School of Medicine - The University of Liverpool · 2013-08-16 · Psychiatry 47 9 2 Primary Care...

School of Medicine

Year 4 Clinical

Logbook 2012/2013

(If found please return to School of Medicine, University of Liverpool,

Cedar House, Ashton Street, Liverpool L69 3GE)

Name:

Student ID: Group:

Contact Number:

2 Student ID

Contents Speciality Page number Number of cases Verbal presentations

Medicine 10 29 2

Surgery 15 24 case 7 CBDs

Palliative Care 32 3 1

Paediatrics 37 10 0

O & G 42 10 0

Psychiatry 47 9 2

Primary Care 55 2

Educational Supervisors feedback

64 4

Clerking deadlines Students must log the following on to SPIDER: Date Minimum number of Clerkings Minimum number of KCEs

14th December 2012 25 30

22nd February 2013 50 50

12th April 2013 70 65

7th June 2013 92 84

TO BE ALLOWED TO SIT THE SUMMATIVE ASSESSMENTS YOU MUST HAVE 92 CLERKINGS LOGGED ON SPIDER BY 4pm on 7th June 2013. As part of their professional commitment students are required to record and log on SPIDER all attended KCEs and give feedback. It is expected that a minimum of 90% (84 KCEs) will be logged by 4pm on 7th June and will be checked as part of the progression review. The number of clerkings logged on SPIDER will be monitored. Students who have not recorded the indicative minimum number of patient clerkings and KCEs by the deadlines above may be asked to provide an explanation of this to the year director. Continued noncompliance will be considered a “fitness to practise” issue. If this book is lost please inform the year clerical officer immediately to arrange collection of a new book. Periodic photocopies should be kept of completed sections of this book in case of loss. Please ensure that the student ID number is completed on any pages prior to photocopying.

3 Student ID

Student Instructions Introduction This book provides a summary of what a student is required to do during clinical placements and when completed, provides evidence that a student has satisfactorily fulfilled these requirements. It has two components: this book and the electronic clinical log (available through SPIDER). It is the student’s responsibility to ensure the completion of this book and to log the entries onto SPIDER as they are signed off Falsification of signatures The School of Medicine considers falsification of signatures to be an unprofessional act of forgery. Any suspicion of falsification of signatures within the logbooks will therefore be investigated and may be considered a fitness to practise issue. The GMC also takes falsification of signatures very seriously such that, if forgery is proven, registration with the GMC may be forfeit. If you are experiencing difficulty in obtaining the signatures you need to comply with the deadlines for interim and final log book completion e.g. for Clerking and KCE logging, please discuss the issue with the educational co-ordinator, or their equivalent, at your clinical placement, and also raise any support needs with your academic advisor or educational supervisor as appropriate. The School of Medicine will always listen to cases of genuine difficulty which are supported by evidence. Patient Clerkings Over the course of the year students are required to write up 92 patient clerkings using the provided proforma (downloadable from VITAL). Each must be neatly written or typed up, reviewed by a clinical teacher and signed off as at least ‘acceptable’ in this book1, AND a summary logged electronically on SPIDER. Please note: Students will not be permitted to sit summative exams if they have not completed the clerkings. A full clerking involves not only taking a satisfactory and relevant history but also examining the patient, reviewing and recording the relevant investigations, listing the differential diagnoses and identifying the most likely cause, outlining a management plan, summarising the case and outlining the pathophysiology. Feedback on clerking will be given using the scale:

(A) Acceptable) Patient clerking written to a level appropriate for a year 4 medical student. If the student does not reach this standard they are required to revise or rewrite their clerking.

(G) Good A well written patient clerking, not requiring any revision

(E) Excellent Patient clerking well above standard and approaching the standard of an F1 doctor.

1 Both clerkings and presentations may need to be repeated until they are at an appropriate standard.

4 Student ID

Verbal Presentations Students are required to present 11 of their case histories verbally to a senior clinician. This is to ensure that students can summarise and present the case verbally as required in LOCAS. These must also be signed off as at least ‘acceptable’ in the feedback section of the clinical portfolio. Case Based Discussions (CBDs) Students are also expected to record their attendance at and involvement (as determined by the clinical teacher) in case based discussions, and ask the clinician to sign and date the entry. Summarise the CBD and enter the summary as a clerkings on SPIDER. Key Clinical Experiences Students are expected to record their attendance and involvement (as determined by the clinical teacher) in key clinical experiences, and ask the clinician to sign and date the entry. Participation in clinical experiences not listed should also be recorded in the clinical portfolio on the page provided. These must then be logged on SPIDER as described on page 2. There are 94 KCEs and Journeys. The scale OGCU will be used:

(O) Outstanding Evidence of preparation for session, fully involved, asks sensible questions

(G) Good Involved in session but not obviously prepared for session

(C) Cause for concern Attends but not properly involved. No preparation

(U) Unacceptable Uninterested in session, does not become involved, no preparation

Carried over KCEs Any KCEs not logged during 3rd year should be brought forward with their details completed on page 59. You must them complete the table on page 59. You should attempt to get these signed off where possible during the year. Patient Journeys The ‘Patient Journey’ aims to assist student understanding of the total patient experience, and the interaction between different specialties within the health service, and between health and social care provision.

The case used in the patient journey should be fully written up as a case history. Each step of the journey is considered a KCE and should be signed off when complete.

When students see their designated educational supervisor they should discuss at least one of the patient journeys.

Practical Skills Students are expected to demonstrate competency in a number of practical skills (as listed in the clinical logbook). You must ensure that the supervising clinician signs and dates the entry. Should you have the opportunity to participate in practical skills not listed; these can also be recorded in the clinical portfolio. End of Placement Feedback Students must ensure that the medicine / surgery and psychiatry feedback is completed. Students must make sure to make time with the senior clinical teacher, preferably the consultant of the firm, to complete the form.

5 Student ID

Academic Advisor All students on the MBChB programme at the University of Liverpool are allocated an Academic Advisor (AA) who is responsible for providing appropriate support in-year to help students to fulfil their academic potential. The AA will be the person best placed to fulfil this role, and will change each year. You will be told who your AA is at the start of each academic year. The schedule of routine meetings will vary with year group but in general, your AA will discuss your academic performance, and provide advice on how it can be improved. Your AA is the first port of call if you are having problems with your academic studies, and may also be able to suggest where else you can obtain help, if you are experiencing difficulties with any other aspect of University life. Pastoral Support In addition to the generic pastoral support services offered by the University (see inside rear cover), available to all students, students on the MBChB programme can also access more targeted/specialist help and support for non-academic issues via the Student Support Administrator (see inside rear cover). Members of the Medical School’s Student Support Team can provide both advice on School level procedures and assist with signposting to central and specialised support services as appropriate. Preparatory Knowledge Tasks To find the PKT programme log into VITAL and on the left hand navigation in your year VITAL course module there is a link to PKT. PKTs have been introduced to the clinical course to help you link your academic knowledge to the clinical programme. Please complete the 2 tasks relevant to each clinical event and discuss between yourselves and the clinical teacher. At this stage not all clinical teachers will be aware of this project, so please do not be reticent, encourage the clinical teacher to be involved if time allows. These tasks are formative and as such you will not be examined directly on the PKT itself; however as these are all derived from learning objectives in the course the subject matter may be included in exams. They will also be very good revision material. If you would like to join the superuser group for the PKTs and take part in improving the PKTs and help develop the project further please contact Rachel Blanchard ([email protected]). If you have any general comments please contact Rachel Blanchard ([email protected]) OSCE Errors In your logbooks, you will find pages 66-67 of this book set aside for OSCE errors. The university clinical skills team will inform you individually if you have an OSCE error to complete from the previous year’s OSCE. If you do not have a remedial OSCE to undertake, indicate this on the form and sign it. The remedial OSCE pages will be scrutinised at progression review and it will be taken very seriously, as an issue of professional conduct, if what is written in the logbooks does not match our records.

mailto:[email protected]


6 Student ID

PBL Students will attend these sessions and ask their facilitator to sign and comment on their participation, communication and preparation in PBL at the end of each scenario Vaccination for Medical Students GMC tomorrows Doctors 2009 (paragraph 140) states “Students should protect patients, colleagues and themselves by being immunised against serious communicable diseases where vaccines are available”. It is therefore your responsibility to ensure that you are vaccinated against seasonal flu and swine flu in conjunction with clinical placements. The vaccination is however not compulsory and there may be good reasons for you not to receive it; for example severe allergy to eggs or previous flu vaccine. (http://www.cdc.gov/flu/protect/keyfacts.htm). Please ensure you have received seasonal and swine flu vaccination when it becomes available from your GP. If this is not possible, please discuss with your local subdean team.

Vaccine given by:

Signed:

Date:

Intimate Examinations under Anaesthesia

Medical students are NOT PERMITTED TO UNDERTAKE ANY INTIMATE EXAMINATIONS WHILST A PATIENT IS ANAESTHETISED. Properly supervised and with full informed consent, intimate examinations on patients who are awake can be undertaken. It is your professional responsibility to respect the patient’s wishes, do not feel pressurised to undertake such an examination if you feel it is inappropriate. Chaperoning You MUST never examine a patient if you are not chaperoned. This applies to ALL branches of medical practice. You are advised to always see a patient with a student colleague. Occasionally a fellow student will not be present, in which situation you must be chaperoned by a nurse or other member of the clinical team. When you write up the clerking, it is permissible for each student to use the same patient. However you must write up the case from your notes independently. Absence Log All absences from clinical placements MUST be recorded with the reason for the absence by the student in the absence log. GMC Guidance Tomorrow’s Doctors: http://www.gmc-uk.org/education/undergraduate/tomorrows_doctors_2009.asp

Professional Values and Fitness to Practise: http://www.gmc-uk.org/education/undergraduate/professional_behaviour.asp

http://www.gmc-uk.org/education/undergraduate/tomorrows_doctors_2009.asp

http://www.gmc-uk.org/education/undergraduate/professional_behaviour.asp

7 Student ID

Disability To be completed by the student:

I have declared a disability and/or dyslexia to the Medical School Yes / No

I confirm that my disability/dyslexia is the same as when I was last assessed by the Disability Support Team (DST)... Yes / No

Date of last assessment by DST (mm/yy)

Signed:

Date:

Statement of understanding: Confidentiality and use of social media

http://www.liv.ac.uk/medicine/curriculum-map/links/

I confirm I have read the documents relating to Caldicott, confidentiality and using social

media.

Name in capitals_________________________ Student number _________________

Signed ________________________________ Date __________________

http://www.liv.ac.uk/medicine/curriculum-map/links/

8 Student ID

Notes for Clinical teachers Patient Clerkings Each student is expected to write up each of the cases as described in the clinical logbook. When you are satisfied that the case has been written to a competent standard, you should complete the relevant entry in the paper clinical portfolio. Please ensure that the student has completed their student ID number at the foot of the page prior to signing. Please score these case histories as on the following scale:

A (Acceptable) Case history written to a level appropriate for a Y4 medical student. Students may be required to revise or rewrite their history to reach this standard

G (Good) A well written case history, not requiring any revision

E (Excellent) Case history well above standard, and approaching the standard of an F1 doctor

It is expected that students will be able to consider the principles of management. Please ensure that you review this along with all other aspects of the case. Case Presentations, Examinations and Practical Skills Each student should also be assessed on their verbal presentation of 11 of their cases, as well as the listed clinical examinations and practical skills. These too should be scored on the above scale. Key Clinical Experiences Please sign the clinical portfolio to confirm the student’s attendance, and indicate their involvement using the OGCU* feedback scale

*(O) Outstanding Evidence of preparation for session, fully involved, asks sensible questions


(C) Cause for concern

Attends but not properly involved. No preparation


Feedback At the end of the first medicine/surgery placement and psychiatry, the student will ask you to complete a feedback form. Please use the form as guidance.

9 Student ID

PBL Please date and sign at the end of each PBL scenario and comment on the student’s participation, communication and preparation in PBL. Examples of comments from year 1&2:

Participation

Little evidence of participation.

Occasionally participates but usually at a superficial level. Shows limited interest.

Makes regular contributions, and suggests hypotheses and learning goals. Comments are relevant.

Good participation, and usually shows a deep understanding of the topic.

Frequent and constructive participation. Asks relevant questions, and always shows a deep understanding. Interested and enthusiastic.

Communication

Poor communication skills. Is unable to express simple ideas.

Limited skills. Can express simple concrete ideas

Appropriate communication skills, but has some difficulty with abstract concepts.

Good skills. Can express complicated ideas.

Excellent skills. Always able to explain points and views clearly and precisely.

Preparation

little evidence of preparation for tutorials

Some preparation, but usually limited to single source, e.g. text book

Prepares well. Uses different sources, but synthesis sometimes uneven.

Usually well prepared. Uses different sources and shows ability to synthesize different perspectives.

Always well prepared, with deep understanding of material from multiple sources.

10 Student ID

Medicine PBL Diabetes and Endocrinology

Date Signature of PBL facilitator

Name (Block capitals) of PBL facilitator

Facilitator Comments

Participation: Communication: Preparation:

The Comatose Patient





11 Student ID

Anaemia





Neurological Disorders





Elderly Medicine





12 Student ID

Patient Clerkings – Medicine

(This includes history, examination & review of appropriate investigations)

Date of rotation: DD/MM/YYYY – DD/MM/YYYY

Diagnosis Date

A-G

-E* Signature

Name (Block capitals)

4c.EM1 Acute confusion

a.

b.

4c.EM2 Anaemia a.

b.

4c.EM3 Chest Pain

4c.EM4 Chronic disease management

a.

b.

4c.EM5 Coma

a.

b.

4c.SR1 Contraception consultation

Assessment *A-G-E This is a 3-point scale: Acceptable Good Excellent A G E If the clerking was not of an acceptable standard do not complete the entry, the clerking may be presented again after further practice.

These data must be logged on SPIDER

13 Student ID


Diagnosis Date

A-G

-E* Signature


4c.DE1 Diabetic case a. emergency

4c.DE2 Diabetic case b. journey

4c.EM6 Febrile patient

a.

b.

4c.CA1 Heart Failure

4c.MS1 Inflammatory joint disease

a.

b.

4c.CA2 Palpitation

4c.DM1 Patient with rash

a.

b.



14 Student ID


Diagnosis Date

A-G

-E*

Signature


4c.EM6 Patient with a swollen leg

4c.GR1 Parkinson’s disease

4c.RE1 Renal Failure

4c.RS1 Respiratory failure

a.

b.

4c.SR2 Sexual health consultation

4c.EM7 Shocked patient (including sepsis)

a.

b.

4c.GR2 Stroke



15 Student ID

Surgery PBL Road Traffic Accident (RTA)





Lower Limb Ischaemia





16 Student ID

Swelling in the Neck





Breast Lumps





17 Student ID

Patient Clerking – Surgery

(This includes history, examination & review of appropriate investigations)


Diagnosis Date

A-G

-E* Signature


Orthopaedics 4c.MS2 Any fracture

4c.MS3 Arthritis (joint replacement)

4c.MS4 Fractured neck of femur

4c.MS5 Soft tissue problem

Vascular 4c.VA1 Arterial disease

4c.VA2 Venous disease

Breast 4c.BC1 Lump / pain

Lump / pain

Gastrointestinal 4c.SU1 Abdominal pain

4c.SU2 Abdominal / groin mass

4c.SU3 Change in bowel habit

4c.SU4 GI Bleeding



18 Student ID

Patient Clerkings – Surgery

Diagnosis Date

A

-G-E

*

Signature


Soft tissue 4c.SU5 Lipoma / lymph node

4c.SU6 Neck / thyroid

Urology 4c.UR1 Difficulty in passing urine

4c.UR2 Haematuria

4c.UR3 Loin pain

Emergency

surgery

4c.ES1 1.

4c.ES2 2.

4c.ES3 3.

4c.ES4 4.

4c.ES5 5.patient journey

Ophthalmology 4c.OP1 Red eye

4c.OP2 Cataract / Visual impairment



19 Student ID

Surgery

Tutorials / Case Based Discussions

Topic Date

OG

CU

*

Signature Name

(Block capitals)

Anaesthetics

4k.AN1 IV fluids

4k.AN2 Oxygen administration

4k.AN3 Pain management

4k.AN4 Peri-operative care

4k.AN5 Pre-operative assessment

Surgery

4k.MS2 Nerve injuries

4k.MS3 Spinal cord compression

Extras





20 Student ID

Key Clinical Experiences (KCE)

Date

OG

CU

*

Signature Name

(Block capitals)

General Medicine

4k.EM1 AMU acute session

1


2


3

4k.GS1 Ascites aspiration

4k.CA1 Cardiology clinic

4k.EM4 Death certification

4k.DM1 Dermatology clinic

4k.GR1 Falls clinic

4k.GH1 GI endoscopy / ERCP

4k.GR2 MDT care of the elderly

4k.RS1 Non-invasive ventilation

4k.GH2 Nutrition assessment

4k.RS2 Pleural aspiration/ Insertion of chest drain

4k.EM5 Post mortem

- one session should be on-call to 10pm

KCEs must be logged on SPIDER

21 Student ID


Date

OG

CU

*

Signature Name

(Block capitals)

Critical Care

4k.CA2 Coronary care ward round

4k.CC1 Ward round 1

4k.CC2 Ward round 2

Surgery

4k.SU1 Acute surgical admissions 1

4k.SU2 Acute surgical admissions 2

4k.EN1 ENT session 1

4k.EN2 ENT session 2

4k.GS2 Chemotherapy session

4k.GS3 MDT surgery / cancer

4k.OP1 Ophthalmology clinic / tutorial

4k.MS1 Orthopaedics fracture clinic

4k.SU3 Outpatient clinic 1

4k.SU4 Outpatient clinic 2

4k.SU5 Theatre session 1

4k.SU6 Theatre session 2






22 Student ID


Date

OG

CU

*

Signature Name

(Block capitals)

Anaesthetics

4k.AN6 Session 1

4k.AN7 Session 2

Sexual and reproductive health

4k.SR1 Contraception clinic

4k.SR2 Sexual health clinic

Radiology

4k.RA1 Chest x-ray reporting session

4k.RA2 CT session

4k.RA3 Interventional radiology

4k.RA4 MR session

4k.RA5 Ultrasound session

Microbiology

4k.ID1 Infection control meeting

4k.ID2 Lab session tutorial







23 Student ID

4k.DE1 - The Diabetic Journey (GP)

The following have been identified as KCEs relating to the management of diabetes mellitus in primary care

Date

OG

CU

*

Signature Name

(Block capitals)

4k.DE1a Diagnosis and initial medical assessment (can

be completed as CBD)

4k.DE1b Lifestyle advice / assessment of risk

factors

4k.DE1c First review of treatment/ monitoring control/ need to step up

treatment

4k.DE1d Routine follow-up (usually practice

nurse(PN))

4k.DE1e Annual review (GP and/or PN)

4k.DE1f Retinal Assessment

4k.DE1g Foot care

4k.DE1h Involvement of specialist nurse (for patients on insulin)$

$ Some practices initiate and monitor the use of insulin in primary care

Ideally the same patient experience







24 Student ID

4k.SU7 - The Surgical Journey

Date

OG

CU

*

Signature Name

(Block capitals)

4k.SU7a Initial admission

assessment

4k.SU7b Theatre care (implicit the patient will go to

theatre)

4k.SU7c Pathology sample management including processing and histological review of the

slides

4k.SU7d Post op ward round

4k.SU7e Discharge planning







25 Student ID

4k.CA3 - The ACS Journey

Acute Coronary Syndrome (ACS)

Date

OG

CU

*

Signature Name

(Block capitals)

4k.CA3a Admission

assessment

4k.CA3b Immediate

management

4k.CA3c

Reperfusion (thrombolysis / PCTA as

appropriate)

4k.CA3d

Coronary care unit (CCU)/heart emergency centre (HEC)

ward round

4k.CA3e Cardiac

rehabilitation







26 Student ID

4k.GR3 - The Stroke Journey

Date

OG

CU

*

Signature Name

(Block capitals)

4k.GR3a Initial assessment

by stroke team

4k.GR3b Family discussion of diagnosis and

management

4k.GR3c Imaging for stroke

4k.GR3d SALT assessment

4k.GR3e Physio / OT assessment

4k.GR3f MDT meeting

4k.GR3g Discharge planning

4k.GR3h Home visit (may be undertaken in GP attachment)







27 Student ID

Practical Skills

These must be undertaken (with appropriate supervision and only after relevant teaching/clinical skills lab practice) on real patients in the clinical environment (not in a clinical skills lab or on mannequins).

Date

A-G

-E*

Signature Name

(Block capitals)

4p.VA1 Ankle – brachial index

4p.01 IM injection 1o

4p.UR1 Male catheterisation

4p.SU1 Rectal examination (patient awake)

4p.SU2 Scrubbing for theatre

4p.DM1 Skin swabs for bacterial, fungi and viral culture

4p.02 Venous cannulation

1o may be completed in primary care/CCT

Assessment *A-G-E This is a 3-point scale: Acceptable Good Excellent A G E If the practical skill was not of an acceptable standard do not complete the entry, the practical skill may be repeated again after further practice.

Skills must be logged on SPIDER

28 Student ID

Additional Practical Skills

Skill Date

A-G

-E*

Signature Name

(Block capitals)


29 Student ID

Consultant or Senior Clinician to complete at end of first medicine / surgery placement – please ask the student to present up to 2 cases and review the clerking; use the following table to guide feedback

Review of Clerking Comments/actions to take

Verbal Presentation (2 cases)

History appropriate

Examination complete

Investigations reviewed

KCE reflection

LOCAS preparation

Careers discussion

Consultant (senior clinician) to complete. Please give the student feedback about

their clinical participation, using the form below

Clinical Participation Comment / Action Outstanding Always participates without prompting. Well prepared for session(s)

Good Usually participates without prompting. Prepared for majority of programme

Cause for Concern Needs prompting to participate; expects to be taught

Unacceptable Reluctant to become involved, disruptive no evidence of preparation

30 Student ID

Professionalism To be completed by Subdean Team or member of firm including senior nurses

Attendance and Punctuality Comment / Action Outstanding 100% attendance, always punctual

Good Usually attends & punctual

Cause for Concern Usually attends, sometimes punctual. Student shows no sign of concern if late

Unacceptable Rarely punctual or unacceptable attendance

Appearance incl. dress code Appropriate Inappropriate

Involvement with patients

Outstanding Proactively discusses patient with nurses, reports back relevant information

Good Asks nurses for suitable patient, may report back to nurses relevant information

Cause for Concern Attends wards but doesn’t seek advice or report back to nursing staff

Unacceptable Finds patients without discussion with nurses and does not report back information

31 Student ID

Involvement with staff

Outstanding Proactively seeks advice from ward team, polite and respectful of team members

Good Sometime seeks advice from ward staff but does not relate to ward team on regular basis

Cause for Concern Will often not seek advice or information from ward team

Unacceptable Disregards advice from ward team and will be dismissive of advice

Please ask the students if they are having any problems of an academic, personal or health nature and encourage them to seek support. Be aware of student support services for:

Personal issues; Senior Tutor Rev. Dr David Taylor,

([email protected]; 01517944787 or 07803963899)

Academic issues; Academic Sub Dean Dr Lyn Williams

([email protected]; or [email protected]; 01517948756)

Disability issues; Dr Fiona Watson

([email protected]; 01517954370)

If there are issues of concern please ensure that the Clinical Subdean’s office and 4th year directors c/o Debbie Prescott ([email protected]; 01517954358) at the School of Medicine are kept informed. Yellow concern forms may be used.

Reflection or any actions to take

Signed

Name & Designation

Date

Signed (student)






32 Student ID

Palliative Care

Date of rotation: DD/MM/YYYY – DD/MM/YYYY PBL Palliative Care – Care of the Dying





Patient Clerking

(Involves taking history, appropriate examination investigations, review of management)

Date

A-G

-E

Signature Name

(Block capitals)

4c.PC1 Care of the Dying Patient

4c.PC2 Physical symptoms

4c.PC3 Spiritual/Psychological /family distress


33 Student ID

Practical Skills

Date

A-G

-E*

Signature Name

(Block capitals)

4p.03 Giving subcutaneous injection

4p.PC1 Setting up syringe driver


Palliative Care - Key Clinical Experiences (KCE)

Date

OG

CU

Signature Name

(Block Capitals)

4k.PC1 Assessment of patient requiring palliative care

4k.PC2

Awareness of commencing and completing Liverpool Care Pathway for the Dying Patient (LCP)

4k.PC3 Contribution to ethics history

4k.PC4 Death certification and cremation form completion

4k.PC5 Experience of communication in palliative care

4k.PC6 Opioid prescribing

4k.PC7 Prophylactic prescribing of drugs for a dying patient


34 Student ID

Feedback form –Palliative care Consultant (senior clinician) to complete – please ask the student to present 1 case

and review the clerking; use the following table to give feedback

Review of Clerking Comments

Verbal Presentation (1 case)

History appropriate



KCE reflection

Consultant (senior clinician) to complete. Please give the student feedback about

their clinical participation, using the form below





Signed (consultant)

Name & Designation

Date

Signed (student)

35 Student ID

To be completed by member of firm including senior nurses Professionalism


Good Usually attends & punctual

Cause for Concern Usually attends, sometimes punctual. Student shows no sign of concern if late








36 Student ID















Signed

Name & Designation

Date

Signed (student)






37 Student ID

Paediatrics

Date of rotation: DD/MM/YYYY – DD/MM/YYYY PBL – Paediatrics – Chronic Childhood Illness





Patient Clerkings

Diagnosis Date

A-G

-E Signature

Name

(Block capitals)

4c.PA1 Acutely ill child

4c.PA2 Cardiac problem

4c.PA3 Chest problem

4c.PA4 Child with complex needs

4c.PA5 Child with joint problems


38 Student ID

Paediatrics

Patient Clerkings

Diagnosis Date

A-G

-E* Signature


4c.PA6 GI problem

4c.PA7 Ill child in GP practice / 1o

care

4c.PA8 Neurological problem

4c.PA9 Paediatric hospital journey

4c.PA10 Renal problem



39 Student ID

Paediatrics


Date

OG

CU

*

Signature Name

(Block capitals)

4k.PA1 Community paediatric clinic

4k.PA2 Diabetic clinic

4k.PA3 General clinic

4k.PA4 Health visitor clinic 1o

4k.PA5 Nutrition / dietitian consultation

4k.PA6 Observe informed consent

4k.PA7 Specialist clinic (e.g. epilepsy)

4k.PA8 Surgical clinic

1o - may be undertaken in primary care






40 Student ID

Paediatrics

Practical Skills

Date

A-G

-E*

Signature Name

(Block capitals)

4p.PA1 Blood glucose testing

4p.PA2 Developmental assessment

4p.PA3 ENT examination

4p.PA4 Fluid prescription

4p.PA5 Inhaler technique

4p.PA6 Paediatric GALS

4p.PA7 Paediatric prescription

4p.PA8 Urine collection and assessment

Assessment *A-G-E This is a 3-point scale: Acceptable Good Excellent A G E If the practical skill was not of an acceptable standard do not complete the entry, the skill may be presented again after further practice.

Practical skills must be logged on SPIDER

41 Student ID

4k.PA9 - Paediatric journey

Date

OG

CU

*

Signature Name

(Block capitals)

4k.PA9a Initial admission assessment

4k.PA9b Observing consent or discussions with parents / carers

4k.PA9c Treatment / management planning (theatre care for surgical patient)

4k.PA9d Post treatment assessment (post op ward round for surgical case)

4k.PA9e Discharge planning

4k.PA9f Home visit (may be undertaken on GP day)

Ideally, as many of these events as possible should be with the same patient






42 Student ID

Obstetrics & Gynaecology


Obstetrics PBL – Abnormal pregnancy





Gynaecology PBL - Subfertility





43 Student ID

Patient Clerkings Obstetrics

Date

A-G

-E~

Signature Name

(Block capitals)

4c.OG1 Antepartum Haemorrhage

4c.OG2 Bleeding in early pregnancy 1*

4c.OG3 Bleeding in early pregnancy 2*

4c.OG4 High risk pregnancy problem**

4c.OG5

Suspected hypertensive disease of pregnancy

* one of these cases to include investigation for a pregnancy of unknown location

** This should be one of a: multiple pregnancy b: Suspected preterm labour c: medical disorder (e.g. diabetes, epilepsy)

Assessment ~A-G-E This is a 3-point scale: Acceptable Good Excellent A G E If the clerking was not of an acceptable standard do not complete the entry, the clerking may be presented again after further practice.


44 Student ID


Patient Clerkings Gynaecology

Date

A-G

-E*

Signature Name

(Block capitals)

4c.OG6 Endometriosis

4c.OG7 Infertility

4c.OG8 Menstrual dysfunction

4c.OG9 Suspected gynaecological malignancy

4c.OG10 Urinary incontinence



45 Student ID



Date

OG

CU

*

Signature Name

(Block capitals)

4k.OG1 Care of woman in early puerperium

4k.OG2 Care of woman in labour

4k.OG3 Cervical smear

4k.OG4 Colposcopy

4k.OG5 Early pregnancy unit / Gynae emergency room

4k.OG6 Elective or Emergency Caesarean section

4k.OG7 Hysterectomy

4k.OG8 Hysteroscopy

4k.OG9 Laparoscopy

4k.OG10 Obstetric emergency#

4k.OG11 Ultrasound clinic

# this includes how to resuscitate an acutely unwell patient (could be undertaken as a

simulation)

*(O) Outstanding

Evidence of preparation for session, fully involved, asks sensible questions






46 Student ID


Practical Skills

Date A

-G-E

*

Signature Name

(Block capitals)

4p.OG1 Speculum examination

Assessment *A-G-E This is a 3-point scale: Acceptable Good Excellent A G E If the practical skill was not of an acceptable standard do not complete the entry, the skill may be presented again after further practice.

Practical skills must be logged on SPIDER

47 Student ID

Psychiatry


Comorbidity Some patients present with more than one symptom, providing you cover each aspect of the individual presenting symptom adequately, it is permissible to present the same patient for two case histories. E.g. anxiety and depression, deliberate self-harm and depression and schizophrenia and substance misuse may present as comorbidities. Patient Clerkings Cases in psychiatry may be presented to consultant/staff grade psychiatrists, registrars/specialist trainees (>ST2), experienced community psychiatric nurses (CPNs), occupational therapists or social workers. Consultant Shadowing It is hoped that 4th year centres will organise for your to a consultant. Many patient clerkings and KCEs will be done as part of this shadowing. Psychiatry PBL – Mental Health





48 Student ID

Patient Clerkings

Date

A-G

-E

Signature Name

(Block Capitals)

4c.PS1 Anxiety / panic / phobia$

4c.PS2 Deliberate self harm

4c.PS3 Dementia

$ these cases may be clerked on your GP day during the psychiatry rotation, but presented when back in psychiatry



Name of consultant to shadow

49 Student ID

Psychiatry

Patient Clerkings

Date

A-G

-E*

Signature Name

(Block capitals)

4c.PS4 Depression$

4c.PS5 Mania, hypomania or

bipolar disorder

4c.PS6 Personality disorder ∆

4c.PS7 PTSD ∆

4c.PS8 Schizophrenia

4c.PS9 Substance misuse

∆ These diagnoses may be undertaken as a case based discussion (CBD) $ This case may be clerked on your GP day during the psychiatry rotation, but presented when back in psychiatry



50 Student ID

Psychiatry


Date

OG

CU

*

Signature Name

(Block Capitals)

4k.PS1 Drug abuse clinic

4k.PS2 Multidisciplinary team meeting/ ward round

4k.PS3 Old age psychiatry

4k.PS4

Outpatient environment – assessing new referrals







51 Student ID

Psychiatry


Date

OG

CU

*

Signature Name

(Block Capitals)

4k.PS5 Session with liaison referrals team

4k.PS6

Shadowing a ward primary nurse /none medical member of CMHT






52 Student ID

Feedback form – Psychiatry placement Consultant to complete – please ask the student to present up to 2 cases and review the clerking; use the following table to give feedback



History appropriate



KCE reflection

Consultant to complete. Please give the student feedback about their clinical participation, using the form below





Signed (consultant)

Name & Designation

Date

53 Student ID

Professionalism To be completed by member of firm including senior nurses


Good Usually attends & always punctual or always attends usually punctual

Cause for Concern Usually attends, sometimes punctual. Student shows sign of concern if late








54 Student ID







a. Personal issues; Senior Tutor Rev. Dr David Taylor,


b. Academic issues; Academic Sub Dean Dr Lyn Williams


c. Disability issues; Dr Fiona Watson




Signed

Name & Designation

Date

Signed (student)






55 Student ID

Primary Care

GP/CCT sessions

After each GP /CCT session students should take time to reflect on the day and identify learning needs. Students should discuss these with their GP to identify how these can be met.

Week beginning Mon

CCT group 1 CCT group 2 Topic

27 8 12 week1

Orientation and introduction CCT introduction at base hospital

Students should make contact with GP

3 9 12 Week 2

1st GP for students in Group 1

1st CCT for students in Group 2

Ice breakers LNA Introduction to reflection and professionalism

10 9 12 week 1

1st CCT student Group 1

1st GP students group 2

17 9 12 week 2 GP CCT

Introduction to audit 1st case presentations 24 9 12

week 1 CCT GP


Dermatology 8 10 12 week 1 CCT GP

15 10 12 Week 2 GP

Teaching Break No CCT 22 10 12

week 1 GP

29 10 12 Week 2

GP CCT Dyspnoea 1(cardiac)

5 11 12 week 1

CCT GP


Dyspnoea 2(respiratory) 19 11 12

week 1 CCT GP


GP Emergencies 5 12 12 week 1 CCT GP

10 12 12 week 2

GP CCT Student determined session

56 Student ID

17 13 12 week

Xmas Holiday No GP or CCT 24 13 12 week

1 1 13 Week 1 CCT GP Student determined session


Collapse? Cause 14 1 13 week 1 CCT GP


Formulary /Pharmacology review 28 1 13 week 1 CCT GP

4 2 13 week 2 GP CCT Red Flags

11 2 13 week 1

GP Teaching Break No CCT 18 2 13

Week 2 GP

25 2 13 week 1

CCT GP Red flags

4 3 13 week 2

GP CCT LOCAS Practice Feedback on GP attachment 11 3 13

week 1 CCT GP

18 3 13 week 2

GP CCT Infections/antibiotics

25 3 13

Exam Exam Proposed formative exam no teaching

29 3 13

Easter Break

8 4 13 Week1

CCT GP Infections/antibiotics

15 4 13 week 2

GP CCT

22 4 13 week 1

CCT GP

29 4 13 week 2

GP CCT

6 5 13 week 1

CCT GP

13 5 13 Week 2

GP CCT

20 5 13 week 1

CCT GP

28 5 13 week 2

GP CCT

57 Student ID

GP Audit

GP practice

Title of Audit

Brief description

List three learning outcomes

1.

2.

3.

Audit successfully completed

Signature of GP: Print Name: Date:

Comments from GP lead:

58 Student ID

Key Clinical Experiences (KCE) for specialties and GP

Additional KCE Sessions

(indicate the rotation the KCE was logged in)

Date

OG

CU

*

Signature Name

(Block Capitals)






59 Student ID

Carry Over KCEs

Date

OG

CU

Signature Name

(Block Capitals)

60 Student ID

Feedback form – GP /CCT GP to complete – please ask the student to present 2 cases and review the clerking; use the following table to give feedback


Verbal Presentation (up to 2 cases)

History appropriate



KCE reflection

GP / CCT to complete. Please give the student feedback about their clinical participation, using the form below





Signed (consultant)

Name & Designation

Date

61 Student ID

Professionalism To be completed by a member of the PCHT team


Good Usually attends & always punctual or always attends usually punctual

Cause for Concern Usually attends, sometimes punctual. Students show no sign of concern if late



Involvement with patients Comment

Outstanding Proactively discusses patient, reports back relevant information

Good Asks PCHT team for suitable patient, may report back relevant information

Cause for Concern Attends but doesn’t seek advice or report back to staff

Unacceptable Finds patients without discussion with PCHT team and does not report back information

62 Student ID



Good Sometime seeks advice from PCHT staff but does not relate to ward team on regular basis

Cause for Concern Will often not seek advice or information from PCHT team

Unacceptable Disregards advice from PCHT team and will be dismissive of advice








If there are issues of concern please ensure that the 4th year directors c/o Debbie Prescott ([email protected]; 01517954358) at the School of Medicineare kept informed. Yellow concern forms may be used.


Signed

Name & Designation

Date

Signed (student)






63 Student ID

Education Supervisor to complete by 19th October 2012– please ask the student to present 2 cases and review the clerking; use the following table to guide feedback



History appropriate



Patient journey discussion

KCE reflection

Exam preparation including LOCAS

Careers discussion









Signed

Name & Designation

Date

Signed (student)






64 Student ID

Education Supervisor to complete by 17th May 2013– please ask the student to present up to 2 cases and review the clerking; use the following table to guide feedback



History appropriate



Patient journey discussion

KCE reflection

Exam preparation including LOCAS

Review of placement feedback








If there are issues of concern please ensure that the Clinical Subdean’s office and 4th year directors c/o Debbie Prescott ([email protected]; 01517954358) at the School of Medical Education are kept informed. Yellow concern forms may be used.

Signed

Name & Designation

Date

Signed (student)






65 Student ID

Practical procedures The following practical procedures are listed in the GMC’s document “Tomorrow’s Doctors” (2009). By graduation, students are expected to be able to carry these out safely and effectively in accordance with the guidelines provided by the NHS Trust in which they are working. A variety of appropriate assessments will be used to test proficiency in these procedures.

Procedure

1. Measuring body temperature

2. Measuring pulse rate and blood pressure

3. Transcutaneous monitoring of oxygen saturation

4. Venepuncture

5. Managing blood samples correctly

6. Taking blood cultures

7. Measuring blood glucose

8. Managing an electrocardiograph (ECG) monitor

9. Performing and interpreting a 12-lead electrocardiograph (ECG)

10. Basic respiratory function tests

11. Urinalysis using Multistix

12. Advising patients on how to collect a mid-stream urine specimen

13. Taking nose, throat and skin swabs

14. Nutritional assessment

15. Pregnancy testing

16. Administering oxygen

17. Establishing peripheral intravenous access and setting up an infusion; use of infusion devices

18.Making up drugs for parenteral administration

19. Dosage and administration of insulin and use of sliding scales

20. Subcutaneous and intramuscular injections

21. Blood transfusion

22. Male and female urinary catheterisation

23. Instructing patients in the use of devices for inhaled medication

24. Use of local anaesthetics

25. Skin suturing

26. Wound care and basic wound dressing

27. Correct techniques for ‘moving and handling’, including patients

28. Giving information about the procedure, obtaining and recording consent, and ensuring appropriate after care

29. Hand washing (including surgical ‘scrubbing up’)

30. Use of protective equipment (gloves, gowns, masks)

31. Infection control in relation to procedures

32. Safe disposal of clinical waste, needles and other ‘sharps’

66 Student ID

OSCE Remedial Work Injection Technique & Venepuncture The safe administration of subcutaneous and intramuscular injections and safe disposal of sharps are important parts of the responsibility of any doctor. If you have been asked to complete these pages you have not adequately demonstrated competence in carrying out some aspect of the above, either in injection technique or in venepuncture stations in the OSCEs. Reasons for this include:-

administering the wrong drug

administering an incorrect dose

incorrect disposal of a needle

not having sufficient time to demonstrate the above in the station Your OSCE error can be found on the OSCE feedback you will received via email. On your clinical attachments during the forthcoming academic year, you must complete satisfactorily five assessments of the relevant procedure, indicated on the front of the booklet. THE FIRST ASSESSMENT MUST BE UNDERTAKEN IN A HOSPITAL CLINICAL SKILLS FACILITY, NOT ON THE WARDS. These can be signed as satisfactorily completed by a competent clinical teacher, including members of the clinical skills staff or a senior member of the nursing staff. You are advised to gain supervised practice before attempting your first assessment, to ensure that you can meet all of the assessment criteria. You must have completed at least two of the assessments by the end of semester 1, ready for the mid-year progression review. The remaining assessments may be undertaken in semester 2. You must submit a satisfactorily completed booklet in order to be allowed to progress to your next year. Assessment Criteria There are no time constraints for performing these assessed criteria (i.e. not under OSCE time limits)

Selection of the correct drug and checking against the prescription sheet

Calculation of the correct dose

Assembly of syringe and needle, if necessary, without contamination

Preparation of ampoule/vial

Accurate drawing up of required dose o including expulsion of air and removal of surplus drug

Change of needle, where appropriate

Demonstration to assessor of syringe containing correct amount of selected drug

Administration of selected drug by an acceptable technique

Safe waste disposal

Adequate record-keeping

67 Student ID

OSCE Error:

(Please tick all that

apply)

administering the wrong drug

administering an incorrect dose

incorrect disposal of a needle

not having sufficient time to demonstrate the above in the

station

Assessment Record

Drug

& dose Sharps

disposal Signature, status

& date Comments

1

The first assessment must be undertaken in a clinical skills facility

2

3

4

5

Please sign and date the form below if you are not required to complete the above OSCE error form. Remember this will be checked at progression review and incorrect completion will be regarded as an issue of professional conduct.

Student signature:

Date:

68 Student ID

Absence Log

First date of absence

Date of return

Reason

Useful Contact Details Debbie Prescott (Year Clerical Officer)

[email protected] 0151-795-4358

Prof. Geoffrey Gill (Year Director)

[email protected]

Clinical Subdean’s Office (To be completed by student)

69 Student ID

Academic advisor meetings Introductory meeting

Academic advisor

Signature

Date of meeting

January / February 2013

Date


Signature

Feedback

April 2013

Date


Signature

Feedback

School of Medicine - The University of Liverpool · 2013-08-16 · Psychiatry 47 9 2 Primary Care...

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