Trainee Benefits
Participation in research, audit and QI work is a core part of delivering high quality care and, as such, is often a component of training requirements. This project aims to help trainees develop these skills and demonstrate this within their portfolio, as well as providing educational opportunities and resources around the topic of nutrition. This document aims to provide some guidance on what specific outcomes can be realistically achieved through participation, and the different levels of engagement that may be part of this.
The benefits of participation are anticipated to include:
Curriculum domains
Whilst the primary goal of this project isn’t educational in nature, active engagement with the project and the surrounding literature can, depending on your level of prior knowledge, contribute to a number of the domains on the Anaesthesia and ICM curriculum.
CCT in Anaesthetics - Professionalism in Medical Practice (Annex A)
CCT in Anaesthetics - ANNEX A
CC_D3_01 Commits to the importance of being a good team member, working collaboratively, striving for high standards by all
CC_D4_01 Commits to understanding that the role of a consultant involves leadership in clinical management, service delivery and forward planning
CC_D5_01 Commits to searching and comprehending medical literature to guide reasoning
CC_D5_02 Commits to recognising the importance of research [clinical and laboratory] in the development of clinical practice is aware of current areas of research and achieves competence in understanding, and explaining, the methodology and statistics involved
CC_D5_03 Commits to the principle of interprofessional cooperation for audit/quality improvement projects in improving practice
CC_D5_04 Commits to contributing to quality improvement processes e.g. • Audit of personal and departmental/directorate/practice performance • Errors / discrepancy meetings • Critical incident and near miss reporting
CC_D6_04 Commits to the efficient use of resources and encouraging others to do the same
CC_D7_01 Continuously seeks to improve and update their knowledge and skills, using a variety of strategies, whilst keeping records of learning that are planned and undertaken, reflecting on their outcomes
CCT in Anaesthetics - Basic Level Training (Annex B)
HT_BK_03 Lists the likely causes and risk factors for conditions relevant to mode of presentation
IN_BS_01 Interprets clinical laboratory data
OA_BK_03 Explains the indications for and interpretation of preoperative investigations
GU_BK_01 Outlines the principles of preoperative assessment of patients undergoing major and minor surgery, including guidelines on the appropriateness of simple tests [i.e. NICE guidelines]
POM_BK_01 Describes the importance of comorbid disease in the planning and safe conduct of anaesthesia
POM_BK_03 Describes the effects of acute and chronic disease on patient outcomes after surgery
POM_BK_04 Describes the requirements for preoperative investigations including indications for specific tests
POM_BK_05 Interprets fundamental preoperative investigations
POM_BK_11 Describes methods of patient optimisation which reduce risk in the perioperative period
POM_BK_13 Describes specific organisational interventions which improve patient outcomes (e.g. care bundles, enhanced recovery pathways)
PB_BK_18 Red blood cells: production and turnover, haematinics, haemoglobin and its variants including abnormal haemoglobins eg thalassaemia, HbS
PB_BK_19 Anaemia: acute and chronic adaptations – Iron absorption, transportation, metabolism
CCT in Anaesthetics - Intermediate Level Training (Annex C)
POM_IK_03 Describes strategies for prehabilitation and patient optimisation and the limits of such strategies
POM_IK_07 Describes appropriate preoperative strategies for minimising the use of blood products
CCT in Anaesthetics - Higher Level Training (Annex D)
POM_HK_01 Describes strategies for prehabilitation and patient optimisation and the limits of such strategies
POM_HK_04 Describes how quality improvement principles could be used to develop local services
POM_HK_05 Critically analyses evidence related to perioperative practice
POM_HK_06 Explains the importance of primary and social care in perioperative pathways
CCT in Anaesthetics - Advanced Level Training (Annex E)
AT_D4_01 Demonstrates understanding of the need to be aware of new trends and developments and; • Questions the status quo • Actively looks for ways to improve clinical practice and the patient experience • Commits to the changing roles and responsibilities of healthcare groups as practice develops • Is receptive to the attempts of others to improve practice • Urges responsible individuals and groups to seek and implement beneficial change M
AT_D4_02 Understands the importance of research [clinical and laboratory] in the development of clinical practice in their chosen area[s], is aware of current areas of research and achieves competence in understanding, and explaining, the methodology and statistics involved
AT_D5_04 Takes the initiative in: • Demonstrating the efficient use of resources and encouraging others to do the same • Identifying and reporting any significant deficiency of resources • Contributing to discussions and planning for service and facilities development
AT_D6_02 Develops a personal learning network of individuals and organisations including; attending specialist educational meetings and reads specialist journals in special interest areas of practice
POM_AK_02 Demonstrates in-depth knowledge of preoperative optimisation of acute and chronic co-morbidity using an evidence based approach
CCT in Anaesthetics - Teaching and Training, Academic and Research (Including Audit), Quality Improvement, and Management for Anaesthesia, Critical Care and Pain Medicine (Annex G)
Basic Level
AR_BK_05 - Understands the steps involved in completing the audit cycle
AR_BK_06 - Understands the different methods for obtaining data including patient feedback questionnaires, hospital sources and national reference data.
AR_BK_07 - Understands the role of audit including but not exclusively improving patient care and services, risk management etc
AR_BS_07 - Keeps up to date with national reviews, key new research, and guidelines of practice e.g. NICE and SIGN
AR_BS_10 - Contributes data to a local or national audit
Intermediate Level
AR_IK_04 - Understands the links between audit and quality improvement
AR_IS_03 - Supports audit by junior medical trainees and within the multidisciplinary team
Higher Level
AR_HK_01 - Understands their role in supporting quality through participating in and promoting audit of clinical outcomes
AR_HS_13 - Uses the findings of an audit to develop and implement change
AR_HS_14 - Contributes to local and national audit projects as appropriate e.g. NCEPOD and SASM
Higher Level
AR_HK_01 Understands their role in supporting quality through participating in and promoting audit of clinical outcomes
AR_HS_05 Designs, implements and completes audit cycles
AR_HS_12 Encourages discussion amongst colleagues on evidence-based practice AR_HS_13 Uses the findings of an audit to develop and implement change
The CCT in Intensive Care Medicine (Part III) - Syllabus:
11.6 - Critically appraises and applies guidelines, protocols and care bundles.
12.15 - Participates in quality improvement under supervision (Participates in research or audit under supervision - ICM portfolio system).
North West ARCP Criteria
Anaesthesia
The annual review of competency progression (ARCP) in the Northwest requires:
There must be evidence in your LLP that you have actively participated and significantly contributed to one of the following per year:
We feel that active participation in all steps of the study, with appropriate evidencing, can meet these ARCP criteria.
This can include:
These roles will likely be relatively simply achieved by a trainee acting as a local site coordinator for the project.
Not everyone will wish to participate to this extent, and we encourage trainees to participate to a smaller extent e.g. contribution to just data collection, with the understanding that this will not by itself meet ARCP requirements (but can contribute to them).
Publication and/or Presentation Acknowledgement
The whole purpose of these regional projects is to bring the power of large scale collaboration to audit, QI and research projects.
We believe that an essential part of this is that every collaborator is fairly recognised for their contribution in any publication or presentation of the total project.
The acknowledgement process for this study will follow the process outlined in the NWRAG constitution.
References
The benefits of participation are anticipated to include:
- Curriculum competencies
- ARCP
- Publication/presentation
Curriculum domains
Whilst the primary goal of this project isn’t educational in nature, active engagement with the project and the surrounding literature can, depending on your level of prior knowledge, contribute to a number of the domains on the Anaesthesia and ICM curriculum.
CCT in Anaesthetics - Professionalism in Medical Practice (Annex A)
CCT in Anaesthetics - ANNEX A
CC_D3_01 Commits to the importance of being a good team member, working collaboratively, striving for high standards by all
CC_D4_01 Commits to understanding that the role of a consultant involves leadership in clinical management, service delivery and forward planning
CC_D5_01 Commits to searching and comprehending medical literature to guide reasoning
CC_D5_02 Commits to recognising the importance of research [clinical and laboratory] in the development of clinical practice is aware of current areas of research and achieves competence in understanding, and explaining, the methodology and statistics involved
CC_D5_03 Commits to the principle of interprofessional cooperation for audit/quality improvement projects in improving practice
CC_D5_04 Commits to contributing to quality improvement processes e.g. • Audit of personal and departmental/directorate/practice performance • Errors / discrepancy meetings • Critical incident and near miss reporting
CC_D6_04 Commits to the efficient use of resources and encouraging others to do the same
CC_D7_01 Continuously seeks to improve and update their knowledge and skills, using a variety of strategies, whilst keeping records of learning that are planned and undertaken, reflecting on their outcomes
CCT in Anaesthetics - Basic Level Training (Annex B)
HT_BK_03 Lists the likely causes and risk factors for conditions relevant to mode of presentation
IN_BS_01 Interprets clinical laboratory data
OA_BK_03 Explains the indications for and interpretation of preoperative investigations
GU_BK_01 Outlines the principles of preoperative assessment of patients undergoing major and minor surgery, including guidelines on the appropriateness of simple tests [i.e. NICE guidelines]
POM_BK_01 Describes the importance of comorbid disease in the planning and safe conduct of anaesthesia
POM_BK_03 Describes the effects of acute and chronic disease on patient outcomes after surgery
POM_BK_04 Describes the requirements for preoperative investigations including indications for specific tests
POM_BK_05 Interprets fundamental preoperative investigations
POM_BK_11 Describes methods of patient optimisation which reduce risk in the perioperative period
POM_BK_13 Describes specific organisational interventions which improve patient outcomes (e.g. care bundles, enhanced recovery pathways)
PB_BK_18 Red blood cells: production and turnover, haematinics, haemoglobin and its variants including abnormal haemoglobins eg thalassaemia, HbS
PB_BK_19 Anaemia: acute and chronic adaptations – Iron absorption, transportation, metabolism
CCT in Anaesthetics - Intermediate Level Training (Annex C)
POM_IK_03 Describes strategies for prehabilitation and patient optimisation and the limits of such strategies
POM_IK_07 Describes appropriate preoperative strategies for minimising the use of blood products
CCT in Anaesthetics - Higher Level Training (Annex D)
POM_HK_01 Describes strategies for prehabilitation and patient optimisation and the limits of such strategies
POM_HK_04 Describes how quality improvement principles could be used to develop local services
POM_HK_05 Critically analyses evidence related to perioperative practice
POM_HK_06 Explains the importance of primary and social care in perioperative pathways
CCT in Anaesthetics - Advanced Level Training (Annex E)
AT_D4_01 Demonstrates understanding of the need to be aware of new trends and developments and; • Questions the status quo • Actively looks for ways to improve clinical practice and the patient experience • Commits to the changing roles and responsibilities of healthcare groups as practice develops • Is receptive to the attempts of others to improve practice • Urges responsible individuals and groups to seek and implement beneficial change M
AT_D4_02 Understands the importance of research [clinical and laboratory] in the development of clinical practice in their chosen area[s], is aware of current areas of research and achieves competence in understanding, and explaining, the methodology and statistics involved
AT_D5_04 Takes the initiative in: • Demonstrating the efficient use of resources and encouraging others to do the same • Identifying and reporting any significant deficiency of resources • Contributing to discussions and planning for service and facilities development
AT_D6_02 Develops a personal learning network of individuals and organisations including; attending specialist educational meetings and reads specialist journals in special interest areas of practice
POM_AK_02 Demonstrates in-depth knowledge of preoperative optimisation of acute and chronic co-morbidity using an evidence based approach
CCT in Anaesthetics - Teaching and Training, Academic and Research (Including Audit), Quality Improvement, and Management for Anaesthesia, Critical Care and Pain Medicine (Annex G)
Basic Level
AR_BK_05 - Understands the steps involved in completing the audit cycle
AR_BK_06 - Understands the different methods for obtaining data including patient feedback questionnaires, hospital sources and national reference data.
AR_BK_07 - Understands the role of audit including but not exclusively improving patient care and services, risk management etc
AR_BS_07 - Keeps up to date with national reviews, key new research, and guidelines of practice e.g. NICE and SIGN
AR_BS_10 - Contributes data to a local or national audit
Intermediate Level
AR_IK_04 - Understands the links between audit and quality improvement
AR_IS_03 - Supports audit by junior medical trainees and within the multidisciplinary team
Higher Level
AR_HK_01 - Understands their role in supporting quality through participating in and promoting audit of clinical outcomes
AR_HS_13 - Uses the findings of an audit to develop and implement change
AR_HS_14 - Contributes to local and national audit projects as appropriate e.g. NCEPOD and SASM
Higher Level
AR_HK_01 Understands their role in supporting quality through participating in and promoting audit of clinical outcomes
AR_HS_05 Designs, implements and completes audit cycles
AR_HS_12 Encourages discussion amongst colleagues on evidence-based practice AR_HS_13 Uses the findings of an audit to develop and implement change
The CCT in Intensive Care Medicine (Part III) - Syllabus:
11.6 - Critically appraises and applies guidelines, protocols and care bundles.
12.15 - Participates in quality improvement under supervision (Participates in research or audit under supervision - ICM portfolio system).
North West ARCP Criteria
Anaesthesia
The annual review of competency progression (ARCP) in the Northwest requires:
There must be evidence in your LLP that you have actively participated and significantly contributed to one of the following per year:
- Audit with recognisable standards (eg. audit recipe book)
- Re-audit to close the audit loop
- Contribution to development of new clinical guidelines
- Contribution to quality assurance/improvement programs
- Major reviews of clinical effectiveness/outcomes in a local Trust
We feel that active participation in all steps of the study, with appropriate evidencing, can meet these ARCP criteria.
This can include:
- Personal study time spend:
- Reading guidelines
- Reading local protocols
- Exploring literature and educational content behind the study
- Registration of audit with local department
- Local collection of data - this may include organising colleagues to assist with data collection.
- Presentation of personalised site data locally with regional data for comparison
- Consideration of changes to local
These roles will likely be relatively simply achieved by a trainee acting as a local site coordinator for the project.
Not everyone will wish to participate to this extent, and we encourage trainees to participate to a smaller extent e.g. contribution to just data collection, with the understanding that this will not by itself meet ARCP requirements (but can contribute to them).
Publication and/or Presentation Acknowledgement
The whole purpose of these regional projects is to bring the power of large scale collaboration to audit, QI and research projects.
We believe that an essential part of this is that every collaborator is fairly recognised for their contribution in any publication or presentation of the total project.
The acknowledgement process for this study will follow the process outlined in the NWRAG constitution.
References
- RCOA. CCT in Anaesthetics - Intensive Care Medicine (Annex F). https://www.rcoa.ac.uk/CCT/AnnexF
- Northwest School of ICM. Training programme information. https://mmacc.uk/ICUguides.html
- Northwest School of Anaesthesia. ARCP Requirements. https://eanaesthesia.com/arcp/
- RCOA - CCT in Anaesthetics - Teaching and Training, Academic and Research (Including Audit), Quality Improvement, and Management for Anaesthesia, Critical Care and Pain Medicine (Annex G). https://www.rcoa.ac.uk/CCT/AnnexG
- FICM. The CCT in Intensive Care Medicine (Part III) - Syllabus. https://www.ficm.ac.uk/trainingcurricula-and-assessment/curriculum
