6. Themed Days - Primary Care

6.8. Respiratory disease

Preparatory work

Preparatory work  

In preparation you should have reviewed the following resources;  

  • Watch this 3 minute video by Asthma and Lung UK outlining the extent of respiratory conditions within the UK.  You should note down 1 key statistic and cause for respiratory conditions to discuss further on the day. 

  • Watch Pam  discuss her experience of living with Chronic Obstructive Pulmonary disease (COPD) in this 7-minute video.    What had a particular impact on you from this video? 

  • In this patient information video, Debbie, a respiratory nurse specialist indicates some key things to look out for in asthma in children.  On the day you might discuss why these features occur in asthma?  What did you observe how she communicated the features? 

  

Aims  

To introduce you 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.  

Learning outcomes  

By the end of the day you 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.   Reflect upon the key features you might see in a child with asthma as outlined by Debbie in the preparatory video.  What stood out for you when Pam described her experience of living with COPD?     

  

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 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.   See an example video here  

  • Introduction to examination of the respiratory system, adults and/or children 

  • Review the British Thoracic Society which has lots of useful resources e.g. clinical guidelines for respiratory conditions. 

  • Review the  Asthma UK website which also has useful resources e.g. asthma action plans. 

  • Review the BMJ best practice website on Coronavirus disease 2019 (COVID-19) which has comprehensive and free online resource that covers various aspects of COVID-19, including epidemiology, diagnosis, management and follow up.

Questions for you 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?