Clinical Assessment in Primary Care – MSc

This introductory course prepares you as an experienced practitioner to acquire systematic and structured history taking, physical examination and diagnostic reasoning skills in relation to four systems: the cardiovascular system, the respiratory system, the gastrointestinal system and the urinary system.

It will help you assess adults with undiagnosed presentations, distinguish normal from abnormal findings and formulate differential diagnoses in order to manage, treat or refer patients.

The vision for the course is to enable practitioners to facilitate the NHS Long Term Plan (NHS 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).

Who is it for?

This course is suitable for primary care practitioners who want to advance their clinical practice, and who wish to progress to a non-medical prescribing course following completion of the course at Level 7.

Timetable

This course runs in the autmn and the spring each year. You'll have 3 hours of face to face teaching per week for 10 weeks.

Term 1

Sep:
Wednesday 22 September 2021
Wednesday 29 September 2021

Oct:
Wednesday 6 October 2021
Wednesday 13 October 2021
Wednesday 20 October 2021

Nov:
Wednesday 3 November 2021
Wednesday 17 November 2021
Wednesday 24 November 2021

Dec: 
Wednesday 1 December 2021
Wednesday 15 December 2021

Benefits

This course may be taken as standalone or credits can be carried forward onto the BSc/GradDip/PGDip Public Health (District Nursing) programme or the BSc/PGDip Primary Care (Practice Nursing) programme.

Credits

This course is worth 15 credits toward eligible programmes.

Content outline

• consultation models and methods of history-taking and documentation
• anatomy and physiology of the cardiovascular system, the respiratory system, the gastrointestinal system and the urinary systems
• physical examination skills (including auscultation, inspection, palpation and percussion) to assess the aforementioned systems
• interpretation of assessment findings to enable the distinction between normal and abnormal findings and formulate differential diagnoses using a variety of diagnostic support tools
• role of the multidisciplinary team in managing and treating patients.

By the end of the course you will be able to:

Knowledge and understanding:

• Recognise aspects of symptoms which suggest significant pathology (red flags) and evaluate physical signs to differentiate between normal and abnormal
• Analyse and interpret history and physical findings to develop appropriate differential diagnoses and a plan of action (including anticipatory care) based on research and national guidelines and protocols
• Assess when additional expertise is necessary and when there is a need to make objective and appropriate referrals.

Skills:

• Use a consultation model to frame a consultation and use the presenting problem to guide the assessment strategy
• Demonstrate knowledge of when and how to use equipment
• Reflect on an assessment you have undertaken and the performance feedback you have received, and respond constructively
• Generate highly structured notes documenting the progress of a consultation to provide evidence of patient contact and to inform the clinical reasoning process.

Values and attitudes:

• Demonstrate the ability to promote patient comfort, privacy and dignity, and identify when the use of chaperones is appropriate
• Promote professional standards associated with assessing, diagnosing and caring for patients with complex conditions or patients showing signs of deteriorating health
• Demonstrate the ability to promote effective collaboration within a multi-professional context (including collaboration with informal carers).

Teaching

This course is taught through face-to-face teaching, including taught sessions and clinical skills demonstrations and practice.

Assessment

As part of this course, you are required to take part in a single-station Objective Structured Clinical Examination (OSCE) in the Clinical Skills Centre. Whilst performance in the OSCE is mandatory, your performance is not graded. Instead, you will be given formative written feedback by the examiner.

The graded assessment is a written assignment. You are required to write a 3,000-word essay in which you provide an evidence-based and critical account of your OSCE performance. This should include details of

1. why you did what you did
2. how you did what you did
3. what aspects of your performance should be improved upon.

Credits

This course is worth 15 credits toward eligible programmes.

Non-EEA students can only apply as part of a programme, not as a stand-alone course.

Any new or experienced registered nurses in primary care may take this course.

English requirements

If your first language is not English, one of the following is required:

• A first degree from a UK university
• A first degree from an overseas institution recognised by City, University of London as providing adequate evidence of proficiency in the English language, for example, from institutions from Australia, Canada or the United States of America.
• International English Language Test Service (IELTS) a score of 7.0 is required with no subtest below 7.0
• Pearson Test of English (Academic) score 72 required
• TOEFL 100 overall with 24 in Writing, 20 in Listening, 19 Reading and 20 Speaking
• Other evidence of proficiency in the English language, which satisfies the board of studies concerned, including registration with your professional regulator.

• Bickley, L.S., & Szilagyi, P.G., (2009). Bates guide to physical examination and history taking, (10th ed.). Philadelphia: Lippincott Williams and Williams.
• Cox, C. (2010) Physical assessment for nurses. Chichester: Wiley and Blackwell.
• Elsevier. Cross, S., & Rimmer, M. (Eds). (2007). Nurse Practitioner: Manual of clinical skills. (2nd ed.). Edinburgh: Balliere Tindall
• Hopcroft, K., & Forte, V. (2010). Symptom sorter (4th ed). London: Radcliffe
• Lippincott Williams & Williams (2010) Health assessment made incredibly visual (2nd ed). Philadelphia: Lippencott Williams & Williams
• Simon, C., Everitt, H., & Van Dorp, F., (2014) Oxford handbook of General Practice (4th ed.). Oxford: Oxford University Press.