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Level 1 guidance checklist 031109

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Paediatric Guidance Checklist

These standards were derived to assist in the assessment of the

paediatric training standards of in your deanery







Specialty: LEVEL 1



The Programme (which may consist of several posts) should

provide:

1. Supervision /

1.1 An educational supervisor that is a Consultant paediatrician trained in

assessment and appraisal

1.2 An educational supervisor who is available for 0.25 PAs per trainee per

week of educational supervision

1.3 Evidence that the assessment strategy is being delivered

1.4 Trainers receive appropriate training on the delivery of the assessment

strategy

1.5 Clinical supervision ensures Patient Safety



2. Other Personnel

2.1 Sufficient consultant paediatricians trained in educational and clinical

supervision to provide support for all trainees in the department

2.2 More than one ST4 -8 in the children’s department

2.3 Supervision at all times for ST1 and ST2 trainees by those who have

at least Level 1 competences/guidance on safe cover arrangements for

paediatric out of hours



3. Service requirements and facilities

3.1 Specialty specific requirements of related clinical departments

that are involved in delivery of the curriculum: Any surgery and

anaesthesia undertaken to be consistent with current best practice advice

(e.g. Surgery for Children: Delivering a First Class

Service 2007)

3.2 Specialty specific requirements of service departments

relevant to delivery of curriculum (e.g. investigation departments,

PAMs departments): Access to a radiologist with paediatric interest, a

paediatric dietician, paediatric SALT, Paediatric physiotherapy and

occupational therapy. Access to play specialists and CAMHS.

3.3 Specialty specific requirements of clinical networks: Department

participates in available clinical networks e.g. neonatology, diabetes



3.4 Clinical Standards and Guidelines

Each department runs an appropriate induction and utilises up to date

guidelines and protocols



3.5 Phlebotomy:Junior doctors should not be used to provide a routine

phlebotomy service for the outpatient department or General Practitioners.







4. Educational activities and training

4.1 Specialty specific clinical exposure required to provide

sufficient learning opportunities(NB if giving workload data ensure it is explicit

whether this is number per annum or number trainee would be expected to be exposed to

over entire programme):

Paediatric Guidance Checklist

These standards were derived to assist in the assessment of the

paediatric training standards of in your deanery



Level 1 programme consisting of a series of posts which allow adequate

opportunity to cover the range of level 1 competences



St1-2 should be predominantly acute general paediatrics with 6 months of

neonatal intensive care and some training in sub-specialty paediatrics



Appropriate clinical activity

Assessment of 400 acute new presentations per trainee per year of

training



During 6 months neonatal intensive care training opportunity to be present

at 30 deliveries requiring attendance and to admit 20 infants to

NICU/SCBU

4.2 Specialty specific requirements for structured training

opportunities to include courses:

Training in child protection awareness to include formal education and

training courses which cover the Level 1 (ST1-3) safeguarding

competences

Relevant resuscitation training for example APLS/EPLS and NLS

Structured programme of formal teaching and learning opportunities to

complement work-place based training and ensure curriculum coverage

4.3 Specialty specific requirements for other experiential

learning(excluding clinics and ward rounds): Level 1 training should

include awareness of child health provision outside the hospital setting e.g.

schools, community based clinics, primary care, and opportunities to

experience and to witness multidisciplinary team working where possible



4.4 Administration of IV Antibiotics: Trainees should be fully trained in

the preparation and administration of IV antibiotics as this may be

necessary in an emergency situation. E.g. a child with meningococcal

sepsis.

4.5 Newborn Examinations: Junior doctors should not be routinely

expected to perform examinations of well newborn infants during evening

and night shifts, unless this is clinically indicated.



5. Working patterns

5.1 Safe cover arrangements for paediatric department out of hours in

line with RCPCH guidance

5.2 Evidence of compliance with existing employment rules to working

time

5.3 Working intensity and pattern that is appropriate for learning

5.4 Acute general paediatric experience including the out of hours

commitment will provide essential training for this level of training

5.6 Working patterns which allow trainees to regularly attend at least

60% of regional training days

5.7 inappropriate attendance to the Delivery Suite

Clear local guidance should be in place to indicate which deliveries

Paediatric staff should attend, minimising presence where there is no

proven need. Guidance should be reviewed on a yearly basis.

Paediatric Guidance Checklist

These standards were derived to assist in the assessment of the

paediatric training standards of in your deanery



6. Specific Post requirements

6.1 ST1 - 3 neonatal training must be provided in units that undertake

Level 2 and 3 neonatal intensive care

6.2 General training based in acute settings must include emergency

duties, inpatients and outpatients



7. Enabled to learn new skills, necessary skills and curriculum

coverage (specialty specific)

This section can be used to highlight marker conditions to which trainee should be exposed or the

numbers of cases/procedures that trainee will be expected to see/do. Ensure that it is clear whether

any numbers are for whole training programme or per annum

7.1 Specialty specific marker conditions trainee should be exposed

to:

Problems; Fever, fits, breathing difficulty, diarrhoea, vomiting,

developmental delay, rashes, hypoxia, chronic disease, child abuse and

neglect, prematurity, jaundice, faltering growth, behavioural problems,

common post natal problems, post natal screening, resuscitation and

stabilisation of a sick child



Diagnoses; diabetes, epilepsy, asthma, cerebral palsy, respiratory distress

syndrome, congenital heart disease, nephrotic syndrome, arthritis,

anaemia, head injury, ingestion, infectious diseases, gastroenteritis,

childhood cancer, cystic fibrosis

7.2 Specialty specific skills/procedures trainee needs to complete:

Bag, valve mask ventilation, blood sampling (capillary and venous) lumbar

puncture, intravenous lines, tracheal intubation, umbilical vein

catheterisation, prescribing, interosseous needle insertion



8. Access to clinics and ward rounds and long term care of patients

8.1 Specialty specific numbers and types of clinics expected to

attend (including outreach clinics):

10 clinics per 6 months

5 clinics when in neonatal post

8.2 Specialty specific ward rounds consultant led and independent

per week:

Regular attendance at daily consultant led ward rounds



9. Meetings

9.1 Specialty specific number and types of MDT/multi-professional

meetings expected to be exposed to:

1 MDT meeting per 6 months at level 1 (e.g. Discharge planning, complex

care, safeguarding)



10. Clinical audit

10.1 Evidence of trainees participation in clinical governance (at least 1

full audit/year, preferably completing an audit cycle and attendance at

critical incident meetings)

10.2 Evidence of trainees participation in clinical guideline development

Paediatric Guidance Checklist

These standards were derived to assist in the assessment of the

paediatric training standards of in your deanery





11. Teaching appraising and assessing

11.1 Opportunities to deliver formal and informal teaching (e.g. to medical

students or peers) and receive feedback

11.2 Opportunities for involvement in and contributing to the assessment

of others (e.g. giving feedback)

11.3 Opportunity to receive training in work-place based assessment





12. Research

12.1 Provide opportunity to acquire level 1 competences in research

12.2 Provide opportunities to be involved in clinical research



13. Management

13.1 Opportunities to be involved in management e.g. participation in

management meetings and projects

13.2 Opportunities for communication with colleagues e.g. Handover and

discharge letter writing

13.3 Administrative duties including preparation of notes, finding

equipment, filing of results within patient notes and locating and retrieving

patient medical records following admission should not routinely be the

responsibility of junior doctors. Trainees should assist with these tasks

when appropriate but sufficient clerical support should exist within the

department.



AND MUST BE WILLING TO HOST THE MRCPCH

CLINICAL EXAM



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