Foundation Programme Curriculum 2021 - NACT UK
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
2021
Foundation Programme
Curriculum
The 2021 Foundation Programme curriculum
Aims
Approach
Assessment
Aims
The Foundation Programme is part of the continuum of medical education
Undergraduate Foundation Specialist GP or
training Programme Training Consultant
Generic Training
Training to equip the 21st century doctor
To remain fit for purpose the Foundation Programme
must evolve with medical practice and training to
equip the 21st century doctor for practice.
• Aug 2021 update is based on:
• The requirements of the regulator
• The current role of the doctor in the 21st century (the
curriculum defines this)
• Simpler to follow
• Reduced assessment
Three outcomes of the Foundation Programme
To complete the programme successfully, the Foundation Doctor (FD) must
demonstrate that they are:
HLO1:
THETHE
CLINICIAN
CLINICIAN HLO2:
THE HEALTHCARE
THE HEALTHCARE
WORKER
WORKER HLO3: THE PROFESSIONAL
A professional, responsible for
An accountable, capable and A valuable member of the
their own practice and portfolio
compassionate clinician healthcare workforce
development
These are the Higher Level Outcomes (HLOs) of the Foundation Programme and
underline the generic nature of Foundation training.
Thirteen professional capabilities
For clarity we can break these 3 areas down into 13 professional capabilities:
HLO1:
THETHE
CLINICIAN
CLINICIAN HLO2:
THE HEALTHCARE
THE HEALTHCARE
WORKER
WORKER HLO3: THE PROFESSIONAL
Direct and indirect patient care: Integrating into the healthcare Professional requirements and
1. Clinical Assessment workforce: expectations:
2. Clinical Prioritisation 6. Sharing the Vision 11. Ethics and Law
3. Holistic Planning 7. Fitness to Practise 12. Continuing Professional
8. Upholding Values Development
4. Communication and Care
9. Quality Improvement 13. Understanding Medicine
5. Continuity of Care
10. Teaching the Teacher
Holistic care and breadth of care • The Foundation Doctor must understand how to apply these capabilities across the range of modern healthcare settings: • Acute care (including acute mental health care) • The management of chronic illness • Community care (including population health) • The Foundation Doctor must understand how to apply these capabilities to the holistic care of the patient specifically dealing with: • Physical health • Mental health • Social health • The new curriculum specifically states the ‘parity of mental and physical health’ conditions
Approach
Support for the Foundation Doctor • The 2021 curriculum emphasises the importance of good support for Foundation Doctors • Foundation Doctors are very inexperienced and need close support • The curriculum states clearly that fair treatment for all is mandatory and that Foundation Doctors from certain backgrounds, particularly IMGs, may be less familiar with the UK training system and need more support to understand it • All supervisors must be up to date with equality and diversity training which must include reference to unconscious bias and differential attainment • All clinical and educational supervisors must be recognised for the role by the GMC and must have up to date CPD in foundation training • Educational Supervisors in particular should ensure they are aware of the broad/pluripotent nature of foundation training • Education providers are required to monitor the diversity of those that train foundation doctors
An experiential approach
The curriculum continues to take an
experiential approach:
• Places the Foundation Doctor in a series of clinical
placements to allow exposure to:
• Acute/chronic/community and population
health
• Physical/mental health/social needs
• Most programmes will remain 3 x 4 months in each
year, but other formats are permitted at the
discretion of the Foundation School Director as long
as the curriculum requirements can be fulfilled
• Clinical training should as far as possible be ‘patient
focused’ not ‘task focused’
• The focus is on the acquisition of generic capabilitiesGuiding training
Known Known
• In each placement the Foundation Doctor to self Ask to others
will have:
• A Clinical Supervisor (CS)
Feedback
• Support from other professionals – the Known Open area Blind area
curriculum acknowledges the importance of by others
these – they form the Placement Supervision
Group (PSG)
Tell
• In each placement the Foundation Doctor Self disclosure
can develop their skills under supervision,
reflect on their progress and receive Unknown
Hidden area Unknown area
by others
feedback
• It’s all about ‘self actualization’
• The curriculum defines the role of the CSOther methods of learning
• Not all Foundation Programme Curricula can be learned/practised in the clinical
setting by all Foundation Doctors
• As well as experiential learning we have:
Direct learning Self developmentDirect learning • Teaching/training specific to the Foundation Programme • The 2021 curriculum defines areas that education providers must include as ‘core’ learning unless it is clearly available to all Foundation Doctors in their programme • These are topics that are not usually available to all Foundation Doctors or are not common practice • Including these will help to prepare the doctor for up-to-date practice and help medical practice to evolve more quickly
Direct learning
The core learning topics are:
• Mental health including mental illness • Frailty
• Health promotion and public health • End of life care
• Simulation • High risk prescribing
• Leadership • Teaching skills
• Quality improvement methodology • Patient safety
• Appraisal of evidence • Safeguarding
• Careers guidance • Use of new technologies and the
• Integration of acute illness into chronic disease digital agenda
management and multiple comorbidities
The curriculum further defines required content for this training but not the training methods used.Self development • Foundation Doctors will want to develop their practice in different ways • This will include online learning, reading and reflection • Most Foundation Doctors will now be given time for self development to undertake these activities
Following the curriculum
• As the FD progresses through
their training, they will undertake Reflection Supervised
activities that will help them on progress learning events
(SLEs)
develop the 13 FPCs
• The FD will be expected to Record of self
Multisource
develop a portfolio of evidence development
feedback
(MSF)
to reflect this progress eportfolio
on, anger
• Across each training year the Placement
Educational Supervisor (ES) will Record of Supervision
core learning Group (PSG)
help to guide their training Clinical feedback
• The curriculum defines the role Supervisor
reports (CSRs)
of the ESThe eportfolio
• Foundation Doctors will gather
evidence in their portfolio to fulfil
the 3 HLOs:
HLO1: An accountable, capable and
Experiential
compassionate clinician Does (SLEs)
(observation)
HLO2: A valuable member of the healthcare
workforce
Shows how Simulation
(demonstration of skills)
HLO3: A professional, responsible for their
own practice and portfolio development
Knows how Learning /
(application of knowledge) reflection
• Following Miller’s pyramid some
evidence carries more weight Knows
than others (knowledge)
• The curriculum uses the term
‘Hierarchy of Evidence’Supervised learning events (SLEs)
• While working in the clinical
setting the Foundation SLEs
Doctor will undertake • miniCEX
various tasks and receive HLO1: CLINICIAN • DOPS
feedback
• CBD
• Some of this feedback will
HLO1: CLINICIAN
be recorded formally in SLEs
HLO2: HEALTHCARE WORKER • LEARN
• The 2021 curriculum does HLO3: PROFESSIONAL
not specify any particular
• LEADER
number or types of SLE to HLO2: HEALTHCARE WORKER
be included but simply • Developing the clinical teacher
offers them as a way of
recording progress against
the 3 HLOs/13 FPCsMultisource feedback (MSF) / team assessment of behaviour (TAB) • Very established feedback tool in Foundation Programme • Specified variety of individuals who contribute • Used to obtain feedback largely for: HLO2: HEALTHCARE WORKER but also evidence for: HLO3: PROFESSIONAL HLO1: CLINICIAN • Foundation Doctors are expected to carry this out at least once in F1 and once in F2 • Foundation Doctor-led process • Useful tool for all Foundation Doctors but particularly helpful for those with limited insight when combined with the self evaluation
Placement supervision group (PSG) PSG: • Will feed back to the Foundation Doctor on a day-to-day basis (e.g. senior nurse, ward pharmacist, social worker, therapist, dietician, practice nurse) • May contribute to TAB • Will feed back to CS for CS report and at least one CSR should include the report of a PSG (at least 3 members) The formal PSG report for the CSR is lead by the CS and is used mainly to inform: HLO1: CLINICIAN but some evidence for: HLO2: HEALTHCARE WORKER HLO3: PROFESSIONAL
Core and non-core learning
Min
30 hours
30 hours
The Foundation Doctor is required to log a The Foundation Doctor is required to log 30
minimum of 30 hours of core learning. hours of self development/non-core learning
such as departmental teaching (or extra core
hours).Reflection and the summary narrative
Like all doctors, Foundation Doctors are
required to reflect on their practice.
• Reflection:
• Should lead to change or reinforcement of
practice
• Can take the form of personal reflection,
reflection with a supervisor or group
reflection
• May be based on individual cases/events
or on overall development/progress
• Some reflection should be recorded in the
portfolio
• Over each level of training the Foundation
Doctor will need to reflect on their overall
progress using summary narrativeAssessment
Assessment
• Assessment will be continuous and feedback
from various groups of healthcare
professionals will inform the CS and ES
• The curriculum identifies the difference
between summative and formative
assessment
• Satisfactory progress will be recorded by the
CS and ES in the form of:
• CS end of placement reports
• ES end of year reports (in Scotland 3 CS and 3 ES
end of placement reports with 1 FPD end of year
report)
• The curriculum allows for ‘reasonable
adjustments’Types of assessment
Formative assessment Summative assessment
• Supervised Learning Events • Clinical Supervisor Reports
• The Personal Learning Log • Educational Supervisor Reports
• The Summary Narrative • Prescribing Safety Assessment (F1 only)
• Portfolio Evidence (Curriculum Linkage)
• Placement Supervision Group
• Multisource Feedback (TAB)Summative assessments – clinical supervisor reports (CSRs)
• The CS will consider the Foundation CS assessment of Information from the
Doctor’s performance in the clinical FD performance MDT (including PSG)
environment and will gather
information from the multidisciplinary
team CSR ESR
• The report produced will be used
summatively to inform the ARCP panel
• All information provided as evidence
such as PSG, SLEs, reflections and
learning log will be regarded as
formative learning but will feed into
ARCP panel
the CS assessment of performanceEducational Supervisors’ end of year report
Provides a summative assessment of: • Curriculum coverage • TAB
• Evidence of learning • PSG
• Curriculum coverage (Foundation Doctor
• CSRs • Other evidence
links evidence to each FPC)
• Summary narratives
• Evidence of learning (core and non-core)
• Clinical supervisor reports
ESR
• Completion of 3 summary narratives
detailing the Foundation Doctor’s rationale
for selecting the evidence provided
• TAB and PSG - used formatively to inform the
trainee about their progress; the FD must
have at least 1 satisfactory TAB and 1
satisfactory set of PSG feedback by the ARCP
ARCP panel
• Any evidence from other meetingsKey changes to assessment
• Reduced ‘assessment burden’ on the
Foundation Doctor
Experiential
• Summary narrative to be written by Does (SLEs)
(observation)
Foundation Doctor for each HLO to show
rationale for selecting evidence uploaded Shows how Simulation
and mapped (demonstration of skills)
• No minimum number of SLEs Knows how Learning /
(application of knowledge) reflection
• Foundation Doctor to link adequate
evidence to 13 FPCs in accordance with Knows
hierarchy of evidence (knowledge)
• eportfolio will allow up to 10 pieces of
evidence per FPC and will allow each
piece of evidence to be used 3 times
… contdKey changes to assessment cont’d
• Mandatory use of at least 1 satisfactory PSG per year
• Parity of evidence of physical and mental health
• A FD who only links physical health evidence should be guided
to provide evidence of mental health learning
• This should include all the elements in Miller’s pyramid:
experiential learning (SLEs), reflections, learning, simulation,
feedback (TAB, PSG)
• Evidence should cover
• Acute care (including acute mental health care)
• The management of chronic illness
• Community care (including population health)
• Foundation Doctor must demonstrate acute clinical
skills (FPC2)
• Includes mental health
• Could be evidenced by an ALS / ILS course or other methodOverview of assessment process
HLO1: An accountable, capable and HLO2: A valuable member of the HLO3: A professional, responsible for
THE CLINICIAN THE HEALTHCARE WORKER
compassionate doctor healthcare workforce their own practice and portfolio
development
Direct and indirect patient care: Integrating into the healthcare Professional requirements and
1. Clinical Assessment workforce: expectations:
2. Clinical Prioritisation 6. Sharing the Vision 11. Ethics and Law
3. Holistic Planning 7. Fitness to Practise 12. Continuing Professional
8. Upholding Values Development
4. Communication and Care
9. Quality Improvement 13. Understanding Medicine
5. Continuity of Care
10. Teaching the Teacher
Assessment Assessment Assessment
• CSR • CSR • CSR
• ESR • ESR • ESR
• TAB • TAB • eportfolio evidence
• PSG • PSG • Learning log
• eportfolio evidence • eportfolio evidence • Engagement in feedback on training
• PSA certificate (F1 only) • Form R / SOARStandards
F1 F2
(one year) (min one year)
• Entrustment to work safely in a • Deliver safe, compassionate care with indirect
supervised environment supervision in areas covering generalist practice
• Successful completion of the • Be prepared to develop more specialist skills
Prescribing Safety Assessment (PSA)
• Know how to make a useful contribution to the
quality and development of healthcare care
• Show the ability to work within a team
• Appreciate the breadth of medical practice
• Be able to care for their own wellbeing and
understand how to plan a careerARCP requirements
Provisional registration and a licence to practise with the To undertake the first year of the foundation programme, doctors must be provisionally registered with the GMC and hold a licence to
GMC (F1 only) practise. In exceptional circumstances (e.g. refugees), a fully registered doctor with a licence to practise may be appointed to the first year of
a foundation programme.
Full registration and a licence to practise with the GMC To undertake the second year of the foundation programme, doctors must be fully registered with the GMC and hold a licence to practise.
(F2 only)
Completion of 12 months (WTE) training (taking account of The maximum permitted absence from training, other than annual leave, is 20 days (when the doctor would normally be at work) within each
allowable absence) 12 month (WTE) period of the foundation programme.
Where a doctor’s absence goes above 20 days, this will trigger a review of whether they need to have an extra period of training (see GMC
position statement on absences from training in the foundation programme – June 2013).
A satisfactory educational supervisor’s end of year report The report should draw upon all required evidence listed below.
If the FD has not satisfactorily completed one placement but has been making good progress in other respects, it may still be appropriate to
confirm that the FD has met the requirements for progression.
Satisfactory educational supervisor’s end of placement An educational supervisor’s end of placement report is required for all FD placements EXCEPT for the last FD placement at each level of
reports training; the educational supervisor’s end of year report replaces this.
Satisfactory clinical supervisor’s end of placement reports A clinical supervisor’s end of placement report is required for ALL placements. At least one CSR in each level of training must make use of PSG
feedback. All of the clinical supervisor’s end of placement reports must be completed before the doctor’s Annual Review of Competence
Progression (ARCP).
Satisfactory Team Assessment of Behaviour (TAB) Minimum of one per level of training
Satisfactory Placement Supervision Group report (PSG) Minimum of one per level of training
Satisfactory completion of all curriculum outcomes The FD should provide evidence that they have met the 13 foundation professional capabilities, recorded in the eportfolio.
Evidence to satisfy FPC1-5 must include direct observation of at least 5 clinical encounters in the form of SLEs and the specific life support
capabilities specified in FPC2.
Satisfactory engagement with the programme Learning log of core/non-core teaching and other learning
Reflection including summary narrative
Contemporaneously developed portfolio
Engagement with feedback on training programme
Completion of relevant probity / health declarations including Form R / SOAR or equivalent
Successful completion of the Prescribing Safety Assessment The F1 doctor must provide evidence that they have passed the PSA within two years prior to entry to the programme or on completion of the
(PSA) - (F1 only) programme.
Evidence of completion of additional requirements set by
HEE/NES/NIMDTA/HEIW and approved by UKFP BoardSummary of changes to the 2021 FP curriculum
• Written to link explicitly with GMC’s GPCs
• Clear statement of the expectation of equitable treatment for all FDs
• Number of Higher Level Outcomes (previously ‘Sections’) reduced
from 4 to 3 (Clinician, Healthcare worker, Professional)
• Number of Foundation Professional Capabilities (FPCs) that have to
be demonstrated have been reduced from 20 to 13
• There is no specific number of formative SLEs that need to be
undertaken (previously 16) but to demonstrate the HLOs, examples
of practice must be submitted as summative evidence against
learning outcomes across a variety of placements
• Importance of Placement Supervision Group (PSG) emphasised and
made mandatory to ensure a broader range of healthcare
professionals provide feedback to Foundation Doctors
• The curriculum introduces a more formal hierarchy of evidence to
emphasise the importance of direct observation in the workplace as
the most crucial evidence that the FD has fulfilled the HLOs
… cont’dSummary of changes to the 2021 Foundation Programme curriculum • Specific ‘core’ teaching sessions make explicit the need for training programmes to provide teaching in certain areas including simulation • The curriculum endorses current practice for the recording of a ‘personal learning log’ of ‘core’ and ‘non-core’ learning both as evidence of engagement with the programme and for use as evidence for the acquisition of FPCs • The new curriculum defines the role of the doctor • The new curriculum makes a specific statement regarding the importance of mental health and specifies a syllabus covering this important area of medical practice • A ‘summary narrative’ provides additional opportunities to reflect on progression and curriculum achievement to complement current reflective practice • The review has provided an opportunity to develop a curriculum that considers and incorporates recent work in the area of differential attainment and highlights the importance of monitoring this • The curriculum explicitly allows for reasonable adjustments to the assessment of performance
2021
Foundation Programme
Curriculum
https://foundationprogramme.nhs.uk/curriculum/
curriculum2021@foundationprogramme.nhs.ukYou can also read
