Learning outcomes for 3 months: - All of the below except those in medical expertise relating to acute management of the difficult airway; it will be expected that trainees complete a 2nd ICU rotation or anaesthetics rotation for the remaining 3 months of critical care training to obtain these skills
Medical Expertise - Assesses the need for a patient to commence intensive care medicine management. - Accurately assesses the grade and difficulty of a patient's airway. - Provides routine care of the intensive care patient, including prevention of complications. - Recognises organ failure and support strategies. - Creates appropriate treatment plans for a stabilised critical care patient.
Prioritisation & Decision Making - Justifies a decision to admit or refuse a patient to a critical or intensive care unit to the supervising intensivist. - Makes safe and timely decisions for a complex or critical patient.
Communication - Develops good rapport with patients, their families and staff. - Develops strategies to professionally convey bad news. - Communicates management and treatment plans to patients and their relatives. - Clearly documents discussions and decisions about advanced care orders and end-of-life care.
Teamwork & Collaboration - Allocates and briefs an ICU team prior to the arrival of a critical patient to the ICU. - Collaborates with other inpatient teams to develop management plans. - Engages in a team debrief after a resuscitation.
Leadership & Management - Reviews errors and adverse events to identify possible improvements to patient safety, e.g. by participating in morbidity and mortality meetings. - Understands the role of Intensive Care Medicine in the wider hospital setting.
Health Advocacy - Recognises limitations of treatment and end of life issues, and discusses these with family members. - Informs patients and other clinicians if admission to the intensive care unit may be inappropriate. - Recognises and manages the potential organ and tissue donor. - Shows commitment to the best interests of the patient and the profession by recognising and respecting cultural diversity. - Demonstrates the skills required to deliver patient-centred care to people from diverse cultural backgrounds. - Balances patient autonomy with best clinical practice.
Scholarship & Teaching - Undertakes a self-reflection to aid learning and to plan immediate and future learning with their supervisor. - Identifies learning points from any experience during a shift that will enhance Intensive Care Medicine practice. - Describes the clinical relevance of a published article as applied to Intensive Care Medicine. - Justifies when to change intensive care practice from published clinical guidelines after incorporating critically appraised published articles.
Professionalism - Complies with their professional and training responsibilities and obligations. - Obtains informed consent from patients or family members, where appropriate. - Independently analyses own workplace behaviour and puts in place corrective strategies to modify behaviour when necessary. - Acts as a positive role model for junior staff. - Proactively seeks, accepts and constructively responds to feedback.
Procedural skills that the trainee is expected to be able to perform: - Advanced airway management (for 3 month placements, trainees are expected to be able to do this with direct supervision). - Use of non-invasive and invasive ventilation. - Set up invasive haemodynamic monitoring, including arterial cannulation and central venous cannulation, and interpretation of monitoring results. - Use of sedation. - Stabilise and transport a critically ill or injured patient.
ACEM Anaesthetics Crit Care Learning Outcomes
Learning outcomes for 3 months - Competent in assessing and managing ASA 2 grade patients - Minimum 100 episodes of airway management, including 25% intubations
Medical Expertise - Assesses a patient prior to sedation/anaesthesia and classifies based on the ASA classification scale. - Accurately assesses the grade and difficulty of a patient’s airway. - Applies knowledge of pharmacologic agents and procedures to provision of appropriate sedation, anaesthesia and analgesia. - Creates a post-operative care plan for a patient who is recovering from anaesthesia.
Prioritisation & Decision Making - Justifies the decision to categorise a patient to an ASA classification. - Manages intra-hospital and/or inter-hospital transfers of critically ill patients. - Prioritises clinical tasks and call for assistance when required.
Communication - Establishes good rapport with patients, families and staff. - Demonstrates effective communication skills, including active listening, attending to verbal and nonverbal cues, adapting to individual patient contexts and recognising and addressing miscommunication. - Avoids major miscommunication by identifying and moderating negative emotions/behaviours.
Teamwork & Collaboration - Uses principles of good teamwork to perform as a member of a well-functioning team with all other clinicians in the immediate patient encounter. - Provides clear and concise instructions to assisting staff with clinical tasks. - Supports the performance of other team members to produce optimal teamwork.
Leadership & Management - Reviews errors and adverse events to identify possible improvements to patient safety, e.g., participate in morbidity and mortality meetings. - Understands the role of the anaesthetist in the wider hospital setting.
Health Advocacy - Shows commitment to the best interests of the patient and the profession by recognising and respecting cultural diversity. - Tailors care to the specific cultural needs of the patient. - Elicits a patient’s knowledge and experience of anaesthesia and corrects unrealistic expectations and misconceptions. - Balances patient autonomy with best clinical practice in patient encounters. - Informs patients and other clinicians when providing anaesthesia may be inappropriate.
Scholarship & Teaching - Undertakes a self-reflection to aid learning and to plan immediate and future learning with their supervisor. - Identifies learning points from any experience during a shift that will enhance Emergency Medicine and Anaesthesia practice. - Justifies variance of clinical practice from clinical guidelines after incorporating critically appraised research.
Professionalism - Complies with their professional and training responsibilities and obligations. - Obtains informed consent from patients. - Recognises situations to waive consent, e.g. life-saving procedures. - Demonstrates an understanding of the complexities in patient-centred care that may require external legal or ethical opinion. - Independently analyses own clinical practice and puts in place corrective strategies to modify behaviour when necessary. - Displays a good attitude with regard to work. - Proactively seeks, accepts and constructively responds to feedback.
In addition, the trainee will be able to use the following equipment for procedures: - A range of airway adjuncts. - A range of invasive airway equipment. - Ventilators for both NIPPV and IPPV. - A range of equipment used for invasive haemodynamic monitoring (only mandatory for 6 month placements, highly desirable for 3 month placements).