THE EUROPEAN DATABASE ON SUBSPECIALIST TRAINING IN NEONATOLOGY – WHERE ARE WE TODAY IN EDUCATIONAL HARMONIZATION? Morten Breindahl MD, PhD, Council Member of the ESN

Department of Neonatology, Level IV NICU The National University Hospital in Copenhagen, Denmark - Part of a larger society

Learning outcome Breindahl et al. ESPR 54 th Annual Meeting, Porto, October, 2013  After this session you shall be able to:  Understand the background for and contents of the European Curriculum and Syllabus for Training in Neonatology as well as the Assessment Framework for Specialist Trainees in Neonatology  Discuss the status of subspecialty training in Neonatology in Europe  Identify at least three areas where harmonization is still lacking behind  Discuss potential barriers against and drivers towards further harmonization of educational standards in Europe

Agenda Breindahl et al. ESPR 54 th Annual Meeting, Porto, October, 2013  Overview of the European Database on Subspecialty Training in Europe  How was it constructed, who participated, what does it show?  Main results, similarities and differences between participating countries  Database and process outcome – tasks to be completed in the future

Background: ESN Curriculum st version. Sidarto B. Oetomo, NL nd version. Michael Obladen, D rd version. Neil Marlow, UK 2008 Transparency. Gorm Greisen, DK 2010 Database. Morten Breindahl, DK 2011 All UEMS countries included 2011 Database published on ESN website 2012 Results published in Neonatology 2013 European Network on HArmonization of National Curriculi on neonatal Education (ENHANCE) Breindahl et al. ESPR 54 th Annual Meeting, Porto, October, 2013

Curriculum and Assessment Framework  Support of national training programmes  Aims at  Harmonising training in Neonatology  Establishing clearly defined standards of knowledge and skills  Fostering the development of a European network of tertiary care centres for Neonatology  Minimal record of clinical progression:  13 key competencies  3 levels  Additional demands:  Other key areas  Reflective notes  Academic meetings (> 3/year)  Other CME activities  Abstracts, publications  Audits (> 3)  Certification of courses European Curriculum and Syllabus for Training in Neonatology Assessment Framework for Specialist Trainees in Neonatology Breindahl et al.ESPR 54 th Annual Meeting, Porto, October, 2013

Aims of the database  Improve transparency of the national guidelines compared to ESN curriculum  Publish similarities and differences  Induce harmonisation through:  National self-reflection on own deviations from the majority  ESPR/ESN modifications of official requirements to reality Breindahl et al.ESPR 54 th Annual Meeting, Porto, October, 2013

Method  Construction of database based on ESN curriculum:  (Basic characteristics)  Training – knowledge  Training – skills  Key competencies  Personal development  Recording of progress  contact to UEMS members  Identification of contact persons  Data collection, registration, verification of data  Agreement with ESN Curriculum  Publication of database on ESN website  Publication of results in Neonatology Breindahl et al.ESPR 54 th Annual Meeting, Porto, October, 2013

Results 1: Overall characteristics  Response rate  100% (30/30)  National/ESN curriculum  76% (23/30): National  13% (4/30): ESN Curriculum  10% (3/30): Neither  Length of training  Paediatrics: 4.1 [2-6] years  Subspecialist: 2.4 [1-6] years  Years in NICU: 1.2 [0-4] years Breindahl et al.ESPR 54 th Annual Meeting, Porto, October, 2013

70% - 73%  94% (28/30)  Resuscitation  Neurology  Communication and counselling  Anomalies, genetics  Intensive care  Fluid balance  Haematology  Metabolism  Nutrition  Immunity  Family care  Management skills  Transport of newborns Results 2: Uniformity  96% (29/30)  Epidemiology  Patho-/ physiology Foetus Premature Mature  Pharmacology  Neonatal care  Follow-up of high risk infants  Ethics and legal issues Training/ knowledge Training/ skills Key competencies  93% (28/30)  Practical procedures  Diagnosis  Clinical practice  Communication  Technology  Teaching ESPR 54 th Annual Meeting, Porto, October, 2013

Results 3: Differences  67% (20/30)  Personal skills necessary for fulfillment of the leadership role within the team and unit/ hospital  Counsellor  Manager  Leader  Teacher  Clinical governance and audit  Statistical and interpretative skills  77% (23/30)  Completion of other key areas  Perioperative care  Fetal medicine  Clinical genetics  Developmental assessment  Reflective notes  Research activity  Academic meetings  CME activities  Research activity  Audits  Courses Personal developmentRecording of progress Breindahl et al.ESPR 54 th Annual Meeting, Porto, October, 2013

Database outcome  Knowledge  Skills  Competencies  Common understanding of the essential qualifications needed to practice neonatology at a tertiary level  Basic characteristics  Personal development  Recording of progress  Different prerequisites, cultures and systems call for cooperation, exchange of information and experiences High uniformityConsiderable differences Breindahl et al.ESPR 54 th Annual Meeting, Porto, October, 2013

Proces outcome, goals and solutions  All UEMS members: 30 countries  100% response rate  Willingness to  Participate  Report  Interest in  Changing  Adapting  Developing  Transparency achieved  Goals  Make ESN the organization for neonatologists and trainees  Complete harmonization of national training curriculi  Complete directory of tertiary care centres for neonatology  Solutions  Visibility  Transparency  Influence  Harmonization  Partnership Process outcomeGoals and solutions Breindahl et al.ESPR 54 th Annual Meeting, Porto, October, 2013

Building bridges in Europe Breindahl et al. EAPS, Copenhagen 2010 ESPR, New Castle 2011 Cluj-Napoca 2013 ESPR, Porto 2013 ESPR, Istanbul 2012 ESPR 54 th Annual Meeting, Porto, October, 2013