Guidance on the implementation of the 2016 changes to the Cardiology curriculum

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Guidance on the implementation of the 2016 changes to the Cardiology 2016 changes to the 2010 Cardiology were approved by the GMC on 6 September 2016. In summary these changes are: Requirement for level 3 competence of implantation of temporary cardiac pacemaker moved from ST5 to end of ST7 Core training in echocardiography has been strengthened, including introduction of a free-of-charge elearning module in the first year of specialty training and an enhanced based for basic echo training. Temporary pacing The extension to time allowed for temporary pacing will apply from 1 November 2016. Trainees who have not yet achieved level 3 competence will have until the end of ST7 to meet this and this is reflected in the updated ARCP decision aid. Echocardiography elearning package The elearning package is accessible via the British Society of Echocardiography website (www.bsecho.org). Satisfactory completion will automatically generate a certificate that can be downloaded and saved in the eportfolio personal library. The elearning package will be recommended to all trainees from October 2016 and the SAC will seek feedback via both the BSE training committee and the British Junior Cardiologists Association over the following 12 months, modifying any areas of clinical uncertainty. All trainees starting from August 2016 will be expected to have completed the elearning module by the end of core cardiology training (2019). By 2018, all new entrants to cardiology training programme to be able to complete this module within their first 12 months (ST3). Echocardiography The updated Echocardiography Curriculum Delivery Tool replaces the previous version and all trainees should use this tool from October 2016 onwards. Trainees in ST4 and ST5 will be asked to complete the for five video cases in their ST5 year and reference their existing log books to the syllabus as set out in this tool. Trainees who have commenced advanced subspecialty training by August 2016, who should have already demonstrated competency in echocardiography, will not be expected to complete the tool retrospectively. The implementation plan will ensure all trainees currently undertaking core training will have fulfilled the s of the revised within two years of implementation. A local lead responsible for echocardiography training has been identified in each deanery/letb to coordinate and oversee training. To assist with this implementation plan the BSE are organising a training day, with help from the SAC, in early 2017 to discuss the revised and clarify standards expected of trainees. The 2010 with 2016 amendments, updated ARCP decision aid and Echocardiography Curriculum Delivery Tool are available on the JRCPTB specialty webpage.

Eportfolio guidance The Echocardiography section of the on the eportfolio has been updated with the 2016 amendments. There will not be a separate so trainees can maintain the linked evidence on the 2010. Trainees should discuss the revised s and the guidance with their educational supervisor. Cardiology modification 2016 mapping of changes The table below lists the 2016 amendments to the 2010 Cardiology. Please note, only the relevant content of each section is shown to demonstrate the changes. Page 2010 (amendments 2015) 2010 (amendments 2016) Description of change 21 Examinations and Certificates Examinations and Certificates Added content: Advanced Life Support Certificate (ALS) IRMER The Examination or KBA in Cardiovascular medicine The BSE elearning Module BSE accreditation in core echocardiography BSE elearning module to list with description The BSE elearning module complements experiential learning early in training and completion by end of ST3 is expected. Designed to be formative rather than summative, trainees can resit this module as often as they wish during this year. A certificate of satisfactory completion should be up-loaded on to eportfolio. BSE accreditation in adult transthoracic echocardiography can be used in place of DOPS assessments. Details of the processes required for BSE accreditation are available at www.bsecho.org. 24-26 Assessment during ST3 (Core Training) Assessment during ST3 (Core Training) Additional content: Echo

DOPS Echocardiography - a minimum of 2 by at least 2 different assessors (from 2 lists). The Echocardiography Curriculum Delivery Tool will be used to ensure appropriate coverage of syllabus Assessment During ST4 (Core training) DOPS Echocardiography - a minimum of 2 by at least 2 different assessors (from 2 lists). The Echocardiography Curriculum Delivery Tool will be used to ensure continued appropriate coverage of syllabus to record coverage of syllabus and to reflect the change in for temporary pacing Assessment during ST5 (Core training) DOPS Echocardiography - a minimum of 6 summative DOPs by at least 2 different assessors (from 3 lists). In addition, the Curriculum Delivery Tool, including 5 video cases demonstrating different pathology, must be completed and certified by either STC lead for echo training or by the Educational Supervisor. The alternative to the above is to achieve BSE accreditation. Pericardiocentesis, Temporary Pacing and Cardioversion trainees should be Level 3 competent in Cardioversion by the end of ST5 (6 DOPS with a minimum of 2 different assessors indicates reliability). Try to complete a DOPS assessment each time you do a pericardiocentesis or Temporary Pacing, again recording them as a formative assessment, but asking the trainer to indicate the level of competence. 27-36 Guideline for the Use of WPBA during Specialist area Cardiovascular Medicine Training Pericardiocentesis try to complete a DOPS assessment each time you do this procedure and Level 3 competence is expected at the end of ST7 Guideline for the Use of WPBA during Specialist area Cardiovascular Medicine Training Pericardiocentesis and Temporary Pacing try to complete a DOPS assessment each time you do these procedures and Level 3 competence is expected at the end of ST7 To reflect the change in for temporary pacing

42 Core Procedures and Investigations requiring DOPs assessment Core Procedures and Investigations requiring DOPs assessment Table updated to show (a) Level 3 for temporary pacing not required until ST7 and (b) Level 3 and completed Curriculum Delivery Tool or BSE accreditation specified for Transthoracic Echocardiography for ST5-ST7 and change to pacing 116-7 Echocardiography (Core) Echocardiography (Core) BSE elearning module and delivery tool added as possible assessment method to syllabus table Added description: For training in echocardiography at each hospital, you must have a supervisor who should be a senior and experienced echocardiographer, ideally BSE accredited. There should also be a named consultant lead for echocardiography training at that site. Where that is not possible, training will be overseen by the echo lead from your local Specialty Training Committee. In order to acquire basic training you will need focused bleep free training sessions, typically a minimum of 12 lists per year. The theory component will be largely self-taught with self directed and distance learning (journal, textbook & internet sources). The BSE elearning Module will complement this and should be completed early in training. Completion and certification is expected by end of ST3. The necessary skills, attitudes and expertise will come from a mixture of experiential learning (on-the-job experience, i.e. regular scheduled scanning sessions in work plans), formal training at study days, including simulation training, and/or postgraduate courses. BSE elearning module and added as possible assessment methods for Echocardiography in syllabus table as indicated Requirements for echo placement updated Assessment will be based upon the following: (i) completion of the BSE elearning module; (ii) completion of the Echocardiography Curriculum Delivery Tool (available at JRCPTB web-site www.jrcptb.org.uk/specialty/pages/cardiology), which will demonstrate appropriate coverage of

1 November 2016 syllabus and (iii) a log-book of cases. For guidance, 250 cases should be collected in a period of 24 months to qualify for BSE adult accreditation; (iv) trainees will undertake DOPS (on lists of cases) during core cardiology training; (v) BSE Accreditation in adult echocardiography is regarded as equivalent to completion of core training in echocardiography