Medicine in Society Guide Malta 2021/22

6.6. Day 6: Respiratory Medicine

Preparatory work

In preparation students should have reviewed the following resources;

• The BMJ Best Practice on Coronavirus disease 2019 (COVID-19) is a comprehensive and free online resource that covers various aspects of COVID-19, including epidemiology, diagnosis, management and follow up. This resource is updated regularly.
• Public health England’s Inhale data, which is an online tool showing information about respiratory diseases, including COPD and asthma, for each clinical commissioning group (CCG) area.
• Another useful source for local information about respiratory disease, including clinical priorities and services, is the interactive map on the Respiratory Futures website.
• The British Thoracic Society has lots of useful resources e.g. clinical guidelines for respiratory condition and COVID-19 information for people with lung disease.
• The British Lung Foundation website has details of different respiratory conditions, UK statistics for lung disease and an excellent section where you can get a patient’s perspective on COPD by reading and watching the stories of people who live with and have experienced COPD.
• The Asthma UK website also has useful resources e.g. asthma action plans.

 

Aims

To introduce students to respiratory illness, its impact on patients, society and the practice workload; and to introduce students to health promotion measures designed to improve respiratory health. To consider the changes and challenges in assessing and managing respiratory conditions during to the COVID-19 pandemic.

Learning outcomes

By the end of the day students should be able to:

• List common respiratory illnesses in children and adults that are seen in primary care
• Describe the basic assessment of a child with an upper respiratory tract illness (URTI)
• Describe and reflect on the impact of chronic respiratory disease from a patient’s perspective, focusing on the issues of loss of function, autonomy, and well-being and its impact on daily life
• Outline the health promotion interventions, including smoking cessation interventions, provided by the practice team to prevent or manage respiratory illness
• Demonstrate a basic examination of the respiratory system
• Demonstrate the measurement and interpretation of peak expiratory flow

 

Example timetable

9.30 – 10.30	Tutorial on respiratory illnesses
10.30 – 10.45	Tea break
10.45 – 11.45	Prepare for patient encounters Plan questions and observations   Patient encounters Some students can sit in on virtual clinic with GP/practice nurse Other students to interview patient/s with a respiratory condition
11.45 – 12.45	Students feedback to group on what their patient encounters and group discussion
12.45 – 13.45	Lunch
13.45– 15.00	Teaching session with practice nurse about peak flow and spirometry measurement   Followed by breakout tasks; students work in pairs/small groups for case studies using peak flow and spirometry measurements   Includes tea break
15.00 – 16.00	Group debrief on cases Set homework for next session

 

Suggested Activities

• Tutorial on respiratory illnesses – could include brainstorm of common respiratory symptoms presenting in primary care, long term respiratory diseases and their impact on patients and the practice team’s workload, students presenting pre-agreed topics based around preparatory work, ‘hot topics’ e.g. COVID-19.
• Virtually sitting in on routine clinic with a member of the primary care team and observe particularly respiratory presentations, including acute and chronic symptoms, long term condition management e.g. asthma checks, health promotion activities e.g. flu jabs.
• Interview a patient with a respiratory condition.
• Teaching session with practice nurse to demonstrate spirometry and/or peak flow measurement (NB-there are lots of videos of this if no one can deliver the teaching session) and/or case studies interpreting peak flow and spirometry results.
• Introduction to examination of the respiratory system, adults and/or children, and to what extent this has changed due to COVID-19 e.g. remote assessment. This video from eGPlearning considers the respiratory exam by video consultation. 

 

Questions for students to consider

• If you met a patient with COPD or asthma– how did they describe their life, what did they find most difficult, did they see themselves as ill?
• Did you see or discuss acute respiratory illnesses?  How did this impact on the GP’s workload?  Should patients do more to self-manage minor illness?  How can healthcare professionals support them to do this?
• How has COVID-19 changed how acute respiratory symptoms are assessed and managed?
• How has COVID-19 affected people with chronic lung disease?