.nhs.uk) King's College Hospital NHS Trust provides healthcare and emergency services for a cosmopolitan and ethnically diverse community in South East London which accounts for 70% of its work. It is also a major academic centre with close links to King's College University of London under whose auspices the new Medical and Dental Schools, known as the Guy's King's and St. Thomas' Hospitals Schools of Medicine and Dentistry, came into being on 1st August 1998. This union has heralded the many changes which will take place over the next few years within education and research which in turn will have some effect upon the service. The opportunity is to create a world class medical centre between King's College and the two teaching hospital Trusts. King's College Hospital is renowned for those specialties which attract referrals from all over the United Kingdom and abroad, and also supports leading edge research and an undergraduate medical school. Examples of such specialist work include liver (with the largest liver transplant programme in Europe), renal and cardiac services, and pioneering work in neonatal medicine and diabetes. King's College Hospital also encompasses the Neurosciences Centre for South East England. However King's provides vital and extensive acute hospital services to the residents of S.E. London and this element has always been the bedrock of teaching and research programmes. King's College Hospital employs some 4,200 people and currently has two inpatient sites - at Denmark Hill and Mapother House. The Trust's mission statement is: "Achieving Excellence in Patient Care" Department of Postgraduate Medical & Dental Education The Department of Postgraduate Medical & Dental Education has overall responsibility for ensuring the provision of education and training for postgraduate doctors and dentists within King’s meets the educational standards as prescribed by the SELWDC & London Deanery. The department delivers a wide range of generic courses which are popular and free to King's doctors and dentists, manages junior doctors study leave, organises protected teaching
  9. 9. sessions for foundation programme doctors, manages the induction process for doctors & dentists as well as have responsibility for a number of other key educational functions. KCL Library & Information Services Centre The information service centre at King's is open Monday to Saturday and has study desks, photocopiers, TV/video players, microfilm reader/printer, scanner and a hot drinks machine. In addition, the ISC has subscription to 252 print journals, a further 4,850 full text electronic journals and holds approximately 20,500 books. There are also 67 computers linked to KCL network with Microsoft office packages, EMBASE, Medline and PsycINFO. Internet access is also available. 1. JOB SUMMARY This approved training post provides a range of practical and educational opportunities for the first year of a two year foundation programme. The postholder will develop a variety of generic and acute care competencies that focus upon the appropriate skills, knowledge and attitudes required in order to ensure high quality & safe care is experienced by every patient. Achievement of these competencies will be further developed during the second year of the foundation programme. The postholder will be required to attend medical induction on their first day of employment and receive a local induction and orientation on the first day to each attachment. The postholder will rotate through 3 to 4 of the attachments listed below (please see appendix one for details of individual posts and rotations). 2. ATTACHMENTS AND CORE DUTIES & RESPONSIBILITIES a) Medicine The medical care group is currently undergoing organisational change and the existing 3 firm structure will move to 2 firms. It is hoped that all new arrangements are finalised by April 2005 but consultants will work in the following firms: General Medicine Firm 1 (General Medicine, Healthcare of the Elderly, Rheumatology & Respiratory) You will work with one or more of these consultants: Dr Barker/Dr Gray/Dr Blackburn/Professor Moxham/Professor Jackson/Dr Lyall/Dr Bryant/Dr Cormican/Dr Gordon (Posts 6, 7, 9, 10, 11, 12, 13, 15, 16, 17, 18, 24, 25, 28, 30, 32, 33, 34, 35& 37) General Medicine Firm 2 (General Medicine, Endocrinology, Healthcare of the Elderly & Gastroenterology) You will work with one or more of these consultants: Professor McGregor/ Dr Alywin/ Dr Edmonds/ Dr Hopkins/ Professor Kalra/ Dr Pillay/ Dr Forgacs/ Dr Chung-Faye/Dr Gayle/Dr Pathansali (Posts 1, 2, 3, 4, 5, 8, 14, 18, 19, 20, 21, 22, 23, 26, 27, 28, 29, 31, 33, 36& 38) Duties: The postholder will be expected to clerk patients admitted on emergency take days, manage patients' medical illnesses under supervision, assess medical patients arriving in A&E under supervision, request investigations / treatments for patients, take patients' histories and carry out routine patient examinations, communicate with patients, attend and undertake ward rounds as required, provide cover for colleagues in an emergency and when on annual / study leave, participate in the training of medical students attached to the Firm, provide discharge summaries etc. to promote good liaison with General Practitioners, liaise with patients' relatives and provide on-call services as required.
  10. 10. Paediatrics Professor Greenough (Posts 4, 6, 10 & 13) Duties: The postholder will be expected to assist the Paediatric SHOs, manage children attending A&E, present cases on ward rounds, organise investigations and treatment of children on wards, clerk children prior to elective surgery and prepare theatre lists, write discharge letters/prescriptions when children are discharged, communicate with parents on the ward, attend and contribute to ward meetings and provide some on-call. Intensive Care Unit Dr Ervine (Posts 7, 8, 11 & 19) Duties: The postholder will be expected to attend daily wards rounds, under close supervision carry out diagnosis and treatment planning, participate in data collection and processing, use electronic patient database and acquire the basic clinical skills for ICU. General Practice Dr Hopkin-Jones - Keston House Surgery, Purley (Posts 1, 2 & 3) Duties: The postholder will be expected to take surgeries after appropriate induction, deal with patients who have chronic and terminal conditions, carry out home visits, provide out of hours care with a GP Principal, discuss cases following all consultations and experience all clinical work of the practice. b) Surgery Firm 1 Mr Roberts/Mr Schulte/Ms Marsden. - General Surgery with an interest in Breast & Endocrine Surgery (Posts 23, 34, 36, 37 & 38) Firm 2 Mr Jones/Mr Rashid/Mr Edmondson/Mr Baskerville - Vascular Surgery (Posts 4, 5, 6, 7, 8, 9 & 10) Firm 3 Mr Bowles/Mr Patel/Ms Psalia - General Surgery with an interest in Hepatobiliary, Pancreatic & Laparoscopic Surgery (Posts 1, 2, 3, 11, 12, 14, 15, 16, 17, 19 & 20) Firm 4 Mr Rennie/Mr Leather/Mr Papagrigoriades - General Surgery with an interest in Colorectal & Laparoscopic Surgery (Posts 22, 24, 26, 27, 28, 30 & 32) Firm 5 Mr Heaton/Mr Rela, Mr Muiesan.Mr Atkinson.Mr Patel/Mr Bowles - Hepato-Pancreatic- Biliary Surgery (Posts 13,18,21,25,29,31,33& 35 Orthopaedics Mr Wilkinson/Mr Varma - Knee Mr Li/Mr Rajan - Foot Mr Compson/Mr Sinha/Mr Philips - Upper Limb Mr Groom/Ms Philips/Mr Lahoti - Limb Re-construction (Posts 4, 6, 8, 12, 14, 15, 16, 17, 21, 22, 25, 27, 29, 30, 31, 22, 33, 34, 35 & 36)
  11. 11. Urology Mr Walsh/Mr Muir (Posts 5, 9, 20, 23, 24, 26, 37 & 38) Duties: The postholder will be expected to take patients' histories and carry out routine patient examinations, communicate with patients', provide day to day medical care under supervision, clerk patients admitted on emergency take days, run pre-assessment clinics, prepare and submit theatre lists, participate in in-patient and day surgery operating lists, request investigations / treatments for patients, attend and undertake ward rounds as required, provide cover for colleagues in an emergency and when on annual / study leave, participate in the training of medical students attached to the Firm, provide discharge summaries etc. to promote good liaison with General Practitioners, liaise with patients' relatives, provide on-call services as required and participate in data collection and processing
  12. 12. 3. LEARNING OBJECTIVES During the year you will be given appropriate opportunities in order to develop and achieve each of the competencies identified below to F1 level (see foundation curriculum). This will be necessary in order to progress to Year 2 of the Foundation Programme 1.0 Good Clinical Care 1.1 History Taking, Examination & Record Keeping Skills. (i) History Taking - Routinely undertakes structured interviews ensuring that the patient’s concerns, expectations and understanding are identified and addressed. (ii) Conducts examinations of patients in a structured, purposeful manner and takes full account of the patients dignity and autonomy (iii) Understands and applies the principles of diagnosis and clinical reasoning that underlie clinical judgement and decision-making. (iv) Understands and applies principles of therapeutics and safe prescribing. (v) Understands and applies the principles of medical data and information management: keeps contemporary, accurate, legible, signed and attributable notes. 1.2 Demonstrates appropriate time management and decision making 1.3 Understands and applies the basis of maintaining good quality care and ensuring and promoting patent safety. (i) Always maintains the patient as the central focus of care (ii) Makes patient safety a priority in own clinical practice (iii) Understands the importance of good teamworking for patient safety (iv) understands the principles of quality and safety improvement (v) understands the needs of patients who have been subject to medical harm or errors and their families. 1.4 Knows and applies the principles of infection control. 1.5 Understands and can apply the principles of health promotion and public health. 1.6 Understands and applies principles of medical ethics and of relevant legal issues. (i) Understands and applies the principles of medical ethics (ii) Demonstrates understanding of, and practises appropriate procedures for valid (iii) Understands the legal framework for medical practice
  13. 13. 2.0 Maintaining Good Medical Practice (i) Learning: Regularly takes up learning opportunities and is a reflective self-directed learner (ii) Evidence base for medical practice: knows and follows organisational rules and guidelines and appraises evidence base of clinical practice. (iii) Describes how audit can improve personal performance 3.0 Relationships with patients and Communication (i) Demonstrates appropriate communication skills (see also 1.3) 4.0 Working with Colleagues (i) Demonstrates effective team work skills (ii) Effectively manages patients at the interface of different specialties including that of Primary Care, Imaging and Laboratory Specialities. 5.0 Teaching and Training (i) Understands principles of educational method and undertakes teaching of medical trainees and other health and social workers 6.0 Professional Behaviour and Probity (i) Consistently behaves with a high degree of professionalism (ii) Maintains own health and demonstrates appropriate self-care 7.0 Acute Care (i) Promptly assess the acutely ill or collapsed patient. (ii) Identifies and responds to acutely abnormal physiology. (iii) Where appropriate, delivers a fluid challenge safely to an acutely ill patient. (iv) Reassesses ill patients appropriately after initiation of treatment (v) Requests senior or more experience help when appropriate. (vi) Undertakes a secondary survey to establish differential diagnosis (vii) Obtains an arterial blood gas sample safety, interprets results correctly (viii) Manages patients with impaired consciousness including convulsions (ix) Safely and effectively uses common analgesic drugs
  14. 14. (x) Understands and applies the principles of managing a patient following self-harm (xi) Understands and applies the principles of management of a patient with an acute confusional state or psychosis (xii) Ensures safe continuing care of patients on handover between shifts, on call staff or with ‘hospital at night’ team by meticulous attention to detail and reflection on performance (xiii) Considers appropriateness of interventions according to patients’ wishes, severity of illness and chronic or co-morbid diseases (xiv) Has completed appropriate level of resuscitation training (xv) Discusses Do Not Attempt Resuscitation (DNAR) orders, advance directives appropriately (xvi) Requests and deals with common investigations appropriately. 4. EDUCATIONAL REQUIREMENTS & DEPARTMENTAL MEETINGS • To take responsibility for own learning and engage in a wide range of learning opportunities including: - Attendance at weekly teaching sessions and 4 half day workshops organised by the Department of PGME in order to develop the underpinning knowledge linked to both generic and acute care competencies - Attendance at local training events such as academic meetings, audit meetings, firm meetings, research meeting, journal clubs, on the job training. - Self-directed learning, computer-based learning & small group teaching - Weekly Grand Rounds • Regular meetings with Educational Supervisor in each placement to: - Agree learning and assessment plans - Review and monitor progress - Sign off level of competency reached during each rotation • Seek help, formally and informally from appropriate people in time to address any problems that may arise. • Undertake a range of clinical-based assessments which will be managed by a range of healthcare professionals including clinical supervisors, other doctors, nurses and AHPs. • Participate in educational appraisal. • Maintain a portfolio of evidence to support learning that has taken place and the development of competencies throughout the year. • Participate in self-evaluation, reflective practice and life-long learning. 5. ANNUAL LEAVE Annual leave entitlement is 27 days per annum which is to be divided and taken equally amongst each rotation except for Orthopaedics and Urology where annual leave cannot be taken during those attachments. You will be required to follow the department's local
  15. 15. procedure for requesting leave, which will be issued to you as part of your local induction and orientation. 6. ACCOMMODATION King's has self-contained and fully equipped studio apartments available at Grove Vale, East Dulwich, SE22. 7. OCCUPATIONAL HEALTH REQUIREMENTS You will be required to complete a health questionnaire in connection with your application to King's College Hospital NHS Trust. Proof is required of a negative result for Hepatitis B and Hepatitis C viruses. We are able to accept identification Verified (ID verified) results of Hepatitis B surface antigen and hepatitis C virus RNA over six months. If you do not have proof of a negative test in paper form or on your SMART card, you will need to arrange for a blood test with King's Occupational Health Department, bringing with you a form of identification including a picture and signature e.g. new style driving license/passport. King's College Hospital F1 Educational Programme Posts & Rotations 4 Months 4 Months 4 Months Post 1 Medicine 2 Surgery 3 GP Post 2 Surgery 3 GP Medicine 2 Post 3 GP Medicine 2 Surgery 3 3 Months 3 Months 3 Months 3 Months Post 4 Ortho Medicine 2 Surgery 2 Paeds Post 5 Urology Medicine 2 Surgery 2 Medicine 2 Post 6 Ortho Medicine 1 Paeds Surgery 2 Post 7 Medicine 1 Medicine 1 ICU Surgery 2 Post 8 Medicine 2 Surgery 2 Ortho ICU Post 9 Surgery 2 Surgery 2 Urology Medicine 1 Post 10 Surgery 2 Paeds Medicine 1 Medicine 1 Post 11 Surgery 3 ICU Medicine 1 Medicine 1 Post 12 Surgery 4 Ortho Medicine 2 Medicine 2 Post 13 Paeds Surgery 5 Medicine 1 Medicine 1 Post 14 Medicine 2 Medicine 2 Surgery 3 Ortho Post 15 Medicine 1 Medicine 1 Surgery 3 Ortho Post 16 Medicine 1 Medicine 1 Ortho Surgery 3 Post 17 Medicine 1 Medicine 1 Ortho Surgery 3 Post 18 Medicine 1 Medicine1 Medicine 2 Surgery 5 Post 19 ICU Surgery 3 Medicine 2 Medicine 2 Post 20 Urology Surgery 3 Medicine 2 Medicine 2 Post 21 Ortho Surgery 5 Medicine 1 Medicine 1 Post 22 Ortho Surgery 4 Medicine 2 Medicine 2
  16. 16. Post 23 Medicine 2 Urology Medicine 2 Surgery 1 Post 24 Medicine 1 Medicine 1 Surgery 4 Urology Post 25 Medicine 1 Medicine 1 Surgery 5 Ortho Post 26 Medicine 2 Medicine 2 Urology Surgery 4 Post 27 Medicine 2 Medicine 2 Ortho Surgery 4 Post 28 Medicine 2 Medicine 2 Surgery 4 Medicine 1 Post 29 Medicine 2 Medicine 2 Surgery 5 Ortho Post 30 Surgery 3 Ortho Medicine 1 Medicine 1 Post 31 Surgery 5 Ortho Medicine 1 Medicine 1 Post 32 Surgery 4 Ortho Medicine 1 Medicine 1 Post 33 Surgery 5 Medicine 1 Ortho Medicine 2 Post 34 Ortho Surgery 4 Medicine 2 Medicine 2 Post 35 Medicine 1 Ortho Medicine 1 Surgery 5 Post 36 Surgery 1 Medicine 2 Medicine 2 Ortho Post 37 Medicine 1 Surgery 1 Medicine 1 Urology Post 38 Medicine 2 Urology Surgery 1 Medicine 2 JH - PGME February 2005
  17. 17. JOB DESCRIPTION Post Title & Grade: F2 Pilot - Senior House Officer (11 Month Rotation Post) Rotations: 1 x 3 Month Rotation 4 x 4 Month Rotation Departments: Accident & Emergency Public Health Nuclear Medicine Location: King's College Hospital NHS Trust Hours/Rota: Banding as at start date of contract King's College Hospital NHS Trust King's College Hospital NHS Trust provides healthcare and emergency services for a cosmopolitan and ethnically diverse community in South East London which accounts for 70% of its work. It is also a major academic centre with close links to King's College University of London under whose auspices the new Medical and Dental Schools, known as the Guy's King's and St. Thomas' Hospitals Schools of Medicine and Dentistry, came into being on 1st August 1998. This union has heralded the many changes which will take place over the next few years within education and research which in turn will have some effect upon the service. The opportunity is to create a world class medical centre between King's College and the two teaching hospital Trusts. King's College Hospital is renowned for those specialties which attract referrals from all over the United Kingdom and abroad, and also supports leading edge research and an undergraduate medical school. Examples of such specialist work include liver (with the largest liver transplant programme in Europe), renal and cardiac services, and pioneering work in neonatal medicine and diabetes. King's College Hospital also encompasses the Neurosciences Centre for South East England. However King's provides vital and extensive acute hospital services to the residents of S.E. London and this element has always been the bedrock of teaching and research programmes. King's College Hospital employs some 4,200 people and currently has three inpatient sites - at Denmark Hill, Dulwich and Mapother House. The Trust's mission statement is: "Achieving Excellence in Patient Care" 1. JOB SUMMARY This approved training post provides a range of practical and educational opportunities for the second year of the two-year foundation programme. The postholder will further develop a variety of generic and core specialist competencies that focus upon the appropriate skills, knowledge and attitudes required in order to ensure high quality & safe care is experienced by every patient. At the end of the year, the London Deanery will summatively assess whether the postholder has successfully achieved the competencies required for the second year of the foundation programme
  18. 18. The postholder will rotate A&E as well as 2 of the attachments listed below (please see appendix one for details of individual posts and rotations). 2. DETAILS OF POSTS/ ROTATIONS/EDUCATIONAL SUPERVISORS a) Accident & Emergency - Dr Tunji Lasoye Trainees will work in this busy inner city A&E department seeing over 110,000 new patients a year. They will gain experience in managing a whole spectrum of acute and less acute presentations under the supervision of middle grade doctors(24 hours a day) and Consultants( up to 14 hours a day). There are opportunities to participate in audit and research projects. Trainees will also be involved in the teaching of medical students on the shop floor. b) Nuclear Medicine - Muriel Buxton-Thomas Trainees will work within the nuclear medicine department and will assess patients undergoing functional imaging and therapeutic procedures in nuclear medicine. In addition they will involve in the management of in-patients, attend ward rounds, out- patient clinics and review clinical endocrinology patients. There will also be opportunities for audit and research methods. c) Public Health - Yvonne Doyle Trainees will be based in an Acute Care Trust with links to a Care Trust, Mental Health Trust, Local Health Protection UUNet and the Medical School, and will build an understanding of public health practice in South East London. They will gain direct experience of work in one or more areas of public health, such as an assessment of an aspect of preventable premature mortality and recommendations for clinical and cost-effective interventions to reduce this, an evaluation of a local screening programme, the management of an outbreak of communicable disease, the development of clinical governance including audit, clinical effectiveness and management of untoward incidents and an equity audit. Trainees will also develop core management skills including presenting data and evidence, handling meetings, and persuading and motivating colleagues. Post 3 Months 4 Months 4 Months 1 A&E Nuclear Medicine Public Health 2 Public Health A&E Nuclear Medicine 3 Nuclear Medicine Public Health A&E 4. LEARNING OBJECTIVES During the year you will be given appropriate opportunities in order to develop and achieve each of the competencies identified below to F2 level (see foundation curriculum). This will be necessary in order to be signed off as successfully achieving the two-year foundation programme. 1.0 Good Clinical Care 1.1 History Taking, Examination & Record Keeping Skills.
  19. 19. (ii) History Taking - Routinely undertakes structured interviews ensuring that the patient’s concerns, expectations and understanding are identified and addressed. (ii) Conducts examinations of patients in a structured, purposeful manner and takes full account of the patients dignity and autonomy (iii) Understands and applies the principles of diagnosis and clinical reasoning that underlie clinical judgement and decision-making. (iv) Understands and applies principles of therapeutics and safe prescribing. (vi) Understands and applies the principles of medical data and information management: keeps contemporary, accurate, legible, signed and attributable notes. 1.7 Demonstrates appropriate time management and decision making 1.8 Understands and applies the basis of maintaining good quality care and ensuring and promoting patent safety. (vi) Always maintains the patient as the central focus of care (vii) Makes patient safety a priority in own clinical practice (viii) Understands the importance of good teamworking for patient safety (ix) understands the principles of quality and safety improvement (x) understands the needs of patients who have been subject to medical harm or errors and their families. 1.9 Knows and applies the principles of infection control. 1.10 Understands and can apply the principles of health promotion and public health. 1.11 Understands and applies principles of medical ethics and of relevant legal issues. (iv) Understands and applies the principles of medical ethics (v) Demonstrates understanding of, and practises appropriate procedures for valid (vi) Understands the legal framework for medical practice 2.0 Maintaining Good Medical Practice (iv) Learning: Regularly takes up learning opportunities and is a reflective self-directed learner (v) Evidence base for medical practice: knows and follows organisational rules and guidelines and appraises evidence base of clinical practice. (vi) Describes how audit can improve personal performance
  20. 20. 3.0 Relationships with patients and Communication (ii) Demonstrates appropriate communication skills (see also 1.3) 4.0 Working with Colleagues (iii) Demonstrates effective team work skills (iv) Effectively manages patients at the interface of different specialties including that of Primary Care, Imaging and Laboratory Specialities. 5.0 Teaching and Training (ii) Understands principles of educational method and undertakes teaching of medical trainees and other health and social workers 6.0 Professional Behaviour and Probity (xvii) Consistently behaves with a high degree of professionalism (xviii) Maintains own health and demonstrates appropriate self-care 7.0 Acute Care (i) Promptly assess the acutely ill or collapsed patient. (ii) Identifies and responds to acutely abnormal physiology. (xix) Where appropriate, delivers a fluid challenge safely to an acutely ill patient. (xx) Reassesses ill patients appropriately after initiation of treatment (xxi) Requests senior or more experience help when appropriate. (xxii) Undertakes a secondary survey to establish differential diagnosis (xxiii) Obtains an arterial blood gas sample safety, interprets results correctly (xxiv) Manages patients with impaired consciousness including convulsions (xxv) Safely and effectively uses common analgesic drugs (xxvi) Understands and applies the principles of managing a patient following self-harm (xxvii) Understands and applies the principles of management of a patient with an acute confusional state or psychosis (xxviii) Ensures safe continuing care of patients on handover between shifts, on call staff or with ‘hospital at night’ team by meticulous attention to detail and reflection on performance (xxix) Considers appropriateness of interventions according to patients’ wishes, severity of illness and chronic or co-morbid diseases (xxx) Has completed appropriate level of resuscitation training
  21. 21. (xxxi) Discusses Do Not Attempt Resuscitation (DNAR) orders, advance directives appropriately (xxxii) Requests and deals with common investigations appropriately.
  22. 22. 5. EDUCATIONAL REQUIREMENTS • To take responsibility for own learning and engage in a wide range of learning opportunities including: - Attendance at weekly teaching sessions organised by the Department of PGME in order to develop the underpinning knowledge linked to both generic and core specialist competencies - Attendance at local training events such as academic meetings, audit meetings, firm meetings, research meeting, journal clubs, on the job training. - Self-directed learning, computer-based learning & small group teaching • Regular meetings with Educational Supervisor in each placement to: - Agree learning and assessment plans - Review and monitor progress - Sign off level of competency reached during each rotation • Seek help, formally and informally from appropriate people in time to address any problems that may arise. • Undertake a range of clinical-based assessments which will be managed by a range of healthcare professionals including clinical supervisors, other doctors, nurses and AHPs. • Participate in educational appraisal for revalidation purposes. • Maintain a portfolio of evidence to support learning that has taken place and the development of competencies throughout the year. • Participate in self-evaluation, reflective practice and life long learning. 6. ANNUAL LEAVE Annual leave entitlement is 27 days per annum pro-rata, which is to be divided and taken equally amongst each rotation. King’s College Hospital NHS Trust Department of Postgraduate Medical and Dental Education
  23. 23. Job Description Post Title: Clinical Supervisor Grade: Consultant PA: N/A Responsible to: Educational Supervisor (day-to-day) Foundation Training Programme Directors (overall) Accountable to: Specialty Lead Clinician Job Summary To take overall responsibility for supervising trainees' day-to-day clinical and professional practice. Some Clinical Supervisors may also take on the role as Educational Supervisor (see separate job description) Main Duties & Responsibilities 2. Supervision • Supervise the trainees' day-to-day clinical and professional practice, providing constructive feedback on their performance. • Ensure trainees have access to an appropriate range and mix of clinical exposures which will support them in achieving the foundation competencies. • Identify other suitable doctors and healthcare professionals who could assess trainees once they have attended the Assessment & Supervision training organised by PGME. (Please note that nurses/AHPs etc can only assess DOPS & complete the rating forms for Mini-PATs). Those nurses/AHPs etc who are only completing forms for Min-PATs can be trained locally by a person who has already attending the training. • Liaise with the Educational Supervisor regarding any up to date information about the foundation programme. • Refer any difficulties or problems to the Educational Supervisor and keep accurate notes of any meetings with trainees. • Liaise with the Educational Supervisor regarding trainee's progress and any identified learning/training needs. 2. Assessment • Support the assessment process by using a range of assessment tools, DOPS, Mini- CEX, Mini-PAT and CBD. Judge trainee's performance against the competences and make appropriate assessment decisions: a) DOPS - Direct Observation of Procedural Skills (4 per trainee per year) Observing trainees carrying out a practical procedure from the acute care skills list found in the curriculum. You must only carry out ONE DOPS per trainee and complete assessment forms accurately. Provide immediate constructive feedback to the trainee on their performance.
  24. 24. b) Mini-CEX - Mini Clinical Examination Exercise (4 per trainee per year) Observing trainees carrying out a clinical encounter/interaction with a patient from the acute care skills list found in the curriculum. You must only carry out ONE Mini-CEX per trainee and complete assessment forms accurately. Provide immediate constructive feedback to the trainee on their performance. c) Mini-PAT or TAB - Mini Peer Assessment Tool or Team Assessment of Behaviour (1 per trainee per year or 2 if there are concerns. This is an assessment that collates views from a range of co-workers (previously 360 degree assessment). If asked by a trainee there is a form that needs to be completed. d) CBD - Case Based Discussion (6-8 per trainee per year) Discussing entries made in the case notes by the trainee to assess the trainees level of decision-making and clinical reasoning to be explored in detail. Complete assessment forms accurately.
  25. 25. King’s College Hospital NHS Trust Department of Postgraduate Medical and Dental Education Job Description Post Title: Educational Supervisor Grade: Consultant PA: 0.25wte (estimated) Responsible to: Foundation Training Programme Director(s) Accountable to: Specialty Lead Clinician Job Summary To take overall responsibility for the education and development of foundation trainees. Some Educational Supervisors may also take on the role as Clinical Supervisor (see separate job description) Main Duties & Responsibilities 3. Management & Communication • Act as the key person in the speciality for overseeing foundation trainees. • Ensure appropriate training opportunities in order for trainees to gain the required competences. • Communicate any information regarding the foundation programme to clinical supervisors to ensure they are up to date with foundation programme requirements and documentation. • Attend the Foundation Faculty meetings on a quarterly basis and disseminate relevant information to clinical supervisors and any other appropriate people within the department. • Be the first point of contact for trainees who have concerns/issues about their training, and if these cannot be resolved locally refer any difficulties or problems to the Foundation Programme Directors(s). Keep accurate notes of any meetings with trainees. • Liaise with the Foundation Programme Clinical Facilitator regarding trainees progress and their learning/training needs. • Upon request provide information to the Department of Postgraduate Medical Education about the foundation programme/trainees. This includes information for reports and signing certificates of satisfactory service. • Participating in any inspection visits to foundation trainee posts.
  26. 26. 2. Local Induction & Orientation • Take overall responsibility for ensuring that the department/ward has a local induction & orientation programme in place for new trainees. • Ensure all local induction checklists & clinical competency checklists are sent to the administrative person within the department who has responsibility for recording local induction on STARs and filing the checklists for auditing purposes. • Update the departmental local induction handbook/documentation and clinical competencies checklists as an when necessary. 3. Educational Meetings • Arrange to meet trainees at the beginning of each rotation to: a) check the trainee has received a local induction b) ensure the clinical competency checklists have been completed c) discuss the trainees learning needs, how these will be developed and what assessment methods will be used to evaluate whether the trainee is achieving the competencies. Write this up in the learning and assessment plan. d) discuss the types of evidence the trainee might collect for their portfolio to demonstrate they have achieved competency. e) discuss the trainees career intentions and provide appropriate guidance and support. • Meet trainees at the mid-point of each rotation to: f) provide support to the trainee. g) review the trainees progress and provide support to them for the development of their portfolio. c) ensure trainees are engaging in the assessments process and that trainees are achieving the competencies. h) complete all relevant documentation. • Meet trainees towards the end of each rotation to: a) provide on-going support to the trainee b) review the trainees progress by ensuring all assessments have been completed and reviewing the trainees evidence in order to determine which competencies have been achieved during the rotation. i) make a note of any issues/out standing assessments/on-going learning needs which need to be carried over into the next rotation. d) complete all relevant documentation. 4. Appraisal & Revalidation • Appraise trainees annually using the NHS appraisal documentation and ensure that they are collecting sufficient and appropriate evidence for re-validation. (http://www.dh.gov.uk/PolicyAndGuidance/HumanResourcesAndTraining/LearningAndPe rsonalDevelopment/Appraisals/AppraisalsArticle/fs/en? CONTENT_ID=4031937&chk=gd4wB6). • Ensure the date of appraisal is recorded on STARS.
  27. 27. Careers Advice Foundation training should offer F1 and F2 trainees the opportunity to explore career options. In addition to rotating through a range of specialties and settings, foundation trainees need access to advice and accurate information about current and future career opportunities. They will also need support, advice and coaching to help plan their careers. Career planning will entail foundation trainees learning and being coached about how best to align their aptitudes, strengths and interests with the needs of the NHS. Robust workforce information, as well as clarity about career pathways, is essential. Good career planning will also involve helping trainees understand that life-long learning is at the core of a successful career, enabling flexibility and adaptability throughout their medical working lives. Deaneries must ensure that those who provide career advice and coaching are trained appropriately. It will not be sufficient for Educational Supervisors to offer informal career advice, as has often occurred in the past. From August 2005 Deaneries will receive funding to support the development of a robust career advisory service, which will entail the provision of appropriate advice and information by trained career advisors. Career Advisers Dr Jan Welch Mr Matthew Bowles Dr Tunji Lasoye Careers Fair We will be organising a half day careers fair for the trainees where they will receive a talk from the Clinical Tutor followed by the opportunity to meet and chat with doctors including SpRs & a GP from a range of specialties. Trainees will have completed Sci 45 prior to this event so will have some information about the areas they are most suited to, and we would expect each trainee to speak to doctors from at least 5 specialties. We will also be inviting Educational Supervisors plus some external bodies such as the London Deanery, NHS professionals, BMJ careers etc. Career Surgeries We will be planning career surgeries throughout the year as we have always done for our PRHOs, where trainees meet individually with The Clinical Tutor, the Deputy Clinical Tutor, the Foundation Programme Director(s) and the Postgraduate GP Sub-Dean. We are looking at planning the dates for these soon. In addition, there will be opportunities for trainees to meet with a career adviser from the South East Thames Foundation School and sessions for trainees to meet with Carol Hjelm from KCL careers services to assist trainees with their CVs, carry out Sci 45 etc.

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