Signing off Logbook Competencies.
Trainees will be required to complete the competencies within their logbook to evidence their learning and skills throughout their training.
Basic competencies need to be completed by the end of ST2. Intermediate competencies need to be completed by the end of ST5. Advanced competencies need to be completed by the end of ST7.
Logbook competencies should be signed by Consultants, not other trainees. Any trainee signatures will need countersigning by your Educational Supervisor.
Competencies are split in to three levels; level 1, level 2 and level 3.
Please review your logbook carefully so you know which level each competency needs to be signed off at by the end of each stage of training.
There are several competencies that can potentially be signed off using ‘other methodologies’. The RCOG introduced this to facilitate learning and potentially facilitate sign-off for certain conditions that aren’t commonly encountered in clinical practice.
Other methodologies can be used in situations where clinical exposure hasn’t occurred, which is possible given the rarity of some conditions; however, this is not meant to replace clinical exposure and hands on experience should be encouarged at all times.
Examples of other methodologies include:
- Case-based discussions
- Departmental teaching
- Guideline discussion
- Practical skills and procedure courses
To be signed off at level 1, the trainee should:
- Demonstrate a thorough understanding of the principles of the competence/clinical skill/situation, including the indication for the procedure and the common complications
- Be aware that, before undertaking any clinical skill under direct supervision, if possible they’ll have observed the procedure on a number of occasions
- Use other methodologies (OM; e.g. drills, simulation, e-learning and case-based discussion assessments) if direct experience of the procedure or clinical problem hasn’t been possible
To be signed off at level 2, the trainee should:
- Perform the clinical skill/manage the case under supervision
- Be aware that the number of times the competence/clinical skill/situation needs to be assessed depends on the complexity of the case and individual aptitude
- Be aware that there’s therefore no limit to the number of times the procedure can be supervised and there’s no advantage in having a module signed off until there’s certainty the trainee can safely perform the procedure in a number of different clinical situations and levels of complexity
- Be able to manage any unexpected complications but know when to summon senior help
To be signed off at level 3, the trainee should:
- Demonstrate the ability and confidence to perform the clinical skill/situation competently when senior staff aren’t immediately available, e.g. out of the hospital
- Show a willingness to move on to experiential learning with further case exposure
- Demonstrate a willingness to keep a record of the number of cases/procedures subsequently managed, including any complications and their resolution
- Remember that competency is a baseline level for safe independent practice, with further exposure and experience leading to proficiency and subsequently expertise (the latter will generally be developed post-CCT)