Clinical Assessment in Primary Care (Level 7)

Program Overview

This introductory course equips experienced practitioners with skills in history taking, physical examination, and diagnostic reasoning for four systems: cardiovascular, respiratory, gastrointestinal, and urinary. Participants learn to distinguish normal from abnormal findings, formulate differential diagnoses, and manage or refer patients appropriately. The course aligns with the NHS Long Term Plan, Transforming Primary Care, and the Five Year Forward View, emphasizing patient-centered care and proactive interventions.

Program Outline

Degree Overview:

Vision:

• Enable practitioners to facilitate the NHS Long Term Plan (2019) and informed by Transforming Primary Care: Safe, proactive, personalised care for those who need it most (Department of Health 2014) and Five Year Forward View (NHS 2014).

Objectives:

• Prepare practitioners to acquire systematic and structured history-taking, physical examination, and diagnostic reasoning skills for patients with commonly presenting problems in primary care.
• Help practitioners assess adults with undiagnosed presentations, distinguish normal from abnormal findings, and formulate differential diagnoses.
• Equip practitioners to manage, treat, or refer patients effectively.

Description:

This introductory course equips experienced practitioners with skills in history taking, physical examination, and diagnostic reasoning for four systems: cardiovascular, respiratory, gastrointestinal, and urinary. Participants learn to distinguish normal from abnormal findings, formulate differential diagnoses, and manage or refer patients appropriately. The course aligns with the NHS Long Term Plan, Transforming Primary Care, and the Five Year Forward View, emphasizing patient-centered care and proactive interventions.

Outline:

Content:

• Consultation models and methods of history-taking and documentation
• Anatomy and physiology of the cardiovascular, respiratory, gastrointestinal, and urinary systems
• Physical examination skills for the mentioned systems (auscultation, inspection, palpation, percussion)
• Interpretation of assessment findings
• Differential diagnoses using various diagnostic tools
• Role of the multidisciplinary team in patient management

Learning Outcomes:

• Knowledge and Understanding:
• Recognize symptoms suggesting significant pathology (red flags) and differentiate normal from abnormal signs.
• Analyze and interpret history and physical findings to develop appropriate differential diagnoses and action plans based on research and national guidelines.
• Assess the need for additional expertise or referrals.
• Skills:
• Employ a consultation model to guide assessment strategies.
• Use equipment effectively and appropriately.
• Reflect on assessment performance and feedback constructively.
• Generate structured consultation notes for patient contact and clinical reasoning.
• Values and Attitudes:
• Promote patient comfort, privacy, and dignity, identifying when chaperones are appropriate.
• Uphold professional standards in assessing, diagnosing, and caring for complex or deteriorating patients.
• Collaborate effectively within a multi-professional context, including informal carers.

Structure:

• 10 weeks, 3 hours per week (face-to-face teaching)
• Full-day practical sessions
• Term 1: Wednesdays (September - November) and Friday (December)
• Term 3: Wednesdays (May - July)

Individual Modules:

• History Taking and Documentation: Techniques for effective patient interviewing and record-keeping.
• Anatomy and Physiology: Detailed study of the cardiovascular, respiratory, gastrointestinal, and urinary systems.
• Physical Examination Skills: Hands-on training in auscultation, inspection, palpation, and percussion for the mentioned systems.
• Interpretation of Assessment Findings: Critical analysis of examination data to distinguish normal from abnormal findings.
• Differential Diagnosis: Development of differential diagnoses based on examination findings and available diagnostic tools.
• Management and Referral: Strategies for appropriate patient management, including treatment, referral, and multidisciplinary team collaboration.

Assessment:

Teaching:

• Face-to-face sessions comprising lectures, clinical skills demonstrations, and practice.
• Mandatory single-station Objective Structured Clinical Examination (OSCE) with formative written feedback.
• Graded 3,000-word essay reflecting on OSCE performance and areas for improvement.

Credits:

• 15 credits towards eligible programmes.

Careers:

Eligibility:

• Registered nurses in primary care, both newly qualified and experienced.

Other:

• This course can be taken as a standalone or contribute to the BSc/GradDip/PGDip Public Health (District Nursing) or BSc/PGDip Primary Care (Practice Nursing) programmes.
• Credits can be used towards postgraduate degrees in healthcare.
• Recommended reading materials listed in the context.
• Tutors' profiles with expertise and experience in clinical assessment and primary care.