The Diploma of the Faculty of
Sexual & Reproductive
Healthcare:
An innovative training programme
DFSRH – why change?
• National drive to increase access to LARC and ↓
unplanned pregnancy rates (inc. teenage pregnancy)
• Demand for sexual health training outstrips supply,
leading to delays in training
• Trainees arrive at clinics under prepared
• Theory, practical training and assessments often not
linked
• Tension: service v training for trainees and for course
organisers, and 3-4 day courses are expensive to run
• Major investment in e-learning by Department of Health
http://www.e-lfh.org.uk/e-srh
E learning Component if not
Doing Diploma
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Visit: www.e-lfh.org.uk/e-srh
Select the ‘sign up for access’ button on the left
Complete the registration form and click ‘ submit’
For support email support@e-lfh.org.uk
Diploma – Registration
To register for the Diploma:
• Go to FSRH website - www.fsrh.org
• Click training, choose new DFSRH Stage 2
• Download and complete Trainees Registration Form
• Post form to FSRH and pay £50
Trainee
Pathway
Preparation of trainees for clinical experience
Entry requirements will ensure that trainees access DFSRH
training at an appropriate stage in their training
Knowledge/theory component all on e-SRH, and can be
refreshed if there is a delay in starting clinical training
9 assessments will have been completed in Course of 5
• This will include topics such as sterilisation counselling and
diaphragms that were sometimes difficult to provide in clinics
• All trainees will have done model arm training for subdermal
implants
Plan for changeover
• Continue current practical training with log book for those
who attend theory courses up to December 2009. (3 years to
complete from date of theory course.)
• All trainees who take the e-learning route to follow the new
blended learning package with an e-portfolio.
The components of the two training programmes are not
interchangeable.
The Diploma of the Faculty of Sexual & Reproductive
Healthcare:
Entry requirements
1. Consultation skills
To be signed by educational supervisor, (self certified if GP or
consultant). Before going on Course of 5, trainee must be able
to
• Adapt consultation style to suit the patient
• Address patients’ ideas, concerns and expectations and
answer their questions
• Assess whether a patient is competent to consent to
treatment and ensure consent is well-informed
• Protect confidentiality
• Make an appropriate offer of a chaperone
• Demonstrate clear record-keeping
• Use time effectively in consultations
2.
Is able to give an
intramuscular injection
3. Basic gynaecological examination
Trainee
1. Must be able to perform a basic gynaecological examination
including:
– Digital vaginal examination
– Speculum examination
2. Has been observed taking a cervical cytology sample and
understands the need for audit of cytology results to confirm
competence
Or
Has achieved locally agreed competence to participate in
cervical cytology screening programme.
Trainee
Pathway
The Diploma of the Faculty of Sexual & Reproductive
Healthcare:
The Course of Five
Course of 5:
Purpose
 To demonstrate that delegates have a good knowledge of the
theory– to empower and prepare them for clinical
experience
 Ask questions from theory course content
 To consolidate theory course eg handle barriers, pill packs etc
• To practice sexual history taking – using the right vocabulary
• Explore personal issues – prejudices, emotional, religious eg
termination, young people
 Assessment of knowledge application rather than knowledge
itself, (which is assessed in e-learning)
Course of 5:
Delivery
• 5 one hour sessions
• Delivered in small groups (4 or less)
• Standardised format: course material includes lesson
plans, teaching notes, cases, lists of equipment needed etc
• Facilitators not lecturers to deliver sessions
• Candidates are advised to prepare for the sessions
• Assessments for each session
Advantages of Small Groups
1. Delivery
Maximum 4 trainees to each facilitator
• Opportunity to ask questions from e-learning
• Gain ‘hands on’ practical experience eg swab taking
• Deal with issues not easily encountered in practical session eg
diaphragms
• Explore difficult consultations and skills required in ‘safe’
environment rather than a busy clinic
• Opportunity for significant number of assessments removing
the burden from practical sessions
Advantages of Small Groups
2. Administrative
• Flexible delivery, directed by local needs
– to a small group or one-to-one as stand alone sessions or
full day
– To a large number of groups with rotating stations
• Administration reduced – forms standardised
• More options for venues
• Course can be run more frequently as less time out of clinical
work for facilitators
• Course of Five can generate local income to replace that of
DFSRH theory course
Overview of Course of 5
sessions and assessments
Course of 5 sessions
•
Session 1: Taking a
sexual history and HIV pre test discussion
•
and testing
Session 2: STI screening and testing and teaching the use of
condoms
Session 3: Practical aspects of contraception
•
Session 4:
•
Session 5: Managing sensitive
•
Young people
scenarios
Assessments
• Focuses learning
– Consolidates knowledge from e-SRH
– Preparation recommended before attending
• Scenarios that are not always encountered in clinic
– eg sterilisation, requests for diaphragm
– Group discussion and views of others often valuable
• Makes effective and efficient use of practical sessions
– Trainees better prepared when they arrive in clinic
– Less competencies to be assessed in clinic
– Fewer sessions likely to be required
Assessments
• Recorded in e-portfolio by course convenor (directly, or
via a ticket request from trainee)
• At least 7 of the 9 must be assessed as satisfactory to
move on to practical sessions.
• Maximum of 2 assessments can be repeated during
clinical experience by agreement with the primary
trainer
• Less than 7 passed – repeat whole Course of 5
Assessments
Trainees are expected to demonstrate an appropriate
professional, non judgemental attitude.
This is an explicit component of the Course of 5
assessments.
Further guidance from the General Medical Council publication
‘Good Medical Practice’ (www.gmc-uk.org)
Trainee
Pathway
The Diploma of the Faculty of Sexual & Reproductive
Healthcare:
Clinical experience
and
assessments
Clinical experience
and assessments
•
Trainee-led, more emphasis on experience and
assessment, less on teaching basics
• Theoretical knowledge has already been assessed in elearning
• Trainees at an appropriate stage in their postgraduate
medical training
7 core topic areas
1.
Effective contraception choices consultation
2.
Consultation for a woman wishing to use an oral or injectable
contraceptive, patch or vaginal ring
3.
Assess and advise a woman wishing to use an intrauterine method or
subdermal implant, prior to insertion
4.
Managing a request for emergency contraception
5.
Taking an appropriate history and assessment of a woman with
bleeding problems whilst using hormonal methods
6.
Take an appropriate sexual history and risk assessment for STI and
pregnancy, and perform the appropriate tests for an asymptomatic
woman or man requesting sexual health screening
7.
Taking an appropriate history and assessment of a woman with vaginal
discharge or pelvic pain
Assessment tools
• ACP (Assessment of Clinical Practice)
structured assessment of a directly observed consultation
• RDCP (Reflection and Discussion of Clinical Practice)
structured assessment based on a
has not been directly observed
• Consultation feedback
consultation which
• At least one assessment for each core topic
1. Contraception choices
2. Hormonal contraception
3. Intra uterine/ subdermal methods
4. Emergency contraception
5. Bleeding problems with hormonal methods
6. STI risk assessment and screening
7. Vaginal discharge and pelvic pain
• At least 4 ACP’s (observed consultations)
One ACP in topic 1
One ACP for topic 3
One ACP for topic 6 or 7
One ACP in one of the other topic areas
The remaining assessments may be ACP or RDCP
Summary of
progress chart
Check list for
topic 1
An acceptable assessment is one where the
trainee is assessed as competent at the level
of independent practice in each section
(with the exception of those marked * if not relevant).
Letters of Competence
(LoC SDI and LoC IUT)
• May be run in tandem with DFSRH
• Can apply for LoC at same time as Diploma (but not before)
• LoCs have additional e-SRH modules which will cover the
theory component for all those taking the LoC SDI or IUT
• SDI model arm training is part of the Course of 5; trainees
who have taken the old diploma course will still need model
arm training for LoC SDI, but can use e-SRH for the theory
Local Courses
• New Croft Centre 2012
February 14, April 17 and October 16
Contact Joanne Borthwick 0191 229 2871
• Practical training throughout North East and
Cumbria