Introductory Booklet - Royal Australasian College of Surgeons

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Introductory Booklet. Care of The Critically Ill. Surgical Patient. Course. Produced by. The Royal Australasian College of Surgeons ...
Care of The Critically Ill Surgical Patient Course

Introductory Booklet

Produced by The Royal Australasian College of Surgeons

The Royal Australasian College of Surgeons

An Introduction to the

CARE OF THE CRITICALLY ILL SURGICAL PATIENT AUSTRALASIAN PROGRAMME

Introductory Booklet 3rd Reprint, November 2005

CCrISP Introductory Booklet, Royal Australasian College of Surgeons FOREWORD The CCrISP course aims to educate the trainee in many of the practical aspects of critical care which the surgeon must learn to provide for his or her unwell patients. These patients may be emergencies, recovering from major surgery or suffering complications and may be found on wards, high dependency or intensive care units. Good management, often relying on basic principles which are common across the range of surgical practices, can prevent many problems developing, as can timely intervention. Additionally, the trainee surgeon must learn to communicate well with patients and colleagues, particularly those from anaesthesia and intensive care. CCrISP offers a framework which the trainee can use to achieve these ends. Over 100 CCrISP Courses have been run in over 30 centres in the UK, Hong Kong and Australasia. Its success is attested to by its widespread adoption and the courses for physicians and house officers which have been modelled on it. As the CCrISP Course develops, liaison with and input from a range of like-minded enthusiasts for good critical care practice can only strengthen the course and our historical ties and mutual professional respect ensure we are well placed to learn from each other. The CCrISP Course was initially set up with funds raised by public subscription in memory of the 96 young people who died at the Hillsborough football stadium, Sheffield, in April 1989. It is an honour to be asked to introduce this document about the Care of the Critically Ill Surgical Patient (CCrISP) Course in Australasia and a privilege to have been asked to bring the programme here. Our experience has been that our juniors have found it valuable, our patients have benefited and that our faculty enjoy teaching it. On behalf of the CCrISP Steering Group in the UK and the many instructors there, I wish you the same success and look forward to working with you. Iain D Anderson FRCS Tutor in Surgical Critical Care Royal College of Surgeons, England January 2002 (reprinted January 2000 & November 2005)

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FOREWORD At a time when the quality and safety of patient care is seen as an intimate product of clinical training, the Care of the Critically Ill Surgical Patient course remains as relevant today as it was upon its inception a decade ago. Scores of junior doctors have enjoyed and benefited from participating on this skills-based course. Many others have gained enormous professional rewards by being part of the multidisciplinary instructor faculty. The course provides a truly unique opportunity for consultant clinicians to teach, interact with and influence the behaviours of our junior doctors, whilst developing effective instructional skills. Likewise, the course provides an ideal opportunity for junior doctors to develop skills not only in the assessment and management of critically or potentially ill patients, but also in relational competencies, clinical responsibility and leadership. The CCrISP programme was developed in the United Kingdom, by the Royal College of Surgeons, England, spearheaded by Mr. Iain Anderson. Since being adopted in 2000 by the Royal Australasian College of Surgeons, the Australasian CCrISP faculty has contributed significantly to nd the production of the 2 edition of the course. The programme has been actively supported by the Australian College of Emergency Medicine, and the Australian & New Zealand College of Anaesthetists. Indeed, the instructor faculty is drawn largely from members of the three Colleges mentioned. For those of you who manage critically ill patients and have the passion for teaching junior doctors, I invite you to join the CCrISP instructor faculty. I have no doubt that you will find the experience enormously rewarding. Adrian Anthony FRACS Chair CCrISP Committee Royal Australasian College of Surgeons November 2005

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ACKNOWLEDGEMENTS On behalf of the Royal Australasian College of Surgeons, the Board of Basic Surgical Training is indebted to Mr. Iain Anderson (Tutor in Critical Care, Royal College of Surgeons, England). Without his ongoing support and goodwill, and that of his fellow colleagues, there would not have been the opportunity to adopt the CCrISP programme in Australasia. Professor Brian Rowlands (Nottingham, UK), Dr. Jonathan Goodall (Salford, UK), Mr. Robert Sayers (Leicester, UK) and Dr. Gary Smith (Portsmouth, UK) are also acknowledged for their generous and invaluable involvement in the inaugural Australasian CCrISP courses held in Perth (1999), Sydney and Melbourne (2000). This truly was an intercollegiate effort and it remains the privilege of the Board of Basic Surgical Training to administer such a highly regarded programme. The Board of Basic Surgical Training would also like to commend the Australian & New Zealand College of Anaesthetists and the Australian College of Emergency Medicine in facilitating the implementation of the CCrISP programme. The involvement of these specialist Colleges is integral to the success of the course and reflects the multidisciplinary approach to surgical critical care. The CCrISP faculty and administrative staff from both Australia and New Zealand have made a monumental contribution to the ongoing delivery of the programme in Australasia. This collective venture has maintained a healthy momentum of the programme. The individuals involved are too many to mention by name, but importantly, they continue to work in the development and delivery of CCrISP. Their ongoing interest and commitment to CCrISP is gratefully acknowledged.

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CONTENTS Foreword Acknowledgements 1. What is CCrISP? 2. CCrISP Objectives & Principles 3. Why Do We Need CCrISP? 4. Course Faculty 5. Course Candidates 6. Course Overview 7. Teaching the Course 8. What Else Does CCrISP Offer? 9. Getting Involved with CCrISP

This introductory booklet on the CCrISP course is supported by a Faculty Handbook, CD-ROM and a CCrISP course manual, all of which are available to course instructors. Please refer to the last page for contact details. The Royal Australasian College of Surgeons. www.surgeons.org

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Care of the Critically Ill Surgical Patient, Australasia – Introductory Booklet

1.

WHAT IS CCrISP ?

Welcome to the Care of the Critically Ill Surgical Patient (CCrISP) Programme. The CCrISP course has been adopted as one of three practical courses that all Basic Surgical Trainees are required to complete in the 2-year Basic Surgical Training Programme. The primary aim of the course is simple – to improve the management of critically ill patients by the doctor in training. Over two-and-a-half days, the course emphasises anticipation, prevention, early recognition and management of complications. It encourages trainees to adopt a system of assessment to avoid errors and omissions, and uses relevant clinical scenarios to reinforce these objectives. The course assists the trainee in developing simple, useful skills for managing critically ill patients, and promotes the coordination of multidisciplinary care where appropriate. The course is as much about putting clinical knowledge, acumen, and procedural skills to use as it is about communication, responsibility and leadership. Although all Basic Surgical Trainees are asked to complete the course, CCrISP is sufficiently generic to be suitable for any doctor in training who is likely to encounter critically ill patients (either surgical or medical). By virtue of the programme content, the course is delivered by a multidisciplinary faculty comprising of anaesthetists, intensivists, emergency physicians, surgeons and nurses. Each faculty is invited to contribute their expertise throughout the course and to instill good practices amongst the trainees. Importantly, the course material continues to be carefully reviewed to ensure that the programme remains relevant, accurate and up to date. The faculty and trainees are invited to provide feedback about any aspect of the course. The course does not advocate the ‘best’ or ‘only’ way to manage patients, but rather ‘one safe way’. This is determined by consensus and reflects accepted mainstream critical care practice throughout Australia and New Zealand. The CCrISP course is enjoyable, rewarding and worthwhile for both trainees and faculty. It stands as a highly relevant programme benefiting the skills of doctors as well as the safety and quality of healthcare throughout Australasia.

© 2005 Royal Australasian College of Surgeons

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2.

CCrISP OBJECTIVES & PRINCIPLES

The objectives of CCrISP are simple – the course is directed at trainees to advance the practical, theoretical and personal skills necessary for the care of the critically ill surgical patient.

The following principles are reinforced throughout the course:



Accept responsibility for patient management



Adopt a systematic approach to patient assessment



Appreciate that complications tend to cascade rapidly



Anticipate and prevent complications with simple, timely actions



Apply effective communication skills to facilitate patient care



Ask for appropriate assistance in a timely manner

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3.

WHY DO WE NEED CCrISP ?

There is acknowledgement that critically ill patients are often managed poorly. This may occur for any number of reasons but the outcome for the patient is too often singular and regrettable – death! It is even more regrettable because in many instances the demise of the patient could have been anticipated and prevented if only simple, timely measures had been undertaken. This is underscored by evidence from the UK. Patients admitted to intensive care were twice as likely to die if they received sub-optimal care prior to entering ICU, whereas patient care could have been optimised in 1 most instances by simple, prompt actions . Closer to home, the data appears no more encouraging. The Quality in Australian Health Care Study revealed that 65% of adverse events in hospitalised patients resulted from failure in either the assessment or management process, with a high preventability factor, and associated with significant 2 permanent disability and mortality . Other data suggests that a significant proportion of ICU admissions and hospital mortality result from failure to 3 recognise or act upon evidence of clinical instability . This worrying problem is compounded by a number of present day characteristics. The hospitalised patient is older, sicker and undergoes more invasive and physiologically challenging procedures, and treatmentrelated complications continue to rise. The trainee, on the other hand, has reduced contact time with patients, cares for patients in an increasingly ambulatory setting, often liaises less frequently with consultants and almost universally has relinquished the continuity of patient care for safer work practices. Clearly, there is a need to redress the unacceptable outcomes, and to this end the CCrISP course is just one strand of an intended wider safety net for patients and healthcare providers alike.

1 McQuillan P et al, “Confidential Inquiry into Quality of Care Before Admission to Intensive Care”. Br Med J 1998;316:1853-1858 2 Wilson R et al, “An analysis of the causes of adverse events form the Quality in Australian Health Care Study”. Med J Aust 1999;170:411-415 3 Buist M et al, “Recognising clinical instability in hospital patients before cardiac arrest or unplanned admission to intensive care” Med J Aust 1999;177:22-25

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4.

COURSE FACULTY

The following are allocated as faculty for each course: Course Director Course Coordinator Instructors (8 – 10) Instructor Candidates (2 – 4) Potential Instructors (up to 4) Nurse Co-Teachers (optional) Actor Simulated patients (4) Nurse observers (up to 4) 4.1

Course Director & Coordinator

The principal responsibility of the Director is to facilitate the coherent and effective delivery of the course, and to ensure the welfare of all participants. This is undertaken in close collaboration with the course Coordinator, and by liaison with the faculty. The course Coordinator is primarily responsible for the administration, organisation and availability of the vast array of resources required for the course. Persons who wish to direct or coordinate on courses will be assisted in gaining the necessary experience. 4.2

Instructors

Specialists, Provisional Fellows and senior accredited trainees from the disciplines of surgery, anaesthetics, intensive care and emergency medicine are welcome to join the course faculty. Ideally half of the instructor faculty will represent non-surgical specialties. A high instructor to participant ratio is achieved by allocating 16 participants and a minimum of 9 instructors to each course. All CCrISP instructors should have an active interest in the management of critically ill surgical patients, and be interested in the teaching of trainees. Instructors should be prepared to engage the course participants whilst offering accurate and constructive feedback, and instructors themselves should be interactive and enthusiastic throughout the course. It is important that all instructors support the objectives of the programme and draw on their clinical expertise in delivering the course.

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It is equally important that instructors are mindful of the need to deliver a course to a standard, both in content and teaching. The content is determined by consensus and undergoes periodic review. There is no intention, nor is it desirable, to advocate a single, exclusive management approach, but for the purposes of maintaining clarity and integrity of the course, the content represents accepted, mainstream critical care practice, and should be regarded as such by all instructors. The faculty is invited to return comment on any aspect of the programme for review. 4.3

How to Become A CCrISP Instructor



The initial exposure to the CCrISP course in all cases will be as a Potential Instructor. Potential instructors will observe and involve 1 themselves in all aspects of the 2 /2-day course. There is opportunity for potential instructors to actively participate in the demonstration and practical sessions. This is the most effective way for orientating new instructors to the course programme.



Potential instructors with formal instructional training, as approved by ® the C C r I S P Committee (e.g. on EMST , APLS, ‘Surgeons as Educators’ or other analogous courses) will then be eligible to teach their first course as an Instructor Candidate under the supervision of the Course Director, and following satisfactory demonstration of instructional ability, progress directly to become a qualified CCrISP Instructor.



Those without formal training are required to participate in a ‘CCrISP Instructors Course’ before teaching as an instructor candidate. The instructor course aims to familiarise potential instructors with contemporary educational principles and to assist participants in developing the necessary teaching and assessment skills using the CCrISP programme for reference. Currently, CCrISP Instructor 1 Courses are scheduled twice a year, and are conducted over 2 /2 days.

All instructors should be prepared to participate in one to two courses per year to maintain their instructor status. Instructors who wish to direct on courses will be assisted in gaining the necessary experience, initially as a Director Candidate.

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4.4

Nurses as Co-Teachers

Senior nursing personnel may be invited to co-teach with an instructor on a session relevant to their area of expertise. Examples include pressure monitoring, nutrition, wound care, communication skills and tracheostomy care. The following process is involved in identifying nurses who wish to participate in this role. 

The course director and coordinator will be responsible for identifying and inviting local nurses wishing to co-teach.



Nurses interested in co-teaching must have attended a CCrISP course as a nurse observer, and support the principles and objectives of the course.



The objectives of the teaching session and expectation of the nurse’s involvement must be clearly documented by the director and discussed with the nurse.



Co-teachers will not be required to attend faculty activities and will not be involved in the assessment of participants. Nurses will co-teach in a purely voluntary capacity.

4.5

Actor, Simulated Patients & Nurse Observers.

An integral feature of CCrISP is the use of realistic, clinically pertinent scenarios to reinforce the CCrISP objectives. An actor is employed for the communication scenarios and medical students, student nurses or surrogate patients are used as simulated patients during other demonstration or practical scenarios. The CCrISP programme encourages the participation of nurses and provides for nurses with a surgical or critical care interest to observe the course and participate in the practical scenarios. This is intended to propagate the CCrISP principles as good critical care practice amongst all healthcare professions.

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4.6

Faculty & Course Dinners

The faculty dinner is an important opportunity for all faculty members to become familiar with each other in a relaxed and social setting. This facilitates faculty interaction that is crucial for the course, not to mention the renewing or formation of friendships. The dinner is particularly important for new instructors and for faculty who are not local to where the course is being held. All faculty members are therefore expected to attend. The course dinner is similarly important to allow faculty and participants to interact away from the educational setting. This is particularly beneficial in building friendly rapport and facilitating the teaching and learning process for the course. Attendance by all faculty members and participants is expected.

© 2005 Royal Australasian College of Surgeons

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5.

COURSE PARTICIPANTS

The course is designed for trainees who work in a hospital environment and who encounter critically ill surgical patients. Sixteen participants are allocated to each course. The majority of enrolments are Basic Surgical Trainees but non-surgical participants involved in the management of critically ill patients are also encouraged to enroll for the course. Participants are required to have completed at least 12 months of clinical nd training and may therefore undertake CCrISP from as early as in their 2 post-graduate year. The course aims to develop the clinical, procedural and interpersonal skills of participants that will help in the acute care of patients. The emphasis is on the importance of the individual trainee accepting responsibility in the assessment and management of patients. The course may therefore be regarded as an important step for trainees in the transition to becoming advanced trainees. There is no suggestion that the course equips the trainee to be an expert in critical care, but rather to recognise when it may be best to seek senior or multidisciplinary assistance. The requirements for successful completion of the course are: 1. Familiarity of the course manual prior to the course and submission of the pre-course MCQ upon registration. 2. Full attendance at all components of the course. 3. Demonstration of appropriate attitude and enthusiasm, and of adequate knowledge, skills, and clinical insight throughout the course. 4. Effective assessment and management skills using the CCrISP principles and algorithm during the summative practical clinical scenario on the final day. A participant’s progress throughout the course is guided by regular formative feedback from the faculty. This process is crucial in maintaining a high standard of performance by all participants. In addition, each participant will have an assigned instructor as a mentor for the course, who will act as a contact person to discuss his or her performance or any

© 2005 Royal Australasian College of Surgeons

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other aspect of the course. It has become apparent that the CCrISP course enables appraisal of a number of personal attributes of the participant. Although these attributes are not formally graded during the course, there is opportunity for participants to receive useful and confidential feedback on this aspect of their performance. Participants who fail to meet requirements 1 – 3 (see previous page) for the successful completion of the course will be counselled accordingly and will be invited to attend either part of, or the entire course at a later date. Similarly, a participant will be counselled for a non-satisfactory performance during the summative clinical assessment (requirement 4), before being invited to re-sit the entire course at a later date. All successful participants will receive certificates acknowledging completion of the CCrISP course.

© 2005 Royal Australasian College of Surgeons

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6.

COURSE OVERVIEW

6.1

Features of the CCrISP Programme 

A focused two-and-a-half day practical course.



High instructor to participant ratio (~ 10:16).



Consensus curriculum of surgical acute care topics.



Multidisciplinary specialist faculty.



Systems & protocol based learning.



Interactive lectures, demonstrations & small-group practical sessions with data assimilation, clinical decision making & ample hands-on experience for all participants.



Use of simulated patients & clinically relevant scenarios.



Emphasis on communication & organisation as vital skills in acute surgical care.



Regular & confidential formative feedback & summative practical assessment.



Enjoyable atmosphere & camaraderie.

© 2005 Royal Australasian College of Surgeons

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6.2

Course Schedule

PRIOR EVENING

Precourse Faculty Orientation Meeting (~2 hours) Faculty Dinner (may be held on another evening)

TIME 0745

DAY 1 Coffee & Registration

TOPIC

0800

Welcome

0820

Introduction to Care of the Critically Ill Surgical Patient

0835

Assessing the Critically Ill Patient

0910

Demonstration: Patient Assessment [4 INSTRUCTORS]

0930

MORNING TEA

0950

Practical Skills (4 simulated patient stations x 15’) – Assessing the Critically Ill Patient [2 INSTRUCTORS & SIMULATED PATIENT PER STATION]

1050

Respiratory Failure – Prevention & Management

1135

Shock & Haemorrhage

1215

LUNCH

1245

Communication – A Vital Skill in Critical Care

1315

Cardiac Disorders in Surgical Critical Care

1355

Renal Dysfunction in Surgical Critical Care

1425 – 1740

Practical Skills (4 stations x 45’) – Pressure Monitoring – Advanced Shock Management – Communication & Organisational Skills (I) – Renal Scenarios [2 INSTRUCTORS PER STATION]

1555 - 1610

AFTERNOON TEA

1740

Participant Feedback

1745 – 1815

Faculty Meeting

DAY 1 EVENING

Course Dinner (Faculty & Participants)

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TIME 0800

MCQ Review

DAY 2

TOPIC

0815

Sepsis

0855 – 1035

Practical Skills (4 stations x 25’)  Airway management  Tracheostomy management  Wound Assessment & Management  Stoma Care & Management [2 INSTRUCTORS PER STATION]

1035 – 1050

MORNING TEA

1050

Nutrition & Nutritional Intervention

1130 – 1300

Practical Skills (4 stations x 45’)  Sepsis scenarios  Communication & Organisational Skills (II)  Dysrhythmia management  Chest radiology & respiratory care [2 INSTRUCTORS PER STATION]

1300 – 1340

LUNCH

1340 – 1510

Practical Skills (4 stations x 45’) – continued as above

1510 – 1530

AFTERNOON TEA

1530

Pain Management

1615

Demonstration: Assessment of the Injured Patient  Beyond the Golden Hour [6 INSTRUCTORS]

1700

Participant Feedback

1715 – 1745

Faculty Meeting

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TIME 0800

Faculty Preparation

DAY 3

0830

Course Summary

0900 – 1215

1.

TOPIC

Final Candidate Assessment: Practical Management of the Critically Ill Surgical Patient (4 simulated patient stations x 45’) [2 INSTRUCTORS, 1 NURSE, 1 SIMULATED PATIENT PER STATION]

Scenarios 1, 2, 3, 4: – clinical assessment – data interpretation – plan of management – communication skills – feedback 2.

Surgical Ward Round (75mins) [1 – 2 INSTRUCTORS]

1215

LUNCH & COURSE EVALUATION FORM

1245 – 1400

Faculty Meeting & Participant Feedback Please Note: all of faculty to make arrangements to remain at course until 1400.

PLEASE NOTE: Courses are held on weekdays or over weekends and are scheduled to maximise the availability of course venues, equipment, instructors and participants.

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6.3

Faculty Meetings

Four faculty meetings are held during the course, and attendance by instructors is mandatory. The pre-course meeting held on the evening before the course is an important prelude to introduce faculty members and to orientate the faculty to their responsibilities and to the course schedule. This includes a review of participants and of teaching and mentor allocations. It is also the ideal time to revisit a number of core issues regarding the CCrISP programme, and to clarify any questions. The performances of participants, faculty allocations, curriculum review and any other relevant issues are discussed during the faculty meetings held at the end of each day.

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7.

TEACHING THE COURSE

Each instructor is encouraged to bring his or her own style of teaching to the course. Instructors will need to be familiar with the course material, content and format, and understand and apply the principles of contemporary adult education. The course consists of large group presentations, demonstrations and small group practical interactive sessions. Materials for teaching are supplemented by a course manual (which participants are expected to read prior to the course) and a faculty handbook with CD-ROM. The faculty handbook describes the teaching and learning requirements for each session of the course and has imprints of the available slides or a list of equipment and materials to aid in preparing the teaching session. The CD-ROM contains slide presentations relevant to various teaching sessions. Instructors will be informed of which sessions they are to be involved in 4 – 6 weeks prior to the course. Each instructor will be asked to present up to 2 lectures and will be allocated 4 – 5 practical sessions in addition to the final assessment practical station. Where an instructor is required to teach on a topic not totally familiar to him or her, it would be prudent for that instructor to liaise with a faculty member who is conversant with the topic to adequately prepare the session. Instructors are asked to incorporate five key elements towards an effective teaching process during the course. 1. Adequate preparation: Ensure familiarity with teaching materials and content. Do not leave this to the last minute. 2. Set clear objectives: Clearly define what participants are expected to learn and why. Remember it is not possible to teach everything on a topic in the given time – select what is considered to be important and relevant to the course. 3. Content delivery: Be enthusiastic, clear and consistent – link content to other parts of the course. Engage participants in the progression of the session. Use clinically relevant examples to illustrate issues and be mindful of the audiovisual aids that are used. Reinforce key points. Keep to time.

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4. Practical skill teaching: Prepare by checking and being familiar with the equipment prior to the session. Ensure all participants have adequate attempts at performing the skill and that all participants in the group are involved throughout the session. Remember to include the following components to facilitate efficient learning of a task. 

Accurate description and demonstration of task



Immediate correction of errors



Reinforce good and correct performance



Evaluate performance

Teach the skill in 4 separate stages before asking participants to practice. 

Instructor demonstrates skill in real time



Instructor accurately describes each step of the skill during slower demonstration



Participant describes each step of the skill whilst instructor demonstrates



Participant describes each step of the skill whilst performing skill

5. Critiquing & Feedback: it is essential to provide ongoing, accurate and constructive feedback to each participant. Always start by commenting on what the participant did well. Ask the participant and then the rest of the group the following questions: 

What do you think went well?



What could be done differently next time?

Each instructor will be asked to mentor 1 – 2 participants during the course. The purpose of ‘mentoring’ is to provide confidential feedback on performance and as a process for participants to discuss any concerns.

© 2005 Royal Australasian College of Surgeons

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8.

WHAT ELSE DOES CCrISP OFFER?

Apart from the obvious educational value for participants, the CCrISP programme offers a number of unique benefits for faculty members. 

Opportunity to meet and interact with other specialty colleagues in a collegiate and sociable setting.



Truly appreciate the multidisciplinary approach to surgical critical care.



Update personal knowledge and understanding of critical care issues.



Ability to interact and develop rapport with trainees.



Ideal setting to foster enduring, good clinical practice by trainees.



An enjoyable and rewarding teaching experience.



A forum to develop personal educational skills.



Opportunity to undertake formal instructional training on a CCrISP Instructor Course.



Activity recognised as continuing professional development.



Involvement in the ongoing review and development of the course curriculum

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9.

GETTING INVOLVED WITH CCrISP

It is important for the CCrISP programme to continue recruiting new instructors, directors and coordinators. Prospective faculty should appreciate the commitment required both in time and effort. Each course 1 runs for 2 /2 days and faculty should be prepared to participate in 1 – 2 courses per year. This may involve travel interstate or across the Tasman. Related travel expenses are fully reimbursed and the Royal Australasian College of Surgeons will meet accommodation and meal costs up to $A250.00 per day (excluding GST). Furthermore, the College will meet costs associated with attending a CCrISP Instructor Course for Potential Instructors. To become a CCrISP instructor, interested persons should – 

Be a consultant, a provisional fellow or a senior accredited trainee at equivalent level of a provisional fellow.



Have an active interest in acute surgical care and in the teaching of trainees.



Support the objectives and principles of the course.



Attend an entire course as a potential instructor, and undertake a CCrISP Instructor Course if required.



Demonstrate satisfactory instructional ability as an instructor candidate on a subsequent course.



Be prepared to instruct on 1 – 2 courses per year.

Those who wish to become involved are invited to contact the Skills Training Department, Royal Australasian College of Surgeons (please see next page) or forward the “expression of interest” form attached as the next page.

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EXPRESSION OF INTEREST To register your interest please complete and return this form to the Royal Australasian College of Surgeons, Skills Training Department.

I wish to express my interest in being involved as an Instructor on the CCrISP programme. Please contact me with further information.

Surname First name Specialty Status (Consultant / Senior Trainee)

Mailing Address

Telephone Facsimile Mobile Email

Please e-mail, fax or mail to:

Antoinette Moar Skills Training Department Royal Australasian College of Surgeons College of Surgeons’ Gardens Spring Street MELBOURNE VIC 3000 Telephone: 03 9276 7421 Facsimile: 03 9249 1298 E-mail: [email protected]

© 2005 Royal Australasian College of Surgeons

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