Anders Bergenfelz and Paul F Ridgway on behalf of NASCE
In 2014, NASCE was announced at the ICOSET conference in Harrogate. NASCE is a European Union of Medical Specialists (UEMS) sponsored initiative to network and accredit skills centres within the European Union and its affiliates. With its origins in the surgical section of the UEMS, the NASCE project has grown since the planning phase in 2012. It is now a ratified multidisciplinary joint committee (MJC) of the UEMS, reinforcing the founding wish to network clinical centres with focuses not only limited to general surgery. The MJC now includes anaesthesia, urology, opthalmology, cardiology, orthopaedics and gynaecology. In all 12 sections of the UEMS have signed up to the programme.
The roots of the NASCE programme are in the need to regularise and validate simulated based training. The debate about the need for simulation based training has moved from whether it is efficacious, to defining its role in healthcare training. Simulation now has specific uses in many undergraduate and postgraduate curricula. Large amounts of resources and money are being heterogeneously applied by various medical jurisdictions to skills training. This is in a relative vacuum without robust international standards or fora where dissemination of innovative validated techniques can be readily achieved. Across Europe, there are wide variations in the application of simulation and availability of skills centres. The centres themselves range from a single room in a hospital open for part of a week with low fidelity simulators to supra-regional centres dealing with a variety of disciplines utilising high cost, high fidelity simulation. There is a need to support the whole range of these centres as each fulfils important, different purposes within the healthcare training environment.
NASCE had the initial plan to have three standards of skills centres to be suitable for accreditation. While the smaller focused centres will be catered for in time, the first call for NASCE seeks to accredit two centre types: Multispecialty format and Single specialty format. A transparent, robust statute and governance framework has been placed around the organisation after an international consultation process lasting 18 months. All documents are available online at www.NASCEnet.org. The first tranche of centres have been accredited following the inaugural Accreditation Review Board meeting of NASCE in February 2015.
These new accredited centres subscribe to NASCE principles that are based around the wish to facilitate excellence in delivery of skills training across Europe within a modern, fit for purpose accreditation association. It is predominately centre based accreditation. There are other processes within UEMS for accrediting content so NASCE’s major focus is around minimum standards for effective delivery of simulation in training. There are several uses of NASCE accreditation for the centre: The process of going through accreditation will allow the centre’s organisational tier a chance to forensically examine their processes, identifying areas of strengths, weaknesses, opportunities and threats. While this is a useful process, particularly matching their units up against internationally developed standards, what has those of us involved in NASCE most energised is the ability of the resultant growing network of centres to gain and disseminate techniques and innovations with outcome data. This sharing of experience is a cornerstone of the network and will populate the yearly for a with the scientific endeavour as well as evolving NASCE as its members see fit over time.
The process for accreditation is underway since 2014, with details on the above website for those wishing to apply. It is transparent and standardised, after the European consultation process hosted by the UEMS. The accreditation period lasts for four years. The process involves international survey of the centre under specified headers which include governance, administration, competencies, teacher attributes, research and development. The difference between the two levels of accreditation is predominately around the learners, those that are trained through the centre. The Multispecialty format will have many disciplines catered for, while the Single speciality format, although no less important, will have single disciplinary focus with streamlined governance and administration requirements.
Although technological innovation has proceeded in day to day life at a pace, the diffusion of innovation of simulation in medical training has been slow over the last two decades. There has been a lot of literature reinventing or finessing the wheel. NASCE represents a potential for Skills centres to accredit their processes, have objective international data to take to their funders regarding development and participate in a network which visibility of the marriage of innovation with pragmatic learner-centred outcomes. Those of us involved in the initial development of NASCE are very excited at the possibilities that the programme offers to the wider community of healthcare trainers. The NASCE is now a reality. The accredited network is expanding rapidly. We encourage you to consider joining this exciting programme.