This module will teach students the clinical skills required to develop competence in history taking and physical assessment as required by an advanced clinical practitioner. It will enable students to develop skills in clinical decision making, differential diagnosis and care planning.
Students need to be currently registered with their professional body (NMC/HPC/GPhC) and have at least 3 years relevant experience in clinical practice.
Module will run
Spring Term 2019-20 to Summer Term 2019-20
This module aims to enable students to take a holistic health history from a patient/carer and to develop skills in assessing a patient's physical and mental health and cognitive ability.
Students will develop physical examination skills across the body systems, and be able to adapt these to the age of the patient, the setting, and individual needs and preferences of the patient. Students will then develop the art and science of clinical decision making and care planning.
Module learning outcomes
By the end of the module students should be able, using a holistic and patient centred approach, to:
Be skilled in taking an accurate, comprehensive and focused history, including mental health and mental status assessment.
Demonstrate competence in performing a comprehensive physical examination.
Have an overview of changes across the lifespan in the approach to the examination and expected findings.
Synthesise information acquired through history taking and physical assessment in order to form differential diagnoses for the individual patient.
Evaluate the presenting patient and likely diagnoses in order to plan evidenced based care in collaboration with the patient and colleagues as required and/or refer for further assessment/tests/treatment as appropriate.
Identify warning signs (red flags) in the individual patient and manage/refer as appropriate.
Accurately document subjective and objective data from the patient and be able to communicate these appropriately, in writing and verbally, with other members of the clinical team.
History taking and consultation skills, including for different age groups/people with difficulties with communication/ in different settings.
Physical assessment of body systems (ENT/Head and neck/respiratory/cardiovascular system/abdominal examination/male and female reproductive system/urinary system/nervous system/musculoskeletal system/skin)
Mental health and mental status assessment.
Assessment of the sick child/elderly person.
Assessment of the acutely ill patient.
Assessment/diagnosis and treatment of specific signs and symptoms and diseases.
Developing patient centred care and the promotion of self management and collaborative care.
The summative OSCE will comprise 5-8 stations each lasting 10 to 20 minutes. Students must achieve 75% of the criteria being examined to pass the station. Unsafe practice will receive an automatic fail. Students must pass each station to pass the module, which will be marked as Pass/Fail.
In the event of a student failing a station, they will only have to retake that station.
ongoing formative case study assignments made available to students and discussed in class.
feedback from facilitators during practical sessions on history taking and physical examination skills
a formative OSCE of 3 stations, delivered in the same format as the summative OSCE, with feedback given prior to the summative OSCE.
Students will also be expected to be able to discuss their advanced clinical practice portfolio they have been working on in clinical practice, demonstrating they are completing the requisite number of hours and are 'on track' towards achieving competency as an ACP.
Kumar, P., & Clark, M. (Eds.). (2017.) Clinical medicine (9th Ed.). London: Elsevier
Bickley, L. S., (2012). Bates' guide to physical examination and history taking (11th Edition.). Wolters Kluwer Health/Lippincott Williams & Wilkins
Rushforth, H., (2009). Assessment made incredibly easy! London : Lippincott Williams & Wilkins
Simon, C., Everitt,. Van Dorp, F. (2014). Oxford handbook of general practice. Oxford : Oxford University Press
Roper, T.A., (2014) Clinical Skills (2nd Edition.). Oxford:Oxford University Press
Longmore M., Wilinson I., Baldwin A & Wallin E. Oxford handbook of clinical medicine. Oxford: Oxford University Press.
Blann, Andrew D., author. (2013). Routine blood results explained [electronic resource]. Keswick, Cumbria : M&K Publishing