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Key: Common competency framework competencies Medical leadership framework competencies Health inequality framework competencies Core Module 5: Core Surgical Skills Learning outcomes: To understand and demonstrate appropriate knowledge, skills and attitudes in relation to basic surgical skills Knowledge criteria GMP Clinical competency GMP Professional skills and attitudes GMP Training support Evidence/assessment Legal issues around consent to surgical procedures, including consent of children, adults with incapacity and adults and children in emergency situations 1,2 Interpret pre-operative investigations 1 Recognise the need for and initiate collaboration with other disciplines, before, during and after surgery 3 Basic Practical skills course (RCOG approved) Logbook Demonstrate the ability to select the operative procedure with due regard to degree of urgency, likely pathology and anticipated prognosis 1 RCOG Obtaining Valid Consent Guideline. RCOG website. MRCOG Have an awareness of the need to meet targets 1 RCOG Consent Advice series Mini CEX Develop the ability to work under pressure and recognise limitations 2 Department of Health website Reflective learning Show the need to appreciate and recognise that decision making is a collaborative process between the surgical team members 3 Local courses MRCOG Part One StratOG.net: The Obstetrician and Gynaecologist as a Professional. Ethical and legal issues etutorial MRCOG Part Two Arrange pre-operative management Recognise potential co morbidity Name and mode of use of common surgical instruments and sutures Obtain valid consent 1,3,4 Complications of surgery Explain procedures to patient 3 Regional anatomy and histology Advise patient on postoperative course Commonly encountered infections, including an understanding of the principles of infection control Within agreed level of competency for the procedure: Choose appropriate operation Exhibit technical competence Make intraoperative decisions Manage intra-operative problems Audit project OSATS – opening and closing abdomen CbD Knowledge of the NHS Improvement Programme Enhanced Recovery principles to enhance patient safety and optimise pre, intra and postoperative care Principles of nutrition, water; electrolyte and acid base balance and cell biology. 1,3,4 Clinical skills essential for: o Common clinical skills-delivery of twins fetal bradycardia and ventouse delivery, malposition at full dilatation Confident in stepping up from ST2 to ST3 Increase responsibility and promote patient safety Appropriate use of blood and blood products Non-clinical skills essential for: o Understanding of senior midwife coordinator expectations of an ST3 on delivery suite o Best practice in telephone consultations and referral o Coping and dealing with serious untoward incidents including debriefing and feedback. o Improving resilience –looking after yourself General pathological principles MRCOG Part Three Assessment in Laparoscopic Simulation with OSATS The Obstetrician and Gynaecologist journal Learning resources available at NHS Improvement Programme website – Enhanced Recovery (Gynaecology) http://www.improvem ent.nhs.uk/enhancedr ecovery2/Gynaecolo gy.aspx 1 GMC Good Medical Practice (GMP) Domains: Domain 1: Knowledge, skills and Performance Domain 2: Safety and quality Domain 3: Communication, Partnership and Teamwork. Domain 4: Maintaining Trust Key: Common competency framework competencies Medical leadership framework competencies Health inequality framework competencies Knowledge criteria GMP Clinical competency GMP Professional skills and attitudes GMP Training support Evidence/assessment Resilience training; Step-up course or equivalent 2 GMC Good Medical Practice (GMP) Domains: Domain 1: Knowledge, skills and Performance Domain 2: Safety and quality Domain 3: Communication, Partnership and Teamwork. Domain 4: Maintaining Trust Key: Common competency framework competencies Medical leadership framework competencies Health inequality framework competencies Appendix to Module 5: Details of Knowledge Criteria: Knowledge of the NHS Improvement Programme Enhanced Recovery principles to enhance patient safety and ensure: patients are in the optimal condition for treatment patients have different care during their operation patients experience optimal post-operative rehabilitation Legal issues around consent to surgical procedures, including consent of minors (and Fraser competency), adults with incapacity and adults and children in emergency situations. Name and mode of use of common surgical instruments. Knowledge of sutures and their appropriate use. Prevention and complications of surgery including: Venous thromboembolism Infection (wound, urinary tract, respiratory, intra-abdominal and pelvic) Primary and secondary haemorrhage (intraoperative and postoperative). Relevant clinical anatomy. Relevant bones, joints, muscles, blood vessels, lymphatics, nerve supply and histology. Characteristics, recognition, prevention, eradication and pathological effects of all commonly encountered bacteria, viruses, Rickettsia, fungi, protozoa, parasites and toxins, including an understanding of the principles of infection control. Principles of nutrition, water, electrolyte and acid base balance and cell biology. Knowledge and awareness of anaesthesia: general anaesthetic, conscious sedation, regional and local. General pathological principles including general, tissue and cellular responses to trauma, infection, inflammation, therapeutic intervention (especially by the use of irradiation, cytotoxic drugs and hormones), disturbances in blood flow, loss of body fluids, hyperplasia and neoplasia. Knowledge and awareness of use in complications of Diathermy and other energy sources Curriculum Module 6: Postoperative Care 3 GMC Good Medical Practice (GMP) Domains: Domain 1: Knowledge, skills and Performance Domain 2: Safety and quality Domain 3: Communication, Partnership and Teamwork. Domain 4: Maintaining Trust Key: Common competency framework competencies Medical leadership framework competencies Health inequality framework competencies Competence level Basic level Intermediate level Advanced level Not required Core Module 5 Logbook Level 1 Date Level 2 Signature Date Signature Level 3 Date Signature Interpret preoperative investigations Arrange preoperative management Obtain informed consent Choose appropriate operation Open and close the abdomen Exhibit technical competence Make appropriate operative decisions Manage intraoperative problems Training Courses or sessions Date Title Signature of educational supervisor Obtaining consent Basic Practical Skills in Obstetrics and Gynaecology course (RCOG approved) 4 GMC Good Medical Practice (GMP) Domains: Domain 1: Knowledge, skills and Performance Domain 2: Safety and quality Domain 3: Communication, Partnership and Teamwork. Domain 4: Maintaining Trust Key: Common competency framework competencies Medical leadership framework competencies Health inequality framework competencies Resilience training; Step-up course (or equivalent) Authorisation of signatures (to be completed by the clinical trainers) Name of clinical trainer (please print) OSATS Opening and closing the abdomen Signature of clinical trainer Each OSATS should be successfully completed for Independent Practice on 3 occasions before the module can be signed off Date Date Date Signature Signature Signature 5 GMC Good Medical Practice (GMP) Domains: Domain 1: Knowledge, skills and Performance Domain 2: Safety and quality Domain 3: Communication, Partnership and Teamwork. Domain 4: Maintaining Trust Key: Common competency framework competencies Medical leadership framework competencies Health inequality framework competencies COMPLETION OF MODULE 5 I confirm that all components of the module have been successfully completed: Date Name of educational supervisor Signature of educational supervisor 6 GMC Good Medical Practice (GMP) Domains: Domain 1: Knowledge, skills and Performance Domain 2: Safety and quality Domain 3: Communication, Partnership and Teamwork. Domain 4: Maintaining Trust