MSc Surgical Care Practice preceptorship session Susan Hall RGN MSc (Clinical Sciences) Senior Lecturer in Surgical Care Practice Preceptorship SD introduction1

Session objectives Definition of the SCP role Establishing an SCP post Trainers Delegation & accountability Clinical governance Educational expectations Support 2Preceptorship SD introduction

What is a Surgical Care Practitioner? ‘SCPs are non-medical practitioners … who have extended the scope of their training to work as members of surgical teams. They can perform surgical intervention and preoperative and postoperative care under the supervision and direction of a consultant, although not independently.’ Royal College of Surgeons of England Preceptorship SD introduction

Why do we need extended & expanded roles? To ensure patient safety by the provision of appropriately trained assistance, necessary due to: The impact of the European Working Time Directive Changes in training strategies for medical professionals Changes in the popularity of specialities among surgical trainees Reduction in the number of surgical trainees / increase in service provision needs 4Preceptorship SD introduction

Establishing an SCP post Is it needed / are senior staff from all disciplines in agreement? Risk assessment & review of policies & procedures FUNDING Suitable academic course Intercollegiate basic surgical skills course Identification of a support framework Clinical Supervisor Mentor Job description Robust Relevant TIME Attendance on academic course Personal study time Ongoing assessment & CPD 5Preceptorship SD introduction

Legal & ethical considerations in advanced roles Governance of the role Regulation of individual practitioners Negligence Bolam Wilshire Professional indemnity insurance Demonstration of competence Consent / refusal Montgomery Preceptorship SD introduction6

7 ‘the standard of care of the SCP must be that of the medical role which she [sic] is replacing’ Dimond 2015

Course Outline Preceptorship SD introduction8

25 hours / week clinical time is required over a two year period Preceptorship SD introduction9

The successful trainee modified from Simpson & Rowlands (2008) Understands that the patient remains their primary focus Recognises their own limitations Takes responsibility for their own learning Is always willing to learn from colleagues across the interprofessional spectrum Pays attention to the details of illness Reflects on decisions made by themselves, and others Develops the skills to work both independently and as part of a team Takes responsibility for their own actions Does not permit ego to affect their performance Offers support to colleagues Maintains an up to date, evidence based knowledge and skill level Constantly works to improve their practice in line with the principles of clinical governance Participates in departmental research Preceptorship SD introduction10

Delegation It is the responsibility of the person delegating the task to ensure that the person to whom they are delegating is suitably: Trained Competent Sufficiently experienced to perform the task safely It is the responsibility of the delegating practitioner to ensure that appropriate supervision is provided 11Preceptorship SD introduction

Logbook Logbooks Mandatory for surgical trainees Recognised as best practice for consultant and staff grade surgeons Required for SCP trainees Recommended for tenured SCPs 12Preceptorship SD introduction

13 Don’t tell me, MORE paperwork!!##**

Core practice document Identifies the core competencies expected of SCP trainees by the Royal College of Surgeons of England & Anglia Ruskin University 14Preceptorship SD introduction

Learning agreements Enable maximisation of training opportunities Support focus on competence Start of training After annual review Goal setting Identification of resources Support interim, review meetings Preceptorship SD introduction15

SWOT analysis Completed as soon as possible after training starts Repeated at the beginning of year two Repeated if there is a significant change in circumstances Preceptorship SD introduction16

Academic life It will be demanding Time for self directed study is invaluable The University offers assistance to students who have not been in active education for some time Tutors are only an away 17Preceptorship SD introduction

Dealing with negativity 18Preceptorship SD introduction