Work Based Assessments

ACEM Training

TS1 (up to 3-years)

  • 12 FTE months of core ED (adult / mixed)
  • EM-WBA completion
    • 8x mini-CEX (1x neuro, 1x cardio, 1x resp, 1x GIT)
    • 1x communication (handover)
    • 1x communication (referral)
  • Mandatory ACEM module completion
    • Indigenous health and cultural competence
    • Assessing cultural competence
    • Critical airway management
    • ACEM core values
  • Primary exam completion (Written and VIVA)

TS2

  • 12 FTE months of core ED
  • EM-WBA completion
    • 4x CBD
    • 2x mini-CEX (2x medium complexity)
    • 1x communication (handover)
    • 1x communication (referral)
  • Mandatory ACEM online module completion
    • Clinical supervision
    • Giving feedback
    • Ultrasound

TS3

  • 12 FTE months of core ED
  • EM-WBA completion
    • 4x CBD (2x high complexity)
    • 3x mini-CEX (2x high complexity)
    • 3x shift reports
  • Mandatory ACEM online module completion
    • Clinical leadership
  • ACEM Fellowship exam (Written)

TS4 (up to 12-yrs)

  • 6 FTE months of core ED training
  • 6 FTE months of elective training
    • ED or non-ED (ultrasound, medical administration, toxicology, retrieval)
    • 2x uninterrupted 3-month blocks at different sites OR
    • 1x uninterrupted 6-month block at single site
  • EM-WBA completion
    • 3x shift reports in-charge
    • 2x team lead / intubations
  • Mandatory ACEM online module completion
  • 1x Morbidity and Mortality presentation
  • 1x Formal teaching presentation
  • 1x Guideline / Protocol review / audit
  • ACEM Fellowship exam (Clinical)

Non-ED training time

  • Completed TS1 – TS3
  • 6 FTE months
  • 2x uninterrupted 3 FTE month blocks. Each block may be completed in different discipline at different sites OR
  • 1x uninterrupted 6 FTE month block in a single discipline at single site
  • Placements in any of the following: Paediatrics, Anaesthetics, ICU

Major referral / Non-major referral training time

  • 6 FTE months need to be completed in a major referral centre i.e., Liverpool
  • 12 FTE months need to be completed in a non-major referral centre i.e., CTN

Paediatric Requirement

  • Can be commenced in TS1, but completion not mandatory to complete TS1
  • Maximum 2x DOPS and 1x mini-CEX can be completed in TS1
  • Must be completed in TS3 to enter into TS4
  • All components are undertaken in paediatric EDs, not during paediatric rotation
  • 3x CBDs (1x medium and 1x high complexity, 1x 2-12yo, 1x <2yo)
  • 3x mini-CEX (2x medium complexity, 1x DC communication, 1x focused assessment 2-12yo and unclear diagnosis, and 1x focused assessment <2yo + unclear dx)
  • 2x DOPS (1x specimen collection, 1x procedural sedation <5yo)
  • Paediatric portfolio (200x cases <5yo, 200x cases 5-15yo, 50x cases ATS 1 or 2, 150x cases ATS 1-3. Encounter = Hx, PEx, Mx, Disposition, Documentation)

Research Requirement

  • Can be commenced in TS1, but completion not mandatory to complete TS1
  • Must be completed in TS3 to enter into TS4
  • Satisfied by wither coursework or completion of trainee research project

Procedural Requirement

  • 12x core procedures (arterial line insertion, CVL insertion, procedural sedation, regional anaesthesia, fracture reduction, dislocation reduction, corneal FB removal / nasal packing, intubation, LP, DC cardioversion, pleural drain insertion, POCUS)
  • 9x assessment domains (1x technical, 8x non-technical)
  • All core procedures must be performed at level of junior FACEM i.e., performed independently in all 9 assessment domains, by TS4
  • Can be commenced in TS1, but completion not mandatory to complete TS1

Critical Care Requirement

  • Completed during TS2 – TS4
  • 6 FTE months of critical care training (anaesthetics, ICU)
  • 2x uninterrupted blocks of 3 FTE months (different disciplines, different sites) OR
  • 1x uninterrupted block of 6 FTE months (single discipline, single site)

For more information, click here

ACEM Curriculum

ACEM Term Dates

Trainee Handbook

TRAINEES WHO JOINED ACEM PRIOR TO 2022


TRAINEES WHO JOINED ACEM AFTER 2022

Local WBA Coordinator

Changes to FACEM Curriculum

  • For trainees who joined ACEM prior to 2022, WBAs could only be counted during advanced training. 
  • From 2022, WBAs can be counted towards training from Training Stage 1.

Shift Reports

  • Dr Atul Goel will allocate these prior to commencement of each term and allocations can be found on the whiteboard outside the registrar room. 
  • All shift reports will be conducted during a day shift.
  • Shift reports will conducted in all areas of the department i.e., acute/resus, fast track, paeds and ESSU.
  • Late Phase ATs / TS3 and TS4 will all do Shift Reports as In-Charge and carry the admitting phone.

Case-Based Discussions

  • Dr Atul Goel will allocate these prior to commencement of each term and allocations can be found on the whiteboard outside the registrar room. 

Mini-CEX and DOPs

  • A non-clinical FACEM is allocated to supervising WBAs Monday-Friday 0900-1700.
  • This FACEM will be identified at the Chef’s meeting and it is incumbent on the trainee to seek out supervision during their shift.

    Minimum Requirement

    • We encourage trainees to do more than the bare minimum as it pertains to EM-WBAs. 
    • It formalises and institutes bedside teaching as part of your everyday training experience.
    • Failing that, please see the information provided by the college in regards to the minimum requirements in terms of numbers and complexities.

    ITA Checklist

    • During your beginning and end of term assessment, the DEMTs will complete the following ACEM Requirements checklist with you

    TS1 – TS4 (42-months FTE in ED + 6-months FTE in Critical Care)

    • These DOPS procedures, considered integral to the practice of emergency medicine, involve a trainee being observed by an Assessor whilst performing a specific clinical procedure.
    • The Assessor rates and provides feedback on the trainee’s performance, from the technical part of performing the procedure to post-procedure management and discharge advice, as applicable.
    • The Procedural Requirement will be noted by the relevant Trainee Progression Review Panel once all core DOPS have been completed successfully and submitted in the online Trainee Portal.
    • ACEM DOES NOT EXPECT THAT TRAINEES WILL BE SUCCESSFUL ON THEIR FIRST ATTEMPT

    Core DOPS / Procedures List

    DOPS / Procedural Requirement Process at Campbelltown 

    • 8 out of 9 assessment domains are based on non-technical expertise. It is expected that you complete the online learning modules developed to meet this need in order for you to pass these assessment domains. 
    • To be signed off as satisfactory for a procedure, trainees must complete the following:
      • Theoretic component – Online learning modules, click HERE
      • Practical component – Direct supervision in simulated environment
      • Practical component – Direct supervision in clinical environment and logbook completion
      • Assessment component – 2x Formative assessments and 1x Summative assessment, unless otherwise stipulated
    • Prior to successful completion, procedures will be entered as unsatisfactory with an explanation of why i.e., part of local procedure credentialing process

    Structured Marking Templates

    • These have been developed by Daniel to ensure the feedback you receive is structured, objective and constructive.
    • These can be found under Procedures Tab – ACEM CORE DOPS – MARKING SHEETS
    • Print them off and hand them to your FACEM assessor prior to commencing your DOPS.
    • These can be handed back and used to close any learning gaps which may have been uncovered and assist in OSCE preparation.

    ACEM Portal

    TS1 (12-months FTE in ED)

    • 8x Mini-CEX
      • At least 1x Cardio, 1x Resp, 1x Neuro and 1x GIT

    TS2 (12-months FTE in ED)

    • 4x Mini-CEX
      • 2x medium complexity

    TS3 (12-months FTE in ED)

    • 3x Mini-CEX
      • 2x high complexity

    TS4 (6-months FTE in ED)

    • 2x Team leads in intubation / resuscitation

    Mini-CEX at Campbelltown

    • We have developed online modules to help you prepare for your Mini-CEX.
    • We have developed marking sheets to provide objective and structured feedback.

    ACEM Portal

    CTN ED Assessment Guides

    • History Taking
    • Cardiorespiratory Examination
    • GIT Examination
    • Neurological Examination
    • Mental State Examination
    • Limb Examination
    • Paediatric Examination
    • Eye Examination
    • Templates

    TS1 (12-months FTE in ED)

    • 1x Handover
    • 1x Referral

    TS2 (12-months FTE in ED)

    • 1x Handover
    • 1x Referral

    Referral – Overview

    • Request to specialty service external to ED (inpatient / receiving team)
    • Does not apply to referrals made to allied health or ESSU
    • FACEM observes referral conversation (phone, person) between trainee and referral recipient OR FACEM assumes the role of recipient for a simulated referral prior to referral being made
    • Click HERE to watch a demonstration video

    Referral – Assessment

    • Communication
      • Demonstrate principles of good communication
      • Convey information in a structured format
      • Check referral recipient’s understanding 
      • Reach a negotiated understanding / consensus
      • Demonstrate importance of handover documentation
    • Prioritisation & Decision Making
      • Demonstrate appropriate clinical reasoning in facilitating referral
      • Evidence-based risk stratification tools
      • Impression and DDx
      • Clinical and diagnostic testing
      • Analytic thinking
      • Refer to salient aspects (urgency, patient assessment, provisional diagnosis, complications, pitfalls, provisional and further management plans / issues)
    • Teamwork & Collaboration
      • Demonstrate a collaborative approach focused on patient outcomes
    • Health Advocacy
      • Demonstrate patient advocacy

    Handover – Overview

    • Transfer of professional responsibility and accountability for some / all aspects of clinical care
    • Can be to another team member in ED (ESSU FACEM), for more than one patient and for patients whom the trainee has had primary responsibility of assessment and management
    • Assessment may include all or part of a clinical handover
    • Can be of a section or physical area of the ED, or of more than one patient at the conclusion of a shift
    • Click HERE to watch a demonstration video

    Handover – Assessment

    • Communication
      • Display principles of good communication
      • Convey information in a structured format
      • Check handover recipient’s understanding
      • Minimise risks associated with clinical handover
      • Demonstrates importance of handover documentation
    • Medical expertise
      • Perform handover of essential information
      • Recognise high risk features
      • Outline appropriate DDx
      • Identify undifferentiated patients
    • Prioritisation and Decision Making
      • Identify key decision making and potential gaps in decision making
      • Prioritise outstanding tasks
      • Highlight potential deterioration and outline appropriate management

    ACEM Portal

    TS2 (12-months FTE in ED)

    • 4x CBD (2x medium complexity)

    TS3 (12-months FTE in ED)

    • 4x CBD (3x high complexity)

    CBD at Campbelltown

    • We expect that TS1 trainees will complete at least 2x CBDs during 12-months FTE in ED.
    • We will be assessing your
      • Medical Expertise
      • Prioritisation and Decision Making
      • Teamwork and Collaboration
      • Health Advocacy
      • Communication incl case notes
      • Professionalism

    ACEM Portal

      FACEM CBD Feedback Guide (produced by D Gaetani)

      TS1 – TS3 (36-months FTE in ED)

      • 3x Mini-CEX (1x can be completed in TS1, rest in TS2-TS3)
      • 3x CBD
      • 2x DOPS (2x can be completed in TS1, rest in TS2-TS3)
      • Paediatric portfolio (can only be completed in ED)

      Mini-CEX

      • Patient discharge communication for common diagnosis
      • Focussed assessment + Age 2-12 yo + Unclear diagnosis (verbal communication with child) 
      • Focussed assessment + Age <2 yo + Unclear diagnosis (non-verbal communication with carer)

      CBD

      • At least 1x Age 2-12 yo and 1x Age <2 yo

      DOPS

      • At least 1x Specimen collection for lab analysis + Age <5 yo
      • At least 1x Procedural sedation + Age <5 yo

      Paediatric Portfolio

      • Minimum 400 cases
      • 200 cases related to the management of children <5 yo;
      • 200 cases related to the management of children 5-15 yo;
      • 50 cases classified as triage category 1 or 2;
        • of which at least 25 must be <5 yo
      • 150 cases classified as triage category 1, 2 or 3.

      ACEM Portal

      TS3 (12-months FTE in ED)

      • 3x shift reports (in-charge of an area within the department for entirety of the shift).

      TS4 (6-months FTE in ED)

      • 3x shift reports IN-CHARGE (in-charge of department i.e., holds AMO phone, for entirety of the shift).

      Assessment

      • Specific feedback provided on all domains of Curriculum Framework
      • Assessment of trainee performance regarding factors impacting ED as a whole.
      • Take periodic snapshots of the trainee and feedback throughout and at end of shift.
      • Ask feedback from other clinical staff about trainee performance as deemed appropriate.
      • At least 3 of the 8 components need to be assessed on the form.
      • When providing feedback, it should be directed at the gap between the trainee’s current practice and the ideal practice of a graduating FACEM, not necessarily what is expected from trainee at her level.

      Shift Reports at Campbelltown

      • You will be allocated to a shift report during each term.
      • Shift reports will be conducted in all areas of the department and allocated based on level of seniority. 

      ACEM Portal

      TS4 (ED or Non-ED)

      • Formal teaching presentation

      Scholarship & Teaching at Campbelltown

      • Regardless of stage of training, trainees will be expected to present at least 1x formal teaching session per year.

      ACEM Portal

      TS3 or TS4 (18-months FTE in ED)

      • At least 1x guideline / protocol review or clinical audit

      Clinical Audit or Guideline / Protocol review – Assessment

      • Topic selection (Plan)
        • Identify and justify need for review
        • Identify potential barriers in conducting review
        • Identify strategies to mitigate potential bias
        • Critically evaluate departmental / organisational practice and variation from current guideline / protocol
        • Consider local governance requirements
      • Methodology (Do)
        • Propose parameters for focused literature search surrounding protocol / guideline
        • Design stakeholder questions
        • Analyse and respond to stakeholder feedback
      • Analysis (Study)
        • Critically appraise literature review and compare against previous guideline / protocol
        • Demonstrate a collaborative approach and incorporate stakeholder perspectives in guideline / protocol
      • Recommendations (Act)
        • Draft a new or modified guideline / protocol
        • Provide rationale for maintaining or modifying guideline / protocol based on evidence and stakeholder perspectives
        • Discuss plan for implementation, education and dissemination
        • Identify plan for feedback cycle and audit
        • Acknowledge contributors
      • More information can be found HERE

      M&M

      • Background and timeline
        • Patient history
        • Observations
        • Investigations
        • Assessment
        • Treatment
        • Other factors (hospital journey)
        • Outcome for patient
      • Evolution of case
        • Identify relevant

      QA / QI Requirement at Campbelltown 

      • As a trainee, you will be allocated to a departmental committee based on preference or need.
      • As a committee member, you will be required to perform at least 1x guideline / protocol review or clinical audit per year, regardless of stage of training.
      • You will be expected to help prepare and present at least 1x M&M every 12-months

      ACEM Portal

      TS4 (6-months FTE in ED)

      • A Team Lead resuscitation/intubation assessment involves the direct observation of a trainee leading a team during the resuscitation or intubation of a patient.
      • The ability to lead a team during a resuscitation or intubation is essential for all FACEMs and this assessment provides the opportunity for trainees to consolidate their leadership skills.
      • The assessor rates and provides structured feedback on the trainee’s performance leading the team.

      Assessment Criteria

      • Prioritisation and Decision Making
        • Plan and prepare for arrival of patient
        • Anticipate problems
        • Demonstrate continued situational awareness with increased task loading
        • Make safe and timely decisions
        • Respond to additional information
        • Recruit specific additional staff and resources as required
        • Incorporate input from team to inform shared decision making
      • Leadership and Management
        • Allocate or reassign roles appropriately
        • Demonstrate authority and control
        • Ensure timely interventions and process
      • Teamwork and Collaboration
        • Employ active listening
        • Provide constructive feedback
        • Intervene to minimise errors in patient care
        • Use conflict resolution strategies as required
        • Support fellow team members during and after resuscitation
        • Debrief team members when required

      ACEM Portal

      Liverpool ED Placement

      • Complete LDP at start of term with designated DEMT
      • Complete ITA at completion of term with designated DEMT
      • Meet EM-WBA and Paediatric-WBA requirements according to stage of training in conjunction with WBA supervisor
      • Be allocated a mentor at the start of term
      • Participate in roster as per contracted FTE hours
      • Engage in scholarship & teaching activities
      • Engage ultrasound, research, QA and QI activities
      • Complete ACEM QA/QI, teaching and leadership requirements (TS3-TS4)
      • Enter paediatric cases into paediatric portfolio as per ACEM requirements
      • See ‘Secondment Logbook

      Paediatrics

      • Meet with term supervisor 

      Primary Exam

      • Completed in TS1 / Provisional Training
      • Assesses application of basic sciences (Anatomy, Physiology, Pathology, Pharmacology)
      • 2x 3hr Written Exams (SCQ)
      • 1x Integrated VIVA (4x 10-minute stations over 1-hr period)
      • For more information, click here

      Fellowship Exam (Written)

      • Completed in TS3 (Written) / Late phase advanced training
      • Assesses trainee’s knowledge, application of knowledge and understanding alignment with TS3 learning outcomes
      • 2x 3hr Written Exams (1x SCQ 120 Qs and 1x SAQ 30 Qs)
      • For more information, click here

      Fellowship Exam (OSCE)

      • Completed in TS4 / Late phase advanced training
      • Successful completion of FEx Written required
      • Conducted over 2 days
      • 10x clinical stations per day
      • Each station lasts 11-minutes (4-minutes reading time, 7-minutes assessment)
      • For more information, click here