Extending Patient Contact Handbook 2018/19

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Book: Extending Patient Contact Handbook 2018/19
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Date: Tuesday, 16 April 2024, 5:39 PM

Description

Extending Patient Contact Handbook

1. Course Administration and Clinical Leads

Contact details for Unit Convenor

Maria Hayfron-Benjamin
m.j.hayfron-benjamin@qmul.ac.uk
020 7882 2505

Contact details for Unit Administrators

Unit Administrators
Mrs Esi Amankwah  - e.amankwah@qmul.ac.uk (0207 882 8786)
Mr Jim Manzano - j.manzano@qmul.ac.uk (0207 882 6421)

Departmental Fax
020 7882 8117

Departmental Address

Academic Unit for Community-Based Medical Education
Barts and The London School of Medicine and Dentistry Garrod Building,
Turner Street
London E1 2AD
 

2. Introduction

This is a community based placement for all Year 2 students at Barts and The London School of Medicine and Dentistry. Students need to continue to meet patients, building on their experiences in Medicine in Society in Year 1 and continue their professional development with the benefit of authentic clinical experiences.

General practice will work as a setting which will bring to life the PBL scenarios, contextualising and broadening your learning and encouraging you to think about the wider, more varied, range of disease presentation. The opportunity to actively engage with patients in a safe, yet authentic, clinical environment will allow you to reflect on your communication skills and your attitudes to patients and illness, forming an important aspect of their professional development. 

Module Aims:

To build on the general practice experience and patient contact in Medicine in Society in Year 1, bring to life the ‘core’ conditions covered in the PBL sessions with clinical experience.

Learning Outcomes:

By the end of this unit, students should be able to:

  1. Apply their theoretical knowledge to clinical situations,
  2. Talk appropriately with patients,
  3. Identify the variety of patients’ concerns, the patients perspective of illness,
  4. treatment and its impact on them and their families
  5. Perform appropriate clinical examinations such as blood pressure and other basic examinations under adequate supervision
  6. Use their observation of senior colleagues in clinical practice to reflect on the attributes required of them as professionals 


3. Extending Patient Contact Timetable

Timetable 2017/18

 

Week

A/B Group

C/D Group

System

1

9/10/18

16/10/18

Cardio-respiratory

2

23/10/18

30/10/18

Cardio-respiratory

3

6/11/18

13/11/18

Metabolism

4

20/11/18

27/11/18

Metabolism

5

18/12/18

8/1/19

Brain and Behaviour

6

15/1/19

22/1/19

Brain and Behaviour

7

29/1/19

5/2/19

Human Development

8

12/2/19

19/2/19

Human Development

9

26/2/19

5/3/19

Human Sciences and Public Health

10

12/3/19

19/3/19

Locomotor

11

26/3/19

2/4/19

Locomotor

12

9/4/19

30/4/19

Review and assessment

3.1. Clinical conditions to be covered

Suggested topics to be covered in EPC session

 

Week

System

Suggested clinical cases

1

Cardio-respiratory

Ischaemic heart disease, hypertension, heart failure, COPD

2

Cardio-respiratory

3

Metabolism

Diabetes, renal disease inc. renal failure, thyroid disease, change in bowel habit (inflammatory bowel disease, Irritable BD, gastroenteritis, malignancy)

4

Metabolism

5

Brain and Behaviour

Parkinson’s disease, back pain, epilepsy, dementia, depression

6

Brain and Behaviour

7

Human Development

Developmental delay/disability, nutrition, chronic disease in childhood, pregnancy, antenatal and post natal care cervical screening

8

Human Development

9

Human Sciences and Public Health

Public health in primary care, health promotion and preventative, falls prevention, drug and alcohol use and mis-use, patient self-management of chronic disease

10

Locomotor

Osteoarthritis and osteoporosis, inflammatory joint disease inc rheumatoid arthritis

11

Locomotor

12

Review and assessment

Revision of any areas that students feel less confident in – should be negotiated with group, observed history taking, final assessment

3.2. Suggested Lesson plan for EPC session

Sample Lesson plan for EPC day 2 - Ischaemic Heart disease

9.00 – 10.00        Presentation/Review of any preparatory work set by tutor.  Review of students’ knowledge of IHD – tutor filling in gaps, correcting errors.  Discussion/tutor presentation on clinical aspect of IHD.  Terms patients might use, medications they might be on etc.  Discussion/Preparation of interview schedule ahead of meeting with patient

10.00 - 11.00       Interview with patient either at home or in surgery – if in surgery suggest that GP give students some time alone with patient to allow them to develop rapport and to observe for some of the time so feedback can be given.  If appropriate GP to demonstrate an element of the cardiovascular exam particularly if patient has good signs. 

11.00 – 12.00      Debrief on interview, self appraisal on communication skills, feedback for colleague that observed the interview, feedback from GP tutor if possible.  Clarify any questions, discuss any new terms or concepts introduced by the interviews.  Look ahead to next session- any prep students need to do etc.

4. Course Description

You will be at a GP practice for 3 hours each Tuesday morning from 9-12 am on 12 occasions during the year alternating with your year 2 MedSoc placement;

you will be in a group of 4 students.

It is expected that each morning will begin with a preparatory tutorial, where you will have an opportunity to discuss your learning needs.

This will be followed by some clinical activity e.g. meeting a patient whose conditions match the PBL units that you are undertaking at the time, examining a patient or practising examination skills on each other, attending a clinic, undertaking practice based investigations (spirometry, ECG recording, blood glucose monitoring, urinalysis), or interpreting laboratory results.

You will also have opportunities to practice communication skills.

You will work in pairs for these activities and will be expected to give feedback to your colleagues; you will also receive feedback from your tutor.

The morning will finish with a debriefing tutorial when you will have the opportunity to ask questions and identify learning needs for forthcoming sessions 

5. Student Assessment

Attendance

 

Tutors are required to complete a placement attendance register, this must be returned with the grade sheets and Professionalism Assessment forms at the end of the unit.

 

Please inform us of any unexplained non-attendance, or any student that misses more than two placement days even if they have provided an explanation.

5.1. Reflective write up EPC placement

Students must write a 500 word reflective essay on an occasion where they interacted with a patient that resonated with them for some reason, for example it made them think of a patient / medical condition in a new light, or it raised some ethical issues, for example where they were required to gain consent from a patient for a task that they were about to perform. You will mark this assignment.

 

Students should demonstrate insight into: their exploration of their feelings about the task; what they said and why; how they approached the patient; how the patient responded; evidence of reflection on achieving ‘informed consent’: what could they do to develop their performance?

 

We suggest the first draft is discussed as a formative exercise as a group on week seven and that student are encouraged to revise their work in the light of the feedback they received from you and their peers. The final submission is for summative assessment at the end of the placement, please consider the students progress in the revision of this document as a key aspect in your mark. Students should be advised to add this to their professional portfolios.

5.2. End of placement assessments for EPC

Please complete an assessment form for each student and return this with their professionalism assessment form by Friday May 2nd 2014. Please discuss your assessment with them on the last day, students find it very valuable to get timely feedback and to have the opportunity to discuss their progress with you. Guidance is provided for the completion of the assessment form. If you have serious concerns about a student for any reasons please let us know as soon as possible so we can take action before the end of the year.

 

The EPC mark is worth 6% of the ‘in course assessment paper” (ICA), other elements of the ICA include PBL attendance and write-ups, end of unit exams, and the MedSoc 2 mark. Students must get 50% overall in their ICA in order to be allowed to sit the summer exams.

 

Extending Patient Contact Unit Marking Guide

 

Attribute                            

Pass (8-10)

Pass (5-7)           

Referred (≤ 4)

 

Knowledge

Knowledge at or above expected for a second year student. Applies scientific knowledge well to clinical care. 

Knowledge level satisfactory, beginning to apply scientific knowledge to clinical scenarios

Knowledge level unsatisfactory, ill-prepared for sessions, poor linkage of scientific knowledge in clinical situations.

Communication Skills

Excellent communication with patients, staff and student colleagues.

Developing communication skills, improvement seen during the year, becoming more confident and skilled in communication in group, with patient and with practice staff.

Communication skills unsatisfactory

Clinical Skills

Competent in performing basic clinical skills e.g. blood pressure, HR, resp. rate, urinalysis, BMI measurement with minimal supervision. Good underpinning knowledge

Understands principles of routine clinical skills, able to perform skills but not yet fluent.

Underpinning knowledge and ability to perform basic clinical skills inadequate.

 

Reflective write-up

Demonstrated insight into patient feelings, own emotional response, context.  Able to stand back from the situation, perhaps looking from different points in time.

Satisfactory account of patient encounter, some insight into patient feelings, own emotional responses

Encounter with patient described but not explored. No insight into patient feelings or own role demonstrated.

 

Global professionalism and attitude

Excellent attitude and approach, very good timekeeping, well prepared for each session               

No problems with attitude or behaviour.

Unsatisfactory behaviour in at least one professional domain, e.g persistent lateness, absenteeism without explanation, poor behaviour with patients

etc.

 

 

 

Student Assessment Form – Extending Patient Contact

 

Overall assessment – Please grade the student’s overall performance taking into account the above attributes. Referred means scoring 20 or less and that the overall performance of the student has raised concerns. Referred students will be seen by their Academic Year Tutor.

 Practice:

Lead GP Tutor:

Names (and positions) of other Teachers who contributed to the assessment:

Please mark the following attributes out of 10 (4 or below is a fail grade)

 

Student Name:

Attachment:

 

 

Attribute

 

Mark out of 10

Free text comments

Knowledge

 

 

 

 

Communication Skills

 

 

 

 

Clinical skills

 

 

 

Reflective write-up

 

 

 

Attitude and professionalism

 

 

 

Total

 

 

 

 

 

 

 

 

                               

                                               

                               

                                                                               

6. Student Safety and Home Visit Policy

Escorted Visits

These refer to visits to patients in their own homes by members of the primary care team accompanied by the medical student. The patient's permission for the medical student to be present during the home visit should be obtained.

Unescorted visits

Where students are expected to visit patients in their own homes without an accompanying healthcare worker the supervising clinician will have previously selected and consented an appropriate patient for such an activity. Patients will have been given details about the purpose of the visit, the timing and the names of the students. Students should ideally visit in pairs, but if they are on a single-student attachment and have met the patient previously and wish to undertake a visit on their own this can be safely managed.

If the following are adhered to all should be well:

  1. Know where you are going and plan your journey
  2. Ask for help and instructions from your tutor if unsure
  3. Ensure your practice knows where you are going and when you are expected back
  4. Be clear about the purpose of your visit and how to conduct yourself
  5. Always carry your identification card, adequate finances to get you home, your mobile phone and an A-Z map
  6. Terminate and excuse yourself from the visit if for any reason you feel unsafe

Students are asked to discuss with their tutors any planned visits they feel uncomfortable with, in which case the tutor will accompany you.

You can access details of your practice if you have lost the information, provided you know the rough location and name from: http://www.nhs.uk/england/

In London you plan a journey using the Transport for London website: http://www.journeyplanner.tfl.gov.uk/index.html 

7. Ethics and Confidentiality

Please remind all students of the importance of patient confidentiality when they begin their placement with you, this should include outlining your practice procedures to maintain confidentiality and examples of how they might inadvertently breach confidentiality e.g. discussing a patient in a public area within or outside the practice; discussing one patient with another; or including patient identifiable data on notes they have made as a resource for their own learning.

Students will be seeing patients either in the GP surgery or visiting them in their own home. They have been asked to bear in mind the following:

  • Patients have a right to confidentiality; therefore please ensure you do not discuss any personal patient information outside of the practice.
  • Although patients should have been informed prior to the session that medical students will be present, you must respect their wishes if they decline to be interviewed or examined by any student.
  • Treat all patients and staff with courtesy and respect, they are generally going out of their way to provide a valuable learning experience for you.
  • Please ensure that you are neatly attired.
  • Please remember that, even though the tutor may have gained consent from the
  • patient, it is important that you reaffirm that consent personally.