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6. Themed Days

6.6. Day 6: Respiratory Medicine

Preparatory work 

In preparation students should have reviewed the following resources; 

  • 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. This resource is updated regularly. 

  • Public health England’s Inhale data, which is an online tool showing information about respiratory diseases, including COPD and asthma, for each clinical commissioning group (CCG) area.  

  • Another useful source for local information about respiratory disease, including clinical priorities and services, is the interactive map on the Respiratory Futures website. 

  • The British Thoracic Society has lots of useful resources e.g. clinical guidelines for respiratory condition and COVID-19 information for people with lung disease. 

  • 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. 

 

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 to 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. 

  • Virtually sitting in on 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? 

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