Follow-up Activities logbook template

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Specialist Advisory Committee in Neonatal/Perinatal Medicine
FOLLOW-UP ACTIVITIES LOGBOOK
Trainee Name:
Trainee MIN:
Date Submitted:
Specialist Advisory Committee in Neonatal/Perinatal Medicine
Follow-up Activities Logbook
About the Follow-up Activities Logbook
The follow-up activities requirement of Neonatal/Perinatal training is comprised of
three main components. Experience in these areas assists trainees in developing the
necessary skills to manage the post-discharge care of high risk infants. Upon
completion of training, trainees are expected to be able to competently conduct
follow-up activities at a consultant level.
These three components of follow-up are:
1)
MULTIDISCIPLINARY DISCHARGE PLANNING MEETINGS
Intended learning outcomes:
 Familiarity with community resources available for post-discharge care of high
risk babies and families
 Sound awareness of potential post-discharge problems
 The ability to plan effective management.
2)
FOLLOW UP OF MEDICAL PROBLEMS IN AN OUTPATIENT SETTING
Intended learning outcomes:
 Familiarity with and competence in managing on-going medical problems in
premature and other high risk babies, including:
o chronic lung disease and home oxygen,
o nutrition and growth and
o early developmental problems.
3)
LONG TERM NEURODEVELOPMENTAL FOLLOW-UP
Intended learning outcomes:
 Familiarity with the main assessment tools used in developmental assessment
 Competence in the diagnosis of common neuro-developmental sequelae of
prematurity and neonatal encephalopathy.
The SAC expects trainees to thoroughly document the experiences gained in each of
the above areas of follow up.
Trainees are expected to document the equivalent of one session per week across
the 2 years of core training. A minimum total of 100 cases need to be documented in
the logbook, comprised of:
o a minimum of 30 multidisciplinary discharge meetings
o a minimum of 40 follow up of medical problems in outpatient settings
o a minimum of 30 long-term neurodevelopmental follow up cases
Prior to the submission of the logbook, trainees must have a supervisor sign off on
their competency to manage the follow-up of high-risk infants at a consultant level.
Please only submit logbooks once the total requirement for follow-up activities has
been met; incomplete logbooks will not be accepted.
Please note that follow-up activities must be documented in this logbook, and
must be typed. Handwritten logbooks or alternative logbook formats will not be
accepted.
Any questions regarding the completion of the follow-up activities logbook can be
directed to the Education Officer to the SAC in Neonatal/Perinatal Medicine, on (02)
8247 6284 or via email at NeonatalPerinatal@racp.edu.au.
Specialist Advisory Committee in Neonatal/Perinatal Medicine
Follow-up Activities Logbook
MULTIDISCIPLINARY DISCHARGE PLANNING MEETINGS
Provide a short description outlining the nature of the meetings attended, what
disciplines were represented and what your role was in that meeting. It is expected
that your role in discharge planning meetings will progress over the course of your
training with you eventually acting independently and providing medical leadership
to the group.
Date of
meeting
Clinical problems dealt with
Your role in the meeting
Name & Signature
of Supervisor
Specialist Advisory Committee in Neonatal/Perinatal Medicine
Follow-up Activities Logbook
Date of
meeting
Clinical problems dealt with
Your role in the meeting
Name & Signature
of Supervisor
Specialist Advisory Committee in Neonatal/Perinatal Medicine
Follow-up Activities Logbook
FOLLOW UP OF MEDICAL PROBLEMS IN AN OUTPATIENT SETTING
By the completion of your training, you should be competent in conducting medical
consultations independently. You should also be competent in the formulation of a
management plan, and be able to clearly communicate this plan in writing to all
health professionals involved in the patient’s care.
Date of clinic
No. of babies attending and main medical problems
Name & Signature of
Supervisor
Specialist Advisory Committee in Neonatal/Perinatal Medicine
Follow-up Activities Logbook
Date of clinic
No. of babies attending and main medical problems
Name & Signature of
Supervisor
Specialist Advisory Committee in Neonatal/Perinatal Medicine
Follow-up Activities Logbook
LONG TERM NEURODEVELOPMENTAL FOLLOW-UP
Provide details of the clinics you attended, including (but not limited to) personnel
attending, assessments commonly done and your role in the clinics. It is expected
that you will progress over the course of your training from observing clinics to
being able to independently conduct neurological and developmental assessments at
a consultant level.
Please identify the assessment tools you have been trained to perform (eg. Bayleys):
1.
2.
3.
Date
Age
of
child
Reason for assessment
and diagnosis
4.
5.
6.
Testing done
Your role
Name &
Signature of
Supervisor
Specialist Advisory Committee in Neonatal/Perinatal Medicine
Follow-up Activities Logbook
Date
Age
of
child
Reason for assessment
and diagnosis
Testing done
Your role
Name &
Signature of
Supervisor
Specialist Advisory Committee in Neonatal/Perinatal Medicine
Follow-up Activities Logbook
COMPETENCY SIGN-OFF
PLEASE ENSURE THIS SECTION IS COMPLETED PRIOR TO SUBMISSION
TRAINEE TO COMPLETE:
Do you feel that you are competent to conduct follow-up activities at a
consultant level?
Yes
No
Comments:
Trainee’s Signature:
Date:
/
.
/
SUPERVISOR TO COMPLETE:
Do you feel that the trainee is competent to conduct follow-up
activities at a consultant level?
Yes
No
Comments:
Supervisor’s Name:
Supervisor’s Signature:
Date:
/
/
.
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