CLINICAL ASSESSMENT AND DECISION MAKING IN MINOR ILLNESS AND INJURY

SHE Level 3
SCQF Credit Points 40.00
ECTS Credit Points 20.00
Module Code M3B925869
Module Leader Keith Cameron
School School of Health and Life Sciences
Subject Paramedic Science
Trimester
  • A (September start)-B (January start)

Pre-Requisite Knowledge

Completion of year 2

Summary of Content

The paramedic in urgent & emergency or unscheduled care environment may be required to appropriately assess and manage non-life threatening minor injuries that they are presented with. The aim of this module is to develop knowledge and skills to enable students undertaking the BSc Paramedic Science programme to further advance their skills in independently conducting a structured clinical assessment which can be applied in acute and primary care settings. This module will entail time spent in practice with paramedic mentors in the ambulance setting and primary/acute care clinicians an alternative clinical environment e.g. accident and emergency, GP practice, Out-of-hours services, NHS24. The majority of placement will occur in the trimester A part of the module with online/distance support from the module lead. Trimester B study will consolidate learning in the practice through integration of the theoretical aspects of decision making. Students will use case studies from paramedic practice to further develop skills and confidence in patient consultation, assessment, treatment, referral, discharge and safe guarding. Consequently, this integrated theory and practice based module aims to promote the development of the safe and effective practitioner working within an acute or primary care setting with a focus on in depth consultation, appropriate treatment pathways and safety.

Syllabus

Clinical Assessment Skills: -360 - Diagnostic history taking and consultation skills - Physical examination techniques - Examination of skin, hair, nails, face, neck, ear, nose and throat - Examination of the head and eyes - Examination of upper and lower limbs. - Cardiovascular Examination - Respiratory system Examination - Neurological Assessment - Musculoskeletal Examination - Assessment of mental health and social influences on health Recognition of a range normal anatomy and common pathophysiology related to the major systems, limbs, head and eyes Recognition of mental health presentations Management and treatment options for a range of acute and primary care presentations Principles of wound assessment, cleaning and appropriate treatment Referral routes using a number of modalities - paper, electronic, telehealth pathways Recording clinical information Safety netting for patient referral and discharge in the community setting Professional, legal and ethical issues Theories and models of clinical decision making

Learning Outcomes

On successful completion of this module the student should be able to1. Demonstrate specialist knowledge of the anatomy, physiology and pathology that underpins the management of minor illness and injury to differentiate and explore normal from abnormal findings for a wide range of acute and primary care clinical presentations 2. Critically analyse and apply evidence based approaches to history taking, assessment and examination and clinical treatment for safe and effective management of patients with minor illness and injuries.3. Analyse techniques designed to elicit a comprehensive diagnostic physical and psychological clinical history via a range of consultation skills and models.4. Demonstrate appropriate knowledge and skills including the techniques of inspection, palpation, percussion, auscultation and movement associated with a complete physical examination of body systems.5. Apply knowledge of disordered physiology and patient assessment, to select and implement appropriate initial management of patients presenting with minor illness and injury 6. Demonstrate a critical understanding of the planning, processes, clinical challenges and limitations relating to the safe discharge or referral of patients within urgent and emergency care7. Appraise legal, ethical, diversity and vulnerability issues relating to the safe management of minor illness and injuries8. Review and analyse clinical decision making models and theory and their influence on clinical practice9. Integrate knowledge gained through the module and from reflection on practice experience, to apply effective evidenced based care and management

Teaching / Learning Strategy

This module uses a blended approach with a range of learning and teaching strategies including, demonstration, clinical scenarios, lectures, tutorials, interactive discussions, directed and self -directed study. The practice component will constitute 15 weeks of practice based learning (600 hours) in 2 settings. 10 weeks will be completed in the Ambulance environment with 5 weeks an acute/primary care setting such as accident and emergency, out of hours, GP and NHS 24 Non-Ambulance Placement: Students will be supported in practice by a named contact. This person will be a registered healthcare professional (HCPC/NMC/GMC/SSSC) with experience and knowledge of supporting student learning. The named contact will enable students to access appropriate learning experiences to meet the learning outcomes of the placement. The student may work with a variety of personal, identified and quality assured by the named contact. Students will complete the appropriate sections of the Practice Assessment Document (PAD) to demonstrate completion of the learning outcomes. The named contact will verify this as a true record of the learning that has occurred. The focus is on student ownership and completion of the elements of the PAD with support from their named contact. Ambulance Placement: Students will be supported and supervised by a paramedic mentor (Practice Educator (PEd)). Paramedic mentors are experienced paramedics working in the out-of-hospital environment attending a wide range of service users. Paramedic mentors will be supported by the module lead and placement lead for the programme as well as internal development and support for mentorship within the ambulance service. Mentors are required to assess the level of practice attained for skills and competencies set out in the Practice Assessment Document (PAD) and determine if the student is meeting the required level of practice at that point in their studies. They are also required to make an assessment of the students interpersonal skills at the end of the placement. If specific competencies are not met due to the lack of exposure to particular patients this can be completed using simulation either in the practice setting or in GCU following the end of the placement. Students are required to take ownership of their learning and to engage with their mentor/named contact to identify specific learning needs. Student submit their PAD for grading by the module lead based on completion of the required elements

Indicative Reading

Bickley, L.S (2012) Bates' Guide to physical examination and history taking (11th Edition), Philadelphia: Lippincott, Williams and Wilkins Brown, E. M. (2008). Heart sounds made easy. 2nd ed, Churchill Livingstone: Edinburgh 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), China: Churchill Livingstone Elsevier Collen, A. (2017) Decision Making in Paramedic Practice Japp, A.G and Robertson, C (ed) (2013) MacLeod's Clinical Diagnosis, China: 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 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 Ambulance Service Towards 2020: Taking Care to the Patient Practice Placement Handbook for students, BSc Paramedic Science (2018) Fitness to Practice/Code of conduct, GCU (2016) Practice Assessment Document (PAD) Guide

Transferrable Skills

-360b7 Develop independent learning by working in a self-directed manner b7 Develop study and IT skills to underpin effective learning b7 Develop critical thinking, decision making and communication skills b7 Work effectively with others in the multidisciplinary team b7 Underpin professional practice through reflection and the integration of theory and practice b7 Appreciate the need for a high level of ethical and professional conduct

Module Structure

Activity Total Hours
Lectures (FT) 12.00
Tutorials (FT) 24.00
Placement 600.00
Independent Learning (FT) 24.00
Assessment (FT) 40.00

Assessment Methods

Component Duration Weighting Threshold Description
OSCE n/a 50.00 40% OSCE Exam: Viva
Submisson of PAD n/a 50.00 40% Submission of PAD