RCEM ARCP Checklist for ACCS CT2 (3)

Formative assessment of 5 Anaesthetic-CEX:

Date of assessment

Assessor’s name

• IAC A01 Preoperative assessment

Date

Name

• IAC A02 Management of the spontaneously breathing patient

Date

Name

• IAC A03 Anaesthesia for laparotomy

Date

Name

• IAC A04 Rapid Sequence Induction

Date

Name

• IAC A05 Recovery

Date

Name

Formative assessment of 8 Specific Anaesthetic CbDs:

• IAC C01 Patient identification

Date

Name

• IAC C02 Post op nausea & vomiting

Date

Name

• IAC C03 Airway assessment

Date

Name

• IAC C04 Choice of muscle relaxants & induction agents

Date

Name

• IAC C05 Post op analgesia

Date

Name

• IAC C06 Post op oxygen therapy

Date

Name

• IAC C07 Emergency surgery

Date

Name

• IAC C08 Failed Intubation

Date

Name

Formative assessment of 6 further anaesthetic DOPS:

• IAC Basic and advanced life support

Date

Name

• IAC D01 Demonstrate function of anaesthetic machine

Date

Name

• IAC D02 Transfer and positioning of patient on operating table

Date

Name

• IAC D03 Demonstrate CPR on a manikin

Date

Name

• IAC D04 Technique of scrubbing up, gown & gloves

Date

Name

• IAC D05 Competences for pain management including PCA

Date

Name

• IAC D06 Failed Intubation practical drill on manikin

Date

Name

PLUS - the Basis of Anaesthetic Practice - if in 6 month post

• Pre-operative assessment

Date

Name

• Pre-medication

Date

Name

• Induction of GA

Date

Name

• Intra-operative care

Date

Name

• Post-operative recovery

Date

Name

• Anaesthesia for emergency surgery

Date

Name

• Management of cardio-respiratory arrest (adult and children)

Date

Name

• Infection Control

Date

Name

Optional modules if in 9 month block

• Sedation

Date

Name

• Regional block

Date

Name

• Emergency surgery

Date

Name

• Safe Transfers

Date

Name

Formative assessments in 2 missing Major Presentations:

• CMP1 Anaphylaxis

Date

Name

• CMP2 Cardio-respiratory arrest

Date

Name

• CMP3 Major Trauma

Date

Name

• CMP4 Septic patient (ideally assessed in ICM)

Date

Name

• CMP5 Shocked patient

Date

Name

• CMP6 Unconscious patient

Date

Name

Formative assessment of any Acute Presentations not yet covered

1.  Date

2.  Date

3.  Date

4.  Date

5.  Date

Name

Name

Name

Name

Name

Formative assessment of 13 practical procedures as DOPS (may be assessed as Mini CEX or CbD if indicated), including:

• ICM 1 Peripheral venous cannulation

Date

Name

• ICM 2 Arterial cannulation

Date

Name

• ICM 3 ABG sampling & interpretation

Date

Name

• ICM 4 Central venous cannulation

Date

Name

• ICM 5 Connection to ventilator

Date

Name

• ICM 6 Safe use of drugs to facilitate mechanical ventilation

Date

Name

• ICM 7 Monitoring respiratory function

Date

Name

• ICM 8 Managing the patient fighting the ventilator

Date

Name

• ICM 9 Safe use of vasoactive drugs and electrolytes

Date

Name

• ICM 10 Fluid challenge in an acutely unwell patient (CbD)

Date

Name

• ICM 11 Accidental displacement ETT / tracheostomy

Date

Name

• Any other

Date

Name

• Any other

Date

Name

All 6 Major Presentations completed

Date

All 38 Acute Presentations completed

Date

All 45 Practical procedures completed

Date

Structured Training Report x2 (one for each placement)

YES / NO

(please circle)

MSF – minimum of 12 responses (annual) with spread of participants as agreed with Educational Supervisor

YES / NO

(please circle)

ACCS AM trainees only -  Multi Consultant Review x 4

YES / NO

(please circle)

Evidence of Audit or Quality Improvement Project (one every 12 months)

YES / NO

(please circle)

Progress in relevant post graduate examinations:

Exams achieved

Resuscitation courses relevant to specialty (ALS, ATLS, APLS or equiv.)

Date

Safeguarding Children Level 2 (upload certificate to ePortfolio)

Date

Progress toward achieving level 2 common competences confirmed by supervisor and trainee (red and blue man symbols)

YES / NO

(please circle)

Number of core training days attended (upload certificates to ePortfolio)

Number

Survey monkey feedback completed for each placement (if a requirement in region)

YES / NO

(please circle)

Trainee signature:

Date:

Education Supervisor signature:

Date:

Education Supervisor name PLEASE PRINT