Assessment in the 3 complex Paediatric Major or Acute Presentations Covered by Mini-CEX or CbD name date name date name date Ultrasound for ST5 Emergency Medical Ultrasound (EMUS) level 1 Continue to complete US log book, case studies and triggered assessments for each module name A: AAA date name B: FAST date name C: Vascular Access date name D: Echo in life support date name E: Level 1 sign off - if completed date Overview by end of ST5 date Structured Training Report MSF minimum of 12 responses (annual) date – with spread of participants as agreed with Educational Supervisor Exams achieved Progress in relevant post graduate examinations: Progress towards Quality Improvement Project (QIP) or CTR YES / NO (please circle) (Advanced stage of completion) YES / NO (please circle) Progress towards completion of Management Portfolio project(s) Progress toward achieving level 4 common competences, YES / NO (please circle) confirmed by supervisor and trainee (red and blue man symbols) Number of regional training days attended upload certificates to number – eportfolio date ALS or equivalent (current provider) upload certificate to eportfolio – ATLS or equivalent (current provider) upload certificate to date – eportfolio APLS or equivalent (current provider) - upload certificate to date eportfolio date Safeguarding children 3 upload certificate to eportfolio – YES / NO (please circle) Survey monkey feedback completed for each placement YES / NO (please circle) ARCP outcome 1 or equivalent for CT/ST4 YES / NO (please circle) Faculty Education Statement supports training progression Trainee signature: Date: Education Supervisor signature: Date: Education Supervisor name PLEASE PRINT
Assessment in the 3 complex Paediatric Major or Acute Presentations Covered by Mini-CEX or CbD date name date name date name Ultrasound for ST5 Emergency Medical Ultrasound (EMUS) level 1 Continue to complete US log book, case studies and triggered assessments for each module A: AAA date name B: FAST date name C: Vascular Access date name D: Echo in life support date name E: Level 1 sign off - if completed date name Overview by end of ST5 Structured Training Report date MSF – minimum of 12 responses (annual) with spread of participants as agreed with Educational Supervisor date Progress in relevant post graduate examinations: Exams achieved Progress towards Quality Improvement Project (QIP) or CTR (Advanced stage of completion) YES / NO (please circle) Progress towards completion of Management Portfolio project(s) YES / NO (please circle) Progress toward achieving level 4 common competences, confirmed by supervisor and trainee (red and blue man symbols) YES / NO (please circle) Number of regional training days attended – upload certificates to eportfolio number ALS or equivalent (current provider) – upload certificate to eportfolio date ATLS or equivalent (current provider) – upload certificate to eportfolio date APLS or equivalent (current provider) - upload certificate to eportfolio date Safeguarding children 3 – upload certificate to eportfolio date Survey monkey feedback completed for each placement YES / NO (please circle) ARCP outcome 1 or equivalent for CT/ST4 YES / NO (please circle) Faculty Education Statement supports training progression YES / NO (please circle) Trainee signature: Date: Education Supervisor signature: Date: Education Supervisor name PLEASE PRINT
arcp_checklist_st5_aug_2015_v2_1.docx