This page is for trainees who have been appointed to a CCT programme in Intensive Care Medicine & are on the 2021 ICM curriculum. You may be pursuing ICM as a single specialty or on a dual programme (e.g. with anaesthesia, acute or respiratory medicine etc.). At Sunderland we can provide all stages of training other than the specialist sections of stage 2 (paeds, neuro and cardiac).
The GMC’s introduction of updated standards for curricula and assessment processes laid out in Excellence by design, requires all medical curricula to be based on high-level learning outcomes(HiLLO) and also to incorporate the Generic Professional Capabilities (GPC) framework. The HiLLOs in this curriculum constitute 4 generic and 10 specialty-specific learning outcomes to be achieved by all ICM trainees as they progress through each stage of training, and ultimately attain a CCT.
The development of the 2021 syllabus for the CCT in Intensive Care Medicine [ICM] has drawn extensively on the Competency Based Training in Intensive Care Medicine in Europe (CoBaTrICE) syllabus. CoBaTrICE is an international partnership of professional organisations and critical care clinicians working together to harmonise training in Intensive Care Medicine worldwide.
The training programme is based on the concept that ensures that the basic principles learnt and understood are repeated, expanded and further elucidated as time in training progresses (spiral learning); this also applies to the acquisition of skills, attitudes and behaviours. The outcome is such that mastery of the specialty to the level required to commence independent practice in a specific post is achieved by the end of training as knowledge, skills, attitudes and behaviours metaphorically spiral upwards.
ICM is the body of specialist knowledge and practice concerned with the treatment of patients with, at risk of, or recovering from potentially life-threatening failure of one or more of the body’s organ systems. It includes the provision of organ system support, the investigation, diagnosis, and treatment of acute illness, systems management and patient safety, ethics, end-of-life care, and the support of families.
Intensive Care Medicine specialists are medical experts in:
The GMC’s introduction of updated standards for curricula and assessment processes laid out in Excellence by design, requires all medical curricula to be based on high-level learning outcomes(HiLLO) and also to incorporate the Generic Professional Capabilities (GPC) framework. The HiLLOs in this curriculum constitute 4 generic and 10 specialty-specific learning outcomes to be achieved by all ICM trainees as they progress through each stage of training, and ultimately attain a CCT.
The development of the 2021 syllabus for the CCT in Intensive Care Medicine [ICM] has drawn extensively on the Competency Based Training in Intensive Care Medicine in Europe (CoBaTrICE) syllabus. CoBaTrICE is an international partnership of professional organisations and critical care clinicians working together to harmonise training in Intensive Care Medicine worldwide.
The training programme is based on the concept that ensures that the basic principles learnt and understood are repeated, expanded and further elucidated as time in training progresses (spiral learning); this also applies to the acquisition of skills, attitudes and behaviours. The outcome is such that mastery of the specialty to the level required to commence independent practice in a specific post is achieved by the end of training as knowledge, skills, attitudes and behaviours metaphorically spiral upwards.
ICM is the body of specialist knowledge and practice concerned with the treatment of patients with, at risk of, or recovering from potentially life-threatening failure of one or more of the body’s organ systems. It includes the provision of organ system support, the investigation, diagnosis, and treatment of acute illness, systems management and patient safety, ethics, end-of-life care, and the support of families.
Intensive Care Medicine specialists are medical experts in:
- Resuscitation
- Advanced physiological monitoring
- Provision of advanced organ support (often multiple)
- Diagnosis and disease management in the context of the most gravely ill patients in the hospital
- Provision of symptom control
- Management and support of the family of the critically ill patient
- End of life care
- Collaboratively leading the intensive care team
- Coordination of specialist and multi-specialty input to complicated clinical cases in the unique context of intensive care.
Stages of ICM training
ICM training programme is outcome based. The times allocated to the stages of training are typical – progression is based upon trainee ability assessed by the ARCP panel.
Stage 1 (CT1-ST4)
Year 1-2 – ACCS/Core Anaesthesia/Internal Medicine training programme + relevant exam pass(see above)
Competitive ST3 entry to ICM training from programmes listed above AND Emergency medicine trainees who have completed ST1-3
ST 3-4 – consolidate the trainee’s knowledge and skills in general diagnosis and patient management and enable trainees who enter from a variety of core programmes to achieve the designated competency levels in ICM by the end of ST4.
Stage 1 exit requirements
- All generic & specialty specific high level learning outcomes (HiLLOs) at competency level as per HiLLO's grid & assessment blue print below.
- 12 months Anaesthesia, 12 months Internal Medicine, 12 months ICM
- 12 months partner specialty
Stage 2 (ST5-6)
- All generic & specialty specific HiLLOs at competency level as per HiLLO's grid & assessment blue print below.
- 12 months Specialist ICM – 3/12 Paediatrics, 3/12 Neurosurgery & 3/12 Cardiothoracics, 3/12 general ICM or further specialist ICM block
- Area of expertise developed during a special skills year
- Expertise can be gained in one of 11 prior approved specialist areas including research in ICM, quality improvement and education as well as specific skills such as echocardiography and catering for the special needs of patients who require extra-corporeal membrane oxygenation (ECMO).
- 24 months of specialist competencies
- FICM examination pass
Stage 3 (ST7)
This 12 month block which must be spent in ICU consolidating the trainee’s competencies and acquiring high-level management and administrative skills, progressively achieving autonomy so that they are competent to take up a consultant post in ICM.
- All generic & specialty specific HiLLOs at competency level as per HiLLO's grid & assessment blue print below.
High Level Learning Outcomes (HiLLO) grid
The ICM curriculum will have 14 High Level Learning Outcomes (HiLLOs) of which 4 are generic and 10 are specialty specific with their associated Generic Professional Capabilities (GPC) domains. (see p8 of the ICM curriculum)
See the HiLLO grid below outlining the domain and the expected capability level for each stage of training. See page 59 of the curriculum OR this document for more detailed information on the HiLLO learning outcomes.
Ultimately the ICM ES will sign off HiLLOs for ICM. The major change is it will feel like a more global judgement, using evidence from MSF, SLE, Cons feedback.
ICM Assessment Guidance
The educational supervisor should review the supervised learning events (SLE) with the ICM trainee to see how they are progressing and to ensure that they are acting on feedback received.
The main formative assessments used in the curriculum are the SLEs listed below:
- Mini-Clinical Evaluation Exercise [Mini-CEX]
- Acute Care Assessment Tool for Intensive Care Medicine [ACAT]. The ACAT assesses the trainee’s ability to manage a body of work over a more extended period of time, better reflecting their performance in practice. In the ICM environment, this will usually be during a rostered clinical duty period and the assessment may focus on a variety of areas including leadership, time management and prioritisation, team working and handover.
- Direct Observation of Procedural Skills [DOPS]
- Case based Discussion [CBD]
- Annual Multi-Source Feedback [MSF] - 12-15 assessors are required from a representative selection (doctors, nursing, allied health care and clerical staff) and a range of seniorities of the above team members. A minimum of 4 senior permanent medical staff is mandatory. The Educational Supervisor will ensure that an adequate number, and breadth of assessor background and seniority is chosen, and will review the evidence of performance.This number of assessors provides a reliable assessment of communication, team working and trustworthiness. The MSF tool is predominantly formative, but does significantly inform the summative decisions that the Educational Supervisor and ARCP panels will be required to make each year regarding progression. Once the MSF is closed it will be reviewed by your ES and be seen as complete.
- Procedures log
- Personal activities e.g. advisory roles, academic activities, publications, form R, e learning, educational activities, teaching patients consultant feedback
- Reflection
- Certificates should be uploaded to personal activities in the milestone and certificates section to ensure it is visible on the ESSR.
To upload & crosslink evidence from another portfolio you must complete a "New entry" in your 'Personal activity" using the name & date of the assessment. Once you have added the learning outcome you can map to the curriculum and then add this supporting document to allow it to be visible on your ESSR.
E portfolio platform
- All trainees will move to the new ICM Life-long learning platform. Click here for a user guide.
- Personal development plans - accessed within the Development box on the home page
- Recording a meeting with your ES. Select personal activity and then supervisory meeting from the drop down menu. you can title the meeting - beginning, mid, additional etc.
- If you have sufficient evidence for your ES to sign off a HiLLO as achieved you must submit a Learning Outcome Completion form (LOC) for your ES.
- All end of placement meetings are recorded using the ESSR form.
Who can complete assessments?
- Consultants, specialty ICM doctors, senior ICM trainees, Advanced Critical Care Practitioners and senior nursing staff can facilitate SLEs providing they are competent to do so and understand their role in facilitating the SLE in particular, the need for timely and constructive feedback
Listed below are a few key points regarding supervised learning events (SLE):
- feedback is the most important element
- ICM trainees should aim to undertake SLEs relevant to their current unit of training
- areas for assessment should be identified by the ICM trainee in discussion with their Educational Supervisor
- requesting assessments retrospectively is considered bad practice and is not acceptable, except in Case-Based Discussions
- the trainee should reflect on the learning event in the SLE
- the trainer should observe the performance of the ICM trainee, and give immediate verbal feedback, as well as suggestions for future development, further reading etc.; they will indicate what level of supervision the trainee requires for that activity
- trainers should comment on clinical and non-clinical aspects of performance, such as professionalism and team-working
- if facilities exist, and it is safe to do so, the assessment can be documented on the ICM ePortfolio at this time; this is the ideal situation
- if the online form cannot be completed at this time, the ICM trainee will send a request for assessment to the trainer electronically
- verbal feedback should always take place at the time of the assessment
- the trainer should complete the online form as soon as possible
- linking the assessment to more than one unit of training may be appropriate
All work based assessments are formative i.e not pass or fail rather provide constructive feedback to support progression. Summative assessments include FICM exam & Stage 1,2,3 training certification.
Capability levels
Capability levels (formerly competence levels) are used to define the minimum required for each HiLLO for progression at each stage of the ICM programme. See below for more details.
Capability levels (formerly competence levels) are used to define the minimum required for each HiLLO for progression at each stage of the ICM programme. See below for more details.
Assessment Blueprint
ARCP
