Assessment is programmatic — no single tool determines progression. Evidence from direct observation, portfolio EPAs and global ratings is reviewed together by the Competence Committee, on a defined cycle, against the Royal College Competency Portfolio for NNCC.
Two observed neurological examinations per block, plus observation of consultations, family discussions and coordination of care.
Observation forms, oral case presentations and consultation notes collected against the case-mix requirements — all de-identified and signed off by the supervisor.
One in-training evaluation report (ITER) per block, guided by the CanMEDS competencies, with documented formative and summative feedback.
The NNCC rotation tracking tool and case log are completed and submitted to the Program Director at the end of each block, documenting clinical exposure and module completion.
Review of readiness for increasing responsibility every three months, with a mentor review on the same cycle and timely support for any fellow not progressing as expected.
360° input from the interprofessional team — nursing, allied health, nurse practitioners and peers — complements supervisor and committee judgments.
The portfolio is organized around the seven major tasks. Each subtask specifies the assessment method, the number of pieces of evidence required, and a mandated case-mix to guarantee breadth of exposure.
| Task & subtask | Evidence required | Required case-mix |
|---|---|---|
| 1.1 · Assess the neonate | 10 observation forms | 2 preterm (1 <29 weeks) · 2 neonatal encephalopathy or stroke · 1 neonatal seizure · 2 direct observations of the neurological examination |
| 1.2 · Formulate management recommendations | 10 oral case presentations or consultation notes | 2 preterm (1 <29 weeks) · 2 neonatal encephalopathy · 1 neonatal seizure |
| 2.1 · Assess the fetus | 2 direct observations | 2 different diagnoses (e.g. ventriculomegaly, CNS malformation/NTD, acquired injury/infection, genetic) |
| 2.2 · Antenatal management recommendations | 2 consultation notes or oral presentations | 2 different diagnoses or presentations |
| 3.1 · Screen for neurodevelopmental problems | 3 direct observations (history & exam) | ≥1 cerebral palsy · ≥1 infantile spasm |
| 3.2 · Develop neurodevelopmental plans | 2 oral case presentations or clinic notes | — |
| 4.1 · Lead coordination of advanced management | 2 observation forms | ≥1 in the critical-care setting |
| 5.1 · Communicate results & plans to families | 4 observations | 2 critical-care · 1 antenatal clinic · 1 follow-up clinic · ≥1 cerebral palsy discussion · ≥1 redirection-of-care discussion |
| 5.2 · Family education on neuroprotection | 1 observation | — |
| 6.1 · Triage referrals to the NNCC service | 2 oral case presentations | An urgent referral · prioritizing multiple same-day requests |
| 6.2 · Manage the consultation load | Supervisor observations over a 1-week period | Interprofessional input encouraged |
| 7.1 · Teach NNCC topics | Supervisor evaluation of ≥2 teaching activities + a teaching log | A range of topics; sustained engagement |
| 7.2 · Conduct scholarly work | 1 scholarly product | Accepted abstract · manuscript · grant/proposal · educational innovation · completed QI project · or practice guideline |
Requirements reflect the Royal College Competency Portfolio for the Area of Focused Competence in Neonatal Neurocritical Care (2025). Patients may overlap across related subtasks where permitted. All entries are de-identified and supervisor-signed.
The committee meets four times a year and bases every decision on the assessment data available for each trainee at the time of review.
Observations, portfolio EPAs, ITERs, multisource feedback and the tracking tool build a longitudinal picture of performance.
A committee member completes a detailed review of each assigned trainee — recent performance, longitudinal patterns, a succinct synthesis and a recommended decision.
The committee determines progression, readiness for enhanced responsibility and achievement of competencies — considering recent and longitudinal performance, patient-safety needs and supervision requirements.
Decisions are reported to the Program Committee for ratification before being communicated to trainees, with timely support plans for any fellow not progressing as expected.
Explore the committees, policies and people that make this assessment system fair, safe and reproducible.
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