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): 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 1 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: 2 Critically examine the principles and practice of GI Nursing, within the context of the Nurse Endoscopist role. Critically examine the key concepts involved in advanced clinical reasoning and decision making. Review the anatomy & physiology of the GI tract, in relation to endoscopic practice. Review pharmacology principles in relation to pre-assessment, patient preparation and GI endoscopic procedures. Critically examine conscious sedation practice and analgesia patient requirements in endoscopy. (Linking to independent prescribing.) Critically discuss Medico-legal issues, including consent and communication skills. Review physical assessment, history taking and clinical examination skills for endoscopy. Critically examine GI patient pathways, differential diagnosis and other investigations linking to endoscopy. Demonstrate understanding of the principles of discussing difficult news and the human factors that influence this. GI endoscopy simulation training on dynamic simulators. Developing motor skills, handling techniques and skilled technique, for diagnostic and therapeutic endoscopy. Review pathophysiology and histopathology of the GI tract – discussing differential diagnosis and patient management. Understand therapeutic endoscopy practice - biopsy and polypectomy Understand principles of emergency management, complications and adverse events during GI endoscopy, and know how to respond. Discuss health promotion and management for the GI patient in Endoscopy Understand the principles and practice of effective patient report writing. Critically discuss professional issues, culture shift and accountability in role extension and advanced practice. Understand the principles for Service development and business planning in relation to endoscopy and the role of Nurse Endoscopist. 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: 3 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 OSCE – for history taking and consent process Presentation to the group on defined topic 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. 4 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/ 5 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 6 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 7 3. What made you want to become a Non-medical / Nurse Endoscopist? 4. Briefly describe your reasons for applying for this course 8 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 9 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 10 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 11 Terms and Conditions Attendance and courses 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 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 Re-registration Policy Payment terms 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 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.