The Logbook That Fails You at 11 PM Before an ARCP
You are nine months into ST4, it is the night before your Annual Review of Competence Progression, and your consultant asks how many GA ETT IPPV cases you have logged under distant supervision in orthopaedic trauma. You open the spreadsheet. The columns do not line up. You exported from the old app and the supervision codes did not map across. There are 47 blank rows.
This is not a hypothetical. Every registrar who has tried to maintain an RCoA-compliant logbook across two different rotations knows the feeling: the sinking realisation that your primary evidence document for progression is full of gaps, inconsistencies, and fields that were never filled in because the interface made it painful to do so standing at the scrub sink at 06:45 with cold gloves and a patient already on the table.
The RCoA curriculum demands granularity. Not just "did anaesthesia" but which technique, which procedure, under what level of oversight, for a patient of what ASA grade and priority classification. That level of detail requires a data structure that enforces completeness — and a capture tool that you will actually use in the gap between the last case and the post-op handover.
What Gets Captured and Why the Field Design Matters
The Supervision field is where most logbooks quietly fall apart. This template carries nine discrete options: Local, Distant, Consultant, NCCG, ST, and four Teaching variants covering ST, CT, Med Student, and Novice. This is not administrative padding. The distinction between Local and Distant supervision is load-bearing data for your WBA portfolio and for the RCoA's curriculum mapping. Distant means the consultant was in the building but not in the room. Local means they were scrubbed in or immediately available within the theatre suite. These mean different things for your independent practice evidence, and a logbook that collapses them into a single "supervised" tick is useless at ARCP.
The ASA field uses a 1–5 rating scale, which mirrors the physical status classification directly. An ASA 4E emergency vascular case tells a fundamentally different clinical story from an ASA 1 routine day case, and the Priority field — Routine, Day Case, Urgent, Emergency — intersects with it in ways that matter for your complexity case distribution. A high proportion of Emergency cases with ASA 3–4 at an early training stage is a flag; a dearth of them at ST6 is equally a flag. The database lets you cross-filter on both simultaneously.
The three-slot anaesthetic technique structure — Anaesthetic 1, 2, 3 — maps to the layered reality of combined technique cases. A thoracic case might be GA ETT IPPV primary, with an Epidural Thoracic as Anaesthetic 2, and nothing in slot 3. A day-case inguinal repair might be Spinal primary with an Ilioinguinal block as Anaesthetic 2 and Local Anaesthetic Infiltration in slot 3. The template does not force you to fit a complex case into a single-technique field, which is the primary failure mode of most app-based logbooks that were built by software engineers who have never been inside an anaesthetic room.
The Three Incidents You Have to Log Anyway
The triple Incidents fields are the part of the RCoA logbook that nobody enjoys filling in, but that the College checks carefully. Incidents 1, 2, and 3 are free-text fields in this template — deliberate. Structured incident reporting forces you into categories that may not fit what actually happened. A laryngospasm in an ASA 1 paediatric case, a failed spinal requiring conversion mid-procedure, an unexpected difficult airway where the videolaryngoscope battery was flat: none of these map cleanly to a checkbox.
You fill them in before the anaesthetic room goes cold. You are still at the machine, the patient is going to recovery, and you type directly into the entry. The gritty version of this workflow is that you do it while the theatre coordinator is closing out the board and the scrub nurse is counting swabs aloud — two simultaneous conversations in the background, your phone in your non-dominant hand, logging a 47-year-old male ASA 2 elective thoracic lobectomy, GA ETT IPPV + Epidural Thoracic, double-lumen tube, OLV with a bronchial blocker as Procedure 3, supervision Distant, duration 06:15–10:40, incidents: "OLV desaturation at 89% requiring brief CPAP, resolved without conversion."
That entry takes ninety seconds. In six months it is your evidence that you can manage single-lung ventilation complications independently.
What the Distribution Looks Like After 200 Cases
After your third or fourth rotation the database starts earning its keep in ways the initial data entry does not reveal. Filter for Specialty: Paediatrics and ASA: 3 or above. Filter for Anaesthetic 1: GA Mask and Supervision: Local. Filter for Procedure 1: RSI and Priority: Emergency. Each of these filters surfaces your case mix against the curriculum competency domains without you manually reviewing 200 entries.
The RCoA has moved toward e-portfolios that pull logbook data automatically, but the underlying data quality still depends on what you entered at the time. A logbook with disciplined ASA grading, accurate supervision coding, and complete technique documentation can be exported and mapped to curriculum outcomes. One with half-filled fields and collapsed supervision codes cannot.
Revalidation evidence does not get better retrospectively. The Percutaneous Tracheostomy you placed at 2 AM on a grade-4 airway with a failed RSI upstream — if it is not in the logbook with the incident narrative and the correct supervision code, it does not exist.