Severn Deanery New Curriculum and LLP FAQ’s – Updated 8th September 2021
What does a HiLLO mean?
○ High-Level Learning Outcome. There are 14 HiLLO’s within the new curriculum.
○ The LOC form is the HiLLO sign off. In order to complete/ sign off a HiLLO then there must be enough of the suggested evidence linked to it. Then the trainee creates a ‘Learning Outcome Form (LOC)’ Form to send to a supervisor. This must be a FICM educational supervisor or Faculty Tutor (This is similar to the CUT form in anaesthetics).
○ From the previous curriculum
■ HiLLO’s = domains
■ Capabilities = competencies
■ SLE’s (Supervised Learning Events) = WPBA’s
- When will I get access to the new eportfolio?
○ FICM have informed us this will be at the end of June
- Will my supervisor also get access to it at the end of the month?
- It looks like the duration of the stages has changed? (e.g. Stage 3 for dual anaesthetics/ICM seems to have added a year)
○ All trainees rotations have been planned with the same amount of training time as in the previous curricula, so as not to extend training time. Trainees doing anaesthesia stage 2 will need to identify what they can evidence towards stage 2 and 3 anaesthesia when they are doing an anaesthesia placement.
○ The TPDs are aiming to avoid changing planned rotations but very happy to look at this with trainees if this is causing concern. This will become clearer through 2021-22.
○ At the moment the advice is that if a trainees rotation is planned then don’t change it.
○ The career progression meeting at your ARCP is the best time to discuss this. Alternatively please contact anaesthesia or ICM TPDs.
- I’m confused about which stage I’m in?
○ Contact Adrian Clarke via email for clarification.
- Will there be guidance for ES sign off to ensure this is a fair process?
○ There will be guidance sessions for the ES in September.
○ Ensure that you evidence appropriately according to the capability level for each HiLLO.
○ There will be triangulation between supervisors and more feedback from a bigger number of sources, focusing more on clinical competencies.
○ Continue what you’re doing now.
○ The evidence on your portfolio needs to stand up to external scrutiny
- Is there a separate logbook on the LLP?
○ No, continue to use your current logbook.
- Where do I upload previous ACRP outcomes?
○ Download from previous e-portfolio as a PDF, save under ‘Personal Activity’ as an ‘ARCP Documents/Form R’ and then it will automatically populate the ‘ARCP Outcomes’ in the ‘Development’ section of the LLP.
○ Alternatively, for the transition, save in the ‘Certificates’ section. Subsequent ARCP outcomes should then be stored in the ARCP Outcomes section.
- Is there a teaching feedback form on the LLP?
○ No, but this was not available on the FICM NES Portfolio for ICM trainees. If a supervisor observes you provide teaching we suggest you use the CBD SLE and make it clear that it is a teaching observation in the description.
- I’m a single specialty ICM trainee currently undertaking my anaesthesia year, how can I generate SLEs for the Initial Assessment of Competencies and beyond?
○ FICM have suggested that you ask local trainers to allow you to generate SLEs as the ICM ones but some departments may not be familiar with this. In this case you may need to complete paper forms, upload them to the FICM LLP as ‘Personal Activity’ and then link them to the Anaesthesia HiLLO (and any other relevant HiLLOs)
- Who can sign off a LOC form for a HiLLO?
○ This will normally be your Educational Supervisor. During specialist modules eg PICU, Cardiac it may be appropriate to ask your supervisor for this block to approve the LOC for the relevant HiLLO but FICM have advised that only FICM approved Education Supervisors can sign off LOC forms (though other clinicians can complete SLEs). It may be worth approaching module leads/ ICM Faculty Tutors prior to a specialist rotation to request that your module supervisor be a FICM Educational Supervisor to facilitate the process.
- What are the logbook requirements on the new Curriculum?
○ This is from the FICM Assessment Strategy: The procedures log is required to evidence maintenance of complex practical skills. Numbers required will depend on the training level and the circumstances of the individual trainee. For example, the ES/CS is more likely to require evidence of maintenance of advanced airway skills from trainees that are undertaking part of their training in areas where these skills are not used regularly.
○ Therefore your procedures log will have to evidence the procedures you have done during each placement which are relevant to your learning – ie in earlier stages this would expected to be competence in all vascular access, progressing to percutaneous tracheostomy (for example) by stage 3.
○ It is clear that non-anaesthesia trainees will be required to log airway interventions, and ensure skills are maintained throughout their training.
○ Log teaching of procedures too as this can be evidence for Teaching and Training HiLLO.
- Which activities can span more than a single Stage?
○ Some activities - for example resuscitation courses - can be used to evidence more than a single stage as long as they remain valid. For example if you complete ALS in Stage 1 this could be used as evidence for Resuscitation HiLLO in both Stage 1 and Stage 2 if still valid. However, please don’t try to recycle activities or SLEs across multiple stages that do not show advancement or progression of learning and experience (ie the QI project you did as an CT1 probably shouldn’t be used to evidence the Stage 3 ‘Quality Improvement’ HiLLO!). Some ES may also consider that for a particular SLE you are performing above the level required – this happens frequently and of course is fantastic. However in order to provide ongoing evidence of improvement it will be easiest to keep clinical SLEs in your current stage of training.
- Can we take study leave to attend to the transition onto the new LLP?
○ The Severn School has not provided study time for transitioning portfolios on any previous curriculum/ portfolio changes. Some departments now offer trainee ‘SPA/admin time’ in the rota and this would be a valid use of that time. Trainees will have varying burdens of LLP transition administration to achieve depending upon their stage and their point within that stage. If you feel you have extenuating circumstances which mean you need specific time to manage your transition then your ES may agree a very small amount of time to help but this must not diminish opportunities for clinical learning.
○ The School want to support us through this but if you do request study leave to optimise your LLP then you must use this wisely.
- How many SLE’s do we need for each HiLLO?
○ FICM have been very clear that there are no absolute numbers and that evidencing the HiLLOs is about quality rather than quality. Clearly the depth and breadth of evidence for each HiLLO will vary so review the HiLLO details and capability levels provided on the LLP. Each HiLLO also has suggested evidence that you can use as a guide. Link everything you feel is genuinely relevant to that particular FICM HiLLO - even if an SLE or activity achieved during a partner specialty placement - and review requirements at an interim meeting with your Educational Supervisor to ensure you’re on track.
○ This is from the FICM Assessment Guidance, with important points highlighted:
○ Each HiLLO must have appropriate evidence for the ES to sign off at the appropriate level for training. The Assessment Blueprint highlights which forms of assessment are most appropriate for each HiLLO (this is also replicated on the LLP). This may be supplemented by other evidence such as (amongst others) development courses, teaching sessions, simulation and self-directed learning. However, where demonstration of performance in practice is required, SLEs and the MSF are likely to form the highest quality of evidence upon which an ES can base their judgement.
○ One assessment may be used to evidence multiple capabilities. However, it must be clear to anyone reviewing such evidence that all capabilities linked were assessed and commented upon during the assessment, and that the assessment tool used was appropriate to assess the capabilities linked.
○ The ES/CS will provide guidance to individual doctors at supervisor meetings regarding the quality and breadth of assessments completed. Doctors performing well will use assessments in a creative way to demonstrate and improve their practice.
○ The numbers of different types of SLE used may change as doctors progress through training. For example, doctors in stage 3 of the training programme may choose to use the ACAT or CBD more than the DOPS or mini-CEX reflecting that evidence of complex decision making and leadership skills may be more useful for learning than observed clinical procedures by this stage of training.
○ It will be necessary to complete multiple SLEs within the same capabilities over a period of time. For example, several DOPS for complex procedures e.g. tracheostomy or emergency airway management would be expected to be completed by different assessors over a period of time to demonstrate progression, and be complemented by a procedures log. For more simple procedures this may not be required.
○ The procedures log is required to evidence maintenance of complex practical skills as described above. However, there is insufficient evidence to support a required number of procedures. Instead, numbers required will depend on the training level and the circumstances of the individual doctor. For example, the ES/CS is more likely to require evidence of maintenance of advanced airway skills from doctors that are undertaking part of their training in areas where these skills are not used regularly.
- How do I create a placement on the LLP?
○ On the FICM LLP dashboard scroll down to ‘Current Placement and Profile’ and click on ‘View and Add Placements’ to add a new placement. At this point you can identify which stage of the Curriculum you are on. Dual Anaesthesia trainees can now create overlapping placements in both the RCoA and FICM tabs. It is important to make the placement dates accurate as when you come to generate an ESSR prior to your ARCP the LLP will automatically populate the ESSR with all the evidence created within the dates of the placement. For those mid-stage you can upload evidence of previous placements and dates as a Word document in ‘Personal Activities’. For evidence achieved in those pre-LLP placements, if you upload it as a PDF and date it within the current placement (and link to relevant Stage HiLLOs) it will also populate the appropriate ESSR.
- What evidence do I need to upload to validate Stages achieved on the NHS e-portfolio?
○ This will vary according to stage - please consult the FICM Transition Document - link on the FICM website and on the Severn Deanery ICM Training Programme useful resources page.
- What evidence will I need to provide at my ARCP?
○ Local guidance for updated ARCP checklists will be published soon and will be available on the Severn Deanery website - watch this space..