Traditional Poster Round
The Royal College of Paediatrics and Child Health (UK) is keen to support doctors transitioning from senior trainee to Consultant / Attending Paediatrician. The RCPCH is piloting a ‘Stepping-Up Programme’ of meetings in several regions of the UK and has developed a formative 'START' assessment (Specialty Trainee Assessment of Readiness for Tenure). This is mandatory for all UK paediatricians before they complete training. However, there is currently no simulation-based education programme which covers the non-technical skills required of Consultant / Attending Paediatricians at either local or national level.
1. Develop a new framework of domains which refer to the various roles expected of a new Consultant / Attending Paediatrician.
2. Use the framework to design a simulation-based education package which prepares senior trainees for the Consultant / Attending role.
Senior trainees were surveyed on their concerns about transitioning to the Consultant / Attending role at the RCPCH National Conference 2017. 16 topics were identified, relating to working independently, within new systems and with new responsibilities. The Paediatric Simulation Programme Team from the Bristol Medical Simulation Centre were keen to develop an education package to address trainees’ concerns, so reviewed the two current frameworks covering non-technical skills for UK paediatric trainees.
1. The RCPCH ‘Progress’ Curriculum uses 11 ‘Generic Learning Outcomes’ (GLOs), derived from the General Medical Council’s (GMC) standards for postgraduate curriculum design.
2. The formative ‘START’ assessment uses six different domains, derived from GMC’s guidance applying to all doctors.
The Bristol Paediatric Simulation Programme team felt that to address the concerns of trainees we needed a framework focused on the roles Consultant / Attending Paediatricians are expected to perform. We combined the existing domains, trainees’ concerns and the input of Consultant / Attending Paediatricians into six new domains:
A two-day education programme has been developed for final-year paediatric trainees using this framework. The programme consists of real time immersive simulations, table top simulation exercises, workshops and innovations such as a simulated 'night-on-call' from home. The programme will be delivered in March 2019 and the project team aims to demonstrate improvements in candidates' confidence and competence regarding the Consultant / Attending role. Improvements in trainees’ readiness to ‘step-up’ will be assessed by senior Paediatricians on the course faculty.
Examples of Development Areas to be addressed with Simulations
• Simulating high pressure, emotionally challenging situations with careful provision for psychological safety, such as the decision to withdraw CPR in a child.
• Challenging candidates to retain situational awareness of whole teams, departments and the wider hospital.
• Developing candidates’ ability to multi-task and prioritise, balancing clinical and non-clinical tasks, demands and pressures. Navigating hospital management and non-clinical work, both advocating for patients and as a senior leader responsible for service provision
• Considering the options available for development and support as a Consultant / Attending Paediatrician. Addressing issues such as stress, mental health and wellbeing for themselves and their teams.