LIBRO + ANEXOS CARDIOLOGÍA

Cardiología Pediátrica. Anexos ❚ 87 Page 45 of 64 Paediatric Cardiology curriculum • To review and amend existing investigation plans • To write an acceptable letter back to the referrer • To communicate with the patient and where necessary relatives and other health care professionals. After initial induction, trainees will review patients in clinic settings, under direct supervision. The degree of responsibility taken by the trainee will increase as competency increases. Trainees should see a range of new and follow-up patients and present their findings to their clinical supervisor. Clinic letters written by the trainee should also be reviewed and feedback given. The number of patients that a trainee should see in each clinic is not defined, neither is the time that should be spent in clinic , but as a guide this should be a minimum of two hours. Clinic experience should be used as an opportunity to undertake supervised learning events and reflection. Reviewing patients with consultants It is important that trainees have an opportunity to present at least a proportion of the patients whom they have admitted to their consultant for senior review in order to obtain immediate feedback into their performance (that may be supplemented by an appropriate WBA such as an ACAT, mini-CEX or CBD). This may be accomplished when working on a take shift along with a consultant, or on a post-take ward round with a consultant. Personal ward rounds and provision of ongoing clinical care on specialist medical ward attachments Every patient seen, on the ward or in outpatients, provides a learning opportunity, which will be enhanced by following the patient through the course of their illness. The experience of the evolution of patients’ problems over time is a critical part both of the diagnostic process as well as management. Patients seen should provide the basis for critical reading and reflection on clinical problems. Ward rounds by more senior doctors Every time a trainee observes another doctor seeing a patient or their relatives there is an opportunity for learning. Ward rounds (including post-take) should be led by a more senior doctor and include feedback on clinical and decision-making skills. Multidisciplinary team meetings There are many situations where clinical problems are discussed with clinicians in other disciplines. These provide excellent opportunities for observation of clinical reasoning, and as the trainee becomes more senior and more self-confident, opportunities for presentation of patients and participation in discussion. Trainees have supervised responsibility for the care of inpatients. This includes day-to-day review of clinical conditions, note keeping, and the initial management of the acutely ill patient with referral to and liaison with clinical colleagues as necessary. The degree of responsibility taken by the trainee will increase as competency increases. There should be