Table 1 Hypothesised competency levels for the FSEP assessment variable

Level 1

CTG use under supervision.

• Understanding the basic physiology of fetal heart rate control

• Being able to recognise what is normal and physiologically correct

• Being able to recognise an abnormal CTG or heart rate pattern

• Knowing who to call for assistance

• Being able to set up and apply a CTG

• Know the principles of conservative management and be able to apply these under supervision

Level 2

Recognising trends in FHR Patterns and the implications of those trends.

• Being able to perform as an independent practitioner, with access to senior/supervisory staff

• Being able to recognise and manage an abnormal CTG and appreciate the underpinning physiology

• Having a detailed knowledge of indications for EFM

• Appreciate the different modes of fetal monitoring and the indications and implications for each

• Appreciate the implications of different management strategies

• Being able to provide basic education for Level 1 practitioners

Level 3

Recognising errors in the interpretation and management of CTG abnormalities, and the implications of those errors.

• Being able to instruct and teach others in EFM and fetal surveillance

• Have a detailed knowledge of the normal and abnormal CTG, including the underpinning physiology

• Being able to recognise and manage unusual abnormalities

• Be able to manage multiple cases in a range of circumstances and understand the implications of those actions

• Being able to nominate other investigations as required and understand their limitations and implications

• Circumstances for referral and applied systems