Postgraduate Diploma in Clinical Paediatric Emergency Care

Purpose

The purpose of the qualification is to develop foundational skills for practising doctors in both routine and complex paediatric emergency care conditions in children, including those from vulnerable populations affected by the neglected diseases of poverty.

The emphasis in the Postgraduate Diploma in Clinical Paediatric Emergency Care would be on core diagnostic skills required at the point of first contact with health care facilities in resource-limited areas. Furthermore, the trainees will be able to diagnose the clinical status of the patient and will be enabled to make an informed referral to the relevant tertiary services. The qualification will also enable trainees to engage in a meaningful conversation with the specialist/subspecialist at the referral centre. This would optimise patient referral patterns for severe cases and reduce needless referrals for less severe conditions. The qualification is designed as an apprenticeship to offer the necessary exposure to the hospital scenarios.

Rationale

The Department of Paediatrics has been training general practitioners from other African countries with the African Paediatric Fellowship Programme (APFP) for some years. These trainees study for a period of a year but depart with no formal qualification. Thus it has become imperative to structure a qualification so that the trainees can obtain a qualification. It is also envisaged that the Postgraduate Diploma in Clinical Paediatric Emergency Care may also be useful to South African doctors, who work in resource-challenged health care settings, as well as to paediatricians, who are not necessarily exposed to these skills and techniques.

Meanwhile there is a critical need for doctors in areas where there is little or no resources to gain skills in diagnosing and managing (often through referral) the most acute paediatric diseases. This Diploma aims to help address that need.

In partnership with the APFP, the Red Cross Children's Hospital Paediatric Emergency Care Service which offer paediatric emergency care including mixed adult and paediatric emergency units as well as university-based departments of paediatrics, doctors will be trained doctors as potential paediatric emergency care doctors for the care of children. Also upon completion of this qualification these trainees will be guaranteed employment.

Recognition of Prior Learning (RPL)

RPL will be possible whereby specific existing knowledge and skills will be assessed in one or more of the courses, against the outcomes of the course and in line with the assessment procedures of the course.

Entry Requirements

Students can apply for the Postgraduate Diploma in Clinical Paediatric Emergency Care if they meet the following requirements:

• Qualified Bachelor in Medicine (MBBS, MBChB or an equivalent qualification).
• Registration with the Health Professions Council of South Africa as a Medical Practitioner or as a Medical Practitioner in the category 'Postgraduate study UCT' is mandatory for applicants coming in via the African Paediatric Fellowship Programme.

This qualification consists of two compulsory modules at NQF Level 8 totalling 120 Credits

• Clinical Management in Paediatric Emergency Care, 90 Credits.
• Essay: Transition and Translation of Knowledge, 30 Credits.

1. Show evidence of skills acquired, knowledge and expertise in the management of paediatric emergency problems at a senior level.
2. Demonstrate early management of acutely ill children of all ages.
3. Be able to deal with a wide range of acute problems and be responsible for the initial stabilisation of critically ill children and with the initial diagnostic workup.
4. Be able to deal with complex problems which demand wide paediatric expertise input from other specialties.
5. Initiating appropriate referral, coordinating the care of the child including the paediatric intensive care.

Associated Assessment Criteria for Exit Level Outcome 1

• A leadership role is assumed and care across primary, secondary and tertiary levels is coordinated and the importance of a multi-disciplinary team approach is understood.
• Knowledge and application of the principles and practice of care of children outside of the hospital, including in Emergency Medical Services (EMS) is displayed.
• Competence in clinical case management of common disorders in paediatric emergency care (covering the clinical presentation, assessment, management challenges and the co-morbidities identified) is demonstrated.
• Appropriate documentation is generated reflecting appropriate case management (history, initial assessment, therapy, response to therapy, disposal plan) and good clinical practice principles is used.
• Knowledge and competence in conducting regular mortality and morbidity reviews to improve quality of patient care is conducted.
• A basic understanding of stress management and debriefing for patients and staff is demonstrated.
• Professionalism in dealing with children and their caregivers is demonstrated.

Associated Assessment Criteria for Exit Level Outcome 2

• A basic understanding of the range of common paediatric emergency conditions is demonstrated.
• Familiarity with standard emergency service equipment is displayed.

Associated Assessment Criteria for Exit Level Outcome 3

• Stabilisation procedures of critically ill or injured children are initiated using recommended international evidence-based guidelines.
• A sound knowledge and application of the principles of triage is demonstrated and applied on arrival at an emergency facility.
• Appropriate diagnostic tests are recommended and applied.

Associated Assessment Criteria for Exit Level Outcome 4

• Working with other specialties and sub-specialties, in complex cases is demonstrated.
• The importance of a multi-disciplinary team approach is understood.

Associated Assessment Criteria for Exit Level Outcome 5

• Clear communication with the necessary personnel and appropriate referral of the resuscitated child to an area that can adequately institute definite care is demonstrated.
• The professional and ongoing learning needs are effectively addressed and communicated so as to competently manage critically ill and injured children beyond the initial stabilisation phase to the seamless care approach.
• Short rotations through EMS, the paediatric trauma unit, Paediatric Intensive Care Unit (PICU), Neonatal Intensive Care Unit (NICU), Paediatric Anaesthesiology and overnight wards are conducted.

Integrated Assessment

Assessment is both formative and summative. Formative assessment is built on continuous feedback on both knowledge and clinical competence. Knowledge is then applied and such application is assessed in the formative assessment and summative assessment and in an extended essay. In addition students are required to maintain a logbook with a minimum number of clinical procedures.