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PORTFOLIO OF LEARNING OF THE COLLEGE OF ANAESTHETISTS – FCA(SA) December 2010 1

CMSA

PORTFOLIO OF LEARNING

Fellowship in Anaesthetics – FCA(SA)

of

The College of Anaesthetists of South Africa

Registrar Name: ………………………………………………………………………………….


ACKNOWLEDGEMENTS This document represents a composite from many sources. We would like to acknowledge the Australian and New Zealand College of Anaesthetists (ANZCA) for their kind permission to use aspects of their Learning Portfolio from June 2006. We also acknowledge Dr WGJ Kloeck for the original document on which the CMSA Portfolio of Learning is based. We further acknowledge the Royal College of Anaesthetists for use of their electronic logbook. NOTE From January 2011 only electronic versions of this document will be accepted. COMPILED BY Dr Dean Gopalan Prof Arthur Rantloane Prof Christina Lundgren For, and on behalf of, The College of Anaesthetists


PORTFOLIO OF LEARNING

CONTENTS SECTION 1 Purpose of the PORTFOLIO OF LEARNING SECTION 2 Trainee Details SECTION 3 Record of Modules (including Logbook)

MODULE 1: Introduction to Anaesthesia and Pain MODULE 2: Professional Attributes MODULE 3: Anaesthesia for Trauma and Orthopaedic Surgery MODULE 4: Obstetric and Gynaecological Anaesthesia MODULE 5: Anaesthesia for Cardiothoracic Surgery MODULE 6: Anaesthesia for Vascular Surgery MODULE 7: Neuroanaesthesia MODULE 8: Anaesthesia for General, Urologic and Plastic Surgery MODULE 9: Anaesthesia for ENT, Eye, Dental, Maxillofacial and Head and Neck Surgery MODULE 10: Paediatric Anaesthesia MODULE 11: Pain Management, Regional Anaesthesia and Sedation MODULE 12: Critical Care MODULE 13: Professional Practice

SECTION 4 Relevant Electronic Links SECTION 5 Attendance at Meetings SECTION 6 Presentations SECTION 7 Research and Publications SECTION 8 Other Activities

Teaching Activities Professional Activities Community / Outreach Activities Critical Incident Record

SECTION 9 Assessments SECTION 10 Declarations of completion of training periods


SECTION 1

The objective of the College of Anaesthetists Registrar training programme is to produce specialist anaesthesiologists with the following attributes to provide safe and quality care to their patients:

• Medical expert • Communicator • Collaborator • Manager • Health advocate • Scholar and teacher • Professional

To achieve these various objectives a detailed and intensive training programme is necessary for registrars. Such a programme has to focus on the development of each of these attributes to produce the appropriate specialist. Maintenance of a detailed Portfolio of Learning assists the Trainee and Supervisors in meeting these objectives. INTRODUCTION What is a Portfolio of Learning? A personal Portfolio of Learning is a detailed inventory maintained by the Trainee. It is used for recording and reflecting on processes and key events during the whole registrar training period. As well as acting as a summary of training, the Learning Portfolio assists in planning learning and will help you to gain the most from your training. The Learning Portfolio can:

• Help you to track your progress by recording Modules completed, clinical experience gained, special cases undertaken, skills learned, and assessments completed.

• Assist you to establish learning plans (and revise them when necessary), time management schedules, and to develop patterns of reflective learning.

• Serve to remind you of the objectives of training and the attributes of a specialist anaesthetist which are to be achieved.

• Promote self-directed learning. The purpose of a Learning Portfolio is to help you and your Supervisors plan and implement training and develop critical and reflective learning and practice. It is based on the “CRITICAL” concept (Certified Record of In-service Training Including Continuous Assessment and Learning). Using the Learning Portfolio Effective self-directed learning depends on self-planning and self-reflection. The Portfolio of Learning is designed to support both of these aspects of learning in the following ways.

• It assists you in planning and recording learning. • It helps you to value your learning experience through review, reflection and assessment

of your training and experiences. • It provides a starting point for discussion of your training with Supervisors. • It can be used as a quality assurance tool to help you to continually improve your learning

and performance. The Learning Portfolio has numerous sections where you can record information about your training. Each of these needs to be completed.

SECTION 1 … PURPOSE OF THE PORTFOLIO OF LEARNING


Additional copies of all forms included in the Portfolio of Learning can be downloaded and printed from the College website (www.collegemedsa.ac.za). These should be inserted into your Portfolio. Reviewing the Portfolio of Learning Reviewing the Portfolio of Learning is an important educational and development process. You should continually review the contents of your Portfolio of Learning and, at intervals, also review the Portfolio with your Supervisor of Training, Module Supervisor, and any support person. Reviewing your Portfolio of Learning will:

• Provide you with feedback so that you can learn from mistakes and build on achievements • Motivate you and enhance your sense of achievement • Enable you to remedy deficiencies in acquiring knowledge, clinical skills and attitudes • Consolidate your learning capability • Help you apply abstract principles to practical contexts • Allow you to track your progress of learning • Help you to assess your achievement • Provide Supervisors with feedback on the effectiveness of their teaching and deficiencies

in your clinical experiences • Provide some audit of your learning activity

Who reviews your Portfolio of Learning?

1. The Trainee

The Portfolio is primarily aimed at improving the Learning process for the trainee. Consequently the primary reviewer of the portfolio remains the Trainee.

2. Supervisors and/or Designated Persons

It is expected that candidates formally meet with their supervisor or designated persons several times each year. At this meeting, supervisors will review the candidate’s progress and should use entries in the portfolio as a basis for discussion. This allows a structuring of the supervision process. By referring to and discussing specific areas of learning and experiences, the supervisor is able to provide informed feedback and constructive advice with regard to problems and deficiencies. In this way the portfolio allows a structuring of the supervision process. Ideally, the portfolio should be made available to the supervisor before the meeting.

3. Academic Anaesthetic Departments

The portfolio provides a record of the registrars training for departmental purposes. This allows academic departments to improve the content and delivery of their training programmes. Further, it provides evidence that various departmental objectives, regulations and targets are met.

4. Faculty / University

The relevant faculty / university may use the portfolio in a similar way to academic departments.

5. Colleges of Anaesthetists of the CMSA.

The CMSA requires evidence that learning has taken place as part of a structured programme. The portfolio is an important piece of evidence for this.


Learning Plans Everyone has a different learning style and, depending on circumstances, rate of learning. A personal Learning Plan helps you to complete a learning assignment in a way that is most effective for you. A Learning Plan organises learning and can help to integrate theory and practice. It can enhance your motivation to learn and your development as a professional. A Learning Plan identifies:

• why you need to learn (trainee aims) • what to learn (learning objectives) • how to learn it (learning processes) • the time frame needed (time management) • how well you have learned (assessment, evaluation, self-appraisal etc) • how to link with past and future learning (reflection)

In preparing a Learning Plan: • Use your current practice and learning style as the basis of the plan. • Know the attributes required and the aims and objectives of the particular Module. • Plan to use the most suitable learning processes for each topic or matter in the Learning Objectives — these include making notes from textbooks and journals, tutorials, web or CD based information, discussions with colleagues, learning in small study groups with other trainees, and self-tests. Learning in small study groups with other trainees is an effective learning process.

Prepare a plan of learning processes for each Module in your Learning Portfolio. Keep referring to your plans and revise them whenever necessary (eg if unforeseen circumstances arise). Record and file your notes in an orderly manner so that you can easily revise. Make a time management plan (see below) and try to stick to your time schedule. Evaluate learning by self tests and through the small study group. Reflection is part of the Learning Plan. Time management Every task requires a minimum time period to achieve, and learning a topic or skill is no different. Know your ability to achieve a particular learning task and plan for the time to spend on it. For example, estimate a time in months that you will need to learn a section (eg Physiology). Break down the time into weeks or days required to complete learning specific topics in the section. Revise your plans (ie reallocate time) whenever necessary. Also consider the time needed for family and friends, recreation, and your health. Reflection Much of the Portfolio of Learning revolves round reflective learning, which is an effective method of getting the most out of clinical experiences, reading, researching and small group learning. Reflection enables the learner to revisit the experience or learning process after the event, in order to extract principles and “bank” them for better future use. Reflective learning uses principles similar to quality assurance, ie using feedback to improve learning and performance (“closing the loop”). Key steps are outlined below.

• Record your initial experience (eg aspects of knowledge, skills, learning process, behaviour, ideas, communication, interactions and feelings). Use your own words and write as much or as little as appropriate.

• Reflect on the experience (ie return to the experience to analyse it retrospectively). Express your reflections.

• Re-evaluate — identify new perspectives, change in practice or behaviour, readiness for application, and commitment to action.

— What was the situation (eg your abilities, available support etc)? — How could this be improved? — What have you learned from this? — How would you do this differently the next time?


Portfolio Completion Criteria

• The Portfolio should always be used in conjunction with the Regulations and Syllabus for admission to the Fellowship of the College of Anaesthetists of South Africa FCA(SA), as may be amended from time to time.

• Entries must at all times be legible and, where indicated, supported by the required signatories (Supervising Consultants and Heads of Departments and their contact details). Add pages to each Section as necessary. Ensure that your name appears on every page. It is strongly advised that you keep an electronic backup copy of all entries, as well as a printed copy.

• Each Rotation will need to be verified by the relevant Head of Department, including the completed “Record of Procedures Done” and “Clinical Practice Rating and Evaluation” for each Rotation.

• The portfolio and supporting certificates and documents must reach the Academic Registrar of the CMSA (together with the relevant assessment fee, if applicable) at least 3 (three) months prior to the commencement of the FCA(SA) Part II Examination. Failure to submit the portfolio before this time will result in the candidate not being invited to the examination.

• The Declaration Forms (Section 10) must be correctly completed and signed before submitting the portfolio to the CMSA. A declaration form for each year is to be signed off by the Head of Department. The original of such form is to be held by the academic department with a copy given to the Trainee.

• A Certificate of Completion of Training is to be completed by the Head of Department when the candidate wishes to register for the FCA(SA) Part II with the CMSA. This Certificate is to accompany the Candidate’s application form.

• Please ensure that you do not include any confidential patient information in the Learning Portfolio.

RETURN_TO_CONTENTS_PAGE


Section 2

SURNAME: ....................................................................................................................................... FIRST NAMES: ................................................................................................................................. ID NUMBER: ..................................................................................................................................... PASSPORT NUMBER: ……………………………………………………………………………………… Append certified copy of either Identity Document or Passport HPCSA NUMBER: ............................................................................................................................ Append certified copy of current HPCSA Registration TRAINEE POST NUMBER: .............................................................................................................. WORK ADDRESS: ........................................................................................................................... ............ ……………………………………………………………………………………………………….. ............ ……………………………………………………………………………………………………….. RESIDENTIAL ADDRESS: ............................................................................................................... ............ ……………………………………………………………………………………………………….. ............ ……………………………………………………………………………………………………….. PREFERRED POSTAL ADDRESS: ................................................................................................. ............. ………………………………………………………………………………………………………. ............. ………………………………………………………………………………………………………. ……………………………………………………..… POSTAL CODE:……………………………………. EMAIL ADDRESS: ............................................................................................................................ TELEPHONE NUMBER: (Work):………………………………. (Home): ............ ……………………… CELLPHONE NUMBER: ................................................................................................................... FAX NUMBER: .................................................................................................................................

SECTION 2 … TRAINEE DETAILS


UNDERGRADUATE MEDICAL QUALIFICATIONS UNIVERSITY: ........................................................................ ….. ........ YEAR:………………………. Append certified copy of Medical Degree Certificate INTERNSHIP HOSPITAL: .................................................................................. ...... YEARS:……………………….

START DATE END DATE ROTATION

YY/MM/DD YY/MM/DD

YY/MM/DD YY/MM/DD

YY/MM/DD YY/MM/DD

YY/MM/DD YY/MM/DD

YY/MM/DD YY/MM/DD

YY/MM/DD YY/MM/DD

Comments:

………………………………………………………………………..…………………………………………

………..…………………………………………………………………………………………………………

………………………………………………………………..…………………………………………………

…………………………………………………………………………………………………………………

COMMUNITY SERVICE HOSPITAL: .................................................................................. ........ YEAR:……………………….

START DATE END DATE ROTATION

Comments:

………………………………………………………………………………………..…………………………

…………………………………..………………………………………………………………………………

…………………………………………………………………………………………..………………………

…………………………………………………………………………………………………………………


POST-GRADUATE TRAINING EXPERIENCE (Prior to commencement of Anaesthetic Registrar Time)

STATUS HOSPITAL DEPARTMENT COUNTRY START DATE

END DATE

YY/MM/DD YY/MM/DD

YY/MM/DD YY/MM/DD

YY/MM/DD YY/MM/DD

YY/MM/DD YY/MM/DD

YY/MM/DD YY/MM/DD

YY/MM/DD YY/MM/DD

Comments:

……………………………………………………………………………………………………………..……

………………………………..…………………………………………………………………………………

………………………………………………………………………………………..…………………………

…………………………………………………………………………………………………………………

COMPLETION OF RELEVANT ANAESTHETIC QUALIFICATIONS (Include all attempts at each examination) (Append certified copy of Certificates)

DATE EXAMINATION EXAM AUTHORITY

RESULT COMMENTS / REMEDIAL ACTION

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD


OTHER POST-GRADUATE QUALIFICATIONS (Append certified copy of Certificates)

DATE EXAMINATION EXAM AUTHORITY

RESULT COMMENTS / REMEDIAL ACTION

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

MEMBERSHIP OF ORGANISATIONS (Include CURRENT membership of associations, societies, professional bodies etc)

ORGANISATION MEMBERSHIP NUMBER

GOOD STANDING


PRIZES, AWARDS, ACCOLADES RECEIVED

DATE PRIZE / AWARD / ACCOLADE REASON AWARDED AWARDING AUTHORITY

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD



Section 3 This section covers all the modules the Trainee needs to complete during the period of Registrar Training.

Note: There will be local institutional / university variations in these. The following modules are recommended:

MODULE 1: Introduction to Anaesthesia and Pain

MODULE 2: Professional Attributes

MODULE 3: Anaesthesia for Trauma and Orthopaedic Surgery

MODULE 4: Obstetric and Gynaecological Anaesthesia

MODULE 5: Anaesthesia for Cardiothoracic Surgery

MODULE 6: Anaesthesia for Vascular Surgery

MODULE 7: Neuroanaesthesia

MODULE 8: Anaesthesia for General, Urologic and Plastic Surgery

MODULE 9: Anaesthesia for ENT, Eye, Dental, Maxillofacial and Head and Neck Surgery

MODULE 10: Paediatric Anaesthesia

MODULE 11: Pain Management, Regional Anaesthesia and Sedation

MODULE 12: Critical Care

MODULE 13: Professional Practice

Note: It may not always be possible to complete the module as a continuous rotation. Modules 2 & 13 may be completed throughout the 48 month training period. The trainee needs to keep a logbook of all cases/procedures done. We recommend the use of the electronic Royal College logbook. Periodic (eg monthly or after every module) summaries of the logbook should be extracted and kept electronically.

SECTION 3 … RECORD OF MODULES


CONSOLIDATED RECORD OF COMPLETION OF MODULES / ROTATIONS The modules below are merely a RECOMMENDATION and will vary at an institutional level. Where modules have been continuous enter start and end dates of registrar time as module start and end dates. MODULE NAME START

DATE END DATE SUPERVISOR

SIGNATURE

Introduction to Anaesthesia and Pain

YY/MM/DD

YY/MM/DD

Anaesthesia for Trauma and Orthopaedic Surgery

YY/MM/DD

YY/MM/DD

Obstetric and Gynaecological Anaesthesia

YY/MM/DD

YY/MM/DD

Anaesthesia for Cardiothoracic Surgery

YY/MM/DD

YY/MM/DD

Anaesthesia for Vascular Surgery

YY/MM/DD

YY/MM/DD

Neuroanaesthesia

YY/MM/DD

YY/MM/DD

Anaesthesia for General, Urologic and Plastic Surgery

YY/MM/DD

YY/MM/DD

Anaesthesia for ENT, Eye, Dental, Maxillofacial and Head and Neck Surgery

YY/MM/DD

YY/MM/DD

Paediatric Anaesthesia

YY/MM/DD

YY/MM/DD

Pain Management, Regional Anaesthesia and Sedation

YY/MM/DD

YY/MM/DD

Critical Care

YY/MM/DD

YY/MM/DD

Professional Practice

YY/MM/DD

YY/MM/DD

Professional Attributes

YY/MM/DD

YY/MM/DD

Other

YY/MM/DD

YY/MM/DD


NON-CLINICAL MODULES Two Non-Clinical Modules are being encouraged as part of the holistic development of registrars. These are the modules on PROFESSIONAL ATTRIBUTES AND PROFESSIONAL PRACTICE. Below are guidelines in respect of these modules.


Trainee’s Aims This Module considers the scope of non-clinical professional issues. It covers the understanding of humanistic issues in professional practice and complements Module 13 Professional Practice.

The overall aim of Module 2 is for Trainees to reflect on and develop the attributes of a medical professional and a specialist anaesthetist. These are outlined below.

Medical Expert • Achieves excellence in clinical practice • Analyses, integrates and adheres to ethical care in clinical practice • Maintains vigilance • Recognises that patient safety is paramount

Communicator

• Establishes effective relationships with patients, families, colleagues and other healthcare workers

• Resolves issues using sound ethical reasoning Collaborator

• Demonstrates exemplary practice as a member of a multidisciplinary team, by exercising flexible leadership, consultation and appropriate delegation

• Shows respect for the expertise and concerns of other team members Manager

• Manages patient care, departmental and personal issues effectively with patience, calm, good humour and insight

• Allocates and uses health care resources wisely • Respects the views of others

Health Advocate

• Maintains personal health and well-being • Promotes health maintenance and occupational safety of patients, self and colleagues

Scholar and Teacher

• Values advances in scientific knowledge; identifies and appraises them critically for incorporation into contemporary anaesthesia practice

• Enriches knowledge with wisdom • Maintains life-long learning • Acknowledges and learns from errors; values appraisal of performance • Contributes to the education and training of students, postgraduate Trainees and other health

professionals Professional

• Recognises that patient confidentiality is essential • Complies with the relevant policies, recommendations, and guidelines in professional practice • Exhibits appropriate personal and interpersonal professional behaviours • Values human diversity • Delivers high quality patient care in a way that is consistent with ethical and medicolegal

obligations of a medical specialist • Conducts practice with integrity, honesty and compassion • Accepts peer determinations of clinical competence and professional capabilities • Recognises and deals with personal and professional limitations

MODULE: Professional Attributes


This Module is to be undertaken during Advanced Training, in the course of normal clinical duties and concurrently with clinical Modules. Trainee’s Aims The aim of this module is for Trainees to understand relevant non-clinical management issues. These range from understanding the culture of the healthcare industry and the anaesthesia profession, to considering one's career development, combining learning, teaching, administration, professional activities with patient care, and integrating professional and personal lives. Learning Objectives

This Module builds on work done in the Module on Professional Attributes and considers knowledge and skills in six components:

• Health infrastructures • Administration and management • Quality assurance • Ethical, legal and indemnity issues • Skills in professional practice • Career and life planning

In this module, the Trainee will demonstrate:

• Knowledge of the relevant South African healthcare national and local (State level) infrastructure • Capacity to work within the framework of anaesthesia departments through a comprehension of their

structure and their processes • Capacity to organise one’s work and learning • Capacity to organise local scientific meetings and research projects • Comprehension of the legal obligations of professional practice in South Africa • Understanding of ethical practice • Communication skills in professional practice • Commitment to lifelong quality assurance • Understanding of a realistic life career plan

MODULE: Professional Practice


The Trainee is referred to the following useful electronic resources:

1. College of Anaesthetists of South Africa Regulations and syllabus

http://www.colegemedsa.ac.za

2. South African Society of Anaesthesiologists (SASA) Practice Guidelines

http:// www.sasaweb.com

3. Royal College of Anaesthetists (RCoA) http://www.rcoa.ac.uk/index.asp?SectionID=3

Logbook http://www.logbook.org.uk/

4. Health Professions Council of South Africa (HPCSA) http://www.hpcsa.co.za

Registration http://www.hpcsa.co.za/registration_criteria.php

Health Acts http://www.hpcsa.co.za/downloads/health_act/health_act_56_1974.doc Ethical rules http://www.hpcsa.co.za/conduct_rules.php Fitness to Practice http://www.hpcsa.co.za/fitness_practice.php

5. Australian and New Zealand College of Anaesthetists (ANZCA) http://www.anzca.edu.au

Training Programme http://www.anzca.edu.au/trainees/atp


SECTION 4 … RELEVANT ELECTRONIC LINKS


ROUTINE DEPARTMENTAL ACADEMIC MEETINGS AND TUTORIALS Record a summary of ROUTINE ACADEMIC departmental meetings in the table below. Include Morbidity and Mortality type meetings here. (Attach Certificates of Attendance if applicable) YEAR DAY FREQUENCY TIME DURATION MEETING/ACTIVITY COMMENTS

SECTION 5 … ATTENDANCE AT MEETINGS


OTHER MEETINGS ATTENDED Record attendance at Post-graduate Meetings, Lectures, Workshops, Refresher Courses, Modules, Seminars, Symposia or Congresses relevant to Anaesthesia. (Attach Certificates of Attendance if applicable) DATE MEETING/

ACTIVITY TOPIC PRESENTER VENUE COMMENTS

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD



SECTION 6 … PRESENTATIONS List all the presentations you have made in the table below. Include lectures, tutorials delivered, papers presented, journal club presentations, clinical case presentations. Where applicable, append letters of invitation to speak. Attach copies of presentations (Power Point or abstract) made.


DATE EVENT TYPE VENUE TOPIC / SUBJECT / DETAILS DURATION COMMENTS

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

YY/MM/DD

SECTION 6 Presentations


RESEARCH INVOLVEMENT BY CANDIDATE Note: The fields below are institution specific and need not be completed if not required by your institution. GOOD CLINICAL PRACTICE (GCP) CERTIFICATION

Completed

Date Completed Certification Authority (Append GCP Certificate) RESEARCH METHODOLOGY COURSE

Completed Date Completed Course conducted by (Append Attendance Certificate) OTHER RESEARCH RELATED COURSES ATTENDED Include other courses attended (eg statistics courses) here. DATE COURSE CONDUCTED BY

YY/MM/DD

YY/MM/DD

YY/MM/DD

SECTION 7 … RESEARCH AND PUBLICATIONS

Y

YYYY / MM / DD

N

YYYY / MM / DD

Y N


THE RESEARCH COMPONENT OF THE MASTERS IN MEDICINE (MMed) The table below is a guide for ensuring that you are progressing in respect of your research. This may vary in your institution. Where possible, append appropriate certificates, letters of approval, etc. STEPS DATE SUPERVISOR

SIGNATURE CHOICE OF SUBJECT YY/MM/DD

CHOICE OF RESEARCH TOPIC YY/MM/DD

LITERATURE SEARCH YY/MM/DD

DEVELOPMENT OF RESEARCH HYPOTHESIS YY/MM/DD

COMPLETION OF PROTOCOL YY/MM/DD

PRESENTATION AT RESEARCH MEETING YY/MM/DD

PROTOCOL REVISION YY/MM/DD

STATISTICAL PLANNING YY/MM/DD

PLANNING OF BUDGET YY/MM/DD

TRANSLATION OF CONSENT YY/MM/DD

SUBMISSION TO POST-GRADUATE COMMITTEE (or equivalent)

YY/MM/DD

POST-GRADUATE COMMITTEE (or equivalent) APPROVAL

YY/MM/DD

APPROVAL BY ETHICS COMMITTEE YY/MM/DD

INSTITUTIONAL APPROVAL (as appropriate) YY/MM/DD

OTHER DEPARTMENTS/ROLE PLAYERS INFORMED YY/MM/DD

DATA COLLECTION COMPLETED YY/MM/DD

DATA ENTRY AND PROCESSING YY/MM/DD

MANUSCRIPT / THESIS COMPLETION YY/MM/DD

PUBLICATION YY/MM/DD

DEGREE AWARDED YY/MM/DD


INVOLVEMENT IN OTHER RESEARCH PROJECTS DETAILS OF PROJECT INVOLVEMENT DATE PRINCIPAL

INVESTIGATOR SIGNATURE & NAME


JOURNAL PUBLICATIONS BY CANDIDATE: (Attach copy of publication) NO. AUTHORS

(list fully in order) FULL TITLE JOURNAL VOL. (NO.) PAGES

1

2

3

4

5

6



TEACHING ACTIVITIES Record here all formal and informal teaching of medical students, interns, medical officers, other registrars, nurses, allied health personnel and any other individuals. Record details of the teaching session and reflective comments if you find them useful in your learning and professional development. DATE TEACHING

ACTIVITY DETAILS REFLECTIVE COMMENTS

YY/MM/DD

SECTION 8 … OTHER ACTIVITIES


DATE TEACHING ACTIVIT DETAILS REFLECTIVE COMMENTS

YY/MM/DD


PROFESSIONAL ACTIVITIES Record here all activities in respect of committees in which you are involved, management structures that you have participated in, and leadership roles that you may have assumed. DATE STRUCTURE ACTIVITY

YY/MM/DD


COMMUNITY / OUTREACH ACTIVITIES Record here all activities that you have participated in as part out outreach or community development. DATE STRUCTURE ACTIVITY

YY/MM/DD


CRITICAL INCIDENT MONITORING Record critical incidents that you experience or are aware of that will help your learning. Include major and minor incidents that occur. eg drug administration errors, failed/difficult intubation, complications of regionals, death on the table. Please ensure that you do not include any confidential patient information or names of individuals involved. DATE CRITICAL INCIDENT NOTES ON LESSON LEARNED OR REFLECT

YY/MM/DD


DATE CRITICAL INCIDENT NOTES ON LESSON LEARNED OR REFLECT

YY/MM/DD



Record or append all assessments here. Such assessments to include:

1. Assessment of Trainee by Supervisor / Module Supervisor

2. Assessment of Module / rotation by Trainee There are institutional variations in these assessments. Include what is used at your training centre. At a minimum, such In-Training Assessment (ITA) forms should include:

i. Period of assessment ii. Module/Block/Rotation completed iii. Supervisor/s of training iv. Date of assessment v. Result of assessment (eg exceeds requirements, meets requirements, does

not meet requirements vi. Evidence of feedback / remedial action if necessary vii. Name of assessor viii. Signature of assessor


SECTION 9 … ASSESSMENTS


Appropriate declarations of completion of training need to be completed and signed by both the Trainee and Supervisor. Four such declarations need to be completed, one for each year of training. In addition, the supervisor needs to complete the required forms when the candidate enrols for the FCA(SA) Part II of the CMSA. Copies of the declaration form are to be held by the academic department.

SECTION 10 … DECLARATIONS OF COMPLETION OF TRAINING PERIODS


DECLARATION ON COMPLETION OF TRAINING – YEAR 1

I, …………………………………………………………….hereby do solemnly declare that all

information contained in this PORTFOLIO OF LEARNING is a true and accurate record of

my professional experience, education and training from dd / mm / cccc to dd / mm / cccc

representing the period of training for the Anaesthetic qualification.

Signature of Candidate: ................................................................................................ Name of Candidate: ...................................................................................................... Trainee Number: ........................................................................................................... Date: ............................................................................................................................. I, …………………………………………………………….hereby declare that I have

inspected the information contained in this PORTFOLIO OF LEARNING in respect of the

Trainee’s professional experience, education and training from dd / mm / cccc to dd / mm /

cccc representing the period of training for the Anaesthetic qualification.

Signature of Academic Head of Department: ................................................................ Name of HOD: .............................................................................................................. Date: ............................................................................................................................. RETURN_TO_CONTENTS_PAGE

Departmental / University

Stamp









Trainee’s professional experience, education and training from dd / mm / cccc to dd / mm /

cccc representing the period of training for the Anaesthetic qualification.



Stamp









Trainee’s professional experience, education and training from dd / mm / cccc to dd / mm

/ cccc representing the period of training for the Anaesthetic qualification.



Stamp


DECLARATION BY ACADEMIC HEAD FOR TRAINEE TO ENROL IN EXAMINATION

I hereby declare that I have inspected the information contained in this PORTFOLIO OF

LEARNING in respect of the Trainee’s professional experience, education and training

from dd / mm / cccc to dd / mm / cccc representing the period of training for the

Anaesthetic qualification.

I further certify that the Trainee has fulfilled the requirements below:

The trainee has successfully completed/is exempt from the FCA(SA) Part I examination

YES NO

The trainee has completed at least three years following full registration by the Health Professions Council of South Africa as a medical practitioner.

YES NO

The trainee will have held a fulltime appointment as a registrar in the Department of Anaesthetics in a teaching hospital or teaching hospital satellite department for at least THIRTY-SIX MONTHS at the time of writing the examination.

YES NO

The trainee has been assigned for three months of the above period to an Intensive Care Unit on a fulltime basis.

YES NO

The trainee has successfully completed all the Departmental and Faculty requirements in respect of training in Anaesthesiology.

YES NO



Stamp

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