Logbook for

F1 Work Shadowing

Your Name:

Introduction

Foundation Year One (F1) work-shadowing is an opportunity for you to familiarise yourself with the policies and procedures of the unit in which you will be working. It also offers an opportunity to practise skills relevant to the F1 year and to assess your future training needs. You will work under supervision alongside the F1 doctor and other members of junior staff, performing the work of the F1including clinical care of inpatients, organisation and administration. You will feel confident in some of the skills and activities from previous clinical rotations. Rather than reinforcing your strengths, try to use this opportunity to identify and work on the gaps and weaknesses.

This logbook identifies areas considered as important and/or difficult by prior F1s at the beginning of their placements. Please use it as a guide to learning. You are not required to obtain counter-signatures, but you should make a rigorous self-assessment of your readiness to perform the tasks detailed here. Your self-evaluation will allow you to identify learning needs for the F1 year and you can use this logbook to discuss your plans with your F1 educational supervisor once you start the F1 year. The logbook should be completed, signed off by the F1 or consultant with whom you are working, and retained by you. Please ensure you take it to your first meeting with your Educational Supervisor upon starting F1.

The aim of this programme is to facilitate your transition from medical student to junior hospital doctor.

The objectives are:

  • To become familiar with the policies and documentation of the unit/hospital, including request forms, patient records and treatment protocols
  • To become familiar with the administrative tasks of the post such as organisation of ward rounds, procedures for referral, discharge planning, use of IT systems
  • To evaluate your preparation for undertaking relevant practical procedures under supervision
  • To ensure that you are competent to complete drug charts, TTO’s, discharge letters and death certificates
  • To ensure that you are ready to prescribe for common problems on your unit
  • To familiarise yourself with the daily routine of the F1 doctor in your unit
  • To identify learning needs for the F1 year.

The nature of the activities will vary depending on the specialty of the unit and random variation. We know you may not experience all the activities in the logbook, but you should actively seek out the opportunities and record areas that have not been covered.

As with prior attachments, you must be identifiable as a medical student and patients should give their permission for you to help with their care. Patients may decline to be seen by a student at any time during their care and if this happens you should let your supervising doctor know so that a qualified member of staff can take on aspects of care assigned to you as a student.

You are encouraged to become involved with the patient documentation on your unit, but ALL PRESCRIPTIONS/FORMS MUST BE SIGNED BY A QUALIFIED MEDICAL PRACTITIONER.

Clinical Experience

You should take on responsibility for specified patients on the unit. Please log in the table below your participation in these aspects of patient care, indicating your self-assessment of skill level attained by ticking one of the four boxes. For areas that you have not practised or in which you lack confidence, please document the reason and indicate what steps you have taken to ensure that you know how to proceed in this area.

Skill/Activity / Self-assessment:
I practised the skill and feel confident in my ability / Self-assessment:
I practised the skill and am confident in my ability but more work needed / Self-assessment:
I did not practise the skill, but am
confident in my ability from prior experience / Self-assessment:
I am not confident in my ability to carry out this task / Comments
Clerk a patient and write an admission note
Arrange initial investigations.
Know procedures/forms for haematology, biochemistry, microbiology and radiology
Explain the treatment and management plan to a patient
Write daily follow-up notes after review of your patients
Write up in-patient medication on the hospital drug chart
(to be countersigned by F1/SHO)
Know how to make referrals as appropriate (to other medical teams, physiotherapy, occupational therapy, pharmacy, specialist nurses and other services)
Prepare for and organise a consultant or registrar ward round
Present a patient summary on the ward round
Be present when significant communication with the patient takes place (e.g. informed consent, giving bad news)
Be present when significant communication with relatives takes place (with patient’s consent)
Support and observe procedures.
Be familiar with unit policies and practice for procedures.
Participate in discharge planning through communication with multidisciplinary team
Write up discharge medication (TTO’s)
(to be countersigned by F1/SHO)
Write a discharge letter to a General Practitioner
Know procedures for certifying death and display ability to complete a death certificate.
Blood grouping and cross matching: know hospital policies and be able to fill out request form.

Prescribing

Prescribing is an area that is sometimes difficult at the beginning of the F1 year, and is thus an important area on which to focus during shadowing. You should know how to complete the drug chart in your unit, including procedures for ‘as required’ drugs. You should find out how to liaise with the hospital pharmacy and where to get advice on prescribing. You should practice and ensure that you are competent to carry out the specific actions listed in the table according to unit policy.

Task / Please tick when completed, adding comments if appropriate
Complete and maintain the hospital drug chart
Assess and write up fluid balance
Anticoagulation:
  1. Location of hospital guidelines
  1. Procedures for monitoring and writing up warfarin including post-discharge arrangements

Diabetes:
  1. Sliding scales
  1. Pre-operative management
  1. Liaison with specialist teams

Antibiotics
  1. Hospital guidelines
  1. Policies for common conditions such as urinary tract infection, pre-op cover, wound infection

Pain relief
  1. Hospital guidelines
  1. Strategies for common conditions, e.g. post-op
  1. Liaison with specialist teams

Common drugs:
  1. Identify and write down the ten most commonly prescribed drugs on your unit, including hypnotics and sedatives
  1. Check that you know the indications and contra-indications, doses, adverse effects and monitoring of these drugs
/ List top ten drugs

Practical procedures

We know that you will have had opportunities to practise many of the procedures listed below. This attachment offers you the opportunity to assess your competence, practise procedures, and identify areas for development during the F1 year. For each of the following indicate which of the procedures you feel competent to perform at the end of the attachment and which you will need to practise further in F1. Make sure you know where to find the equipment to undertake the procedures. You should find out and record the local policies and practices for these procedures (e.g. do nurses on your unit carry out male catheterisations?)

Procedure / Comment
Venepuncture
Insertion of venous cannula
Set up IV infusion
Blood cultures
Arterial blood sampling
Sub-cutaneous injection
Intra-muscular injection
Intravenous injection
12 lead ECG
Insert a urinary catheter (in a man)
Remove a post-operative drain
NG tube insertion
Care of central venous lines and unit policy on using of central lines for sampling

Certification of completion of rotation

This student satisfactorily attended and completed F1 work-shadowing in this unit.

Unit/Hospital:

Comments:

Supervisor Name (BLOCK CAPITALS PLEASE):

Supervisor Signature:

Date of signature: