Libro blanco de las ACES Pediátricas 2024

Libro Blanco de las ACES Pediátricas 2024 164 ❚ 28 Speciality specific clinical knowledge, skills and reasoning are distinguished as essential and core (labelled as 'C') or desirable (labelled as 'D') for two broad groups of problems: • 'C' representing essential/core for problems that are routinely encountered vs • 'D' representing desirable for problems that are rare and therefore may not be encountered during training. The competencies that are essential ('C') will be acquired during training from active hands-on clinical experience and work-based learning, and consolidated through teaching, personal study and continuing professional development. The competencies that are desirable ('D') are required for knowing how to recognise and approach the assessment, diagnosis and management of rare disorders. These are to be acquired through real or virtual clinical experience, case discussions, reports in journals, conferences and continuing professional development. Table 2. Levels of competence for clinical knowledge, skills and reasoning Adapted from those defined by UEMS. Note: throughout 'carers' applies to parents, family members and other carers Level 1 2 3 4 5 Trainee Has observed Can do with assistance Can do but may need assistance Competent to do without assistance Can be 'trusted' to do independently without assistance or need for advice Extent of supervision required Enhanced direct supervision Direct supervision Indirect supervision, when required Occasional ad hoc advice from supervisor Independent and no supervision required. Can supervise others Details for competence 1. Knowledge base Adequate for common problems. But limited ability to apply knowledge. Adequate for common and serious problems. Good for common and serious problems. Good for majority problems and complications. Excellent and can apply to deal with complexity, uncertainty and difficult problems at the level of a consultant. 2. Clinical assessment Rigid formulaic approach to gathering information, not focused and misses important points. Focused consultation but misses some relevant details. Recognises presentation of common problems. Focused hypotheses- driven consultation and gathers pertinent information. Flexible, fluid and efficient consultation. Proficient, targeted and incremental approach to gathering all relevant information. 3. Management and followup Requires guidance from supervisor. Lacks Reasonable management plans but without Appropriate management plans for common and Management plan is responsive to patient & Incorporates patient's, carers' and other professionals' perspective when