Revalidation and anaesthesia

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Revalidation and anaesthesia

• Chris Dodds

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Whats new about revalidation?

• Revalidation
• Enhanced appraisal
• Clinical and non-clinical
• Review of CPD
• Core topics, higher and advanced
• MSF essential
• Personal development plan
• Matching of job plan to Trust needs

• Current Process
• Appraisal
• Clinical and non-clinical
• Review of CPD
• Core topics and against job plan
• Matching of job plan to Trust needs
• Personal development plan
• Increasingly MSF is being used

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Whats new about revalidation?

• Revalidation
• Enhanced appraisal
• Clinical and non-clinical
• Review of CPD
• Core topics, higher and advanced
• MSF essential
• Personal development plan
• Matching of job plan to Trust needs

• Current Process
• Appraisal
• Clinical and non-clinical
• Review of CPD
• Core topics and against job plan
• Matching of job plan to Trust needs
• Personal development plan
• Increasingly MSF is being used

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Essential processes

• CPD
• Enhanced Appraisal
• Multi-source Feedback

Planned for 14,000 Fellows
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CPD

• Autumn 2008
• Specialist societies consulted on range and
  levels of CPD
• Last few received February 09
• March 2009
• CPD working party refined and agreed draft matrix
• July 2009
• Draft matrix returned to Specialist Societies for
  verification and final comments

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CPD Matrix

• Three levels
• Core, higher and advanced
• Core knowledge based and essential
• Dont do it at all and its not in my hospital
• Provided as e-learning
• Evidence from clinical practice accepted
• May be individual exceptions that will need
  evaluation
• Higher directly related to on-call activity
• Advanced directly related to job-planned
  activity

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Four categories
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Example of matrix

• CPD Core topics
• Still 50 points / year
• At least 60 of CPD activity has already been
  done
• The word document has been consolidated to remove
  repetitive items
• Life support includes paediatric, adult, trauma
• obstetric life support has re-entered the matrix

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CPD final stages

• Archive data for all approved events from 2005
• Most Fellows have certificates but no
  identifiable content
• Specialist societies to confirm data and codify
  if possible
• Electronic system
• for all Fellows as part of subscription
• Available to non-Fellows costs to be determined
• New approval process
• Only electronic
• Approved providers
• Audit an intrinsic element

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Appraisal
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Appraisal

• This has to be robust, challenging and uniform
  across the UK.
• Assuring the Quality of Medical Appraisal for
  Revalidation (AQMAR) (RST England)
• The gold standard is an appraisal by someone
  from your own speciality
• It has to map to the new GMC Good Medical
  Practice domains

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Specialist Standards for re-certification

• 4 Domains adapted from Good Medical Practice
• Domain 1 - Knowledge, skills and performance
• Domain 2 - Safety and quality
• Domain 3 - Communication, partnership and
  teamwork
• Domain 4 Maintaining Trust

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Generic Speciality Specific Standards

• Domain 1 Knowledge, Skills and Performance
  standard
• 1.A.1 - maintain professional performance

• Sources of evidence

• Maintain knowledge of the law other regulation
  relevant to practice (13)
•  
• Keep knowledge and skills up to date (13)
•  
•  
• Participate in professional development
  educational activities (12)
•  
•  
• Take part in regular and systematic audit (14)
•  
•  
• Research where performed will meet governance
  requirements

• Peer Feedback
• Multisource Feedback
• References and Letters
• Practice
• Complaints and Compliments
• Incidents including contribution to NPSA and
  confidential enquiries
• Outcomes
•  
• Audit
• National and Clinical Audit
• Education, Training and Development
• CPD
• E-Learning
• Specialty Certificates Courses
• Internal Training
•  

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Maintain knowledge of the law other regulation
relevant to practice (13)
Colour code Green three or more sources of
evidence (not all need to be used) Amber two
sources of evidence both need to be used Red
only one source of evidence, must be robustly
scrutinised
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Speciality specific details
Colour code Green three or more sources of
evidence (not all need to be used) Amber two
sources of evidence both need to be used Red
only one source of evidence, must be robustly
scrutinised
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1.A.3. Participate in professional development
and educational activities
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UK wide anaesthetic appraisal

• Expert group meeting September 7th
• Experienced clinical directors with current
  appraisal practice
• Consensus against good anaesthetist standards
  and GMC GMP generic standards
• Generation of appropriate topics / questions to
  address the generic and anaesthetic specific
  standards
• Documentation completed October
• Presented to GMC / RST for approval
• Training programme for UK developed

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Multi-Source Feedback
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MSF / PF for anaesthesia

• Generic MSF approved by GMC
• Will map to the generic standards
• Will be enough for 98 of practising
  anaesthetists
• Speciality specific MSF must meet the GMC
  standards for MSF (currently draft)
• Anaesthesia specific MSF for each domain within
  GMC GMP framework
• Professional Standards Committee
• Patient feedback (PF) at pilot stage for
  anaesthesia
• Currently where appropriate

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Additional activity

• Communication strategy
• CPD electronic system
• Revalidation e-portfolio
• Appraisal training
• Revalidation road shows

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Communications

• Multimedia process
• Paper to Twitter
• Clear mantra for anaesthesia revalidation
• easy as 1 - 2 3
• Escalating process until launch
• General details / specific examples / regular
  e-mail alerts
• Maintained helpline / support
• Revalidation manager Mr Don Liu

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CPD Electronic Platform

• Commissioned
• Functional specification agreed
• ? version live Nov 2009
• Fully operational January 2010
• Locked and codified matrix
• Reflective section mandatory
• Audit embedded provider / user
• Links to providers
• Links to e-LA / on-line learning sites
• Personal record of activity
• Annual and for revalidation
• Identification of potential gaps

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Revalidation e-portfolio

• Not just for revalidation
• Inter-collegiate working party
• Closely mapped to trainee e-portfolio
• Cross transfer of data from CPD system
• Ability to accept other data sources / summaries
• Other
• Logbook data
• Appraisals
• Personal learning materials

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Appraisal Training

• Identification of lead appraiser for
  anaesthesia in every Trust in the UK
• ltgt 300
• Direct training in Churchill House
• Small group, interactive training
• On-line training materials
• E-learning platform
• For senior trainees
• New consultants and appraisers
• Local assessment and sign off of all anaesthetic
  appraisers
• Register of approved appraisers

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Revalidation Roadshows

• To directly inform Trusts and Anaesthetists on
  the process, progress and preparation for
  revalidation in the UK
• Team
• GMC
• AoRMC
• RCoA
• Others (later)
• Current planned events
• Middlesbrough JCUH
• Leeds - LGI

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Questions?

• The panel