Postgraduate Diploma in Neonatology

Purpose

The purpose is the development in general practitioners of foundation skills in clinical neonatal management (beyond skills acquired in general medical training) to ensure safe practice. On completion of the training the learner should be able to:

• Demonstrate competency in the management of the sick neonate.
• Demonstrated ability to translate knowledge to practice at all levels of health care - primary to tertiary.
• Translate care into a holistic approach for the neonate, addressing all airways, respiratory, feeding, haemodynamic and biochemical needs.
• Demonstrate competency in blood-taking, further laboratory- based screens, chest drains, intubation etc.; interpret laboratory results especially blood gas analysis; understanding ventilation support with appropriate equipment e.g. CPAP.

Rationale

The Department of Paediatrics has been training general practitioners from other African countries in terms of the African Paediatric Fellowship Programme (APFP) for some years. To date the general practitioner trainees who are studying for one year depart with no formal qualification. Thus the institution would like to structure the process so that the trainees leave with a recognised qualification. The trainees will benefit when they their return to their home institution with a recognised qualification. It is envisaged that the diplomas may also be useful to South African doctors in resource-challenged health care settings, and that even paediatricians - who are not necessarily exposed to these skills and techniques - would also find the training helpful.

Those doctors who wish to and qualify for admission to a speciality or subspeciality training qualification (of 4 and 2 years respectively) may apply for admission to such qualifications. There is a critical need for doctors in resource-poor areas to gain skills in diagnosing and managing (often through referral) the most acute paediatric cases. However, many doctors and specialists cannot leave their jobs in the public health care sector in their home countries for extended periods of time, and also do not have the desire to specialise or do research. In the Diploma emphasis is placed on core diagnostic skills required at the point of first contact with health care facilities in resource-limited areas. It would help inform the general practitioner about the clinical status of the patient and assist him/her in making an informed referral to tertiary services.

The immediate need is therefore to provide clinical training and expertise in basic neonatal care and specific skills aimed at targeting the reduction of neonatal deaths in Africa. The Clinical Postgraduate Diploma in Neonatology will be unique in that it is not offered elsewhere and will target junior doctors working in a resource-poor context. The qualification places special focus on reducing neonatal mortality and improving the quality of neonatal care services and programmes at the most basic level of care.

Recognition of Prior Learning (RPL)

The institution's policy provides guidance in terms of the Recognition of Prior Learning for learners interested in enrolling for the qualification.

Entry Requirements

Admission requirements for this qualification are

• Bachelor in medicine (MB BS, MB ChB / equivalent qualification) and approved experience working in paediatrics.
• Registered with Health Professions Council of SA.

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

Modules

• Clinical Management in Neonatology, 90 Credits.
• Essay in Transition and Translation of Knowledge, 30 Credits.

1. Demonstrate competency in a range of clinical procedures relating to treatment of the neonate.
2. Access, analyse, organise and critically evaluate existing knowledge in the field of neonates.

Associated Assessment Criteria for Exit Level Outcome 1

• Diseases which affect neonates are defined, diagnosed and classified.
• Awareness of the prevalence of neonatal complications in Africa and the challenges to correct diagnosis and implementation of care is demonstrated.
• Neonates in need of specific interventions are recognised.
• Techniques relevant to practice for managing neonates are applied.
• Competency in blood-taking, further laboratory - based screens, chest drains, intubation etc is demonstrated.
• Knowledge is translated to practice at all levels of health care primary to tertiary.
• Appropriate knowledge of current recommended international guidelines relevant to practice in the field is applied.
• Care is translated into a holistic approach for the neonate, addressing all airway, respiratory, feeding, haemodynamic and biochemical needs.
• Laboratory results especially blood gas analysis are interpreted.
• Ventilation support with appropriate equipment e.g. CPAP is used.
• Kangaroo care which includes correct handling and positioning is promoted.

Associated Assessment Criteria for Exit Level Outcome 2

• Different theories on the presentation of neonatal complications and diseases are evaluated.
• Problems and issues that reflect a purposeful and critical application of advanced theory, current knowledge and expertise in neonates is analysed.
• Acting ethically and professionally in context of neonates is shown.
• Information in the literature on diabetes is gathered independently, validated and evaluated.
• Clinical discourse that relates to understandable approaches to care of neonates is communicated.
• Integrated knowledge of neonatal diseases and care is translated into own practice
• The skills and knowledge attained from current practice, latest literature is maintained and used during the learning process.

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 an extended essay.

There are three formative assessments (case-based oral tests). A learner who fails two of these after intensive remedial training will forego a Duly Performed (DP) and may be required to withdraw from the programme.

A logbook will be a DP for the final assessment.

The long essay will be a combination of the summary of the epidemiology of the centre the learner is from, including the health care needs and ability to deliver health care for the region.