b'Trainee not progressing in line(a)the CAI reserves the right to suspend the trainee, as a precautionary measure, from the Programme pending with expectations - Clinical the outcome of any investigation, disciplinary process or Medical Council process which is implemented; STEP 1: STEP 2: STEP 3: and/orFormal meeting1st Formal2nd Formal(b) to escalate the process to Step 3 without recourse to with trainee in themeeting in CAI -meeting in CAI -Steps 1 or 2.Hospital - after support provided/ extended time1st Unsuccessfulchange to or withdrawnNote:ITA rotationConcerns regarding employment issues should be managed by the employers Human Resources With the CAI Progression Committee Department.The Chair of Department should bemade aware of such employment issues.Overview Initial steps to address apparent under As identified under the above section The ITA Processperformance - clinicalin Detail, it may be identified during a six-month rotation that a trainee is not progressing clinically in lineStep 1- Formal meeting with Trainee inwith expectations.Responsibility for identifying andthe Hospital:addressing this situation rests with the training sitesThe tutor and one other consultant should meet with Anaesthesiology Department staff in the first instance,the trainee to seek to address the issue.Such a meeting specifically tutors and trainers. can take place at any time during the rotation and is not In the first instance, efforts should be made within limited to the middle or end of the rotation. However, the training sites Department to address any difficultiesthe mid rotation meeting (detailed under Trainee not and guidelines in this regard are outlined in the progressing at middle of rotation:) can constitute this step.sections below. The meeting should proceed as follows:Set aside a formal time for the meeting, providing Concerns about trainee performance sufficient advance notice to the trainee;identifying trainees in difficulty Provide the trainee with the opportunity to give their Identifying trainees in difficulty, whose workplaceown assessment, allowing them to identify and discuss performance or progress is below the standard expectedany difficulties they may be experiencing;for their stage of training, is an essential role for everyoneIdentify areas that need to be addressed by clearly involved with the Training Programme.In all situations,explaining deficiencies and communicating the the welfare of patients and trainees must be considered. expected standard;Put in place appropriate supports e.g.:Staff members within the training sites Department with-Targeted training involving closer additional concerns about any aspect of a trainees performancesupervision and more frequent feedback on progress;must discuss their concerns promptly with the tutor. -Intensified supervision or opportunity for repeat The tutor should take steps to address such concernsexperience;by making specific, confidential enquiries about theEnsure that steps are agreed with the trainee;perceived issues and gathering information from relevantSet a date for progress to be reviewed ensuring enough staff members as well as the trainee. time is allowed for the trainee to have made progress;The tutor should organise individualised learning Unless the issues are serious, i.e. threaten patient safety,experiences if appropriate to assist with difficulties with or are reasonably believed to represent professionalexamination preparation or presentation technique, misconduct, the approach for training issues is oneacquisition of clinical skills or interpersonal skills of a staged response providing support and remedialdevelopment. The trainee has a responsibility to actively strategies to improve performance. The objective isparticipate in these activities;to overcome difficulties in a supportive, holistic andDocument each meeting, the document must be signed collaborative manner within a specified timeframe.by the tutor, other consultant and the trainee.Where an issue arises which is reasonably considered to be serious or is reasonably believed to representIf these steps above do not result in sufficient progress professional misconduct: being made, the trainee should receive an Unsatisfactory Curriculum for the National Specialist Anaesthesiology Training Programme 23'