THE EUROPEAN DATABASE ON SUBSPECIALIST TRAINING IN NEONATOLOGY – WHERE ARE WE TODAY IN EDUCATIONAL HARMONIZATION?

Morten BreindahlMD, PhD, Council Member of the ESN

Department of Neonatology, Level IV NICUThe National University Hospital in Copenhagen, Denmark

- Part of a larger society

Learning outcome

Breindahl et al.ESPR 54th Annual Meeting, Porto, October, 2013

After this session you shall be able to: Understand the background for and contents of

the European Curriculum and Syllabus for Training in Neonatology as well as the Assessment Framework for Specialist Trainees in Neonatology

Discuss the status of subspecialty training in Neonatology in Europe

Identify at least three areas where harmonization is still lacking behind

Discuss potential barriers against and drivers towards further harmonization of educational standards in Europe

Agenda

Breindahl et al.ESPR 54th Annual Meeting, Porto, October, 2013

Overview of the European Database on Subspecialty Training in Europe

How was it constructed, who participated, what does it show?

Main results, similarities and differences between participating countries

Database and process outcome – tasks to be completed in the future

Background: ESN Curriculum

19961st version. Sidarto B.

Oetomo, NL

19982nd version.

Michael Obladen, D

20073rd version. Neil Marlow,

UK

2008Transparenc

y. Gorm Greisen, DK

2010Database.

Morten Breindahl,

DK

2011All UEMS countries included

2011Database published

on ESN website

2012Results

published in Neonatolog

y

2013European

Network on HArmonizati

on of National

Curriculi on neonatal Education

(ENHANCE)

Breindahl et al.ESPR 54th Annual Meeting, Porto, October, 2013

Curriculum and Assessment Framework

Support of national training programmes

Aims at Harmonising training in

Neonatology Establishing clearly defined

standards of knowledge and skills

Fostering the development of a European network of tertiary care centres for Neonatology

Minimal record of clinical progression: 13 key competencies 3 levels

Additional demands: Other key areas Reflective notes Academic meetings (>

3/year) Other CME activities Abstracts, publications Audits (> 3) Certification of courses

European Curriculum and Syllabus for Training in Neonatology

Assessment Framework for Specialist Trainees in Neonatology

Breindahl et al.ESPR 54th Annual Meeting, Porto, October, 2013

Aims of the database

Improve transparency of the national guidelines compared to ESN curriculum

Publish similarities and differences Induce harmonisation through:

National self-reflection on own deviations from the majority

ESPR/ESN modifications of official requirements to reality

Breindahl et al.ESPR 54th Annual Meeting, Porto, October, 2013

Method

Construction of database based on ESN curriculum: (Basic characteristics) Training – knowledge Training – skills Key competencies Personal development Recording of progress

E-mail contact to UEMS members Identification of contact persons Data collection, registration,

verification of data Agreement with ESN Curriculum Publication of database on ESN

website Publication of results in

Neonatology

Breindahl et al. ESPR 54th Annual Meeting, Porto, October, 2013

Results 1: Overall characteristics Response rate

100% (30/30) National/ESN curriculum

76% (23/30): National 13% (4/30): ESN

Curriculum 10% (3/30): Neither

Length of training Paediatrics: 4.1 [2-6]

years Subspecialist: 2.4 [1-6]

years Years in NICU: 1.2 [0-4]

years

Breindahl et al.ESPR 54th Annual Meeting, Porto, October, 2013

70% - 73%

94% (28/30) Resuscitation Neurology Communication

and counselling Anomalies,

genetics Intensive care Fluid balance Haematology Metabolism Nutrition Immunity Family care Management skills Transport of

newborns

Results 2: Uniformity

96% (29/30) Epidemiology Patho-/

physiology Foetus Premature Mature

Pharmacology Neonatal care Follow-up of

high risk infants Ethics and legal

issues

Training/ knowledge Training/ skills Key

competencies 93% (28/30)

Practical procedures

Diagnosis Clinical practice Communication Technology Teaching

ESPR 54th Annual Meeting, Porto, October, 2013

Results 3: Differences

67% (20/30) Personal skills necessary for

fulfillment of the leadership role within the team and unit/ hospital Counsellor Manager Leader Teacher Clinical governance and audit Statistical and interpretative

skills

77% (23/30) Completion of other key

areas Perioperative care Fetal medicine Clinical genetics Developmental assessment

Reflective notes Research activity

Academic meetings CME activities Research activity Audits Courses

Personal development Recording of progress

Breindahl et al. ESPR 54th Annual Meeting, Porto, October, 2013

Database outcome

Knowledge Skills Competencies

Common understanding of the essential qualifications needed to practice neonatology at a tertiary level

Basic characteristics Personal development Recording of progress

Different prerequisites, cultures and systems call for cooperation, exchange of information and experiences

High uniformity Considerable differences

Breindahl et al.ESPR 54th Annual Meeting, Porto, October, 2013

Proces outcome, goals and solutions

All UEMS members: 30 countries

100% response rate Willingness to

Participate Report

Interest in Changing Adapting Developing

Transparency achieved

Goals Make ESN the organization for

neonatologists and trainees Complete harmonization of

national training curriculi Complete directory of tertiary

care centres for neonatology Solutions

Visibility Transparency Influence Harmonization Partnership

Process outcome Goals and solutions

Breindahl et al. ESPR 54th Annual Meeting, Porto, October, 2013

Building bridges in Europe

Breindahl et al.

EAPS, Copenhagen 2010

ESPR, New Castle 2011

Cluj-Napoca 2013 ESPR, Porto 2013

ESPR, Istanbul 2012

ESPR 54th Annual Meeting, Porto, October, 2013