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There are a number of consistently recurring questions which were the subject of a presentation at the first Scottish Multiprofessional Anaesthetic Assistants Development Group Workshop Day held at Stirling University Management Centre in May 2008. These were developed by Steve McIntosh and Stuart Somerville from the SMAAD Group.

What is the timeframe for completing the NES Portfolio for Anaesthetic Assistants?

A. The timeframe very much depends on the individual. However, the portfolio does provide a guideline based on the recommendations made by the Scottish Medical and Scientific Advisory Committee (SMASAC) report on Anaesthetic Assistance (external site pdf).

Month 1 - Supernumerary

Month 2 to 3 - Supervised daytime work

Months 3 to 9 - Supervision as required during the day, supervised night work

Months 9 on - Confirmation of competencies; completion of training (including moving & handling, ILS & in-house practical skills training). Independent practice.

Are experienced staff expected to work on the same timeframe as staff new to theatre?

A. No. Each individual practitioner will be different. It is hoped that these individuals will be able to "Fast Track" through the competency portfolio by concentrating on areas of practice they feel they require additional learning or experience. This can be identified through self-assessment against the portfolio competencies and the completion of an agreed learning contract with their mentor & supervising consultant. Management may have to consider facilitating staff movement between clinical areas to ensure individuals have exposure to the required experience

What qualification does the completion of the portfolio give the individual?

A. The portfolio is recognised across Scotland, supported by NES and endorsed by the RCOA & AAGBI as one of the standards for Scotland. The Scottish Multiprofessional Anaesthetic Assistants Development Group (SMAAD) oversees the maintenance of local Health Board records of mentors & staff who have completed the portfolio. SMAAD also provides individual practitioners with a certificate of completion. The portfolio will also provide evidence of CPD for both NMC & HPC registration.

How much input is required from the named consultant anaesthetists?

A. Ideally as much as possible, although it is recognised that there are very real time constraints on individual consultants. As such, a pragmatic approach must be taken. It is anticipated that the majority of supervision / mentoring will be undertaken by suitably experienced nurses & ODPs. The consultant will be expected to oversee this supervision / mentoring and be involved in the final sign off for practitioners completing the portfolio. The consultant may also be involved in teaching in the clinical setting (where practicable), assessing in the clinical session, providing teaching sessions, providing feedback to the main nursing / ODP mentor, etc.

Is there access to an academic component to underpin the knowledge required to complete the competency portfolio?

A. Yes this currently available either as distance learning modules at Degree and Masters level through the Napier University or as a campus-based modules through Glasgow Caledonian University. The University of West of Scotland also offers a course, which has been endorsed by the Group, covering Core Competencies 1 - 10 and the obstetric, ENT and paediatric competencies.

Is the academic component compulsory?

A. No. Only competencies in Section 1 to 10 and the common themes must be completed. Practitioners working in specialised areas covered by Section 11 to 20 will have to complete these if it is an area of practice they are expected to work in. However, particularly with staff new to theatres, individual departments may feel that completing the academic component is vital in underpinning the knowledge required to successfully complete the competency component.

What happens to practitioners who find it difficult to complete the portfolio to a satisfactory level?

A. Firstly, any issues must be identified early with individuals by mentors & supervising consultant. If individuals will achieve the competencies with an extended time frame / additional support, then it is advised that this should be considered on an individual basis in discussion with the individual staff member, management, mentors & the supervising consultant. If competency issues are more serious then it may be a management decision to deal with this through capability policies.

What happens once individuals have completed the portfolio? Don't you think the portfolio will end up gathering dust on a shelf?

A. Hopefully not. The portfolio is intended to be a "living" document, with staff revisiting it regularly and through reflective practice updating relevant sections. The portfolio is designed to allow staff to continue using it as evidence for NMC & HPC registration. As staff move jobs or geographic areas, their portfolio will be their evidence that they are a competent anaesthetic assistant, so there is incentive from this viewpoint for staff to maintain their portfolio as reflecting their current practice.

ODPs and some nursing staff, currently hold a recognised qualification (SVQ III, DipHE, ENB 182, ENB 183) to act as an anaesthetic assistant. Do they have to complete the portfolio?

A. Although these are recognised qualifications it is important that staff appreciate that the portfolio has a much wider impact on practice than just confirming competency. As has been mentioned a number of times, the portfolio is a "real time" reflection of the individuals current practice and as such provides robust evidence for NMC & HPC registration. It provides employers with evidence that staff are maintaining their CPD and are fit to practice. It also allows individual practitioners the ability to identify & evidence to management, areas of practice that they may require further training or experience in.

Can nurses act as assessors without one of the nationally recognised qualifications?

A. Yes. For the introduction of competency-based training on this scale, we have to start somewhere. Staff acting as mentors should be suitably experienced in both anaesthetic assistance and mentoring. It would be unfair and a waste of the vast amount of experience out there, not to allow these staff to act as mentors when they have functioned in the role of Anaesthetic Assistant safely and competently for a number of years. It is essential that these staff undertake the assessment process to achieve the level of competency defined within the portfolio under the supervision of an appropriate anaesthetist until they gain their certificate. The level of input and support from the nominated anaesthetist(s) would be greater in this circumstance, but over a shorter period, as the experienced practitioner can be "Fast Tracked" as mentioned earlier