TRAINING UPDATE- CSAC Brindha Dhandapani

Aim to cover  Guidance on SLEs for CCH level 3 training  General paediatric competencies for CCH level 3  Fast tracking level 3 training  Sub- specialty ARCP

Assessment instruments for level 3 trainees  SLEs (Supervised Learning Events)  Portfolio review  START (Specialty Trainee Assessment of Readiness for Tenure)  Trainer Reports

Assessment instruments for level 3 trainees  from different sources, on different occasions and using different assessment methods.  where possible, try to exceed the minimum number of assessments required.

E- portfolio  Professional Development Plan  Reflective entries  Skills log  Record of training events  Teaching and presentation resources  Audits and clinical governance  Safeguarding reports  Education supervision documentation  Trainer reports  Assessment reports

Supervised Learning Events(SLEs)  aim for 20 SLEs per training year (pro-rata for LTFT trainees)  ratios for the balance of mini CEX to CbD assessments are for guidance only  minimum of 12/year

MiniCEX Total- 9 (min 3 per year)  2 neuro-disability/ developmental disorder to cover range of ages and settings  2 child protection examinations covering a range of ages  2 Looked after children assessments of children of different ages  1 examination of acute paediatric presentations  2 assessments of complex social /behavioural difficulties

CbD Total- 12 (min 4 per year)  3 neuro-disability to include assessments of children of different ages in a range of settings and must include an example from each of the following categories: communication and autism spectrum disorders, genetic disorders and physical disability  3 behavioural problems, assessment and management to include ADHD prescribing and sleep management  1 assessment and management of long term conditions  1 Looked after children assessments including at least one going forward for adoption  2 assessments of children with Sensory impairment (hearing and/or vision)  1 public health e.g. immunisation query  1 acute presentation

Safeguarding CBD Total - 6 (min 2 per year)  6 reflecting a range of cases including physical, sexual, and emotional abuse and neglect

DOPS Total- 3(1 DOP /year)  Structured developmental assessments e.g., SOGS II, Baileys, Griffiths  Assessment of social communication skills using assessment tools covering different age ranges e.g; ADI–R, ADOS, DISCO

LEADER Total- 3 (Min 1 per year)  Active participation in safeguarding/LAC meeting e.g. CP conferences, strategy meetings, adoption panels  Chairing MDT meetings  Child public health project  Setting up services/ educational meetings/ groups etc  Contribution to service development, audit, guideline development

Optional SLEs HAT  Transition to adult services  Transfer to other teams  Hospital handover ACAT Acute -whilst on call/in hospital

DOC  complete 10 DOCs over 3 years  at least two each of - Safeguarding, - LAC/Adoption, - Education Health Care Plan report - Developmental assessment, - Multidisciplinary / neuro-disability

General Paediatric Training in Level 3 Sub-specialty Training

 National Survey of Paediatric Trainees in % of trainees in sub-specialty training reported spending <70% of their working time within their sub- specialty. -perceived difficulties in obtaining sub-specialty competencies compared to trainees working >70% of their time within the sub-specialty.  Previously the College/CSAC has recommended that no more than 33% of hours worked by all trainees should be in the delivery of emergency out of hours care, equating to ~16 hours of the 48 hours maximum working time

 College guidance revised in September 2015  Paediatric trainees achieving CCT receive accreditation in Paediatrics, and so must be competent in the delivery of acute paediatric and neonatal care

 The 70% guidance should be considered as an ideal aim, and not a hard limit.  Calculation should be based on 20 working weeks during a 6 month placement, i.e. excluding annual and study leave  For doctors training less than full time the expectation is the same as above pro rata and includes the full range of out of hours duties (night time, evening and weekend pro rata)

 Need to maintain and develop acute paediatric competencies throughout Level 3 training.  Appropriate for such competencies to be monitored through SLE, and form part of the Annual Trainers Report.  Advice from deanery leads for clarification, as this varies

Fast tracking level 3 training

 Discuss intention to complete training before their penultimate ARCP and this must be documented in the trainers report.  One year, only in exceptional circumstances less than 6 months before their final ARCP is due.  Agreement with their Educational Supervisor, CSAC Chair and Head of School to bring forward their CCT date and the date of their final ARCP.

 Trainees are unlikely to meet all of the requirements for Level 3 training in less than 36 months with the average time taken by trainees being months.  A period of acting up before they complete their training will support their transition to Consultantcy.

Requirements  complete a pro-rata number of SLEs in the final year of training  Meet required curriculum competencies for General Paediatrics and sub-specialty as agreed with Educational Supervisor and CSAC.  Complete START Assessment and address all areas identified as needing development  Address all items identified in their PDP related to their training and which require completion  Satisfactory trainers reports which clearly demonstrate that the trainee has met the required competencies at every level.

 If CCT date and the date of their final ARCP are brought forward and an outcome 6 is issued, they will be unable to go back into training as the trainee is deemed to have completed their training.  The final decision regarding a trainee wishing to finish their training early rests with the Head of School at the final ARCP meeting.

Sub specialty ARCP outcome

 GMC Position Statement – October 2014 Improving the National Consistency and Approval of Sub-Specialty Training Programmes “A separate independent ARCP outcome is to be recorded for the sub-specialty training. This does not require a separate ARCP meeting to be held, but there must be appropriate input into the decision.”

 CSAC provides a recommendation to the LETB on sub- specialty competency progression – informed by relevant, local input, ie Trainers report.  face-to-face/ telephone discussion/ review of e- portfolio to ensure that the trainee is progressing against the curriculum.  The final decision regarding the outcome eventually awarded rests with the ARCP panel

Questions?