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Type and Title of Submission


Title:

Foundation training and the acutely ill patient: Developing an Emergency Department education programme based on national guidance.

Description:

We aimed to evaluate our existing Emergency Department (ED) FY2 education programme, and identify and introduce novel strategies to deliver the recommendations made in NICE CG50 "Acutely Ill Patients in Hospital".

Category:

Clinical

Does the submission relate to the general implementation of all NICE guidance?

No

Does the submission relate to the implementation of a specific piece of NICE guidance?

Yes

Full title of NICE guidance:

CG50 - Acutely ill patients in hospital

Category(s) that most closely reflects the nature of the submission:

Implementation policy
Staff induction programme

Is the submission industry-sponsored in any way?

No


Description of submission


Aim

Our aim was to evaluate our existing Emergency Department (ED) FY2 education programme, and identify and introduce novel strategies to deliver the recommendations made in NICE CG50 "Acutely Ill Patients in Hospital".

Objectives

1. Evaluate our ED FY2 education programme, using competencies based on NICE CG50 as the gold standard. 2. Identify deficiencies in the teaching package. 3. Introduce novel strategies to deliver the competencies, thereby delivering a comprehensive training programme.

Context

Medical education is constantly evolving, and the delivery of high quality work-place based training is becoming more difficult due to increasing service demand, FY2 doctors working limited 4 month posts, EWTD limits, and medical training becoming increasingly competency driven. As trainers we have been aware of these difficulties, particularly in attempting to balance the delivery of service and training. NICE CG50 (and the subsequent DH document "Competencies for Recognising and Responding to Acutely Ill Patients in Hospital") outlines a number of key competencies for all healthcare providers managing patients in the acute setting. We focussed on the competencies relevant to FY2 doctors working in our ED. A working party consisting of 4 ED Consultants and 2 ED Sisters analysed the existing educational resources available to our FY2 doctors, comprising a 2 day departmental induction, local pathways & guidelines, deanery based generic study days, Advanced Life Support Course (ALS - mandatory for all foundation trainees), and a local e-learning package consisting of 8 modules. The working party identified competencies which were not delivered, and consensus was reached on action that was required to develop a comprehensive 4 month training programme for FY2 doctors in our ED.

Methods

1. Of the 78 listed competencies, 72 were relevant to FY2 doctors working in our ED. 2. 81% competencies were adequately delivered by the existing programme, with 13% partially delivered, and 7% not covered at all. 3. The resource that delivered the greatest number of competencies was the departmental induction (61%), followed by ALS (38%), departmental pathways & guidelines (33%), deanery training days (22%) and the e-learning programme (21%). 4. Resources that were developed to deliver the 14 outstanding competencies included 6 structured workplace based assessments (e.g. chest X-ray interpretation, head injury and cervical spine assessment, breaking bad news), 4 new e-learning modules, updated structured ED documentation, and development of formal junior doctor handover guidance. 5. We developed a blended learning package comprising essential e-learning modules and linked workplace based assessments that trainees can complete whilst working on the shop floor (attached).

Results and evaluation

Audit of trainee satisfaction is ongoing (interim analysis shows high satisfaction compared to previous training experienced). We also plan to audit trainer satisfaction with the blended learning model.

Key learning points

Pressures between service delivery and training are ever increasing. We used the competencies in NICE CG50 and the DH document to develop a focussed education programme that allows us to deliver a comprehensive education programme to our FY2 doctors in a 4 month time period. We would encourage trainers to critically analyse their own teaching packages, and use the NICE guidance as a basis for developing high quality workplace based training in the acute setting. We have developed innovative teaching strategies that allow us to maintain the balance between service delivery and training.

View the supporting material

Contact Details

Name:David Robinson
Job Title:Consultant in Emergency Medicine
Organisation:Bradford Royal Infirmary
Address:Duckworth Lane
Town:Bradford
County:West Yorkshire
Postcode:BD6 9RJ
Phone:01274 364457
Email:David.Robinson@bradfordhospitals.nhs.uk

 

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This page was last updated: 26 October 2009

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.