2021 Curriculum learning syllabus: stage 2

Published: 09/02/2021

Perioperative Medicine and Health Promotion

Stage learning outcome

  • Works with patients to reduce the risks associated with surgery

Key capabilities A to H

A

Delivers high quality, individualised perioperative care to ASA 1-4 patients for elective surgery and ASA 1-3 emergency patients, focusing on optimising patient experience and outcome

B

Liaises appropriately with other healthcare professionals to optimise patient care

C

Explains the principles of shared decision making

D

Makes appropriate plans to mitigate co-morbidities and their treatment in the perioperative period, with particular reference to less common cardiovascular, neurological, respiratory, endocrine, haematological and rheumatological diseases

E

Appreciates how integrated care pathways influence patient outcomes

F

Describes the use and limitations of common risk-scoring systems

G

Recognises when advanced physiological testing is indicated, interpreting the data to help stratify risk
H Applies basic sciences to perioperative care

Examples of evidence

  • SLEs throughout stage of training across range of surgical specialties including emergency surgery, obstetrics, paediatrics, neuro, cardiac and experience in pre-operative assessment clinics.
Personal activities and reflections:
  • attendance at pre-operative assessment clinics
  • knowledge of NICE guidance on shared decision making
  • awareness of integrated care pathways in the devolved nations
  • e-Learning or teaching sessions on risk scoring, cardiopulmonary exercise testing
  • Final FRCA.

Suggested supervision level

  • 3 - supervisor on call from home for queries able to provide directions via phone or non-immediate attendance.

Cross links with other domains and capabilities

  • Management and Professional and Regulatory Requirements
  • General Anaesthesia

Key capabilities I to K

I

Applies the principles of public health interventions such as smoking cessation, reducing obesity and alcohol intake

J

Recognises the potential harms of healthcare interventions

K

Explains how religious, cultural, and lifestyle factors may influence healthcare choices, such as blood transfusions, implants and use of animal derived products

Examples of evidence

  • SLEs throughout stage of training across range of surgical specialties and experience in pre-operative assessment clinics.
Personal activities and reflections:
  • involvement with health promotion interventions with patients in pre-operative assessment clinics such as smoking cessation, prehabilitation
  • knowledge of guidance of use of blood and blood products in Jehovah’s Witnesses.

Suggested supervision level

  • 2b - supervisor within hospital for queries, able to provide prompt direction/assistance.

Cross links with other domains and capabilities

  • General Anaesthesia

Key capability L

L

Describes the needs and roles of carers and those providing support in the perioperative period and applies this to practice

Examples of evidence

  • SLEs throughout stage of training across range of surgical specialties and experience in pre-operative assessment clinics.

Suggested supervision level

  • not applicable.

Cross links with other domains and capabilities

  • Safeguarding
  • General Anaesthesia

Key capabilities M & N

M

Describes the requirement for postoperative organ support and its limitations

N

Applies end of life care as part of a multidisciplinary team

Examples of evidence

  • SLEs throughout stage of training across range of surgical specialties including emergency surgery, neuro, cardiac and experience in intensive care and pre-operative assessment clinics.
Personal activities and reflections:
  • discussion with relatives of patients on Intensive Care.

Suggested supervision level

  • 3 - supervisor on call from home for queries able to provide directions via phone or non-immediate attendance.

Cross links with other domains and capabilities

  • Team Working
  • Intensive Care

Key capabilities O to Q

O

Explains and acts on the importance of perioperative management of haematological conditions including anaemia and coagulopathy

P

Recognises the factors associated with abnormal perioperative nutritional status and applies strategies to mitigate risks where appropriate

Q

Applies adjustments required that co-existing disease and surgical complexity have on the conduct of anaesthesia and perioperative care, including frailty, cognitive impairment and the impact of substance abuse or obesity

Examples of evidence

  • SLEs throughout stage of training across range of surgical specialties including emergency surgery, obstetrics, paediatrics, neuro, cardiac and experience in pre-operative assessment clinics
  • demonstration of application of adjustments for patient groups described above.
Personal activities and reflections:
  • knowledge of local and national guidance on management of anaemia perioperatively.

Suggested supervision level

  • 2b - supervisor within hospital for queries, able to provide prompt direction/assistance.

Cross links with other domains and capabilities

  • General Anaesthesia

Paediatric anaesthesia: key capability R

R

Demonstrates adjustments in perioperative care for children with co-morbidity

Examples of evidence

  • SLEs throughout stage of training across range of surgical specialties including emergency surgery.

Suggested supervision level

ASA 1-3 children aged 1-5:

  • 2a - supervisor in theatre suite, available to guide aspects of activity through monitoring at regular intervals

ASA 1-3 children aged 5 and over:

  • 2b - supervisor within hospital for queries, able to provide prompt direction/assistance.

Cross links with other domains and capabilities

  • General Anaesthesia

Obstetric anaesthesia: key capabilities S & T

S

Plans appropriate obstetric anaesthetic care for all parturients collaboratively with the wider multi-disciplinary team

T

Recognises and manages critical illness in parturients, including immediate resuscitation, and leads the care of acute obstetric emergencies

Examples of evidence

  • SLEs throughout stage of training in obstetrics including out of hours work and experience in pre-operative assessment clinics.
Personal activities and reflections:
  • attendance at obstetric anaesthesia clinics.

Suggested supervision level

  • 3 - supervisor on call from home for queries able to provide directions via phone or non-immediate attendance.

Cross links with other domains and capabilities

  • General Anaesthesia
  • Regional Anaesthesia
  • Resuscitation and Transfer
  • Intensive Care