The CoBaTrICE Collaboration

Overview

Just as basic and clinical research is necessary to create new knowledge as base for patient care, effective education is essential to generate new competent doctors! 
To improve the quality of care of acutely, critically ill and injured patients and their families, this can be achieved using the CoBaTrICE programme. This programme was developed with the support of the European Society of Intensive Care Medicine (ESICM) and from the European Union’s Leonardo da Vinci Programme. The ultimate aim of CoBaTrICE is to assure a high quality level education in intensive care medicine (ICM), to harmonize training in ICM without interfering with national specific regulations, and to allow for free movement of ICM professionals across Europe.
Within ESICM, CoBaTrICE is guided by CoBaFaculty and CoBaForum.

CoBaTrICE underscores the importance of a shift from duration-based to competency-based medical training. Accordingly, it goes far beyond the out-dated “see one – do one – teach one” approach.

CoBaTrICE includes:
•    A syllabus with detailed descriptions of competencies (i.e. the minimum standard of knowledge, skills and attitudes) required for a doctor to be identified as a specialist in intensive care medicine (ICM) [Intensive Care Med 2006, 32:1371-83]
•    A proposal of standards for postgraduate training and training programmes in ICM [Intensive Care Med 2011, 37:385-93]
•    The basic principles of workplace based assessment
•    A first draft of a web-based portfolio.
All these elements are described in more detail on this website.

Competence is understood as the application of current knowledge with required skills and judgement needed to meet the patient‘s medical need. The framework of competencies is based on empirical research [1) Intensive Care Med 2005, 31:553-61 2) Intensive Care Med 2007, 33:1913-20 3) Intensive Care Med 2009, 35:1575-83], educational design and health professionals’ consensus [ Intensive Care Med 2006, 32:1371-83]. Besides strong scientific knowledge and excellent clinical technical skills, key qualities also required are:
•    To communicate effectively with patients, their families and colleagues
•    To act in a professional manner
•    To cultivate an awareness of one's own values and prejudices
•    To provide care with an understanding of the cultural and spiritual dimensions of patients' lives

Assessment of competence is a continuous but progressive process. It is based on workplace based assessment (i.e. formative assessment). This may include mini-clinical examination (Mini-CEX), direct observation of procedures (DOPS), and multi-source feedback, etc. These tools can be adapted to specific need. Also, giving and receiving feedback is a skill that can be learned and improved. Currently, postgraduate training is often supported by a logbook or portfolio, either in paper or electronic form. An example can be found on this website.

A certificate is used as robust and reliable documentation of fitness for safe and efficient practice at the end of this process. For this purpose ESICM has set up the European Diploma in Intensive Care Medicine (EDIC). For further details, see here.

Medical education and training does not end here. As recently pointed out in the “Basel Declaration 2011” of UEMS (European Union of Medical Specialists, www.uems.net), continuous professional development is an essential means to improve the quality and safety of medical practice. 

Within UEMS, Intensive Care Medicine is represented by a Multidisciplinary Joint Committee (MJCICM). Actually, the revision of the EU Directive 2005/36/EC on the mutual recognition of professional qualifications is underway. Possibly, it will be approved by the European Parliament in 2013. As part of this revision, “Common Training Principles (CTP)” probably will be introduced. This will allow having Intensive Care Medicine recognized as “Particular Qualification”.
 

CoBaFaculty

Purpose: To maintain, promote and to develop the CoBaTrICE programme on behalf of the Society.
Composition:
Members are elected by the CoBaForum from the CoBaTrICE National Coordinator group. Representatives from the following ESICM committees are members of the CoBaFaculty: Clinical Training Committee, PACT Management Team, EDIC subcommittee, Systematic Review Unit.
Duties of the members of CoBaFaculty are:
•    To assure coordination and further development of CoBaTrICE programme
•    To define criteria for approval of the training programmes at the national level
•    To assure sustainability of CoBaTrICE programme
•    To facilitate networking with National Training Organisations

CoBaForum

Purpose: To advance the Society’s relations and shared objectives with other National Training Organisations (NTO) and with other stakeholders related to education and training in Intensive Care Medicine.
Composition: One representative (CoBaTrICE National Coordinator) of each NTO that has an agreement with ESICM. More than one representative from a given country may exist when there exists in that country more than one NTO. Each NTO that has an agreement with ESICM has the right to nominate a delegate.
Duties of the members of CoBaForum are:
•    To be responsible for mutual contacts between the Society and the NTOs, in order to improve the relations between both parts
•    To promote training and education based on the concepts of CoBaTrICE in the country
•    To develop and maintain the partnerships between ESICM and each NTO
•    To present proposals to CoBaFaculty
The CoBaTrICE National Coordinators should seek to maintain existing and to develop improved, novel approaches in order to strengthen the collaboration between ESICM, NTOs, National Societies, and further stakeholders in the field of education and training in ICM.