Paediatric Specialty Training Committee (STC)

Paediatric Specialty Training Committee (STC)

Contents

1. Introduction

1. STC membership

1. STC structure and activities

1. Training programme lines of accountability

1. Performance management policy

1. Introduction

The Wales Deanery recognises that effective Specialty Training Committees are central to the delivery of good quality postgraduate medical training. Furthermore it is essential to have good communication between the STC, trainees and departments of paediatrics.

1. STC Membership

Members:

• Head of School – who will usually be the Chair: responsible for organising and chairing the STC

• Specialty Manager

• Regional College Advisor for Paediatrics

• Deanery Training Programme Directors: one for ST1-3 and one for ST4-8

• Local Programme Directors/College Tutors

• Leads for: Education

LTFT

Quality

Professional Support

• Trainee Representatives: ST1-3, ST4-8 for both North and South Wales

• Academic Representative

• RCPCH Wales Representative

• Principal Regional Examiner

• Lay Representative

Members of the STC may perform more than one role

1. Appointments to the STC

The posts of Head of School and Training Programme Director are advertised and appointed by the Deanery for a defined period.

The lead roles are advertised and appointed by the School of Paediatrics. They serve an initial term of 3 years, which can be renewed for a further 2 years.

All the above roles receive annual appraisal. The Head of School is appraised by the Deputy Post graduate Dean, and the Head of School appraises the TPDs and Deanery appointed leads.

The Regional Advisor and Deputy Regional Advisor and are appointed by the Council of the RCPCH following a formal process of appointment co-ordinated by the College. They serve an initial term of three years which can be renewed for a further three years.

The Local Programme Directors/College Tutors are appointed jointly by the Deanery, RCPCH and Heath Boards, for a 3 year term, which can be renewed for a further 2 years.

All of the above individuals have agreed to contribute to careers guidance for trainees.

The Trainee Representatives are elected by the trainee body.

The Academic Representative is the Professor of Paediatrics

Members may also be co-opted onto the STC to perform lead roles.

1. STC meetings and activities

STC business meetings are held biannually with dates circulated well in advance.

Ideally members should attend all business meetings, but attendance at a minimum of 1 meeting a year is mandatory.

STC Quality Improvements are held quarterly with dates circulated well in advance. Ideally members should attend all meetings, but attendance at a minimum of 2 meetings a year is mandatory.

The activities of the STC are to:

• Develop and monitor the training programme against the College curriculum, GMC training standards and the Gold Guide

• Ensure Deanery and College guidelines for assessment and ARCPs are followed.

• Develop training for educational and clinical supervisors

• Facilitate the development of training initiatives and sharing of ideas across training units

• Advise the Deanery on the location of new posts and disestablishment of existing posts where appropriate

• Provide members for ARCP panels and interview panels

• Provide members for quality assessment visits

• Consider information relating to specialty training activity as detailed below:

• Recruitment outcomes
• Equality and Diversity data
• Quality of training ( in liaison with Quality unit)
• Risk reports
• GMC survey
• End of placement evaluation
• ARCP information
• Deanery quality visits to departments

• Exam outcomes (via College)
• Annual ARCP review
• Number of days / panels / trainees
• Outcomes (trends / benchmarking)
• Process (developments / problems)
• Externality reports
• Equality data

1. Training programme lines of accountability

There are clearly defined lines of accountability for training issues:

Clinical Supervisors are responsible for overseeing a trainee’s clinical work and providing constructive feedback on that work during a training placement. A trainee will have several clinical supervisors during a 6 month placement. Any concerns that arise regarding the performance of a trainee will be communicated with the Educational Supervisor and Clinical Director. Any problems which arise regarding the deliverability of training should be discussed with the local program director/college tutor.

Educational Supervisor

A named Educational Supervisor is a trainer who is selected and appropriately trained to be responsible for the overall supervision and management of a specified trainee’s educational progress during a training placement. The Educational Supervisor is responsible for the trainee’s educational agreement. The Educational Supervisor will need to ensure that there is a mechanism in place to gather relevant information from clinical supervisors and the wider multidisciplinary team, in order to be able to provide comprehensive and constructive feedback to the trainee.

Local Programme Director/College Tutor

The Local Programme Directors/College Tutor role is to organise and coordinate the delivery of training within a Health Board, in line with the Deanery and RCPCH training agenda. This includes assessing and implementing changes that are required in order to address concerns raised through the GMC and end of placement surveys. A description of their duties is given on the RCPCH website

The duties include:

• Developing and implementing a structure within the Health Board, that delivers a high quality training programme within a suitable educational environment. This will include:

• Organisation and delivery of the induction program

• Organisation of a local, curriculum based teaching programme and exam preparation

• Developing, supporting and updating educational supervisors

• Liaising with Educational Supervisors about any concerns regarding individual trainees, and informing the Professional support Lead and relevant Training Programme Director of any significant concerns.

• Liaising with the Specialty Lead and Training Programme Director about any problems with curriculum delivery within the department

• Attending ARCPs, interviews and STC

• Acting as the link between the Deanery, the RCPCH and the Health Board.

The Local Programme Director/College Tutor will inform the Clinical Director of any patient safety concerns. Where organisational or trainee issues are site specific the relevant Health Board Local Faculty Lead will be involved.

1. School of Paediatrics Trainee Performance Management Policy

It is important that there is a robust process for identifying, supporting and managing trainees whose conduct, health, progress or performance is giving rise for concern.

The aim of the performance management policy is to identify trainees at an early stage when problems are developing or have recently been identified. The objective is to assess trainees and to develop a management plan which maintains their progress within paediatrics towards attaining their CCT, while prioritising patient safety at all times.

Concerns relating to trainee performance can arise in a number of ways:

• In the workplace from the college tutor, educational supervisor, clinical supervisor or other staff
• From reporting of critical incidents or complaints
• From the trainee themselves
• Problems identified at ARCP

Reasons include

• Examination failure
• Communication problems
• Problems with team working
• Poor attitudes and behaviour
• Health issues
• Social factors
• Personal problems
• Unsuited to speciality

Neither of these lists is exhaustive. All involved with training, including trainees themselves need to identify a clear pathway for management of performance issues.

In the first instance when a concern is raised about a trainee’s performance, the situation should be discussed with the trainee and their Educational Supervisor and Local Programme Director/College Tutor. If the concerns are felt to be significant, the Local Programme Director/College Tutor should gather as much information as possible from all those involved ensuring comprehensive documentation.

The Local Program Director/College Tutor should inform the Professional Support Lead for the School who will liaise with the relevant Training Programme Director and Specialty Advisor. In some cases this would simply be to confirm the course of action already in place. In other cases the Professional Support Lead may request more information and a more detailed assessment including for example an MSF. It is important that a written record is kept of the referral and any action taken. If there are issues of patient safety the Clinical Director must be informed. In line with the Gold guide, the Postgraduate Dean should be communicated with by the Clinical Director in these circumstances.

Trainees may themselves approach the Local Programme Director/College Tutor with matters that are of a performance nature. It would be expected that the Local Programme Director/College Tutor would discuss these with the Professional Support Lead. This is considered a necessary step even with relatively low level concerns.

Issues raised at the ARCP should be discussed with the Training Programme Director and Professional Support Lead. Following an ARCP outcome 2 or 3 a management plan will be formulated and a written record kept. Any concerns raised and the management plan should be communicated to the trainee’s future College Tutor and Educational Supervisor by the relevant Training Programme Director.

The Professional Support Lead will assess each case on its merits. The Wales Deanery has a Professional Support Unit which is managed by Mrs Leona Walsh. The lead will have a relatively low threshold for seeking advice from the Deanery Professional Support Unit, and this will, on occasion lead to a formal referral to the unit. Such referrals must take place by mutual agreement with the trainee. All contact between the Professional Support Lead and the Deanery Professional Support Unit will be recorded.

Additional resources available include the Local Faculty Leads. They are the Deanery's representative in the Health Board and are an important resource in the management of performance. Trainees may prefer to make a direct approach to the Local Faculty Lead in certain circumstances. It is important that when performance issues are managed within the Health Board, involving the Local Faculty lead, that the Specialty Advisor and Professional Support Lead are also kept informed.

Where there are issues of patient safety the departmental Clinical Director must be informed. If a critical incident has occurred the Health Board critical incident reporting process must be followed. Where there are issues of professional misconduct the Health Board conduct policy must be followed. There is a clear responsibility for those managing training to communicate effectively with Health Board management.

For contact details for the relevant individual, contact the Paediatric Specialty Manager on 02920687490 or email

Guidelines for managing trainees given an ARCP outcome 3 for reasons in addition to exam failure

Following an ARCP outcome 3 a management plan will be formulated. The nature of concerns raised and the management plan will be discussed with the trainee’s College Tutor.

The management plan will include:

• Identifying an Educational Supervisor if the trainee is moving to a new placement
• Agreeing frequency of meetings between trainee and Educational Supervisor. These may need to be weekly initially if there are major training issues, but should occur at least every 3 months with a written record kept of each meeting.
• Agreeing clear targets for the trainee to achieve within certain time frames. These will have been discussed at the ARCP.

Examples of targets:

• Punctual attendance at all clinical sessions
• Attendance at classroom/exam teaching sessions and clinical governance sessions
• Attendance at Professional Support Unit/ISP
• Demonstrate satisfactory attitudes and behaviour
• Demonstrate good/improved team working and communication
• Attendance at specific courses eg communication course
• Demonstrate good personal organisation by presentation of all paperwork as required
• Evidence of progress towards completion of primary/final exam
• Completion of X WPBAs – may specify certain areas to be covered
• Satisfactory completion of X
• Complete an MSF

This is not an exhaustive list

Degree of clinical supervision

There needs to be a clear understanding of the degree of clinical supervision required by the trainee and whether the trainee will be working normally on an on-call rota.

Performance review

Dates should be agreed between the College Tutor/Educational Supervisor and the trainee for regular review of progress towards achieving the training targets and reviewing the degree of clinical supervision if required. These should be reviewed at least every 3 months.

The College Tutor should keep the School informed of the trainee’s progress and have a low threshold for liaising with the Professional Support Lead should there be any new concerns.

Documentation

It is important that a written record is kept of:

• All meetings between the trainee and educational supervisor/college tutor.
• Progress towards attainment of targets
• Any concerns expressed by colleagues or other staff
• Any clinical incidents or complaints

Feedback

Regular feedback should be given to the trainee about their performance and progress. Evidence of good practice and improvement should be emphasized whenever possible.

It is important that the trainee feels able to raise any issues concerning them and feels well supported during what will be a difficult and stressful time for them.

Guidelines for management of trainees who have failed the MRCPCH at the end of ST3

The School should be informed as soon as it is known that a trainee will not have completed their MRCPCH by the end of ST3. At their ARCP if there are no other performance, or behavioural concerns trainees will be given a 6 month extension to their training. During the 6 month extension trainees will be expected to:

• Attend exam teaching sessions
• Attend meetings with the Professional Support Unit/ISP if referred
• Demonstrate satisfactory attitudes and behaviour
• Show evidence of progress towards completion of exam

If the trainee has not passed the MRCPCH by the end of their 6 month extension they may be given a further 6 month extension to their training contract.

If they have not passed the exam, by the end of a 1 year extension, they will be released from the training program. If there are no other concerns, they will be able to reapply onto the program when they have passed their exam.