Procedure Skills

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Introduction to Evaluation and Documentation of Clinical Technical Skills

Proficiency in clinical technical skills is an essential component of neonatal-perinatal medicine. This logbook should encourage a more formal approach to the teaching, documenting and evaluation of clinical technical skills. McMaster Fellowship Program Committee has therefore developed a list of procedures and skills for which documentation must be obtained that you have successfully completed the procedure. A generic set of guidelines for successful completion has also been developed. Five essential procedures have been identified as vital during the PEAP period are mandatory to be signed as competent.

Each fellow will receive a “Clinical Technical Skills Record”. When you are performing a procedure, please ask your attending staff to observe you and then “sign off” that the procedure has been completed successfully. You must be observed performing the procedure – word of mouth the next morning is not adequate. The Program Director and your Career Mentor will review your record during your meetings.

Please note that this is merely an extension of the “technical skills” category of your in training evaluation reports. You may perform any procedure, which you feel competent to perform before you have been “signed off”. We also recognize that there may be procedures for which it is impossible to be observed by an attending.
The Royal College requires that a Final In-training Evaluation Report (FITER) be entered for ALL trainees. The FITER requires documentation of required technical skills.

Criteria for Satisfactory Performance

  1. Understand rationale for performing procedure
  2. Assemble all equipment and personnel prior to commencing procedure
  3. Appropriate aseptic technique, including hand washing (Ref: Checklist in next page)
  4. Use of appropriate analgesia
  5. Understand relevant anatomy and uses appropriate landmarks
  6. Use logical sequence when performing procedure
  7. Complete procedure in a proficient fashion
  8. Ask for help if needed
  9. Remain calm
  10. Co-ordinate/direct any other team members
  11. See procedure through to completion (securing/taping, cleaning up, disposing sharps)
  12. Verify success of procedure/placement if lines, ETT etc.
  13. Ensure patient is stable upon completion
  14. Discuss procedure with parents as appropriate

PEAP (Pre-Entry Assessment Program) Trainees

Five procedures have been identified as important. It is mandatory for trainees to be signed off as being competent in these procedures for successful completion of PEAP

They are:

  1. Resuscitation – Bag and Mask Ventilation
  2. Endotracheal Intubation
  3. Insertion of Umbilical Arterial Catheter
  4. Insertion of Umbilical Venous Catheter
  5. Lumbar Puncture