Medicine in Society Guide 2022/23 (copy)

6. Themed Days

6.6. Day 6: Respiratory Medicine

Preparatory work

In preparation students should have reviewed the following resources;

The British Thoracic Society has lots of useful resources e.g. clinical guidelines for respiratory conditions.
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.
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.

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 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.

Sit in on a 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?