ADVANCED CLINICAL ASSESSMENT AND DECISION MAKING IN ACUTE AND PRIMARY CARE

SHE Level 5
SCQF Credit Points 15.00
ECTS Credit Points 7.50
Module Code MMB724202
Module Leader Evelyn McElhinney
School School of Health and Life Sciences
Subject Nursing
Trimesters
  • A (September start)
  • B (January start)
  • A (September start)-B (January start)
  • B (January start)-C (May start)

Pre-Requisite Knowledge

Registered healthcare practitioner with formal agreement for access to suitable mentor(s) to fulfil learning outcomes of module.

Summary of Content

The context of advanced level practice involves the ability to make clinically sound decisions; consequently the aim of this module is to critically develop advanced knowledge and skills to enable Registered Healthcare Professionals to independently conduct robust clinical assessment. This module will entail study of topics and development of advanced skills to demonstrate competence in holistic assessment, consultation skills, clinical decision making, and evidence based practice. Consequently, this integrated theory and practice based module aims to promote the development of a safe practitioner working within an acute or primary care setting, who is able to practice without continual reference to a doctor. At the end of the module the student will be able to take a detailed clinical diagnostic health history and perform a full (head to toe) physical assessment (including -Inspection, palpation, percussion and auscultation). They will be able to prepare relevant documentation, communicate using correct terminology and present their findings and where necessary understand when to appropriately refer-on patients using a number of modalities. Additionally, they will be able to recognise the implications of their findings on clinical management with an understanding of the clinical decision making theory and models which have influenced their decisions and practice. The aim is to prepare them to practice evidence based practice, without continual reference to a doctor.

Syllabus

Diagnostic History taking and consultation skills across the age range Theories and models of clinical decision making Physical examination techniques across the age range Examination of skin, hair, nails, face, neck, ear, nose and throat. Examination of the cardiovascular system Examination of the respiratory system Examination of the abdomen Neurological assessment Introduction to musculoskeletal assessment Recognition of a range of mental health presentations, and referral pathways Normal anatomy and common pathophysiology related to the major systems Management and treatment options for a range of acute and primary care presentations through scenarios and online materials (minor and acute undiagnosed illness) Presentation of clinical patient cases and management plan to multidisciplinary team Referral routes using a number of modalities - paper, electronic

Learning Outcomes

Upon successful completion of the module, students should be able to:1. Critically analyse and evaluate techniques designed to elicit a comprehensive diagnostic physical and psychological clinical history via a range of consultation skills and models across the age range.2. Review and critically evaluate clinical decision making models and theory and their influence on clinical practice3. Demonstrate advanced knowledge and skills including the techniques of inspection, palpation, percussion, auscultation and movement associated with a complete physical examination of body systems acknowledging cultural issues of assessment of a diverse group of patients4. Differentiate and explore normal from abnormal findings for a wide range of acute and primary care clinical presentations5. Apply advanced knowledge of disordered physiology and patient assessment, in order to select and implement appropriate strategies to provide initial management of acute and minor illness in secondary and primary care6. Synthesise knowledge gained through the module and from reflection on practice experience, to apply effective evidenced based care and management7. Apply relevant theory to demonstrate principles of effective communication to relay common and complex patient's conditions and management to other members of the health care team using appropriate documentation, terminology, format and technology8. Critically evaluate the research literature on the value of physical examination signs.9. Successfully complete clinical competencies logbook

Teaching / Learning Strategy

This module uses a blended approach (face to face and online learning). The module uses a range of learning strategies including lectures, seminars, tutorials, interactive discussions, workshops, directed and self-directed study will be utilised depending on where the 'blended' delivery is taking place eg at a venue other than GCU. The fundamental aim of the teaching and learning strategies, irrespective of delivery mode is to support the development of, independent problem solving and decision making within the parameters of their profession competence, role and employers agreed vicarious liability (or equivalent). Directed learning will include a workbook of activities for completion in the practice setting to allow for integration of theory with practice. Students will undertake supervised practice within the clinical setting to accommodate this.

Indicative Reading

Module Handbook GCU learn Indicative reading list Barton, D and Allan D ed. (2015) Advanced Nursing Practice: Changing Healthcare in a Changing World Palgrave Bickley, L.S (2012) Bates' Guide to physical examination and history taking, 11th Ed. Philadelphia: Lippincott, Williams and Wilkins Brown, E. M. (2008). Heart sounds made easy. 2nd ed. Edinburgh, Churchill Livingstone. Dains,J.E., Ciofu Baumann., L., and Scheibel, P. (2011) Advanced health assessment & clinical diagnosis in primary care, Mosby: St Louis Douglas, G, Nicol,F and Robertson, C (ed) (2013) MacLeod's Clinical Examination (13th ed), Churchill Livingstone Elsevier: China JAPP, A.G and Robertson, C (ed) (2013) MacLeod's Clinical Diagnosis, Churchill Livingstone Elsevier: China Raferty, A.T., Lim, E.,and Ostor, A.J.K, (2014) Differential Diagnosis, 4th ed Churchill Livingstone Elsevier Thompson,C., and Dowding, D (2009) Essential decision making and clinical judgement for nurses, Churchill Livingstone: Edinburgh Walker, S., Carpenter, D., and Middlewick, Y (2013) Assessment and Decision Making in Mental Health Nursing, Learning Matters: Sage Policies Ritchie, L (2015) Pulling together: transforming urgent care for the people of Scotland The Report of the Independent Review of Primary Care Out of Hours Services Scottish Government Scottish Government (2015) SETTING THE DIRECTION FOR NURSING AND MIDWIFERY EDUCATION: DELIVERY PLAN 2015-16 Scottish Ambulance Service Towards 2020: Taking Care to the Patient College of Paramedics (2015) Post- registration framework 3rd Edition Current Research Journals related to Topics discussed

Transferrable Skills

-Develop independent learning by working in a self -directed manner -Develop study and IT skills to underpin effective learning -Develop critical thinking, decision making and communication skills -Work effectively with others -Underpin professional practice through reflection and the integration of theory and practice -Appreciate the need for a high level of ethical and professional conduct

Module Structure

Activity Total Hours
Practicals (FT) 20.00
Tutorials (FT) 35.00
Independent Learning (FT) 80.00
Assessment (FDL) 15.00

Assessment Methods

Component Duration Weighting Threshold Description
Course Work 01 n/a 100.00 50% Exceptions Case 1482000 Word Case Study
Course Work 03 n/a 0.00 45% Competency logbook. All components must be passed.
Course Work 02 n/a 0.00 45% OSCE including viva voce