What the eLogbook Doesn't Catch at 3 AM
The FICM ePortfolio system is the mandatory submission platform. It's also the system trainees complete retrospectively, usually in blocks, usually from memory, usually at the wrong level of granularity to support a meaningful ARCP review. A complex resuscitation on a Tuesday night gets recorded as "Cardiac arrest — involvement Major — outcome: Died" because that's what the required fields ask for. The fact that it was a peri-arrest in a non-clinical area, that you performed RSI under distant supervision with a failed first attempt before securing the airway on the second pass with a grade 4 Cormack-Lehane view that you hadn't seen before, and that the incident field should have flagged an equipment failure on the laryngoscope — none of that level of detail survives the six-day gap between the event and the ePortfolio entry.
The logbook that travels with the trainee captures it at the bedside, immediately. The ePortfolio gets populated from accurate source data rather than reconstructed memory.
The Supervision Field Is the Field That Determines Your ARCP
Immediate, Local, Distant, Supervising — the supervision classification for each encounter is what the FICM progression competencies are assessed against. A trainee who has logged 40 admissions but whose supervision level is uniformly Immediate across all of them has a different competency profile than one whose log shows a transition from Immediate through Local to Distant supervision as the training year progresses. The ePortfolio reviewer will notice that pattern, or its absence.
Supervision at the level of "Supervising" — the trainee as the senior for a more junior colleague — is the field that records teaching encounters. Those entries feed into the teaching and supervision competency domain, and they disappear from the record if nobody captured the timestamp and supervision level at the time.
Start and Finish times per encounter, combined with date, produce the hours-per-encounter data. A trainee who is consistently attending complex multi-organ failure patients for 45-minute encounters has a different workload profile than one whose encounter times are 8 minutes. Both might have 60 entries in a rotation, but the clinical intensity is not equivalent, and start/finish times are the only field that captures the difference.
The Procedural Audit
The Procedures multi-select covers the intervention set that ICU trainees are required to demonstrate competency in for FICM progression: arterial line, CVC (femoral, internal jugular, subclavian), chest drain, intubation (RSI, non-RSI, fibreoptic), bronchoscopy, extubation, lumbar puncture, FAST scan, focused echo, PiCCO, PA catheter, brainstem testing, ascitic tap, MRI and CT imaging involvement. Multiple procedures per encounter are selectable — a post-arrest admission where you placed an arterial line, a femoral CVC, and performed a focused echo generates a single record with all three procedures logged.
The Involvement field — Major or Minor — distinguishes between performing the procedure and being present while a senior performs it. A trainee who logs 15 arterial lines all at Minor involvement has observed 15 arterial lines. The distinction matters when the portfolio reviewer is assessing whether the trainee can be signed off for independent arterial line placement.
Number of organ failures (0 through 6) and Level of care (1, 2, 3) establish the acuity of each encounter. A rotation where most admissions are Level 2 care with 1-2 organ failures has a different case mix than one dominated by Level 3 patients with 4+ organ failures. Trainees rotating through different ICUs — a district general and a tertiary cardiothoracics centre — will have visibly different case mix profiles, and that context is relevant to interpreting their competency progression.
Non-Admission and Transfer as Learning Encounters
Type of Contact includes Non-admission and Transfer, not just Admission. Non-admission encounters — where the ICU team reviews a patient and determines that higher-level care is not required, or that outreach is sufficient, or that the referral should be redirected — represent a significant proportion of ICU consultant workload that trainees often undercount. The Reason for Non-Admission field (higher level care not required, outreach sufficient, patient or family refusal, poor prognosis, unable to provide bed, referral to other team) captures the clinical decision, not just the outcome.
Transfer documentation — Intra-hospital or Extra-hospital, with Reason for EH Transfer (specialist care, stepdown care, bed pressures, repatriation) and Mode of Transport (road, helicopter, aeroplane) — captures retrieval and transfer medicine exposure. An ST6 who has done 12 extra-hospital transfers by helicopter has retrievals experience that needs to be in the logbook, not in a mental approximation.
The Incident field — Cardiovascular event, Drug-related event, Equipment-related event, Process of care event, Respiratory event — with free-text Incident Details creates the critical incident log that feeds the reflective practice requirements. Incidents logged at the time of occurrence, with the details still accurate, produce substantively better reflective entries than incidents reconstructed weeks later.
Injuries multi-select (Head, C-spine, Chest, Abdo, Pelvis, Long bone) with First Destination (Ward, Theatre, ICU, HDU, Other hospital, Unsuccessful resuscitation) handles trauma call encounters where the injury pattern and immediate management pathway are the clinically relevant data points. Resuscitation Successful as a discrete field on resuscitation-type contacts removes ambiguity from the most emotionally loaded entries in the logbook.