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A Framework of Competences for the Special Interest Module in Neonatal Paediatrics February 2016 (version 1.0) Royal College of Paediatrics and Child Health www.rcpch.ac.uk
A Framework of Competencesfor the
Special Interest Module in Neonatal Paediatrics
February 2016 (version 1.0)
Royal College of Paediatrics and Child Healthwww.rcpch.ac.uk
This guide is for trainees or other medical professionals interested in undertaking an RCPCH SPIN Module, and for educational supervisors supporting these individuals. We hope that this guide, along with the RCPCH SPIN web pages, will answer your questions and help you understand the requirements of this SPIN Module.
This is Version 1.0. As the document is updated, version numbers will be changed, and content changes noted in the table below.
Version number Date issued Summary of changes
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CONTENTS
Section 1 Introduction.......................................................................................................5
What is a SPIN Module?................................................................................................................5
Introduction to the Neonatal Paediatric SPIN.............................................................................5
Developing excellence...................................................................................................................6
How to use this Framework of Competences.............................................................................6
Undertaking the Neonatal Paediatrics SPIN Module.................................................................7
Progression......................................................................................................................................8
Assessment.....................................................................................................................................8
Recommended reading..................................................................................................................9
Suggested courses.........................................................................................................................9
Equality and Diversity.....................................................................................................................9
Section 2 General Competences in Neonatal Paediatrics...........................................10
Knowledge and Understanding...................................................................................................10
Skills...............................................................................................................................................10
Leadership and Management.....................................................................................................11
Teaching and Research...............................................................................................................11
Communication Skills...................................................................................................................11
Governance and quality improvement.......................................................................................12
Values and attitudes.....................................................................................................................12
Section 3 Specific Competencies in Neonatal Paediatrics............................................13
Practical Procedures and Investigations....................................................................................13
Management of complex congenital abnormalities..................................................................13
Transport........................................................................................................................................13
Airway management.....................................................................................................................14
Surgical problems.........................................................................................................................14
Chronic lung disease....................................................................................................................15
Cardiac problems..........................................................................................................................16
Neurological problems..................................................................................................................16
End of life care..............................................................................................................................17
Follow up........................................................................................................................................17
Section 4 Assessment Strategy for Neonatal Paediatrics.............................................19
Assessment Guidance.................................................................................................................19
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Appendix 1: Paediatrics Standards Checklist...................................................................21
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Section 1 Introduction
What is a SPIN Module?Special Interest (SPIN) modules are the additional training/experience a paediatrician
completes so that they can be the local lead and part of the clinical network providing for
children who need specialist paediatric care.
Trainees, SAS doctors, Consultants and others providing expert care will be able to seek
training in an area of special interest or in aspect(s) of sub-specialty care. This will involve
training, assessment and supervised care. It will vary in breadth and depth, but will often
equate with the training received during a full time 12 month placement.
Please note that SPIN Modules are:
NOT a route to GMC sub-specialty accreditation
NOT required for GMC accreditation in paediatrics or any of its sub-specialties
NOT sub-specialty training and not equivalent to GRID training.
More information regarding SPIN Modules, including how to apply to undertake a SPIN and
how to submit evidence against the competences, is contained in the SPIN Module
Guidance on the RCPCH SPIN webpages.
Introduction to the Neonatal Paediatric SPINThis SPIN Module is for doctors at Level 3 in their General Paediatric training who wish to
work towards an expertise in Neonatal Paediatrics during Level 3 training.
There has been a recent move towards centralisation of neonatal care, meaning that the
most sick and/or extremely premature babies should be born, and cared for, in tertiary
neonatal units. However, a variety of factors exist, for example undiagnosed congenital
anomalies, unexpected rapid delivery of premature babies, and complicated labours and
deliveries of term babies, any of which can lead to an extremely sick neonate being born
outside of tertiary centres. In these situations the local team must provide the initial care for
the baby.
Of equal importance is the previously sick or extremely premature baby who has been cared
for at a tertiary centre, and who is now suitable to be cared for outside of the specialist
arena. A high level of ongoing care, discharge planning and follow-up is paramount.
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A General Paediatrician with an interest in Neonatology would be expected to have the
expertise to manage these complex patients and scenarios, and would likely be nominated
as the ‘neonatal lead’ paediatrician at their place of work. This SPIN module is designed to
allow a trainee to develop this expertise.
Developing excellenceThis framework is aimed at pre CCT SPIN applications. The CSAC will review the feasibility
of post CCT applications after review of this module.
Without a doubt the most important element of practice is clinical excellence. High standards
of knowledge, skills, performance, team working, communication and clinical decision
making are at the heart of this excellence. Furthermore the completion of this module
should aid preparation to become a consultant. It can also be helpful to consider a special
interest with a view to develop it further as a consultant. If you want to show an interest then
do something that shows you are interested:
If it is teaching, collect evidence and consider further training.
If it is management attend appropriate meetings, be involved in quality improvement
initiatives, consider further courses.
If it is palliative or end of life care then keep a logbook, work with a local hospice,
develop a guideline or consider further training.
If it is follow up keep a record of cases, consider specialist neurodevelopment
assessment courses, work with multidisciplinary specialists.
If it is breastfeeding teach and train, gather evidence, work with accreditation teams
for breastfeeding initiatives.
If some of these areas appeal to you then talk to your colleagues and integrate a personal
development plan within your portfolio. This additional learning can stoke up enthusiasm and
help to give you an edge over others when it comes to a consultant interview.
How to use this Framework of CompetencesThis document sets out the competences you need to cover, in addition to the Framework of
Competences for Level 3 Training in General Paediatrics. It gives you a clear picture of
what you have to achieve by the end of this module of training in order to have expertise in
this area.
You should use this document to help you plan your training programme. You can talk to
your SPIN Educational Supervisor about the balance of your experiences and discuss ways
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to ensure you cover all areas you need to. Many of these may have been achieved in other
posts during level 2 or 3 training and a direct link can be made to the curriculum and e-
portfolio in these cases.
This guide should also be used by Schools and Educational Supervisors to ensure that a
programme of training is developed which will allow the doctor undertaking the SPIN to
achieve these competences as part of their Level 3 training for trainees, or their normal work
pattern for non-trainees. In determining this programme, liaison with the relevant CSAC is
important. There is guidance for training and assessment in the module, which the
programme must adhere to.
Undertaking the Neonatal Paediatrics SPIN ModuleThis framework sets out the additional competences for the module which should be
achieved by the end of Level 3 training. Trainees also have to achieve all the competences
in the Level 3 General Paediatric Framework.
For trainees, the SPIN training should be approximately equivalent to 12 months full time, or
pro-rata for Less Than Full Time (LTFT) trainees. Some SPIN modules may require
additional time to gain all competences; this is permissible up to 18 months full time. It is
expected that to achieve the competencies necessary a trainee will spend 12 months
working in a tertiary neonatal unit. A suitable training centre is one which is currently
approved by the neonatal CSAC for higher specialist training (see sub-specialist training
section of the RCPCH website for more detail).
Trainees should not need to take out of programme (OOP) to complete a SPIN module.
Undertaking a SPIN will NOT be considered as a basis for an OOP except in exceptional
circumstances and where both deaneries/LETBs agree and approve the SPIN module
programme. These exceptional circumstances include applications from trainees where
approved training in a particular special interest is not available in their current
deanery/LETB. Permitting OOP for these exceptional circumstances provides a positive
contribution to workforce planning in regions where limited approved SPIN modules are
available. For example, smaller sub-specialties such as Nephrology or Immunology &
Infectious Diseases (IID) may only be available in a limited number of deaneries/LETBs. In
order for applications utilising OOP to be considered by the RCPCH, both deaneries/LETBs
must agree and approve the SPIN module programme and provide clear justification as to
why the module could not be completed in the trainee’s current deanery/LETB.
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Further guidance, including how to apply to undertake a SPIN Module, can be found on the
SPIN Module pages of the RCPCH website.
ProgressionBy the end of the module trainees would be expected to have an understanding of the
structure of neonatal care, the difference between level 1, 2 and 3 neonatal units and the
levels of care required by different neonates. Trainees should be able to assess the severity
of illness and be aware of complications which may develop requiring the level of care a
neonate is receiving to be increased.
Following completion of Level 3 training and the SPIN module, the CCT holder should be
competent to take up a post as a General Paediatrician or a General Paediatrician with a
Special Expertise in this area. It is expected that there will be a requirement in paediatric
services for consultants with special expertise provided by the module. Such posts will
usually form part of a Regional Specialty Network including working with accredited sub-
specialties in this area.
It is recommended but not mandatory that trainees aim to become Neonatal Life Support
(NLS) or equivalent trainers during the 12 month module, and would aim to maintain trainer
status throughout their careers in order to teach NLS skills to junior trainees within their
trusts.
AssessmentThis framework of competences outlines the learning objectives for the SPIN Modules, and
these are the focus of your training. The RCPCH College Specialty Advisory Committee
(CSAC) will want to assess how well you have achieved these objectives and to be confident
that you are fit to practice as a Consultant Paediatrician with expertise in Neonatology.
The RCPCH Assessment Strategy (GMC approved) for Level 3 Training will be used.
Trainees working with their educational supervisors should ensure that the Assessment
Strategy is tailored to cover the area of Special Expertise as well as General Paediatrics and
that learning and assessment are well documented within the e-portfolio. Section 4 of this
document outlines in greater detail the assessment requirements for the SPIN Module,
including suggestions of appropriate evidence for all mandatory competences. Evidence
should be recorded within your e-portfolio.
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Recommended reading Rennie and Roberton, Textbook of Neonatology, Churchill Livingstone (2012)
BAPM website (and membership is strongly recommended)
RCPCH Curriculum for Paediatric Training Neonatal Medicine Level 1, 2 and 3
Training
Tracy Gomella, Neonatology (7th edition), Lange publications (2013)
MacDonald and Seisha (Editors), Avery's Neonatology: Pathophysiology and
Management of the Newborn (7th edition), LWW (2015)
Suggested coursesThere are no mandatory courses in this module, although the trainee should be an NLS
provider and may wish to consider the ARNI (Advanced Resuscitation of the Newborn Infant)
course. There is a collaborative distance learning course run in conjunction with the
University of Southampton and the European Society for Neonatology – specific modules
may be taken although fees apply (http://www.neonataltraining.eu/programme.html).
Trainees may wish to consider courses specific to neonatal medicine, including cranial
ultrasound and cardiac echo courses. Training in neonatal neurology (including MRI
interpretation eg NeoNATE course), difficult airway management, transport stabilisation and
ethical issues could also be considered.
Equality and DiversityThe RCPCH has a duty under the Equality Act 2010 to ensure that its curriculum and
assessments do not discriminate on the grounds of age, disability, gender reassignment,
marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex or
sexual orientation.
Care has been taken when authoring the SPIN Module curricula to ensure as far as is
reasonable and practicable that the requirements for those undertaking the module do not
unnecessarily discriminate against any person on the basis of these characteristics, in line
with the requirements of the Act.
Please contact the RCPCH Quality and Standards Manager if you have any concerns
regarding to equality and diversity in relation to this SPIN Module curriculum.
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Section 2 General Competences in Neonatal Paediatrics All of the following general neonatal competencies should be demonstrated either in
previous posts or by undertaking appropriate work based assessments before application for
CCT. Some of these could also be achieved during the SPIN module in addition to the
mandatory competencies listed in section 3.
Knowledge and UnderstandingBy the end of the module in Neonatal Paediatrics, you will:
know and understand the respiratory, cardiovascular and other physiological
changes after birth
know and understand the development of organ systems for gestational age and
their impact on post-natal adaption
understand the physiology of advanced resuscitation and the response to it
be involved in local, regional and national neonatal data collections
understand about population statistics and know how they might be used in service
development
know and understand how fetal growth and development are assessed
know and understand the impact of major diseases of pregnancy on the fetus
know and understand how fetal anomaly is detected
know where to access up to date information and how to keep neonatal skills and
knowledge up to date.
SkillsBy the end of the module in Neonatal Paediatrics, you will:
be able to carry out practical procedures (insertion of peripheral and central venous
catheters, peripheral and umbilical arterial catheters, chest drains, lumbar puncture)
be able to perform Cranial US to rule out major pathology
be able to perform tracheal intubation and utilise techniques of assisted ventilation for
infants born at all viable gestations
be able to resuscitate very preterm infants, infants with complex congenital
abnormalities and infants with fetal compromise, at risk of developing hypoxic
ischaemic encephalopathy
be able to rapidly diagnose and treat common neonatal disorders using a variety of
diagnostic skills
be able to provide vascular access for short term and long term fluid and nutrition
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support.
Leadership and ManagementBy the end of the module in Neonatal Paediatrics, you will:
have a working knowledge of risk assessment and its application to personal,
professional, clinical and an organisation’s practice
understand and take account in your practice of measures to reduce clinical risk
know the legal and ethical guidelines to support your work and where to find more
information when required
have an awareness of non-clinical managerial skills important to effective running
and change in a paediatric department e.g. resource management, direction setting.
Teaching and Research By the end of the module in Neonatal Paediatrics, you will:
be able to teach basic neonatal life support to health care professionals
demonstrate a range of effective teaching and learning skills in a range of clinical
contexts
understand the difference between population assessments and unit-based studies
and be able to evaluate outcomes for both
be involved in the training, supervision and assessment of medical students and
trainees and other professionals
be able to identify learning needs in a wide range of professionals and build on this in
your teaching
attend the teaching program and sessions for higher specialist neonatal trainees
(neonatal grid trainees)
have knowledge of portfolio research on the unit and its impact, and be able to recruit
patients to clinical trials.
Communication Skills By the end of the module in Neonatal Paediatrics, you will:
be able to counsel parents antenatally and postnatally about serious conditions and
abnormalities and attend antenatal counselling sessions
be aware of diagnosis and counselling, particularly associated with neurological and
respiratory conditions, and have an understanding of other neuro-cognitive outcomes
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be able to appropriately counsel parents and relatives when there is diagnostic and
prognostic uncertainty
be able to communicate effectively with a wide range of professionals such as tertiary
neonatologists, paediatric subspecialists, obstetricians, general paediatricians,
midwives, health visitors and social workers and neonatal transport teams.
Governance and quality improvementBy the end of the module in Neonatal Paediatrics, you will:
understand local and national death notification and congenital anomaly monitoring
procedures
be aware of processes for dealing with and learning from clinical errors and to be
able to work with them
be able to appropriately manage and respond to complaints
be able to develop and implement clinical guidelines, policies and protocols,
understand how they are produced nationally and how these should be used to guide
own practice
participate in and take responsibility for clinical governance activities and encourage
and support colleagues in their participation
be able to contribute to the implementation of national and local health policy
initiatives
be involved in a local quality improvement initiative or project
perform a specific neonatal audits
write or update departmental or regional clinical guidelines
perform and present root cause analysis.
Values and attitudesBy the end of the module in Neonatal Paediatrics, you will:
provide sensitive and compassionate care appreciating the stresses placed on
families following an admission to neonatal care, in full collaboration with them
act in the best interests of the neonate but also support families dealing with difficult
decisions especially in relation to complex long term health needs or end of life
decisions
be able to work well in multi-professional teams both within the main centre and also
within the operational network and beyond.
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Section 3 Specific Competencies in Neonatal Paediatrics
Practical Procedures and Investigations
The following is a list of the mandatory specific competences for which it is critical that evidence must be provided. Trainees will record
evidence within their eportfolio, but may find this checklist helpful to ensure all key areas have been addressed prior to submitting evidence to
the Neonatology CSAC.
By the end of the module in Neonatal Paediatrics, you will:
Suggested evidence types
WBACourse/Conference
Audit, evaluation or QI project Reflection Other
Management of complex congenital abnormalitiesKnow and understand…which conditions need referral to other specialists diagnostic and prognostic issues for major congenital problems including diaphragmatic hernia, major CNS malformation, pulmonary hypoplasia
appropriate genetic investigations. Be able to…counsel parents about serious conditions antenatally Fetal medicine letterobtain consent for genetic testing discuss implications of antenatal or postnatal diagnosis of Trisomy 21.
TransportKnow and understand…
By the end of the module in Neonatal Paediatrics, you will:
Suggested evidence types
WBACourse/Conference
Audit, evaluation or QI project Reflection Other
indications for transport between different units within a network
Review of inappropriate network referrals
the requirements for safe transport including venous access, appropriate sedation and analgesia and the need for other drugs in case of emergency during transit.
Be able to…communicate effectively and be involved in a conference call for a neonatal transfer
maintain safe care until the transport team take over care of neonate participate in at least one acute neonatal transport.
Airway managementKnow and understand…the physiology of advanced resuscitation and the adaptive response to it
NLS or ARNI course
the effects a difficult or failed resuscitation has on other team members.
ARNI course
Be able to…lead a neonatal team in a difficult situation (including extreme prematurity, severe fetal depression and failed resuscitation)
lead a debriefing session following a difficult resuscitation manage an infant with a complicated air leak syndrome, requiring more than one chest drain.
Surgical problemsKnow and understand…
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By the end of the module in Neonatal Paediatrics, you will:
Suggested evidence types
WBACourse/Conference
Audit, evaluation or QI project Reflection Other
common surgical problems in the term infant including abdominal distension and bile stained vomiting
Review of local practices and referral rates
indications for referral for venous access surgery pain management including the management of pre and post-operative pain
indications for GI contrast study risk factors, diagnosis and management of a neonate with suspected NEC.
Be able to…manage neonate acutely unwell with NEC, role of cardiac and respiratory support and indications for urgent surgical review and intervention
manage significant gastro-oesophageal reflux Audit NICE reflux guideline
manage post natal growth failure (indications for parenteral nutrition and specialist milks) and make appropriate referrals for specialist input.
Chronic lung diseaseKnow and understand…indications and complications of post natal steroids including different therapeutic regimes
predictors of long term respiratory outcome including prognostic factors
indications for RSV and other immunoprophylaxis. Review DoH indications each new
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By the end of the module in Neonatal Paediatrics, you will:
Suggested evidence types
WBACourse/Conference
Audit, evaluation or QI project Reflection Other
seasonBe able to…plan and discharge management of infants going home in oxygen interpret overnight pulse oximetry monitoring.
Cardiac problemsKnow and understand…pathophysiology and management of acute massive pulmonary haemorrhage
diagnosis and treatment options of early and late persistent ductus arteriosus.
Be able to…diagnose and provide initial management for infant with primary or secondary (such as MAS) pulmonary hypertension
provide early resuscitation and management for infants with duct dependent cardiac conditions.
Neurological problemsKnow and understand…acute and long term implications or periventricular haemorrhage and be able to communicate these effectively with parent
Cranial ultrasonography course
pathophysiology, causes and diagnosis of perinatal hypoxic ischaemic brain injury
indications for therapeutic total body hypothermia diagnosis management and investigations for the floppy infant Neonatal neurology
course
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By the end of the module in Neonatal Paediatrics, you will:
Suggested evidence types
WBACourse/Conference
Audit, evaluation or QI project Reflection Other
Be able to…perform a cranial ultrasound for an infant with suspected haemorrhage
perform a structured neurological assessment of a neonate Neonatal neurology course
site electrodes and interpret cerebral function monitoring for an infant undergoing total body hypothermia
stabilise and manage multi-organ failure in neonate with HIE.
End of life careKnow and understand…process behind planning perinatal or neonatal palliative care process behind local child death overview panel. Attend local panel
meetingBe able to…attend or conduct a bereavement follow up appointment Copy of letterseek consent for a post mortem and if necessary communicate with the coroner’s office if a referral is indicated
write a death certificate and cremation certificate, liaising with colleagues to complete other sections (if required)
attend a post mortem. Record of attendance
Follow upKnow and understand…multidisciplinary discharge planning for neonates with complex needs indications for formal developmental screening and assessment such as Bailey, SGS.
Attend specialist course
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By the end of the module in Neonatal Paediatrics, you will:
Suggested evidence types
WBACourse/Conference
Audit, evaluation or QI project Reflection Other
Be able to…recognise infants and high risk of neurodevelopmental problems and to make appropriate referrals
perform appropriate follow up for low medium and high risk infants to an appropriate age.
Clinic letter
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Section 4 Assessment Strategy for Neonatal Paediatrics
Assessment GuidancePaediatric trainees undertaking a SPIN Module are expected to follow the Level 3 training
assessment strategy, as outlined below. Trainees are advised to check the RCPCH website
for further information on how to carry out these assessments and what is expected from
those involved in the process. Non-trainees undertaking a SPIN Module must demonstrate
evidence against all competences, but are not bound by the trainee assessment strategy.
However, some of the assessments below e.g. multi-source feedback, may still be
accessible and relevant.
Within the current work based assessment requirements for Level 3 training, paediatric
trainees undertaking the special interest module of assessment are recommended to
undertake at least the following number of assessments specifically related to Neonatal
Paediatrics:
Assessment type Example FrequencyPaediatric Case Based Discussion (ePaedCbD):
discharge planning for an infant with CLD
8 per year
Paediatric Mini Clinical Evaluation Exercise (ePaedMiniCeX)
Counselling for major fetal anomaly
4 per year
Directly Observed Procedure Skills (DOPS)
Cranial ultrasonography 1 per relevant procedure
Direct observation of communication (DOC)
Referral letter or discharge letter 3 per year
Multi-Source Feedback (ePaedMSF)
1 per year
In addition at least one of the SLE tools using the HAT (Handover Assessment Tool),
LEADER (e.g. multidisciplinary discharge planning for neonate with complex needs) and
ACAT (Acute Care Assessment Tool e.g. be able to lead a team in difficult resuscitation
situations) should be undertaken a minimum of once during the attachment.
The majority of ‘Knows and understands’ would be suited to ePaedCbD, reflection or
evidence of teaching presentation. The majority of ‘Is able to’ would be suited to
ePaedMiniCex, DOPS or Acute Care Assessment Tool (ACAT).
ePaedMSF should occur as part of appraisal/revalidation process and include feedback from
at least 12 health professionals (consultants, seniors, peers, junior doctors, nurses, allied
health professionals) including from a neonatologist and/or a Paediatrician with a special
interest in Neonatology, as well as from other consultant paediatricians to provide feedback
on work performance.
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Appendix 1: Paediatrics Standards Checklist
Speciality: Special Interest Module in Neonatal PaediatricsThese standards were designed to assist in the assessment of the paediatric training
standards in your deanery.
The Programme (which may consist of several posts) should provide:
1. Supervision ✓/✗1.1 A clinical supervisor who is a Consultant Neonatologist in a level 3 Neonatal Unit, which is an approved training centre for Higher Specialist Training in Neonatology. All supervisors should be trained in assessment and appraisal
1.2 Evidence that the assessment strategy is being delivered
1.3 Trainers receive appropriate training on the delivery of the assessment strategy
1.4 There is appropriate supervision to ensure patient safety
2. Other Personnel ✓/✗
2.1 Sufficient numbers of Neonatology Consultants to support and supervise. An example of support and supervision is discussion of all cases at the end of each clinic
2.2 At least 8 trainees at ST4-8 providing separate (from other children’s services) 24 hours cover to the neonatal service. A minimum of 2 ST4-8 to be available during the daytime
2.3 Access to the full multi-disciplinary team for training e.g. for developmental care and neurodevelopment
3. Service requirements and facilities ✓/✗
3.1 Specialty specific requirements of subspecialty department:Level 3 neonatal unit approved as a higher specialist training centre
3.2 Specialty specific requirements of related clinical departments that are involved in delivery of the curriculum:Access to tertiary level fetal medicine, access to neonatal surgery, access to neurodevelopmental follow up, neonatal cardiology and clinical genetics during training period. Not all of these sub-specialities need to be provided on a single site or centre
3.3 Specialty specific requirements of service departments relevant to delivery of curriculum (e.g. investigation departments, PAMs departments, surgery or anaesthesia):Paediatric radiology, pathology laboratories able to deal with neonatal conditions,
social services, chaplaincy and pharmacy
3.4 Specialty specific requirements of clinical networks:Functioning perinatal network
4. Educational activities and training ✓/✗
4.1 Specialty specific clinical exposure required to provide sufficient learning opportunities:The programme (which may be more than one unit) must be able to provide exposure to all of the elements of the curriculum and to provide sufficient clinical experience:
Deliveries – at least 3,00 per year<27 week gestation admissions – at least 20 per yearVentilation/Intensive care days – at least 1500 per year
4.2 Specialty specific requirements for structured training opportunities to include courses:This should include
formal time allocated for fetal medicine and where necessary for neonatal surgery (in those units where neonatal surgical patients are managed separately)
safeguarding training to meet standards for HST in paediatrics.
The trainee should be an NLS provider.
Other courses trainees may wish to consider include: ARNI (Advanced Resuscitation of the Newborn Infant) a collaborative distance learning course run in conjunction with the University
of Southampton and the European Society for Neonatology – specific modules may be taken although fees apply (http://www.neonataltraining.eu/programme.html )
courses specific to neonatal medicine, including cranial ultrasound and cardiac echo courses
training in neonatal neurology (including MRI interpretation eg NeoNATE course), difficult airway management, transport stabilisation and ethical issues
4.3 Specialty specific requirements for other experiential learning(excluding clinics and ward rounds):
Perinatal meetingsGovernance/ risk management meetingsManagement and network meetings and activities
5. Working patterns ✓/✗
5.1 Safe cover arrangements for paediatric department out of hours in line with RCPCH guidance
5.2 Evidence of compliance with existing employment rules to working time
5.3 Working intensity and pattern that is appropriate for learning
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5.4 Access to sub-specialty training time which allows achievement of the competences throughout the programme
5.5 This post forms part of a complete paediatric training programme which provides a minimum of five years of acute clinical experience, including out of hours
6. Specific Post requirements ✓/✗
6.1 No cross cover with general paediatric service. Single site cover. Consultant immediately available for advice at all times
7. Access to clinics and ward rounds and long term care of patients ✓/✗
7.1 Specialty specific numbers and types of clinics expected to attend (including outreach clinics):Neonatal follow up – 12 clinics per year (to include neurodevelopmental follow up, infant feeding and chronic lung disease management)
7.2 Specialty specific combined clinics expected to attend:No specific requirements but optional clinics would include cardiology, renal, surgical follow up
7.3 Specialty specific ward rounds consultant led and independent per week:Attend daily consultant led ward rounds and lead at least one independent ward round per week (depending on rota and service pattern)
7.4 Specialty specific involvement in transitional care:Supervision and care of babies on postnatal ward and transitional care
8. Meetings ✓/✗
8.1 Specialty specific number and types of MDT meetings expected to be exposed to:
Fetal medicine and high risk obstetric – 12 per yearPerinatal morbidity and neonatal mortality – 12 per yearSafeguarding – 2 per yearX ray meetings – 12 per yearNetwork meetings – 2 per yearManagement (including consultant meetings) – 2 per year
8.2 Specialty specific other meetings:Neonatal unit teaching
9. Clinical audit ✓/✗
9.1 Evidence of trainees participation in clinical governance (eg at least one full audit per year, root cause analysis or a QI project or attendance at critical incident meetings)
10. Teaching, appraising and assessing ✓/✗
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10.1 Opportunities for formal and informal teaching
10.2 Opportunities for involvement of assessment of others
10.3 Opportunity to be involved in the appraisal of others
12. Research ✓/✗
12.1 Participation in unit specific research including recruiting patients to studies
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If you require further information regarding RCPCH SPIN Modules please see the SPIN
pages of the RCPCH website (www.RCPCH.ac.uk), or e-mail [email protected]
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