Paediatric Assessment Skills Course:
Developing an educational programme to
support implementation of new nursing
roles at Birmingham Children’s Hospital
Heather Steele
Educational Practitioner
Course Development:
• Driven by the need to develop new nursing roles to
support EWTD and HAN implementation in April 2008
• Commitment from consultants/ ANPs
• To provide an opportunity for experienced nurses to
develop ‘advanced’ knowledge, skills and attitudes
to enhance the quality of care delivered to CYP in an
acute healthcare setting
• Flexible approach to skills acquisition
Course development:
• Aimed at Band 6 Practitioners and above
• Masters level critical analysis
• Interactive approach to skills development
• Competencies available in a PAS Skills Passport
• Use of an apprenticeship model of learning with
experienced Clinical Supervisors
Course Delivery:
• Implementation of a 3-day Course in January 2008
with 4 courses
• Course extended to 5 days
• Successful RCN accreditation at the beginning of 2009
Interactive Approach:
The more you learn, the more you know,
The more you know, the more you forget
The more you forget, the less you know
So……… why learn?
PAS Course Structure:
Pre course Revision Workbook
Day 1:
• Introduction to history taking/ documentation
• Recognition of the sick child
• Critical thinking and clinical decision making
• Assessment of the respiratory/ ENT systems
PAS Course Structure:
Day 2:
• Assessment of the CVS/ ECG interpretation
• Blood gas analysis
• Assessment of the neurological system
• Abdominal assessment
PAS Course Structure:
Day 3:
• Clinical assessment of fluid balance and shock
• Assessment of the skin
• Assessment of the febrile child
• Initiatives supporting practice development/ quality
PAS Course Structure:
Day 4:
• Workshops practising history taking skills and
examination skills
• Use of simulation to ‘put it all together’
• Implications of advancing practice
and accountability
PAS Course Structure:
Day 5:
Spent practising skills with a Clinical Supervisor in a clinical
area of choice
H = History
E = Examination
L = Logical deduction
P = Plan of management
“Look and you should see.
Ask and you should be answered!”
Thinking about Critical Thinking:
The difference between child-like thinking
and adult thinking and between
the expert/ non-expert approaches
PAS Course Attendance:
• Course completed by 11 cohorts to date
• 125 nurses and 1 AHP
• Mainly internal plus 16 external participants
PAS Course Attendance:
Also pleased to have been joined by 6 senior
nurses from Queen Elizabeth Hospital in
Blantyre, Malawi
PAS Course Evaluation:
Feedback overwhelmingly positive, with specific
comments highlighting the excellent use of
speakers and resources
“Excellent course, I feel I have learnt many
new skills and theory which I can apply to
my everyday practice”
Measuring Impact:
• Evidence of positive impact on skills acquisition and
service development
• Majority of participants (91.4%) report enhanced
skills post course completion
• 72% using skills in a clinical role and
8% in an educational role
Skills Acquisition:
• History taking (66.6%)
• Assessment of the sick child (97.2%)
• Respiratory examination (60.6%)
• Assessment of the skin (100%)
• Blood gas interpretation (50%)
• Review of CXRs (52.9%)
‘For me the practising skills is still in progress as I get to do it on a
daily/weekly basis. It is a work in progress so I still don’t have the final
competencies signed yet. I have started doing pre-admission clinic for
cardiac catheter patients so am using the majority of what I learnt
during the course during these clinics. The only skill I am not
practicing and don’t think I will is neurological limb tone assessment.’
I found it an excellent course, completely relevant to my job role’.
Developments in 2011:
• Submission of reflection for course completion
• Accreditation with local university, alongside a
portfolio of clinical modules to develop an ENP role
• Continuing educational innovation!
Impact of the PAS Course at BCH NHSFT:
• Improved individual knowledge and skills
• Evidence of improved quality care and patient safety
• Development of new nursing roles
• Innovation in clinical practice
Thank You