GEP Medicine in Society Guide 2021/22

6.7. Coronary heart disease

Preparatory work

In preparation students should have:

• Looked at the NHS conditions website to get a quick overview of what CHD is, how it is diagnosed and treated and the impact it can have on patients' lives.  
• Reviewed this patient.info article considering the different aspects of prevention of CHD and considered the role that the primary care team play in this.
• Found further information about CHD, including up to date information about COVID-19 and heart disease and health promotion advice, on the British Heart Foundation website.
• Watched this (speedy) TED talk by Dr Dean Orrish, an American physician working in the field of preventative medicine, which is about the ‘killer’ American diet causing an obesity epidemic and increasing rates of illness, including CHD.

 

Aims

To introduce students to the pathophysiology of CHD, its impact on population morbidity and mortality, and the health promotion interventions used to try and reduce CHD.

 

Learning outcomes

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

• Explain the process of development of CHD
• Outline the impact of CHD on individuals and on population morbidity and mortality
• Describe key health promotion interventions to reduce morbidity and mortality due to CHD
• Discuss the impact of CHD on an individual patent
• Identify key policy documents relating to CHD

 

Example timetable

9.30 – 10.30	Tutorial on CHD
10.30 – 10.45	Tea break
10.45 – 11.45	Prepare for patient encounters Plan questions and observations   Patient encounters Interview a patient with CHD Sit in on a clinic with GP/practice nurse Observe a health promotion intervention e.g. long term condition check up
11.45 – 12.30	Students feedback to group on their patient encounters   Set up afternoon activity; In small groups visit/research local services/facilities that provide support for people with or at risk of CHD and/or meet someone involved with delivering these services
12.30 – 13.30	Lunch
13.30 – 15.15	Small group activities as planned 1:1 formative feedback meeting with GP tutor Includes tea break
15.15 – 16.00	Feedback to group about visit/research/interview   Set homework for next session

Suggested Activities

• Tutorial on CHD – could include the pathophysiology of CHD; students present on different cardiac conditions; group makes list of risk factors for CHD (modifiable/non-modifiable) and consider health promotion interventions to tackle modifiable risk factors; discuss the impact CHD has on the workload of the practice; review any hot topics e.g. COVID-19 and cardiovascular disorders.
• Review of the practice strategy for monitoring and managing patients with known CHD and at risk of CHD (NSF targets etc.)
• Observation of health promotion interventions aimed at preventing or reducing the risk of CHD.
• Interview a patient with, or at risk of, CHD.
• Case studies – e.g. new patient checks, look for risk factors – which are modifiable and what are the next steps in advising and supporting this patient?
• In small groups visit/research local services/facilities that provide support for people with or at risk of CHD and/or meet someone involved with delivering these services e.g. interview a community cardiac nurse.
• In pairs, students choose a health promotion topic related to CHD and prepare some guidance to give patients.

• Individual meeting with GP tutor for formative feedback on progress to date with learning activities, first written assessment and on professional attitude and conduct.     

  
  

 

Questions for students to consider

• If you met a patient with CHD– how did they describe their life, what did they find most difficult, had they made any lifestyle changes following their diagnosis?
• What local services and facilities did you find out about today? How did they try to meet the needs of the local community? What else do you think would be beneficial to support better health promotion in the area?
• You may have a meeting today with your tutor.  How do you feel you are progressing? Have you set yourself any learning outcomes as a result of your experiences so far? Were you surprised at your tutor’s analysis of your progress?