What is CoBaTrICE?
CoBaTrICE stands for 'Competency-Based Training in Intensive Care Medicine in Europe'. It is an international partnership of professional organisations and critical care clinicians working together to harmonise training in intensive care medicine worldwide. The CoBaTrICE programme links competencies with syllabus, assessment guidelines and online educational resources via this website. We believe that CoBaTrICE will contribute to improvements in the quality of care we deliver to our patients and their families.
The CoBaTrICE Project
The CoBaTrICE Collaboration was formed in 2003 to define outcomes of specialist ICM training and to develop an international training programme in ICM for Europe and other world regions. Part-funded by the European Commission (Leonardo Programme) and the European Society of Intensive Care Medicine (lead organisation), the project had four main phases:
These components were then brought together using curriculum mapping, to create the website which you are now using.
The underlying principle of this project is that an intensive care doctor trained in one country should possess the same core skills and abilities as one trained in another, thereby ensuring a common standard of clinical competence. 'Competence' can be defined in terms of the knowledge, skills, attitudes and behaviours required to perform a particular task, and the standard required in its performance. CoBaTrICE has achieved this through a worldwide process of consultation and consensus-building, involving specialist physicians and trainees, nurses and allied health professionals, patients and their relatives, national and international organisations.
The first step was to create an international collaboration. We brought together more than 80 national coordinators and deputies to represent training organisations in 42 countries; others, including trainees, contributed to the working groups at various stages in the project. The success of CoBaTrICE is due to their enthusiasm and commitment.
An international survey of ICM training, conducted in 2003 - 2004, demonstrated wide national variability in access, ownership, structure and duration of training in intensive care medicine; we identified 54 different training programmes in 41 countries. Few programmes at that time defined the outcomes of ICM training in terms of competencies. More details have been published:
The CoBaTrICE Collaboration. An international survey of training in adult intensive care medicine. Intensive Care Med (2005) 31:553?561. Detailed information about national
ICM training programmes is also available.
Development of core competencies: in the second phase of CoBaTrICE, we used consensus methods to harness the combined wisdom and experience of 535 clinicians and 1391 intensive care patients and relatives to generate ideas for common 'competencies' for specialists in intensive care medicine across national and professional boundaries. These ideas were edited, and submitted to an expert group to determine level of expertise and rate importance. Following iterative review, this process generated a final set of 102 competencies grouped into 12 domains which form the heart of this training programme - see
Competencies. Details of the consensus methodology and results have been published:
The CoBaTrICE Collaboration. Development of core competencies for an international training programme in intensive care medicine. Intensive Care MedTo create the syllabus to support these competencies, we analysed the content of the English-language curricula of international guidelines (ESICM and SCCM) and national ICM training programmes (Australia and New Zealand, Belgium, Canada, Germany, Ireland, Spain, UK and USA), and utilised personal communications from other countries to develop a common set of knowledge, skills, attitudes and behaviours linked to each competence. Editing and removal of redundant material resulted in a database of around 1200 syllabus elements. The syllabus can be viewed either linked to a specific competence or grouped by domain (i.e. the aggregate syllabus for a group of competencies).
Assessment of competence must be conducted in a manner which is transparent, fair, replicable, aids personal learning, and minimises the burden on trainers who are busy clinicians. We used an expert group to consider how best to approach workplace-based assessment, and have developed indicators of competent performance within each domain to guide trainers and trainees. These indicators can be used during routine clinical practice; they are supported by an
assessment toolbox summarising different methods, and a portfolio template (
CoBaFolio) for documenting training activities and progress.
Online educational resources have been identified, evaluated, and linked to competencies to support trainers and trainees. These include research articles, slide presentations, lecture notes and basic sciences texts. This component of the programme requires constant revision and updating.
CoBaTrICE Online
The CoBaTrICE programme has been developed in electronic format using curriculum mapping to link the various components so that competencies can be explored in terms of knowledge elements in the syllabus, hyperlinked to relevant educational resources, and evaluated using a range of assessment tools. We have also provided electronic documents for recording evidence of training and competence in the form of a portfolio which can be tailored to the requirements of individual national training programmes. CoBaTrICE online is not a static product, but will mature and develop with time. The content of the training programme and the competencies themselves will undergo modification through regular review by the European Board of Intensive Care Medicine and the ESICM division of professional development working in close collaboration with a Forum of national training organisations. This dynamic process is essential for incorporating new knowledge into the training of individual practitioners, thereby facilitating translation of validated research into best practice.
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