6.IMPACT RCPL College Tutors Magnus Garrioch

8/22/2019 6.IMPACT RCPL College Tutors Magnus Garrioch

1/20

ILL MEDICAL PATIENTS:

ACUTE CARE AND TREATMENT

Magnus Garrioch, FRCA, FRCPIMPACT National Director,

Consultant in Critical Care,

Manchester Royal Infirmary

Royal College of Physicians of London, College Tutors Day

28th November 2012
https://twimg0-a.akamaihd.net/profile_images/824783578/RCPE_Logo_for_Twitter.JPGhttp://www.ics.ac.uk/http://www.rcoa.ac.uk/http://www.rcplondon.ac.uk/http://www.resus.org.uk/http://www.rcpsg.ac.uk/


2/20

l Describe the project and what it does

l Describe the successes of the project

l Describe the challenges ahead

l Take a straw pole of what RCPL Tutors think about IMPACT

l Encourage RCPL tutors to assist/nominate

IMPACT Project


3/20

l In 2000, courses for cardiac arrest (ALS), trauma (ATLS), surgicalcritical illness (CCrISP)... Nothing obvious for physicians

l IMPACT working party formed in 2003

l A 2 day course to improve the recognition and management of theacutely ill medical patient

l Sponsored by Federation of Medical Royal Colleges, Royal CollegeAnaesthetists and supported by Resuscitation Council andIntensive Care Society

l Approved by Royal College of Physicians Committee on CoreMedical Training for CT1/2 trainees in GIM, Acute Medicine andACCS

IMPACT what is it?


4/20

Comparing IMPACT with other courses

ALS

ALERT / AIM

CCrISP

ILS


5/20

l Teaches recognition and treatment of critical illness based on ABC(DE)

principles to enable management of the acutely unwell medical patient

ACS, asthma, COPD, Diabetes, Poisoning etc.

Skills of central venous cannulation, pleural drainage and NIV

Communication and referral skills

l The course provides the following:

Text book (manual)

Key point presentations (lectures)

Workshops/ hands on skills stations/ critically ill patient scenarioswith actors

Assessment: continuous and summative from scenario

l 16 medical candidates on each course with 4 nurse observers

IMPACT what does it do?


6/20

IMPACT Example of a scenario


7/20

IMPACT:SUCCESSES


8/20

Widespread uptake

l

New centres in 2008

Interest from

Northampton

Liverpool

Wrexham

Norwich

Stevenage

Lancaster

Inverness

Aberdeen

Glasgow

Edinburgh

Belfast

Dumfries

Sunderland

Middlesborough

Isle of Man

Harrogate

HullManchester

Wirral

Nottingham

Kings Lynn

Birmingham

Ipswich

Merthyr Tydfil

Bristol

Cardiff

Barnet

London (x3)

Guildford

TauntonPlymouth


9/20

Increasing course numbers

0

10

20

30

40

50

60

2004 2005 2006 2007 2008 2009 2010 2011 2012

Number

Year


10/20

IMPACT instructor days

0

2

4

6

8

10

12

2004 2005 2006 2007 2008 2009 2010 2011 2012

Number

Year


11/20

Candidate numbers

l Total number of doctor candidates who have done

IMPACT since inception - 4635

l This year (1st Nov 2011 - 25th Sept 2012)

589 candidates


12/20

Positive

Cant recommend it highly enough

Extremely useful for clinical practice has rekindled my interest in acutemedicine

I feel more confident about my knowledge and ability to deal with acutesituations

Excellent practical sessions and scenarios

The small group sessions discussion and practical were excellent andenhanced my knowledge

I found the IMPACT book very useful, to the point and easy to read. Iwould not hesitate to recommend the course to my colleagues

Post course feedback


13/20

Positive

Very informative lectures and hands on scenarios were brilliant

Feel more confident when approaching acutely unwell patient

Really excellent course faculty friendly and good quality teaching

I feel more calm and focussed in acute situationsSmall group teaching and scenario based learning is an excellent way of

teaching as it allows explanation without feeling intimidated by a largegroup

Good consolidation of existing knowledge with reinforcement of a robust

system of assessing patientI wish I had this course during FY2. I believe this course should be

mandatory like ALS for at least the people who are going to do medicineor related specialties

Post course survey feedback


14/20

NegativeI felt a lot of the course content wasnt particularly new and that it was

probably pitched at FY2 level

Course material too basic for CT1/2 level. I was expecting more advancedcontent than ALS in terms of ventilatory support, arrhythmia

recognition. Course probably more useful for medical students/foundation doctors

This course was not pitched at FY2/ST1 level in its delivery although thecontent set out by IMPACT would have been very useful for this stage oftraining

I would personally prefer a more formal assessment at the end or at leastsome faculty feedback on my performance



15/20

NegativeNeed more simulated scenarios, more practice = better performance

For a CMT Trainee course too basic

Disappointed that some sessions taught by people out of their speciality it showed!

The course itself was very good, well conducted and useful. The coursemanual, however, is full of grammatical, spelling and even medical orcontent errors. It just needs better editing!

Lectures sometimes covered topic so superficially at such a basic level thatthey seemed almost pointless (e.g. lecture on AKI pitched at medicalstudent level)



16/20

IMPACT future direction

l Keeping this a high quality course

Responding to feedback

l Keeping the course up to date

Curriculum development group (15 members)

Need to expand CDG

Plan to upgrade course over the next year

l Interaction with other teaching (simulators)

l Acute care scenario in PACESl The F2 CT1/2 debate

Should the course be used for F2 teaching?


17/20

IMPACT upgrade

l Basic subjects stay the same but some additionalmaterial

Acute arrhythmia management

Fluids and transfusion

Acute presentations of chronic kidney disease

l Compulsory on-line reading

l Face to face teaching

more emphasis on case based discussions


18/20

IMPACT challenges ahead

l Keeping the course up to date

Curriculum development group (15 members)

Need to expand CDG

Plan to upgrade course over the next year

l The F2 CT1/2 debate

Should the course be used for F2 teaching?

l

When upgraded should we work towards compulsoryfor acute specialties?


19/20

IMPACT Feedback - What do you think?

l The project?

l Should it be a Royal College thing?

l The F2 CT1/2 debate?

l Compulsory for acute specialties?

l Suggestions

l Questions?


20/20

l Describe the project and what it does

l Describe the successes of the project

l Describe the challenges ahead

l Take a straw pole of what RCPL Tutors think about IMPACT

l Engage more closely with RCPL

l Do you want to get involved?

IMPACT Project

Documents

6.IMPACT RCPL College Tutors Magnus Garrioch