General Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons

MODULE TITLE: GENERAL SURGERY SET 1 COMPETENCIES 25-Sep-2008

DEVELOPED BY: Adrian Anthony, Michael Cox, Graham Cullingford

COMPETENCY PERFORMANCE REQUIREMENTS ASSESSMENT

Medical Expertise

Understand the concept of evidence-based surgical practice Develop knowledge as outlined in the General Surgery Curriculum Demonstrate understanding and appropriate application of knowledge in the management of patients

CLEAR SSE

Assessment and management of patients, both elective and non-elective:

Application of CCrISP principles in patient management obtain accurate, complete and relevant information (e.g. from history, examination, investigations, review of notes) generate an appropriate problem list and justify possible diagnoses formulate and discuss management based on available information and in collaboration with members of the clinical team implement management that reflects an evidence-based approach and good clinical practice appropriately order, interpret and respond to investigations and their results present cases in a clear, orderly, accurate and concise manner

Judgement / Clinical Decision Making

Able to assess and recognise:

a deteriorating, acutely unwell or critically ill patient acute surgical pathology (non-traumatic) acute abdominal pathology soft tissue trauma multiple trauma head injury onset of complications wound complications sepsis multiple organ dysfunction peri-operative risk factors

Able to implement management for:

acute pain control nutritional support fluid and electrolyte requirements discharge planning wound care peri-operative diabetic control peri-operative management of anti-coagulation VTE prophylaxis antibiotic prophylaxis pre-operative preparation prevention of anticipated complications safe and appropriate transfer of patient

SSE CE CCrISP EMST Mini-CEX CLEAR

GENERAL SURGERY SET 1 COMPETENCIES Page 1 of 3

COMPETENCY PERFORMANCE REQUIREMENTS ASSESSMENT

During technical procedures demonstrate:

compliance with universal precautions adherence to correct patient / procedure / site protocol surgical scrub, gowning and gloving appropriate patient positioning and skin preparation adequate surgical access and exposure safe and effective handling of tissue (eg retraction, dissection, resection, suturing) effective haemostasis wound care and closure safe and correct handling and application of surgical instruments and equipment appropriate documentation of procedural record.

Develop safe and effective technical skills for a range of procedures, to include but not confined to:

Technical Expertise assisting in surgery administration of local anaesthesia simple excision of skin / subcutaneous lesion suturing and knot-tying harvest split skin graft harvest full thickness skin graft wound closure (minor, intermediate, and major procedures) appendicectomy (open and laparoscopic) open and close laparotomy exploratory (diagnostic) laparotomy pneumoperitoneum for laparoscopy laparoscopic port insertion proctoscopy intercostal chest drain introduction to diagnostic gastroscopy and colonoscopy

rigid and flexible sigmoidoscopy band ligation of haemorrhoids open haemorrhoidectomy incision and drainage of subcutaneous collections wound exploration and debridement open groin hernia repair vasectomy carpal tunnel release transfix / ligate vessels primary varicose vein surgery minor abdominal wall hernia repair toenail operation hydrocele operation explore scrotum & orchidopexy toe amputation

ASSET DOPS Various Skills Courses

Collaboration

Seek assistance in a timely manner Liaise with members of the unit in the management of patients Collaborate and contribute to team approach to surgical care Develop good working rapport with nurses and other staff

CCrISP

GENERAL SURGERY SET 1 COMPETENCIES Page 2 of 3

GENERAL SURGERY SET 1 COMPETENCIES Page 3 of 3

COMPETENCY PERFORMANCE REQUIREMENTS ASSESSMENT

Communication

Communicate to medical, nursing and other staff on patient management issues Clear, legible, concise, accurate, relevant and contemporaneous documentation Conduct effective clinical handover Obtain patient consent for some procedures and where appropriate Adhere to open disclosure policy Demonstrate qualities of respect, honesty, empathy, listening and understanding

Mini-CEX CCrISP

Health Advocacy Maintain own physical and psychological health Recognise and respond to a colleague in distress

Management & Leadership

Take responsibility for patient management Supervise medical students and junior medical staff Attend to administrative responsibilities of the post

Professionalism

Behave ethically and responsibly Participate in clinical audit process Adopt evidence-base practices Maintain personal training portfolio Critically evaluate own performance; demonstrate awareness of areas for improvement and respond accordingly Seek feedback on performance and respond appropriately Participate in timely in-training formative and summative assessments

Scholar & Teacher

Show initiative and responsibility initiative for own learning Adopt effective learning behaviour to maintain and facilitate knowledge and skills Teach medical students, junior medical staff, and other staff