Medicine in Society Guide 2022/23 (copy)

6. Themed Days

6.9. Day 9: Mobility and Stroke

Preparatory work

In preparation students should have:

Revised what they already know about the pathophysiology of stroke.

Reviewed the NICE Clinical Knowledge Summary for Stroke and Transient Ischaemic Attack.

Watched videos on healthtalk.org of people who have had a stroke or TIA discussing their experiences.
Looked at the Public Health England (PHE) Act-FAST campaign and considered what makes the poster effective

Aims

To introduce students to the effects of stroke, particularly in relation to mobility and the part played by environmental factors, healthcare and other agencies in supporting the impaired person.

Learning outcomes

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

Discuss the impact of stroke on an individual and their family and the role of voluntary agencies in providing support

Demonstrate an understanding of the effect of poor mobility on the individual and the changes needed within the community to be more inclusive of them

Identify important members of the MDT in assessment and care of patients with impaired mobility

Describe a health promotion intervention that can reduce the risk of stroke in an individual at risk

Practise pulse checks, blood pressure measurement, examination of central and peripheral pulses and communication skills

Example timetable

9.30 – 10.30	Tutorial on stroke
10.30 – 10.45	Tea break
10.45 – 11.45	Prepare for patient encounters Plan questions and observations Patient encounters Interview a patient who has experienced a stroke or TIA Home visit to patient, and if appropriate their family/carer, with loss of mobility/function
11.45 – 12.45	Students feedback to group on their patient encounters and discuss the impact of stroke on an individual and their family/carers Set up afternoon activity; In small groups visit or research local services/facilities providing support for stroke survivors and their families/carers or people with mobility problems or other disabilities and/or meet someone involved with delivering these services.
12.45 – 13.45	Lunch
13.45 – 15.00	Small group research/visits/interviews as planned 1:1 formative feedback meeting with GP tutor (for 4-6 students) Includes tea break
15.00 – 16.00	Feedback to group about visit/research/interview and discuss the role of voluntary agencies in providing support Check in on small groups for health promotion posters Set homework for next session.

Suggested Activities

Tutorial on stroke – could cover stroke and TIA, risk factors, possible short and long term sequalae, stroke MDT members and roles, and health promotion interventions that can reduce a patient’s risk; students could work on these areas in breakout groups then present back to whole group.

Meet with member of MDT to discuss role of team members for stroke / disability care; or join an MDT meeting.

Research into or visit to a local voluntary agency providing support to stroke patients, and/or interview person working for such an organisation.

Prepare questions to interview a patient who has problems with mobility.  Include a brief review of their home and work circumstances etc with respect to how well different environments are adapted to help overcome the patient’s disability

Visit a patient with impaired mobility at home, discuss with them any home modifications, impact on travel, work and accessibility.

Session teaching clinical skills e.g. pulse checks, blood pressure measurement, examination of central and peripheral pulses and practise these. Possibility for students to observe new patient checks and/or work alongside practice nurse/HCA to complete initial examinations, including pulse, BP, weight, height. Also, consider how these parameters are being carried out remotely using telemedicine.

Have an individual formative feedback discussion with GP tutor on progress on the course so far, including first written assessment, plan for poster assignment and professional attitude and conduct.

Questions for students to consider

How did you feel meeting a person that had suffered a stroke/had a mobility problem?  What aspects of the meeting were most difficult?  Did the patient seem comfortable with you?  Were you surprised at the impact it has had on their life?

Did anything about the MDT surprise you? Were you aware that so many different professionals were involved in the care of patients with mobility problems?  What role did the GP play?  Was this what you had expected the GPs role to be?

Consider the health promotion interventions you have heard about or observed today; what effect do you think that being told you are at high risk of stroke or heart disease has on an individual?

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?