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Maintaining competencies: How do I keep my skills up?

Maintaining competencies: How do I keep my skills up?. Liam Brennan Addenbrooke’s Hospital Cambridge, UK. Conflict of interest. I am an elected Council member of The Royal College of Anaesthetists I am the former RCoA national CPD adviser Editor, CEACCP

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Maintaining competencies: How do I keep my skills up?

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  1. Maintaining competencies: How do I keep my skills up? Liam Brennan Addenbrooke’s Hospital Cambridge, UK

  2. Conflict of interest • I am an elected Council member of The Royal College of Anaesthetists • I am the former RCoA national CPD adviser • Editor, CEACCP • No financial conflicts of interest

  3. Key learning points • Maintaining & developing competencies • How to select appropriate CPD activity • Quality assurance of CPD activity • Obstacles to maintaining competence

  4. Why maintain & develop competencies? • Professional obligations • Pressure from medical regulators • High profile catastrophes • Increased expectations from patients • Life-long learning • Cross-border working

  5. Bristol heart inquiry 1999

  6. Cross border working – Dr Ubani

  7. How many cases? Kestin et al, 1995

  8. Experiential learning • ~ 2500-3000 cases overall in 7 year training • ‘Competence’ = ~ 30 cases in all sub-specialities (Intermediate/higher training) • ‘Expert’ = 100+ cases in one sub-speciality (Advanced training) • Mastery not achieved pre-CCT CCT is only the start of life-long learning

  9. Which competencies do I need to maintain or develop? • Differences between CME and CPD • Need to consider: • maintaining basic standards ; clinical & non-clinical • keeping up to date in your chosen field of expertise • acquiring and developing new skills • Guidance from regulator/professional organisations • Results of MSF, audit & complaints • Should reflect your whole practice* Whole Practice = clinical & non-clinical ; scheduled & out of hours; independent practice & voluntary work

  10. Rome group CPD recommendations (2004) Accrediting body • Fair, valid & consistent • Set reasonable & credible standards • Quality assurance role • Encourage collaboration between accrediting bodies • Learner • CPD meets their educational needs • Ensure CPD is relevant to their whole practice • Evaluates the extent to which their needs have been met • Organiser/provider • Disclosure of commercial sponsorship • Commercial sponsors must not influence structure • or content of educational activity

  11. Level 1 • Core knowledge & skills recommended of all those who trained as anaesthetists • Combines clinical & non-clinical components • Includes maintaining a broad knowledge of scientific principles • Achievable via review of clinical activity, local meetings, e-learning

  12. Level 2 • Paediatric competencies relevant to non-specialist anaesthetist who manages children ≥ 3 years old • Excludes infant and neonatal practice (other than emergency stabilisation) • Includes team working with retrieval teams and liaison with specialist referral centre

  13. Level 3 http://www.apagbi.org.uk/professionals/education-and-training/revalidation/cpd-matrix/level-3-matrix

  14. Level 3 • Aimed at specialist paediatric anaesthetists • UK advice developed by APA • Should reflect ‘state of the art’ practice • Likely to require attendance at national and international meetings

  15. Resources to maintain competence • Multi-faceted learning methods are optimal • Recognise that people learn in different ways • Group learning (in clinical teams) is very effective • Methods: • Traditional didactic lectures • Personal study • Experiential courses • Simulation e.g. MEPA • Sabbaticals • Working with colleagues • e-learning • Personal reflection on learning essential

  16. How do we know our competence has improved? • Re-audit of practice • Repeat multi-source feedback (inc patient) • Before and after tests of knowledge • Simulator performance in test situations • Peer-review of practice Peer Review

  17. Quality assurance • Ensures CPD activities meet educational, organisational & probity standards • In UK, QA role coordinated by a CPD Board: • Speciality wide representation; RCoA & specialist societies • Appoints CPD assessors • Decides CPD credit allocation • Periodically reviews content of CPD matrix • Reviews participant feedback from CPD activities

  18. Harmonisation of CPD Many obstacles still to overcome: - Mandatory or voluntary - Statutory or professional regulation - Consequences of non-compliance EACMME has made progress Definite benefits for all stakeholders CPD For debate: Should APA & ESPA develop a European specialist paediatric anaesthesia CPD matrix?

  19. Key learning points • Maintaining & developing competencies • How to select appropriate CPD activity • Quality assurance of CPD activity • Obstacles to maintaining competence

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