Application form

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National Nurse Endoscopist Course©
Application Form
Thank you for applying for this course. To help us process your application as quickly as possible,
please complete all the sections, clearly and as full as possible. The course leaders will use the
information you provide on this form to review your application. This information may also be used for
course administration and for the purposes set out at the end of this form. You will be informed about
the outcome of your application within 2 weeks of receipt.
About the course
This course is suitable for all aspiring non-medical / nurse endoscopists. It will be a practical
and interactive course with constant support from experienced nurse endoscopists throughout
the course duration. There is the option of gaining 30 academic credits with Kings College
London (see below).
Topics to be included (see below for learning objectives):
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The principles and practice of GI Nursing
Anatomy & physiology of the GI tract
Pharmacology for endoscopy and safe sedation practice
Medico-legal issues and ethical implications including consent/ communication skills
Physical assessment, history taking and clinical examination
Indications for endoscopy, principals of pre assessment, patient selection, risk
management, co morbidity issues and preparation for endoscopic procedures.
Technical skills of endoscopy and equipment / simulator training
o OGD
o Flexible Sigmoidoscopy
o Colonoscopy
Pathophysiology and histopathology of the GI tract
Therapeutic endoscopy practice - biopsy and polypectomy
The Anus and Rectum master class
Emergency management and complications during GI endoscopy
Health promotion and management for the GI patient in Endoscopy
Professional issues and advanced practice
Role development, continuing education and career pathways for NE
Service development, evaluation and business planning
Relationships within the MDT
Links with JAG / JETS
Conditions of application
 Applicants will need a supporting letter from both their Clinical Supervisor and their Line
Manager detailing their suitability and availability for the course.
 Ideal but not essential is that applicants should be in a trainee endoscopist role with
dedicated training lists, at least one per week.
 Registered on JETS – can be done on course
 Recommend a senior nurse mentor, e.g. an advanced nurse practitioner or similar
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Course Dates
This course consisting of the following 6 taught study days over a 5 month period with support
from experienced nurse endoscopists throughout the course duration.
Tues 13th & Wed 14th January 2015
Wed 1st & Thurs 2nd April 2015
Tues 2nd & Wed 3rd June 2015
Course Fees
£1800 (+ £350 for optional academic accreditation)
For more information about the course or application process please contact
harriet.watson@gstt.nhs.uk and fiona.hibberts@gstt.nhs.uk
Course Aims:
To facilitate the development of safe and competent GI Nurse Endoscopists. Providing the
theoretical knowledge to underpin the extended role in practice.
Learning outcomes
On completion of the course, participants will be able to:
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Critically examine the principles and practice of GI Nursing, within the context of the
Nurse Endoscopist role.
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Critically examine the key concepts involved in advanced clinical reasoning and
decision making.
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Review the anatomy & physiology of the GI tract, in relation to endoscopic practice.
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Review pharmacology principles in relation to pre-assessment, patient preparation and
GI endoscopic procedures.
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Critically examine conscious sedation practice and analgesia patient requirements in
endoscopy. (Linking to independent prescribing.)
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Critically discuss Medico-legal issues, including consent and communication skills.
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Review physical assessment, history taking and clinical examination skills for
endoscopy.
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Critically examine GI patient pathways, differential diagnosis and other investigations
linking to endoscopy.
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Demonstrate understanding of the principles of discussing difficult news and the human
factors that influence this.
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GI endoscopy simulation training on dynamic simulators. Developing motor skills,
handling techniques and skilled technique, for diagnostic and therapeutic endoscopy.
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Review pathophysiology and histopathology of the GI tract – discussing differential
diagnosis and patient management.
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Understand therapeutic endoscopy practice - biopsy and polypectomy
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Understand principles of emergency management, complications and adverse events
during GI endoscopy, and know how to respond.
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Discuss health promotion and management for the GI patient in Endoscopy
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Understand the principles and practice of effective patient report writing.
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Critically discuss professional issues, culture shift and accountability in role extension
and advanced practice.
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Understand the principles for Service development and business planning in relation to
endoscopy and the role of Nurse Endoscopist.
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Support students in practice, advising clinical supervisors as required and DOPS.
Teaching and Learning Methods
An integrated approach will be employed throughout the course, of practical and theoretical
knowledge, skills, observation and simulation. This will be achieved by:
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Lectures from clinical specialists
Group discussions and tutorials
Presentations
Clinical teaching
Clinical observation / live endoscopy sessions
Case studies
SAIL Centre at St Thomas’ Hospital – Simulation and Interactive learning
Endoscopic simulators
Personal reading, study and reflection.
Assessment modalities
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OSCE – for history taking and consent process
Presentation to the group on defined topic
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JAG / JETS/ DOPS with clinical supervisor in clinical practice setting.
A reflection on individual learning outcomes, will be given to each student, to consolidate their
learning, during the period of the course. Areas of further development will be highlighted and
the student will be given opportunity to discuss this with the course leaders. If a ‘pass’ is
awarded for the presentation and OSCE, the student will be given a certificate of successful
completion and attendance of the course.
Work-based learning at King's College London
Participants on the Nurse Endoscopy Course at Guy’s and St Thomas’ have the opportunity to
achieve up to 30 credits towards either an undergraduate Bachelors Degree in Clinical Practice
or a postgraduate Masters in Advanced Practice by completing the work-based learning
module run by the Florence Nightingale Faculty of Nursing & Midwifery at King's College
London. The choice of academic level will be determined by the participants prior learning and
experience.
Work-based learning is student-centred framework for awarding academic credit toward an
award that recognises learning undertaken in practice and work-based environments. It works
on the basis of a close partnership between the education provider, the participant and their
employer. This partnership aims to support changes in service delivery that can bring about
significant benefits to patients.
Participants register for the work-based learning module and on completion of the Nurse
Endoscopy Programme, complete a portfolio of evidence demonstrating achievement of the
work-based module learning outcomes. On successful completion of the module the credit
awarded can be used toward an undergraduate degree or postgraduate masters at King's
College London. Alternatively the credit may be transferred to another higher education
institution through their APL process.
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Participants who indicate to the Nurse Endoscopist Course leaders that they would like to
undertake this option, will need to register via the Kings College London website for the
module at the appropriate academic level and will be invited to attend an introductory
workshop where further guidance will be given. The supplementary fee for undertaking this
option is an additional £350 to cover the extra tutorial and assessment costs. This should be
paid directly to Kings College London.
Please tick the relevant box:
I wish to undertake the academic credit at Undergraduate / Bachelor (degree) level
(6KNIM605 for 30 credits)
I wish to undertake the academic credit at Postgraduate / Masters level (7KNIM764 for 30
credits - students applying for this level must already have a first degree)
I do no wish to undertake any academic credits
Please contact me as I would like more information regarding the academic pathway
There is Information about applying for a degree programme at:
http://www.kcl.ac.uk/nursing/study/applicants/postqualification/applydegree.aspx
There is information about applying for a postgraduate taught programme at:
http://www.kcl.ac.uk/nursing/study/applicants/postqualification/applypgt.aspx
The application form for both is at: https://myapplication.kcl.ac.uk/
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APPLICATION DETAILS
I would like to apply for:
Course name
Non-medical / Nurse Endoscopist Course
Course location
Guys & St.Thomas’ NHS Foundation Trust
Date of application
Your details
First name
Surname
Preferred name
Gender
Male
Female
Nationality
NMC PIN & expiry
Organisation / Home contact details
Preferred contact address Work
Organisation name
Position / Job Title
Work address
Work Telephone
Work Email
Mobile
Home address
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Home
Home Telephone
Home Email
If you require information on local accommodation please tick here and we will send you an
accommodation list.
How did you hear about this Nurse Endoscopist course?
The following information will be used by the course leaders to ensure that you are right for the
course and that the course is right for you.
If you have a disability that requires us to make a reasonable adjustment to enable you to apply,
please tick and we will contact you.
1. Briefly describe your current position and responsibilities.
2. Please provide us with a brief biography that describes your career to date outlining
your academic qualifications post-registration
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3. What made you want to become a Non-medical / Nurse Endoscopist?
4. Briefly describe your reasons for applying for this course
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5. How do you think this course will help you in your role as a Non-medical / Nurse
Endoscopist?
6. If you are already a trainee Non-medical / Nurse Endoscopist please describe what
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you have found both the most challenging and the most rewarding about your role.
7. Is there any further information that you think we should have?
8. Please describe any special needs of which we should be aware (disability, dietary
requirements, etc).
Financial information
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Please tick here to confirm your agreement that the full fee for this course will be paid
either by yourself or your Trust / Sponsor. Delete as appropriate
Should your application be successful, whom should we contact regarding the invoicing
and processing of the payment for your place on the course?
Name
Address
Phone
Email
Applicant’s commitment
I confirm that in signing this application I have read and understood the terms and conditions.
I understand that I have a commitment to attend the course and that failure to do so may jeopardise
my ability to complete the course.
Sponsorship/ Trust Employer commitment
I understand that in signing this application, I have read and understood the terms and conditions and
have the authority to agree them.
I will authorise and enable the applicant named in this application, to attend the course study days
based at Guys and St Thomas Hospital, London.
I commit to provide full funding for this course, and I will ensure full payment is made, if this
application is successful.
I have read and agree with the course terms and conditions
Applicant’s signature
Line manager’s
signature
Sponsor/ Trust /
employer’s signature
Clinical Supervisor’s
signature
Date
Please include your supporting letters with this application (see page 1) and return all to
melissa.cardenas@gstt.nhs.uk
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Terms and Conditions
Attendance and courses
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A place on the Non-medical Nurse Endoscopist course is
subject to review of the application by the course
leaders, and is not transferable to another individual.
A participant on a Non-medical Nurse Endoscopist
course undertakes to attend the full course.
If a participant, having started the course, then withdraws
from the course for any reason, it is not guaranteed that
the participant will be allowed to resume attendance.
If a participant misses any part of the course due to
absenteeism, this may affect whether the course leaders
allow them graduate status.
GSTT retains the right to change the advertised agenda
for a Non-medical / Nurse Endoscopist course or event
without notice to the participants.
Course Leaders will make every effort to give
participants reasonable notice in advance if the venue or
dates for an event is changed.
Conduct during the course
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Participants will be subject to the terms and conditions of
the venue.
In the event of improper behaviour, the course leaders
will have the right to require the participant to withdraw
from the course. In such circumstances a refund will not
be given .
Cancellation and refunds
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Re-registration Policy
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Payment terms
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Attendance on the Non-medic al / Nurse Endoscopist
course is conditional on receipt in full of the course fee
prior to the start of the course.
Payment terms are 14 days from the date of invoice. The
invoice will be issued as soon as the participant has
been accepted on the course.
The person who has signed the application form agrees
to these terms and conditions, and has the authority to
do so. In the event he/she is not so authorised, he/she
will be personally liable for payment of the agreed fee.
Notice of cancellation must be received in writing by post
or by email and is subject to the following terms:
Where notice of cancellation is received fewer than 30
days prior to the first day of the course, the payer will be
liable for 100% of the course fee.
Where notice of cancellation is received between 30 and
56 days prior to the first day of the course, the payer will
be liable for 50% of the course fee
Where notice of cancellation is received more than 56
days prior to the first day of the course, a full refund of
the fee paid will be given, minus a £20 administration
fee.
No refund of fees will be made for absence due to illness
or for withdrawal during the course for any reason.
Participants wishing to defer their place and re-register
will be required to complete a short re-registration form
outlining the circumstances and context of their request.
In cases where a participant wishes to defer their place
before the course they have been originally accepted
onto has even started, the re-registration fee policy only
applies where the request is received fewer than 30 days
prior to the first day of the course (hence the full fee for
the original course is due in full).
Data protection
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If accepted as a participant on a Non-medical / Nurse
Endoscopist course at GSTT, you are agreeing that we
may use your data for the following purposes:
we will use your contact details to send you information
relating to the course and to request feedback
We may publish your name, job title, employer
organisation and course attended as part of our
promotional materials.
We may publish your contact details to the members of
your participant group as part of the information
distributed prior to the course. To opt out, please tick
here:
Except in connection with the activities described above
or where required to do so by law, we will not disclose
your data to third parties without your permission.
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