draft - rcem specialty learning outcomes: describing the scope … draft specialty... ·...
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Last update 19/04/2018
DRAFT - RCEM Specialty learning outcomes:
Describing the scope of practice
The RCEM curriculum sub-committee have identified 13 specialty learning outcomes
that we believe describe independent practice as an Emergency Medicine
Specialist. These range from the skills and knowledge of an expert diagnostician and
resuscitationist, through shop floor leadership to key administrative activities. These
represent a range of what we believe to be relatively discrete activities. They are
not, however, intended to be equal in size and scope. The development of the
clinical skills required for expert emergency care delivery will remain the primary
focus of learning and assessment. We include the wider skill set required to support,
guide, administer, teach and lead to ensure fundamentals are in place to cope with
the huge array of challenges that leading a shift in the ED can pose. This current
document outlines the starting point for development.
The specialty learning outcomes we outline ensure that Generic Professional
Capabilities (fig1.), required by the GMC, are covered. We are also required to
describe levels of entrustment for supervision (Fig 2.). We have included these
below to indicate our initial thoughts on how a clinician might develop in each
aspect. In this way we give an indication of what an independent EM clinician might
be expected to be able to do. These are activities and so the title of each speciality
learning outcome follows on from the following statement;
A fully trained EM specialist will be able to…
The assessment schedule through which progress will be reflected and fed back will
be the minimum that is required for reliable estimates of performance. The FRCEM
exam will remain a key summative step to ensure professional knowledge remains
ensured.
The decision about whether a trainee is ready to progress at key points, usually
where this means a change in responsibility, will be framed as an ‘entrustment
decision’ that the training faculty will be expected to make. These decisions will be
informed by assessment in the work place and will take into account the trainees’
own views and concerns about readiness. Decisions about unreadiness are not
punitive, but a realistic reflection of the wide ranging and challenging nature of EM
care and that differences exist between trainees and are to be expected.
We will highlight indicators of excellence in the specialty learning outcomes as we
further refine. In this way, we aim to have an approach that reflects accurately,
fairly and transparently the range of performance across the varying domains that
people must cover in work. We will use exception reporting to remove the need for
blanket coverage of every element of training, we will allow very clear statements
about whether a trainee is ready to progress and aim to encourage the pursuit of excellence in our plan.
Figure 1. Generic Professional Capabilities
Domain 1: Professional values and behaviours
Domain 2: Professional skills
Domain 3: Professional knowledge
Domain 4: Capabilities in health promotion and illness prevention
Domain 5: Capabilities in leadership and team working
Domain 6: Capabilities in patient safety and quality improvement
Domain 7: Capabilities in safeguarding vulnerable groups
Domain 8: Capabilities in education and training
Domain 9: Capabilities in research and scholarship
Figure 2. Levels of Entrustment for Supervision
1. Observing the activity
2. Acting with direct supervision in the room
3. Acting with supervision available within minutes
4. Acting unsupervised (i.e. under clinical oversight)
5. Providing supervision to others
In drafting our specialty learning outcomes we need to be able to say clearly and
decisively to trainees, the public and ourselves that someone who finishes training
would be fit to look after one of our own.
The following are outlines of the speciality learning outcomes we have developed.
They are presented to give an overview of the approach we propose. They will be
further developed with stakeholder feedback. We seek feedback on the broad
approach we have taken.
Specialty learning outcome 1
A fully trained EM specialist will be able to…
care for low acuity, high complexity,
stable patients
Specifications & Limitations
Patients with multiple complaints requiring a focussed workup around the most
concerning complaint;
Patients with uncommon or unusual complaints; patients unable to provide much
history; those with cognitive impairment, intoxication; patients with complex co-
morbidity or frailty needs.
Relevant GPC domains
1 2 3 4 5 6 7 8 9
Pro
fessio
na
l va
lue
s an
d
be
ha
vio
urs
Pro
fessio
na
l skills
Pro
fessio
na
l kn
ow
led
ge
Ca
pa
bilitie
s in h
ea
lth
pro
mo
tion
an
d illn
ess
pre
ve
ntio
n
Ca
pa
bilitie
s in le
ad
ersh
ip
an
d te
am
wo
rkin
g
Ca
pa
bilitie
s in p
atie
nt
safe
ty a
nd
qu
ality
imp
rov
em
en
t
Ca
pa
bilitie
s in
safe
gu
ard
ing
vu
lne
rab
le
gro
up
s
Ca
pa
bilitie
s in e
du
ca
tion
an
d tra
inin
g
Ca
pa
bilitie
s in re
sea
rch
an
d sc
ho
larsh
ip
Required experience / skills / attitudes / behaviours / knowledge
History
Examination
Differential diagnosis generation
Presentation skills to individuals or ‘board round’
Use of secondary sources
Able to communicate effectively in challenging encounters
Communicating effectively with clinical colleagues
Effective handover
Specialty learning outcome 2
A fully trained EM specialist will be able to…
answer clinical questions on the
shop-floor
Specifications & Limitations
Supporting the clinical team in answering clinical questions about individual patient
care.
Includes an understanding of key pitfalls in diagnostic reasoning, awareness of
when it is appropriate to review patients directly, able to teach these principles to
others as the trainee nears reaches independence.
Relevant GPC domains
1 2 3 4 5 6 7 8 9
Pro
fessio
na
l va
lue
s an
d
be
ha
vio
urs
Pro
fessio
na
l skills
Pro
fessio
na
l kn
ow
led
ge
Ca
pa
bilitie
s in h
ea
lth
pro
mo
tion
an
d illn
ess
pre
ve
ntio
n
Ca
pa
bilitie
s in le
ad
ersh
ip
an
d te
am
wo
rkin
g
Ca
pa
bilitie
s in p
atie
nt
safe
ty a
nd
qu
ality
imp
rov
em
en
t
Ca
pa
bilitie
s in
safe
gu
ard
ing
vu
lne
rab
le
gro
up
s
Ca
pa
bilitie
s in e
du
ca
tion
an
d tra
inin
g
Ca
pa
bilitie
s in re
sea
rch
an
d sc
ho
larsh
ip
Required experience / skills / attitudes / behaviours / knowledge
ECG interpretation
Cognitive psychology of decision making
Bayesian analysis
Diagnostic test methodology
Decision rule design
Use of guidelines
Communicating ideas
Specialty learning outcome 3
A fully trained EM specialist will be able to…
resuscitate anyone and know not to
Specifications & Limitations
Caring for Patients with likely and less common serious/life-threatening
conditions
Resus team membership
Resus team leadership
Post-resuscitation care of patients
End of life decisions, including withdrawing and withholding limiting
resuscitation treatment, consideration of advanced directives and living wills.
Organ donation
Relevant GPC domains
1 2 3 4 5 6 7 8 9 P
rofe
ssion
al v
alu
es a
nd
be
ha
vio
urs
Pro
fessio
na
l skills
Pro
fessio
na
l kn
ow
led
ge
Ca
pa
bilitie
s in h
ea
lth
pro
mo
tion
an
d illn
ess
pre
ve
ntio
n
Ca
pa
bilitie
s in le
ad
ersh
ip
an
d te
am
wo
rkin
g
Ca
pa
bilitie
s in p
atie
nt
safe
ty a
nd
qu
ality
imp
rov
em
en
t
Ca
pa
bilitie
s in
safe
gu
ard
ing
vu
lne
rab
le
gro
up
s
Ca
pa
bilitie
s in e
du
ca
tion
an
d tra
inin
g
Ca
pa
bilitie
s in re
sea
rch
an
d sc
ho
larsh
ip
Specialty learning outcome 3 continued…
Required experience / skills / attitudes / behaviours / knowledge
Can identify likely and less common but serious/life-threatening complaints
Can initiate, lead and complete resuscitation
Can clinically manage patient that has been successfully resuscitated
Can discuss with colleagues and relatives in a professional and empathic
manner, the initiation or possible discontinuation of active interventions when
this is considered to be medically appropriate
Respects patient autonomy and understands when and how they should use
advanced directives such as Do Not Attempt to Resuscitate (DNAR) orders,
living wills and durable powers of attorney
Recognition of futility in pursuing resuscitation in certain cases and the
subsequent ability to manage issues associated with end of life care
Can approach the issue of organ donation sensitively, and is aware of the
associated legislation
Can offer constructive, useful feedback in this domain
The ability to rapidly assimilate the strengths of individual team members to
allow allocation of tasks as necessary
The recognition of the need to perform specific resuscitation tasks by individual
team members
The ability to perform an immediate or delayed team debrief
Communicating ideas
Specialty learning outcome 4
A fully trained EM specialist will be able to…
care for the injured patient
Specifications & Limitations
Able to assess and manage patients with isolated non-life-threatening injuries
Able to manage patients with multiple and/or life-threatening injuries
Have the skills to lead (and be a member of) a multi-disciplinary trauma team
Relevant GPC domains
1 2 3 4 5 6 7 8 9
Pro
fessio
na
l va
lue
s an
d
be
ha
vio
urs
Pro
fessio
na
l skills
Pro
fessio
na
l kn
ow
led
ge
Ca
pa
bilitie
s in h
ea
lth
pro
mo
tion
an
d illn
ess
pre
ve
ntio
n
Ca
pa
bilitie
s in le
ad
ersh
ip
an
d te
am
wo
rkin
g
Ca
pa
bilitie
s in p
atie
nt
safe
ty a
nd
qu
ality
imp
rov
em
en
t
Ca
pa
bilitie
s in
safe
gu
ard
ing
vu
lne
rab
le
gro
up
s
Ca
pa
bilitie
s in e
du
ca
tion
an
d tra
inin
g
Ca
pa
bilitie
s in re
sea
rch
an
d sc
ho
larsh
ip
Required experience / skills / attitudes / behaviours / knowledge
Skills
Ability to perform primary/secondary survey
Examination skills required to identify/diagnose injury including vascular and
neurological consequences
Appropriate use of investigations including XR/CT/US/MRI to confirm
presence/consequences of injury
Management of wounds, soft tissue injuries, fractures and dislocations including
local anaesthetic techniques
Safe use of range of local anaesthetic techniques (field block, ring block,
common regional nerve blocks).
Range of techniques for wound closure (simple dressing, suturing, skin
adhesive, steri-strips).
Management of fractures and dislocations (slings, splints, basic plastering,
manipulation as appropriate)
Removal of foreign bodies from the eye and ear.
Manage a patient with burns
Attitudes & Behaviours
Provide calm and effective leadership in major trauma or Major Incident
scenarios
Participation in local/national audit and research into trauma care
Supervision of a multi-disciplinary team in caring for injured patients, including
Nurse Practitioners/ACPs
Acceptance that all patients presenting to ED are entitled to assessment and a
safe management plan, which may include signposting to other services
and/or education on self-care.
Provide opportunistic advice on accident prevention.
Knowledge
Likely injury patterns dependent upon mechanism of injury
Pathophysiology and management of injury (including specific populations
e.g. elderly, paediatric and pregnancy
Local/regional/national trauma protocols and guidelines
Human factors/non-technical skills that affect performance of team caring for
trauma patient
Major Incident Plans and how they will affect the ED/hospital
Ability to predict likely prognosis/recovery time of injuries including potential
complications
Able to assess burns, wounds and injuries including vulnerable anatomic
structures.
Understanding of social/economic consequences of injury upon individual and
society including specific knowledge of the implications of violent crime (e.g.
gun or knife)
Ability to estimate a timeline of healing and give general and specific safety
net advice on concerning features of potential complications.
Specialty learning outcome 5
A fully trained EM specialist will be able to…
care for the paediatric patient
Specifications & Limitations
Caring for children of all ages from 0-16 years at all stages of development and
children with complex needs and their families.
Relevant GPC domains
1 2 3 4 5 6 7 8 9
Pro
fessio
na
l va
lue
s an
d
be
ha
vio
urs
Pro
fessio
na
l skills
Pro
fessio
na
l kn
ow
led
ge
Ca
pa
bilitie
s in h
ea
lth
pro
mo
tion
an
d illn
ess
pre
ve
ntio
n
Ca
pa
bilitie
s in le
ad
ersh
ip
an
d te
am
wo
rkin
g
Ca
pa
bilitie
s in p
atie
nt
safe
ty a
nd
qu
ality
imp
rov
em
en
t
Ca
pa
bilitie
s in
safe
gu
ard
ing
vu
lne
rab
le
gro
up
s
Ca
pa
bilitie
s in e
du
ca
tion
an
d tra
inin
g
Ca
pa
bilitie
s in re
sea
rch
an
d sc
ho
larsh
ip
Required experience / skills / attitudes / behaviours / knowledge
Be able to interact with children of different stages of development and their
families to elicit the history
Be able to undertake a careful, sensitive and flexible examination of children of
all ages, at different stages of development and with complex needs
Be aware of the different developmental stages of children and their
assessment and how injury and illness can affect this
Acquire the special skills needed to resuscitate children of all ages and know
that this may differ dependent on developmental age and know how this
differs from adult resuscitation
Be aware that paediatric life-threatening emergencies are infrequent and
therefore prior preparation is essential i.e. successful completion of APLS or
equivalent is needed
Specialty learning outcome 5 continued…
Be able to lead a multidisciplinary paediatric resuscitation including trauma
Be able to lead a team debrief following a paediatric resuscitation/trauma
Acquire the special skills needed to manage the paediatric patient– e.g.
airway management, vascular access
Know that the interpretation of vital signs and tests is age dependant e.g. ECG,
radiology, bloods
Be able to prescribe safely for children
Know when to utilize distraction techniques and play therapists to manage
children in the ED
Be able to identify the sick child and initiate appropriate management steps
Know that paediatric trauma is different to adult trauma
Assess paediatric patients with concerning presentations and know that some
of the presenting symptoms could be manifestations of non- accidental injury
(NAI)
Be able to talk with parents and inform them that a social services referral is
being made
Be able to identify those patients needing urgent specialist attention and know
when and how to refer
Have an understanding of which patients can be safely discharged home and
what follow-up they may need
Know the immunisation schedules
Know and respect the legal framework and ethical issues relating to children in
the ED including consent and confidentiality
Know the local procedure for sudden unexpected death in infants and
children (SUDIC)
Specialty learning outcome 6
A fully trained EM specialist will be able to…
deliver ‘Pinnacle’ Emergency Care
Skills
Specifications & Limitations
The EM Physician should be able to perform key emergency skills that are time
critical and/or life/limb saving.
Relevant GPC domains
1 2 3 4 5 6 7 8 9
Pro
fessio
na
l va
lue
s an
d
be
ha
vio
urs
Pro
fessio
na
l skills
Pro
fessio
na
l kn
ow
led
ge
Ca
pa
bilitie
s in h
ea
lth
pro
mo
tion
an
d illn
ess
pre
ve
ntio
n
Ca
pa
bilitie
s in le
ad
ersh
ip
an
d te
am
wo
rkin
g
Ca
pa
bilitie
s in p
atie
nt
safe
ty a
nd
qu
ality
imp
rov
em
en
t
Ca
pa
bilitie
s in
safe
gu
ard
ing
vu
lne
rab
le
gro
up
s
Ca
pa
bilitie
s in e
du
ca
tion
an
d tra
inin
g
Ca
pa
bilitie
s in re
sea
rch
an
d sc
ho
larsh
ip
Required experience / skills / attitudes / behaviours / knowledge
Has the clinical knowledge to identify when key practical emergency skills are
indicated.
Has the clinical knowledge of how to safely conduct the skill.
Has the clinical knowledge to identify when a practical procedure should be
deferred to an in-patient specialist for definitive management.
Has the manual dexterity to perform the skill safely and in a timely fashion.
Specialty learning outcome 6 continued…
Can supervise another team member to complete the skill safely and make
judgements about junior colleagues’ competence in this domain.
Appropriately uses the National Safety Standards for Invasive Procedures
(NatSSIPs) checklist.
Maintains skills for rare procedures that are life-saving and time critical. An
Emergency Physician who has completed their training and is working in an ED
without the in-patient services to provide the skills for rare, life-threatening
conditions (e.g. resuscitative thoracotomy, peri-mortem caesarean section)
should acquire and ensure maintenance of skills via simulation courses, local
training, etc.
Specialty learning outcome 7
A fully trained EM specialist will be able to…
deal with shop floor curve balls
Specifications & Limitations
Individual shop-floor occurrences, situations or circumstances that do not pertain
directly to clinical evaluation, but that need managing effectively.
Relevant GPC domains
1 2 3 4 5 6 7 8 9
Pro
fessio
na
l va
lue
s an
d
be
ha
vio
urs
Pro
fessio
na
l skills
Pro
fessio
na
l kn
ow
led
ge
Ca
pa
bilitie
s in h
ea
lth
pro
mo
tion
an
d illn
ess
pre
ve
ntio
n
Ca
pa
bilitie
s in le
ad
ersh
ip
an
d te
am
wo
rkin
g
Ca
pa
bilitie
s in p
atie
nt
safe
ty a
nd
qu
ality
imp
rov
em
en
t
Ca
pa
bilitie
s in
safe
gu
ard
ing
vu
lne
rab
le
gro
up
s
Ca
pa
bilitie
s in e
du
ca
tion
an
d tra
inin
g
Ca
pa
bilitie
s in re
sea
rch
an
d sc
ho
larsh
ip
Required experience / skills / attitudes / behaviours / knowledge
Understand adult safeguarding issue; capacity assessment;
Dealing with police/FME enquiries on the shop floor
Knowledge of the medical/legal interface on the shop floor
Supporting clinical staff in a shop floor ‘melt down’
Ability to deal with hospital colleagues when accepting clinical handover
appears troublesome
Liaising with primary care colleagues on clinical shop floor matters
Know how to deal with violent or threatening situations
Specialty learning outcome 8
A fully trained EM specialist will be able to…
lead the ED shift as ‘Emergency
Physician in Charge’ (EPIC)
Specifications & Limitations
Provide support to ED staff of all levels and disciplines.
Liaise with the rest of the acute / urgent care team.
Lead the shift!
Relevant GPC domains
1 2 3 4 5 6 7 8 9
Pro
fessio
na
l va
lue
s an
d
be
ha
vio
urs
Pro
fessio
na
l skills
Pro
fessio
na
l kn
ow
led
ge
Ca
pa
bilitie
s in h
ea
lth
pro
mo
tion
an
d illn
ess
pre
ve
ntio
n
Ca
pa
bilitie
s in le
ad
ersh
ip
an
d te
am
wo
rkin
g
Ca
pa
bilitie
s in p
atie
nt
safe
ty a
nd
qu
ality
imp
rov
em
en
t
Ca
pa
bilitie
s in
safe
gu
ard
ing
vu
lne
rab
le
gro
up
s
Ca
pa
bilitie
s in e
du
ca
tion
an
d tra
inin
g
Ca
pa
bilitie
s in re
sea
rch
an
d sc
ho
larsh
ip
Required experience / skills / attitudes / behaviours / knowledge
Knowledge:
Patient flow management & escalation
Risk management across the ED
Understanding of major incident plan
Specialty learning outcome 8 continued…
Skills:
Management of workload
Task prioritisation
Management of staff & allocation of resources including staff
Leadership
Situational awareness
Communication
Management of conflict
Able to conduct a ‘board round’
Providing support & feedback to other staff members
Able to liaise with the rest of the hospital w.r.t safety and performance
Attitude & Behaviour:
Remains calm and professional at all times
Demonstrates assertiveness whilst maintaining professionalism
Provides an acceptable role model to others
Specialty learning outcome 9
A fully trained EM specialist will be able to…
supervise and appraise junior
colleagues
Specifications & Limitations
Supervise the clinical practice of junior colleagues and provide feedback following
this supervision.
Observe clinical practice of a doctor in training in the work place or in a simulated
work environment and debrief the doctor with good judgement in order to support
their learning and development as a clinician.
Support colleagues after a significant event in clinical practice by facilitating a
debrief and taking forward learning opportunities.
Appraise junior doctors.
Relevant GPC domains
1 2 3 4 5 6 7 8 9 P
rofe
ssion
al v
alu
es a
nd
be
ha
vio
urs
Pro
fessio
na
l skills
Pro
fessio
na
l kn
ow
led
ge
Ca
pa
bilitie
s in h
ea
lth
pro
mo
tion
an
d illn
ess
pre
ve
ntio
n
Ca
pa
bilitie
s in le
ad
ersh
ip
an
d te
am
wo
rkin
g
Ca
pa
bilitie
s in p
atie
nt
safe
ty a
nd
qu
ality
imp
rov
em
en
t
Ca
pa
bilitie
s in
safe
gu
ard
ing
vu
lne
rab
le
gro
up
s
Ca
pa
bilitie
s in e
du
ca
tion
an
d tra
inin
g
Ca
pa
bilitie
s in re
sea
rch
an
d sc
ho
larsh
ip
Required experience / skills / attitudes / behaviours / knowledge
Identifies that a junior colleague has gaps in their knowledge, competence or
performance.
Understands the different aspects of non-technical skills relevant to
performance in an emergency physician.
Ability to monitor and observe non-technical skills in clinical practice and in
simulated teaching sessions.
Consistently applies effective techniques to feedback on performance to
colleagues.
Ability to facilitate a debrief after a clinical event to ensure learning is shared
with all members of the team and the wider clinical community as appropriate.
Understands the difference between feedback and debrief and is able to use
both techniques appropriately to support development of junior colleagues.
Respects the process of appraisal in professional practice and supports this
both in junior colleagues, peers and personal practice.
Specialty learning outcome 10
A fully trained EM specialist will be able to…
educate the team
Specifications & Limitations
Set educational objectives and deliver an effective session on any EM topic
Relevant GPC domains
1 2 3 4 5 6 7 8 9
Pro
fessio
na
l va
lue
s an
d
be
ha
vio
urs
Pro
fessio
na
l skills
Pro
fessio
na
l kn
ow
led
ge
Ca
pa
bilitie
s in h
ea
lth
pro
mo
tion
an
d illn
ess
pre
ve
ntio
n
Ca
pa
bilitie
s in le
ad
ersh
ip
an
d te
am
wo
rkin
g
Ca
pa
bilitie
s in p
atie
nt
safe
ty a
nd
qu
ality
imp
rov
em
en
t
Ca
pa
bilitie
s in
safe
gu
ard
ing
vu
lne
rab
le
gro
up
s
Ca
pa
bilitie
s in e
du
ca
tion
an
d tra
inin
g
Ca
pa
bilitie
s in re
sea
rch
an
d sc
ho
larsh
ip
Required experience / skills / attitudes / behaviours / knowledge
Proficient in bedside teaching, small group facilitation and presentation skills
Able to organise local and regional teaching programmes using the RCEM
Curriculum as a blueprint
Able to instruct learners on procedural skills
Able to facilitate a basic simulation session Understanding that not all learners
are the same and different teaching techniques may enhance teaching
dependant on group
Able to tailor teaching content and style dependant on learner’s prior
knowledge
Understands the importance of having clearly defined achievable learning
outcomes
Understand different modes of delivering feedback and knows which is most
appropriate for each learning event
Can re-direct learners to appropriate resources to consolidate learning
Can communicate with other teacher’s appropriately to create a teaching
day relevant to learners need
Can teach in real life scenario’s, engaging the learner whist maintaining quality
patient care.
Able to peer-review others teaching sessions, giving appropriate feedback to
enhance their teaching sessions in the future
Understand key principles of teaching delivery
be able to use a variety of teaching techniques appropriate for topic
be able to use questions as teaching opportunities
be able to use effective constructive feedback
be able to communicate effectively to engage the learner
be able to teach practical skills
be able to organise a regional teaching day or educational course
be able to complete constructive WBPA’s for juniors with guidance for
improvement
Specialty learning outcome 11
A fully trained EM specialist will be able to…
understand, apply and contribute to
research
Specifications & Limitations
Be able to participate in research, take consent and recruit patients (GCP training)
interpret and synthesise research findings.
Relevant GPC domains
1 2 3 4 5 6 7 8 9
Pro
fessio
na
l va
lue
s an
d
be
ha
vio
urs
Pro
fessio
na
l skills
Pro
fessio
na
l kn
ow
led
ge
Ca
pa
bilitie
s in h
ea
lth
pro
mo
tion
an
d illn
ess
pre
ve
ntio
n
Ca
pa
bilitie
s in le
ad
ersh
ip
an
d te
am
wo
rkin
g
Ca
pa
bilitie
s in p
atie
nt
safe
ty a
nd
qu
ality
imp
rov
em
en
t
Ca
pa
bilitie
s in
safe
gu
ard
ing
vu
lne
rab
le
gro
up
s
Ca
pa
bilitie
s in e
du
ca
tion
an
d tra
inin
g
Ca
pa
bilitie
s in re
sea
rch
an
d sc
ho
larsh
ip
Required experience / skills / attitudes / behaviours / knowledge
GCP training- to allow involvement with departmental research
Able to construct PICO questions
Able to search the medical literature for evidence to answer PICO questions
Able to appraise studies of therapy and diagnosis and meta-analyses of the
same
Able to synthesise the findings of studies of therapy and diagnosis to deliver a
‘clinical bottom line’
Able to collate research, audit or QIP findings to present to a meeting as a
poster or oral presentation
Specialty learning outcome 12
A fully trained EM specialist will be able to…
lead an Emergency Medicine Quality
Improvement project to completion
Specifications & Limitations
The Quality Improvement Project must be directed to improve patient care in the
ED.
Projects that aim to save money or meet performance targets are important, but
not necessarily quality improvement, though a QIP might lead to savings.
Relevant GPC domains
1 2 3 4 5 6 7 8 9
Pro
fessio
na
l va
lue
s an
d
be
ha
vio
urs
Pro
fessio
na
l skills
Pro
fessio
na
l kn
ow
led
ge
Ca
pa
bilitie
s in h
ea
lth
pro
mo
tion
an
d illn
ess
pre
ve
ntio
n
Ca
pa
bilitie
s in le
ad
ersh
ip
an
d te
am
wo
rkin
g
Ca
pa
bilitie
s in p
atie
nt
safe
ty a
nd
qu
ality
imp
rov
em
en
t
Ca
pa
bilitie
s in
safe
gu
ard
ing
vu
lne
rab
le
gro
up
s
Ca
pa
bilitie
s in e
du
ca
tion
an
d tra
inin
g
Ca
pa
bilitie
s in re
sea
rch
an
d sc
ho
larsh
ip
Required experience / skills / attitudes / behaviours / knowledge
Knowledge
Understands and can compare and contrast improvement tools and
methodology.
Understands and can compare and contrast the principles of measurement for
improvement, judgement, and research.
Can describe types of measures and methods of assessing variation.
Understands principles of change management.
Skills
Proactively identifies opportunities for Quality Improvement and can lead
multidisciplinary Quality Improvement project teams.
Can supervise a Quality Improvement project involving junior trainees and
other members of the multidisciplinary team using improvement methodology.
Leads and facilitates team-based reflective evaluation of a project.
Organise and prioritise a departmental quality improvement project.
Behaviour
Demonstrates advocacy for clinical quality improvement.
Encourages and supports trainees and other clinicians who want to start
clinical quality improvement.
Engages staff outside the emergency department in quality improvement.
Specialty learning outcome 13
A fully trained EM specialist will be able to…
undertake key administrative tasks
Specifications & Limitations
Medico-legal - handling complaints, reports for coroner or legal services
Risk management – Investigation of a serious incident, participation in ED clinical
governance
Human resources – rota management, recruitment
Management training (Local) – Committee work
Management training (National) – the evolving NHS landscape
Relevant Domains of Competence 1 Professional values and behaviours
Relevant GPC domains
1 2 3 4 5 6 7 8 9
Pro
fessio
na
l va
lue
s an
d
be
ha
vio
urs
Pro
fessio
na
l skills
Pro
fessio
na
l kn
ow
led
ge
Ca
pa
bilitie
s in h
ea
lth
pro
mo
tion
an
d illn
ess
pre
ve
ntio
n
Ca
pa
bilitie
s in le
ad
ersh
ip
an
d te
am
wo
rkin
g
Ca
pa
bilitie
s in p
atie
nt
safe
ty a
nd
qu
ality
imp
rov
em
en
t
Ca
pa
bilitie
s in
safe
gu
ard
ing
vu
lne
rab
le
gro
up
s
Ca
pa
bilitie
s in e
du
ca
tion
an
d tra
inin
g
Ca
pa
bilitie
s in re
sea
rch
an
d sc
ho
larsh
ip
Required experience / skills / attitudes / behaviours / knowledge
Can respond to complaints in a variety of formats including verbal response,
written response and face to face meetings
Can construct a report for the coroner and legal services using information
available from clinical notes
Can assist in leading a SI investigation and be familiar with the tools involved
such as RCA/ 5 Whys/Fishbone
Participate in ED CG meetings
Represent the ED on a Hospital Committee (such as resuscitation committee,
transfusion committee, trauma committee etc.) and feedback to the ED team
meeting
Participate in the daily rota management ensuring adequate skill mix and
cover
Participate in recruitment for the ED
Awareness of the interplay of various agencies in the NHS and how they
interrelate in the evolving NHS Landscape