1. Aims, principles and benefits
ISCP
Aims, principles and benefits

2. Overview Background, Aims, Key principles Curriculum components
Benefits for patients, training, trainees
The syllabus
Skill levels
Stages of training, stages diagram
Curriculum standards
Assessment system
Learning opportunities
Summary of curriculum competences

3. Background
Project
Impetus for change created by the realisation that major changes were needed in surgical training
Project funded by the UK and Irish Departments of Health and Royal Surgical Colleges
The JCST and SACs led the process for curriculum development
Produced on an intercollegiate basis
In partnership with OCAP
In collaboration with those charged with delivering health services
Launched in 2007
Under the umbrella of the JCST

4. Aims
Provision of excellent care for the surgical patient, delivered safely
Highest standards of UK surgical practice through high quality surgical training
Programme of surgical training from core to certification
At completion of training, able to provide common, elective and emergency service and defined level of specialised service

5. Key principles Common format across all surgical specialties
Systematic progression through stages of training
Curriculum and assessment system that meet GMC standards
Competence-based (time points are indicative)
Professional and leadership skills
Delivery by skilled clinicians, appropriately trained
Learning partnership between trainee and trainer
Involvement of qualified members of the multidisciplinary team
Promotion of equal opportunities and diversity in training
Collects data to evaluate and enhance training & assessment

6. Curriculum components
Standards
Assessment
System & methods
Learning
portfolio
Training structure
Syllabus
SAC development & review
Stages of
training
Educational programme
Appraisal & Learning Agreement
Training roles for supervision
Reflective
practice QA
Regulator
approval

7. Benefits for patients
Designed to produce surgeons who are able to provide excellent care for the surgical patient, safely
Promotes effective working practices and service delivery
Provides supervision and accountability through key roles
Provides transparency through an explicit assessment system and portfolio
Ensures lay and patient involvement in curriculum development and review

8. Benefits for training
Provides a structured and supervised framework with a definable endpoint
Promotes high-quality teaching and learning
Based on clear standards covering all surgical specialties
Reviewed and maintained by surgical SACs
Promotes patient safety
Affirms professional and educational values
Rigorous and fully integrated assessment
Meets GMC standards

9. Benefits for trainees
Promotes consistent training experience in the UK
Mandates the interaction between trainer and trainee
Mandates the training of trainers
Provides a clearly defined syllabus
Provides explicit feedback on practice
Provides a portable portfolio of conduct and practice
Provides guidance for professional development
Provides web-based access including Apps

10. Benefits for trainers Maps to standards for trainers
Provides recognisable educational roles and training structure
Provides guidance for trainers, assessors & supervisors
Provides tools for recording discussions with trainees
Helps to provide evidence of trainer engagement for appraisal and revalidation

11. Assigned Educational Supervisor
Training Structure
Multi-professional Team
School of Surgery
Postgraduate Dean
Programme Director
Assigned Educational Supervisor
Trainee
Clinical Supervisor

12. The PD role Organise, manage and direct the training programme
Appoint local faculty as AESs and CSs
Organise faculty development, trainee induction and training for MPT
Oversee progress of individual trainees
Ensure appropriate levels of supervision, training and support
Identify remedial training and resources where required
Work closely with Colleges SACs on curriculum delivery
Administer and chair the ARCP

13. The AES role
Overall educational and supervisory responsibility for the trainee
Ensures induction of the trainee to the unit
Ensures trainee works to the curriculum and assessment system
Ensures patient safety in relation to trainee performance
Acts as a mentor to the trainee
Provides appraisal and a placement learning agreement
Monitors the trainee’s portfolio to ensure educational progress
Presents formative feedback to the trainee
Keeps the PD informed of any issues that may affect training
Involves senior faculty in the formal report to the annual review
Provides an AES report for the ARCP

14. The CS role Under the delegated authority of the AES
Ensure appropriate day-to-day supervision of the trainee
Carries out WBA and delivers feedback
Ensures patient safety in relation to trainee performance
Liaises with the AES and faculty about trainee progress
Keeps the AES informed of any issues about training
Contributes to the AES report for the ARCP

15. The trainee role Takes responsibility for own learning
Triggers WBA frequently
Exploits learning opportunities
Attends educational programme
Agrees the learning agreement with the AES
Raises issues and difficulties promptly
Conducts self-directed learning
e.g. peer and self-assessment and reflective practice
Keeps an accurate and up to date portfolio

16. The syllabus Specialty-based knowledge Clinical skills and judgement
4 Domains:
Specialty-based knowledge
Clinical skills and judgement
Technical and operative skills
Professional and leadership skills

17. The syllabus Defines what trainees should know and be able to do
Informs assessment
Specialty overview of the scope of practice
Key topics that all trainees must be able to manage
Index procedures, indicative of all specialty procedures
Topics can be used as learning objectives
Skill levels indicate the required level of performance

18. Skill levels Indicate the level of competence to be achieved
Ensure learning is based on progression
Increase with depth and complexity of practice
Increase as the need for supervision decreases and trainees become more proficient
Correspond with logbook supervision levels

19. Knowledge skill levels
4. Knows specifically & broadly
CORE
e.g. Can:
Interpret
Distinguish
Compare/contrast
3. Knows generally
e.g. Can:
Explain
Identify
Locate
2. Knows basic
concepts
e.g. Can:
Define
Discuss
Describe
1. Knows of
e.g. Can:
List
Name

20. Knowledge skill levels
4. Knows specifically
& broadly
Intermediate/Final
e.g. Can:
Manage
Judge
Rate / Estimate
3. Knows generally
e.g. Can:
Interpret
Distinguish
Compare/contrast
2. Knows basic
concepts
e.g. Can:
Explain
Identify
Locate
1. Knows of
e.g. Can:
Recall
Discuss
Describe

21. Clinical / Technical skill levels
4. Competent to do without assistance, including complications
Manages common and difficult cases;
UK consultant level;
Can supervise.
3. Can do whole
but may need
assistance
Deals with common problems, variations;
Requires advice rather than help.
2. Can do with assistance
Knows rationale;
Straightforward procedures;
Knows when to ask for assistance.
1.Has observed
Knows steps;
Handles instruments;
Performs some parts.
Knows of

22. Stages of training
Defined to reflect the training pathway of the specialty
Provides a means of charting progress against domains of knowledge, skills and behaviours
Allows benchmarking of progress
Core component is common to all specialties supplemented by a small specialty-specific component
Intermediate and final stages reflects the increasing scope of specialty practice

23. Stages diagram

24. Curriculum standards
Each training stage is underpinned by explicit outcome standards in 4 domains
Standards form the basis for specifying syllabus content
Organise workplace training in terms of case mix and case load
Basis for identifying relevant teaching and learning opportunities

25. Assessment system Learning Agreement
Determines whether trainees are meeting the standards of competence
Learning Agreement
Assigned Educational Supervisor (AES) Report
Workplace-Based Assessment + Logbook
AoA CEX / CBD / DOPS / MSF / OoT / PBA
Courses: ATLS / APLS
Annual Review of Competence Progression (ARCP)
MRCS Examination
FRCS Examination

26. WBA methods WBA Clinical Evaluation Exercise - CEX
Case Based Discussion – CBD
Direct Observation of Procedural Skills – DOPS
Multisource Feedback - MSF
Procedure Based Assessment – PBA
Observation of Teaching – OoT
Assessment of Audit – AoA

27. Learning Agreement Comprises PD Global Objective
Syllabus topics for the stage of training
Agreed learning opportunities and resources
Agreed evidence required - WBA, Exams, Audit etc.
AES Comments
Trainee Comments
Link to portfolio of progress
CS Report
AES Report

28. Learning opportunities
3 broad areas:
Learning from practice
Learning from formal situations
Self-directed learning

29. Learning opportunities
Learning from practice
Any workplace interaction has the potential to become a learning episode
Workplace assessment
Shadow peers and consultants
On-going systematic feedback, both formal and informal
Reflection on practice

30. Learning opportunities
Learning from practice - settings
Theatre
Operative units
Clinic
Ward
Multi-disciplinary meetings
Community

31. Learning opportunities
Learning from formal situations
Educational programme arranged locally
Local, national and international level
e.g. courses, seminars, meetings, simulation (technical and human factors)

32. Learning opportunities
Self-directed learning
Trainee-led
Vital component of continuing professional development
Study groups, journal clubs and peer review
Learning with peers at teaching sessions
Personal study
Written reflections on practice
Research, projects and audits

33. Learning portfolio Repository of evidence of the trainee’s practice
Audit trail of training
Web-based and password protected
Fitness to practise
Planning personal development
Appraisal and the learning agreement
Workplace-based assessment (WBA) and reflective practice
Record of educational achievement
Annual review
Foundation for continuing professional development

34. Reflective practice
Purposeful use of experience/feedback to improve practice
Requirement of the curriculum and part of CPD
Appended to WBA
MSF Self-assessment
Linked to Case-Based Discussion (CBD)
Personal Development Plan
Journal
Entries must respect confidentiality of colleagues and patients

35. Summary of curriculum competences
Clinical Care
History taking, examination skills
Taking consent
Relevant knowledge and diagnostic skills
Ability to formulate appropriate management plans
Procedural (technical) skills
Record keeping
Maintaining good medical practice
Ability to manage time and work under pressure
Decision making and implementation skills
Reflective practice and awareness of own limitations
Initiative and leadership skills
Focus on patient safety
Learning and teaching
Willingness to ask for feedback and to learn from it
Teaching
Relationships with patients & colleagues
Communication with patients and their relatives
Communication with colleagues
Active involvement with your team
Accessibility and reliability