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1 Faculty of Health Sciences. University of Southampton.
WORK-BASED TRAINING
LOG BOOK
CARDIAC PHYSIOLOGY PRACTITIONER TRAINING PROGRAMME
HEALTHCARE SCIENCE
2 Faculty of Health Sciences. University of Southampton.
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3 Faculty of Health Sciences. University of Southampton.
LOG BOOK
BSC HEALTHCARE SCIENCE
Log book – Healthcare Science Cardiac Physiology and Respiratory & Sleep Physiology
Student name
University ID number
University email address
Phone number
Academic tutor name
University email address
Phone number
This document remains the property of the University of Southampton and its care is the responsibility of the student named above. It must be
presented on request to the University of Southampton.
4 Faculty of Health Sciences. University of Southampton.
RECORD OF ONGOING ACHIEVEMENT
My Assessment of Practice document is my `record of on-going achievement’ for practice.
I consent to allow the processing of confidential data about me to be shared between successive placement personnel and with the relevant education providers in the process of assessing my fitness for practice.
Student signature Date
Academic tutor signature Date
PROTECTING THE PUBLIC THROUGH PROFESSIONAL STANDARDS: ACCEPTING APPROPRIATE RESPONSIBILTY
There may be times when you are in a position where you may not be directly accompanied by your placement educator or another registered colleague. As your skills, experience and confidence develop, you will become increasingly able to deal with these situations. However, you must only participate in interventions for which you have been fully prepared or in which you are properly supervised, and which are in keeping with Trust/practice policy. If you have any doubts, discuss them as quickly as possible with your placement educator or academic tutor.
I have read and understood the above statement.
Student signature Date
Academic tutor signature Date
ALL ENTRIES MUST MAINTAIN CONFIDENTIALITY OF SERVICE USERS
5 Faculty of Health Sciences. University of Southampton.
TABLE OF CONTENTS
Guidance for students 6
Summary of work-based assessment and evidence of practice 9
PLACEMENT 1 13
Placement documentation. Placement 1A 21
Record of experience and attendance 31
Placement documentation. Placement 1B 33
Core competencies 39
Direct observation of practical skills 53
Case-based discussions 81
Record of experience and attendance 87
PLACEMENT 2 91
Core competencies 99
Direct observation of practical skills 111
Case-based discussions 151
Mini clinical examination 162
Record of experience and attendance 169
PLACEMENT 3 175
Core competencies 183
Direct observation of practical skills 195
Case-based discussions 223
Mini clinical examination 233
Record of experience and attendance 245
APPENDICES 253
6 Faculty of Health Sciences. University of Southampton.
GUIDANCE FOR STUDENTS
Remember, this is YOUR professional Log Book and you must accept responsibility for accurate
completion:
Actively participate in initial, interim and final interviews with your placement educator.
Identify and affirm learning needs with your placement educator.
Agree an action plan with your placement educator for every practice experience.
Take advantage of every opportunity to work with the placement personnel.
Take advantage of all the learning opportunities available.
Maintain your Log Book.
Make the Log Book available to placement personnel or academic staff on request.
Co-operate with your placement educator to ensure the assessment is completed by the
date(s) specified.
Complete the online evaluation of each practice experience.
ASSESSMENT
Assessment of your performance by the work-based assessor is an integral part of placement. Its
purpose is to ensure the development of professional skills and competently within the practice
setting. Much of the feedback will be informal, e.g. instruction whilst in action, regular supervision
sessions and discussion of cases.
The formal assessment is seen as an extension of this learning process and will take place at least
twice during a placement, i.e. half-way and full-time reports. For these assessments, the placement
assessment forms will be used. Whilst all placements need to be passed, grading only becomes an
issue in Placements 1b, 2 & 3. Of these, the grades for placements 2 and 3 contribute directly to
your degree classification.
Criteria for marking depend upon the stage of training you have reached. The expected progression
of professional cognitive, perceptual and psychomotor skills holds for placement assessment as for
your other assessments.
GRADING OF CORE COMPETENCIES
The placement grades will be converted to the placement mark by the placement team once the
placement assessment report form has been returned to the University.
Placement Failure
The student is deemed to have failed if, at the end of the placement, either:
In section 1, the student is marked as ‘No’, i.e. is unsafe in any of the four criteria
mentioned.
If more than one of the Sections 2, 3 and 4 have three or more criteria graded at E
In the event of one section being failed, i.e. grade E, and therefore awarded a mark equivalent of 20,
the mark carried forward to the degree will be the average mark or 40 whichever is the higher.
7 Faculty of Health Sciences. University of Southampton.
If you do not complete all aspects of the summative assessment of practice at the first attempt you
will be referred. Students are normally allowed a further attempt to complete their Log Book
requirements through a further practice experience. Students who do not achieve the requirements
of the Log Book at the second attempt may be subject to discontinuation from the programme.
All students who fail a practice experience will be asked to meet with their academic tutor to discuss
the next steps.
FORMATIVE ASSESSMENT
As part of the assessment, the work-based assessor will complete a formative assessment. Results
will be discussed with you at the time of completion to ensure timely feedback so that, where
identified, there are opportunities to improve prior to the summative assessment. Where learning
needs are identified, feedback should be delivered with sensitivity and in a manner which will
enhance learning. Learning needs should be made explicit in the comments section and should be
written by both student and work-based assessor following the assessment. If at this stage there are
areas that you may not achieve please contact your academic tutor.
SUMMATIVE ASSESSMENT
Near to the end of the practice experience a summative assessment is completed. Results will be
discussed with you at the time of completion to ensure timely feedback. Where learning needs are
identified, feedback should be delivered with sensitivity and in a manner which will enhance
learning. Comments should be written by both student and mentor following the assessment. If a fail
is recorded, any learning needs must be documented and made explicit.
INCIDENTS IN PRACTICE
To be read in conjunction with the University of Southampton guidelines for reporting concerns for
students safety available through www.southampton.ac.uk/alps or on request from a University
staff member.
Whilst engaged in practice experiences, students may become involved in incidents or accidents.
Should this happen, it is important that personnel at the Faculty of Health Sciences are informed;
not only to enable the monitoring of health and safety issues but also to offer support and guidance
should this be required. The academic tutor must be contacted by the student or their placement
educator and they will advise the student and placement educator of the appropriate action to take.
If there is uncertainty regarding appropriate action to take, contact the Practice Academic Liaison
Lead or academic tutor. In the event of such an occurrence, a form S24 should be completed by the
student with help from their academic tutor. The form should be promptly returned to their
academic tutor at the Faculty of Health Sciences.
Whenever students are involved in an accident or incident or a near miss and a practice organization
“Incident Form” is completed, the student or placement educator must contact the academic tutor
and report this, even if they have only witnessed but were not directly involved in the situation. The
academic tutor will inform the Programme Lead, the Practice Academic Liaison Lead and the
Learning Environment Lead. Follow up action will be agreed and a record will be made in the
student’s file. A redacted copy of the incident form must be forwarded to the Programme Lead or
Academic Tutor who will ensure safe storage in the student file. Following an accident, incident or
near miss students may be required to write a statement.
8 Faculty of Health Sciences. University of Southampton.
Please note – students must NEVER write or submit statements that have not been formally
endorsed by the University.
SUPERNUMERARY STATUS
The primary role of the student undertaking a practice experience is that of a learner and they are
required to be supernumerary. Supernumerary status of students means that students are
additional to the workforce requirement and staffing figures and we advocate the following
principle:
“Students undertaking practice experiences as part of their programme of study are extra to the
established numbers in the practice areas. They will be allocated a negotiated workload that is
within their scope of practice that meets their required learning needs”.
PLACEMENT ASSESSMENT FORMS
Copies of the assessment forms that will be used by the work-based assessor to grade you are
available on the ALPS website (www.southampton.ac.uk/alps/). Please refer to the different
placement headings for the relevant assessment form.
Please remember to ensure your name is on the form and it must be signed by both yourself and the
work-based assessor. The original signed form should be returned to the Placement Office by post
by a member of the placement personnel.
Only one set of final grades will be given for each placement. If you have more than one placement
educator, even if the placement is split into two distinctive parts, all parts involved in your education
whilst in the clinical environment will collaborate in agreeing the final grades.
If, in exceptional circumstances, you are given your assessment form to return to the University,
please ensure that you hand it in or post it to the Placement Assistant, IMMEDIATELY the placement
has finished. We cannot record the successful completion of a Placement until the assessment form
is received.
You may make a copy of your completed assessment forms for your own records.
9 Faculty of Health Sciences. University of Southampton.
SUMMARY OF WORK BASED TRAINING SPECIALIST ASSESSMENT AND EVIDENCE OF
PRACTICE
WORK BASED TRAINING SPECIALIST ASSESSMENT
PLACEMENT 1
Direct Observation of Practical
Skills
Routine electrocardiography (ECG)
Routine blood pressure (BP)
Routine spirometry
Routine oxygen saturation
1 Case-Based Discussion ECG OR spirometry (depending on final block)
PLACEMENT 2
Direct Observation of Practical
Skills
Measure and interpret resting BP
Record resting ECG
Fit and remove ambulatory BP and produce clinical data
Fit and remove ambulatory ECG
Interpret ambulatory ECG
Assist (2nd person) at cardiac exercise stress testing
1 Case-Based Discussion Interpret resting ECG
1 Mini-Clinical examination Heart failure OR atrial fibrillation
PLACEMENT 3
Direct Observation of Practical
Skills
Record resting ECG (assessed at level 6)
Assist (2nd person) at cardiac exercise stress testing
(assessed at level 6)
Assist at diagnostic left heart catheterisation
Assist at implant of permanent pacemaker implantation
2 Case-Based Discussion Cardiac exercise stress testing AND pacing OR catheterisation
2 Mini-Clinical Examination Pre-operative PPM implant OR heart failure OR valve OR CPEX
10 Faculty of Health Sciences. University of Southampton.
RECOMMENDED RECORD OF EXPERIENCE (EVIDENCE)
The table below indicates the volume and areas in which evidence should be collected during work
based training. Please note that these numbers are indicative.
PROCEDURE Year 1 Year 2 Year 3 TOTAL
BP 10 10 10 30
ECG 10 50 50 110
Ambulatory application 5 5 BP / 5 ECG 10 (5 event) 25
Ambulatory analysis 25 25 (5 event) 50
Cardiac exercise stress testing 25 25 50
Left heart catheterisation 25 25
Permanent pacemaker implant (PPM) 10 10
Note: Ambulatory application should be a combination of ECG, including event recorders, and BP
depending upon departmental workload. Ambulatory analysis should contain evidence of both ECG
and BP.
Students are expected to record the 12-lead resting ECG on a range of patients which may include
but are not limited to the following:
Sinus rhythm
Sinus bradycardia/tachycardia
Atrial fibrillation/flutter/ectopics
Atrioventricular blocks
Atrial enlargement
Ventricular hypertrophy
Ventricular tachycardia/fibrillation/ectopics
Electrolytic imbalances
Endocrine disorders
Bundle branch block
Juntional rhythms
Conduction disorders
Pre-excitation syndrome
Myocardial ischaemia and infarction
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LEVELS OF EVIDENCE AND VALIDITY
The student is expected to collect evidence to reflect their exposure to different patients and
pathologies. All evidence must be complete and validated by placement personnel. In addition,
evidence must be complete with reports where appropriate. Photocopies will not be accepted as
evidence.
PROCEDURE EVIDENCE VALIDITY
BP Record of recordings fully documented Include student and practice educator’s reading
ECG 12 lead ECG with report (at least one paediatric)
Student’s initials entered into the system. Report countersigned
Ambulatory monitoring
Referral (application) and report (analysis)
Referral form and report countersigned by practice educator
Cardiac exercise stress testing
Exercise report and ECG traces Student’s initials entered into the system. Report countersigned
Left heart catheterisation
Pressure traces and relevant ECGs recorded
Student’s initials entered into the system. Report countersigned
PPM implant Implant sheet (make/model) and pre- and post-implant ECG
Implant sheet countersigned by practice educator
All pieces of evidence must be anonymised and contain at least the following information:
Patient’s age (not date of birth)
Gender
Outpatient (i.e. cardiac, paediatric)
Inpatient (i.e.ward)
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13 Faculty of Health Sciences. University of Southampton.
PLACEMENT 1
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FACULTY OF HEALTH SCIENCES
RECORD OF STATUTORY AND MANDATORY TRAINING PRIOR TO PLACEMENT 1
Observed sessions Date Facilitator name and signature
Moving and Handling
Basic Life Support
Standard Precautions and Observations (Infection Prevention)
Online sessions Date completed Student signature
Fire
Health and Safety
Equality and Diversity
Conflict Resolution
Safeguarding
PRE-PLACEMENT LABORATORY-BASED SPECIALIST SKILLS
Specialist skill Date completed Trainer signature
Electrocardiography
Manual Blood Pressure
Spirometry
Measurement of Oxygen Saturation
16 Faculty of Health Sciences. University of Southampton.
INDUCTION SIGN OFF
All students need to have basic induction information. Can the Placement Educator discuss and
direct the Student to the following information during their induction period. Both Placement
Educator and Student need to sign and date the below document to indicate that they have given
and received the following information. If an area does not relate to your practice please indicate
with a N/A in the appropriate box.
BLOCK 1 Topics to be covered Signatures Date
Personal issues Discuss any adjustments regarding health or learning needs e.g. latex free gloves, dyslexia, disability
Introduction to key staff
Include all staff working within the practice area and staff responsible for H&S activities
Orientation to practice area
Include: • Staff toilets • Staff rest room/canteen • Where to keep personal belongings • Meal breaks • Relevant link areas and who to contact for visits • Inform of university link – name and contact details
Professional Conduct and Appearance
Discuss: • Dress code • Professional conduct specific to the practice e.g. working guidelines, use of mobile phones, e-mail, internet use
ID Badge Explain policy for ID badges
Confidentiality Discuss importance of maintaining confidentiality and data protection
Fire Policy/Procedure
Discuss: • Local policy & emergency numbers • Location of fire points, exits, fire extinguishers, fire blankets & Fire Policy • Explain procedure for evacuation & alarm tones • Awareness of risks associated with practice areas
Moving & Handling
Discuss: • Local policy and relation to practice area • Location of local moving & handling equipment
Organisational Policy Folders
Student should be aware of the following policies/procedures: • Health & Safety • Infection Control • Professional Behaviour • Human Resources e.g. Harassment, Equal Opportunities, Complaints, etc.
17 Faculty of Health Sciences. University of Southampton.
• Occupational Health • Other policies specific to practice area e.g. Lone Working • Smoking
Accident & Clinical Incidents
Explain: • Procedure for reporting accidents/near misses • Procedure for reporting adverse incidents/near misses
Resuscitation
Explain: • Procedure in event of an emergency e.g. cardiac arrest • Emergency contact numbers
Working patterns
Discuss: • Location, distance and if/when lone working, any travel issues • Supervision when educator unavailable • Finishing at the end of the day • Procedures/expectations for nights/weekends/evenings (unsocial hours) work patterns Following current guidance from the University of Southampton, Faculty of Health Sciences
Sickness & Absence
Explain policy for reporting in the event of sickness or absence including notification to Allocations department (University of Southampton, Faculty of Health Sciences)
Transport Issues Discuss issues related to car parking, hospital transport across sites, public transport
Telephone
Discuss: • Contact details for key educator, team members’ mobiles • Student contact details • Bleep/pager system/emergency system
Equipment Explain: • Basic function of appropriate equipment and where and how to access
Infection Control
The student should be made aware of policies with specific reference to: • Needle stick injury • MRSA • Hand washing
18 Faculty of Health Sciences. University of Southampton.
BLOCK 2 Topics to be covered Signatures Date
Personal issues Discuss any adjustments regarding health or learning needs e.g. latex free gloves, dyslexia, disability
Introduction to key staff
Include all staff working within the practice area and staff responsible for H&S activities
Orientation to practice area
Include: • Staff toilets • Staff rest room/canteen • Where to keep personal belongings • Meal breaks • Relevant link areas and who to contact for visits • Inform of university link – name and contact details
Professional Conduct and Appearance
Discuss: • Dress code • Professional conduct specific to the practice e.g. working guidelines, use of mobile phones, e-mail, internet use
ID Badge Explain policy for ID badges
Confidentiality Discuss importance of maintaining confidentiality and data protection
Fire Policy/Procedure
Discuss: • Local policy & emergency numbers • Location of fire points, exits, fire extinguishers, fire blankets & Fire Policy • Explain procedure for evacuation & alarm tones • Awareness of risks associated with practice areas
Moving & Handling
Discuss: • Local policy and relation to practice area • Location of local moving & handling equipment
Organisational Policy Folders
Student should be aware of the following policies/procedures: • Health & Safety • Infection Control • Professional Behaviour • Human Resources e.g. Harassment, Equal Opportunities, Complaints, etc.
• Occupational Health • Other policies specific to practice area e.g. Lone Working • Smoking
Accident & Clinical Incidents
Explain: • Procedure for reporting accidents/near misses • Procedure for reporting adverse incidents/near misses
19 Faculty of Health Sciences. University of Southampton.
Resuscitation
Explain: • Procedure in event of an emergency e.g. cardiac arrest • Emergency contact numbers
Working patterns
Discuss: • Location, distance and if/when lone working, any travel issues • Supervision when educator unavailable • Finishing at the end of the day • Procedures/expectations for nights/weekends/evenings (unsocial hours) work patterns Following current guidance from the University of Southampton, Faculty of Health Sciences
Sickness & Absence
Explain policy for reporting in the event of sickness or absence including notification to Allocations department (University of Southampton, Faculty of Health Sciences)
Transport Issues Discuss issues related to car parking, hospital transport across sites, public transport
Telephone
Discuss: • Contact details for key educator, team members’ mobiles • Student contact details • Bleep/pager system/emergency system
Equipment Explain: • Basic function of appropriate equipment and where and how to access
Infection Control
The student should be made aware of policies with specific reference to: • Needle stick injury • MRSA • Hand washing
20 Faculty of Health Sciences. University of Southampton.
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21 Faculty of Health Sciences. University of Southampton.
PLACEMENT DOCUMENTATION
Placement 1A
WEEK 1
Hospital
Department
Work-Based Assessor Name Signature
Practice Educator Name Signature
WEEK 2
Hospital
Department
Work-Based Assessor Name Signature
Practice Educator Name Signature
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23 Faculty of Health Sciences. University of Southampton.
PRACTICE PLACEMENT 1A
RÉSUMÉ FORM Week 1: From ___________ to ___________ Week 2: From ___________ to ___________
BSc HEALTHCARE SCIENCE CARDIAC PHYSIOLOGY
Student name: ……………………………………………………… Student ID number: ……………………………………………….
Placement educator(s) name: ……………………………………………………………………………………………………………..…….
Student signature: ……………………………………………….. Date: ……………………………………………………………………..
Educator signature: ……………………………………………... Date: …………………………………………………………………….. Where more than one person is involved in supervising the student, the supervisors must collaborate in
agreeing the final grades and the feedback to the student and should complete a single assessment form to be returned to the Faculty.
Department/hospital/service: ……………………………………………………………….......
Is this student working your standard full time working week? (Please circle) Yes / No
If not, how many days per week? ………………………………………………………………….…
Has the student been unable to work due to sickness/other reason? (Please circle) Yes / No
If so, please indicate on how many occasions:
Sickness: Sickness days in total:
Other: Other days in total:
Has the student been involved in a recorded accident/incident whilst on placement? If Yes, please attach a copy of the completed accident/incident form Yes / No Have you had a clinical briefing either for this placement or previously? If ‘no’, please visit our website to book on one of the next briefing dates: www.sohp.soton.ac.uk/practiceeducators/
Yes / No
Please return this form within one week of end of placement to:
HCS Practice Placement Assistant Faculty of Health Sciences Phone: 023 8059 8835 University of Southampton, Building 67 Fax: 023 8059 7900 Highfield E-mail: sohpcpot@soton.ac.uk
SOUTHAMPTON SO17 1BJ
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25 Faculty of Health Sciences. University of Southampton.
PRACTICE PLACEMENT 1A
RÉSUMÉ FORM Week 1: From ___________ to ___________ Week 2: From ___________ to ___________
BSc HEALTHCARE SCIENCE RESPIRATORY & SLEEP PHYSIOLOGY
Student name: ……………………………………………………… Student ID number: ……………………………………………….
Placement educator(s) name: ……………………………………………………………………………………………………………..…….
Student signature: ……………………………………………….. Date: ……………………………………………………………………..
Educator signature: ……………………………………………... Date: …………………………………………………………………….. Where more than one person is involved in supervising the student, the supervisors must collaborate in
agreeing the final grades and the feedback to the student and should complete a single assessment form to be returned to the Faculty.
Department/hospital/service: ……………………………………………………………….......
Is this student working your standard full time working week? (Please circle) Yes / No
If not, how many days per week? ………………………………………………………………….…
Has the student been unable to work due to sickness/other reason? (Please circle) Yes / No
If so, please indicate on how many occasions:
Sickness: Sickness days in total:
Other: Other days in total:
Has the student been involved in a recorded accident/incident whilst on placement? If Yes, please attach a copy of the completed accident/incident form Yes / No Have you had a clinical briefing either for this placement or previously? If ‘no’, please visit our website to book on one of the next briefing dates: www.sohp.soton.ac.uk/practiceeducators/
Yes / No
Please return this form within one week of end of placement to:
HCS Practice Placement Assistant Faculty of Health Sciences Phone: 023 8059 8835 University of Southampton, Building 67 Fax: 023 8059 7900 Highfield E-mail: sohpcpot@soton.ac.uk
SOUTHAMPTON SO17 1BJ
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27 Faculty of Health Sciences. University of Southampton.
FACULTY OF HEALTH SCIENCES
PRACTICE PLACEMENT 1A
ASSESSMENT OF CORE COMPETENCIES
(Observation Placement)
GENERAL AIM:
During this placement the student will:
Define the role of the HEALTHCARE SCIENCE PRACTITIONER in this setting.
PROCEDURE FOR PLACEMENT:
For this observation placement, the student will be supervised by a qualified healthcare scientist. One or two days will be spent with another discipline, chosen from the professional who work most closely with the clinical/practice supervisor (e.g. medical staff, nursing colleagues). This will enable the student to consider how the practice educator’s role complements other team member’s role in the particular setting of the placement.
By the end of the placement, the student will be able to define the role of the healthcare science practitioner within this area and describe the role of one other discipline.
PROCESS OF ASSESSMENT:
This form has 3 Sections. Sections 1.0 & 2.0 are completed by the practice educator and verified by the work-based assessor and Section 3.0 by the student. Structured assessment will occur at the end of the placement (end of Week 2) but performance in the assessed areas (i.e. Section 2.0) should be discussed throughout the placement.
28 Faculty of Health Sciences. University of Southampton.
1.0 CLINICAL ACTIVITY List patient-based activities in which student has made observations/participated: Comment on the student’s ability to observe and communicate with the multidisciplinary team, patients and their relatives.
Week 1
Week 2
Week 1
Week 2
29 Faculty of Health Sciences. University of Southampton.
2.0 PROFESSIONALISM
Has the student shown (please circle):
Week 1 Week 2
(i) An ability to integrate and co-operate with department staff YES / NO YES / NO
(ii) Initiative in routine tasks YES / NO YES / NO
(iii) An appearance and presentation appropriate to the clinical area YES / NO YES / NO
(iv) Ability to settle in the clinical area within the time of the placement YES / NO YES / NO
(v) An understanding of the professional role(s) in this area YES / NO YES / NO
Have you any advice on aspects of professionalism which would be helpful to the student in further practices?
Week 1
Week 2
30 Faculty of Health Sciences. University of Southampton.
3.0 REFLECTION (for completion by student)
For the next placement, is there:-
a) Anything you would do differently?
b) Any other preparation you would make for your next placement (1B)?
Week 1
Week 2
Week 1
Week 2
31 Faculty of Health Sciences. University of Southampton.
RECORD OF EXPERIENCE AND ATTENDANCE
Please, record your attendance and interventions/procedures observed throughout your observational placement in the table provided following
the below.
EXPERIENCE KEY ATTENDANCE KEY RECORD OF ABSENCES MADE UP
BP Blood pressure X Did not attend Date Number of made up hours
ECG Electrocardiogram (IP / OP) S Student off sick
SPI Spirometry O Other (specify)
SpO2 Oxygen saturation
A-BP Ambulatory BP
A-ECG Ambulatory ECG
ETT Exercise tolerance testing
Cath Left heart catheterisation
PPM Pacemaker implantation
O Other (specify)
32 Faculty of Health Sciences. University of Southampton.
WEEK 1 WEEK 2
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
I verify that this is an accurate account
OUTSTANDING HOURS CARRIED FORWARD
Student signature
Work-based assessor signature
33 Faculty of Health Sciences. University of Southampton.
PLACEMENT DOCUMENTATION
Placement 1B
BLOCK 1
Hospital
Department
Work-Based Assessor Name Signature
Practice Educator Name Signature
BLOCK 2
Hospital
Department
Work-Based Assessor Name Signature
Practice Educator Name Signature
34 Faculty of Health Sciences. University of Southampton.
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35 Faculty of Health Sciences. University of Southampton.
PRACTICE PLACEMENT 1B
RÉSUMÉ FORM Block 1: From ___________ to ___________ Block 2: From ___________ to ___________
BSc HEALTHCARE SCIENCE CARDIAC PHYSIOLOGY
Student name: ……………………………………………………… Student ID number: ……………………………………………….
Placement educator(s) name: ………………………………………………………………………………………………………...…..…..
Student signature: ……………………………………………….. Date: ……………………………………………………………………..
Educator signature: ……………………………………………. Date: …………………………………………………………………….. Where more than one person is involved in supervising the student, the supervisors must collaborate in
agreeing the final grades and the feedback to the student and should complete a single assessment form to be returned to the Faculty.
Overall has the student passed the placement? Yes / No
Department/hospital/service: ……………………………………………………………….......
Is this student working your standard full time working week? (Please circle) Yes / No
If not, how many days per week? ………………………………………………………………….…
Has the student been unable to work due to sickness/other reason? (Please circle) Yes / No
If so, please indicate on how many occasions:
Sickness: Sickness days in total:
Other: Other days in total:
Has the student been involved in a recorded accident/incident whilst on placement? If Yes, please attach a copy of the completed accident/incident form Yes / No Have you had a clinical briefing either for this placement or previously? If ‘no’, please visit our website to book on one of the next briefing dates: www.sohp.soton.ac.uk/practiceeducators/
Yes / No
Please return this form within one week of end of placement to:
HCS Practice Placement Assistant Faculty of Health Sciences Phone: 023 8059 8835 University of Southampton, Building 67 Fax: 023 8059 7900 Highfield E-mail: sohpcpot@soton.ac.uk
SOUTHAMPTON SO17 1BJ
36 Faculty of Health Sciences. University of Southampton.
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37 Faculty of Health Sciences. University of Southampton.
PRACTICE PLACEMENT 1B RÉSUMÉ FORM Block 1: From ___________ to ___________ Block 2: From ___________ to ___________
BSc HEALTHCARE SCIENCE RESPIRATORY & SLEEP PHYSIOLOGY
Student name: ……………………………………………………… Student ID number: ……………………………………………….
Placement educator(s) name: ………………………………………………………………………………………………………...…..…..
Student signature: ……………………………………………….. Date: ……………………………………………………………………..
Educator signature: ……………………………………………. Date: …………………………………………………………………….. Where more than one person is involved in supervising the student, the supervisors must collaborate in
agreeing the final grades and the feedback to the student and should complete a single assessment form to be returned to the Faculty.
Overall has the student passed the placement? Yes / No
Department/hospital/service: ……………………………………………………………….......
Is this student working your standard full time working week? (Please circle) Yes / No
If not, how many days per week? ………………………………………………………………….…
Has the student been unable to work due to sickness/other reason? (Please circle) Yes / No
If so, please indicate on how many occasions:
Sickness: Sickness days in total:
Other: Other days in total:
Has the student been involved in a recorded accident/incident whilst on placement? If Yes, please attach a copy of the completed accident/incident form Yes / No Have you had a clinical briefing either for this placement or previously? If ‘no’, please visit our website to book on one of the next briefing dates: www.sohp.soton.ac.uk/practiceeducators/
Yes / No
Please return this form within one week of end of placement to:
HCS Practice Placement Assistant Faculty of Health Sciences Phone: 023 8059 8835 University of Southampton, Building 67 Fax: 023 8059 7900 Highfield E-mail: sohpcpot@soton.ac.uk
SOUTHAMPTON SO17 1BJ
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39 Faculty of Health Sciences. University of Southampton.
CORE COMPETENCIES
Placement 1B
40 Faculty of Health Sciences. University of Southampton.
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41 Faculty of Health Sciences. University of Southampton.
FACULTY OF HEALTH SCIENCES
CLINICAL/PRACTICE PLACEMENT 1B
CORE COMPETENCIES ASSESSMENT FORM
GENERAL AIMS:
During this placement the student will:-
Develop their communication and interpersonal skills with patients/clients and colleagues.
Apply aspects of theoretical study to clinical practice.
Develop skills in the assessment and treatment/management of patients/clients and in the
evaluation of the effectiveness of their intervention with guidance from the clinical
educator.
Develop self-management skills and an appreciation of the expectations of professional
practice.
Begin to reflect on aspects of practice in the light of experience and advice.
This form is the second of a series of 4 forms for assessing students on Practice Placements 1A, 1B, 2
and 3. The forms have been designed to show the student’s progression and development during
his/her practice experience throughout their degree course.
PROCESS OF ASSESSMENT
The assessment form has 4 sections. The student is assessed formally on each section twice during
the placement. The first assessment is half-way through the placement and is formative, the second
occurs at the end of the placement, is summative and provides the placement mark.
In addition to the formal assessment it is expected that the practice educator and student will meet
on a regular basis to discuss his/her performance to date. In the light of this discussion, the student
and the practice educator will negotiate and set specific objectives to be achieved during the
following week(s).
Please also complete the “ADVICE TO STUDENT” sections at both formal assessment times, i.e. half-
time and full-time to confirm the rationale for the grades given and give recommendations for the
student’s future performance.
42 Faculty of Health Sciences. University of Southampton.
GUIDELINES FOR USING THIS FORM
SECTION 1
This section on safety is not graded. The student is either safe or unsafe.
SECTIONS 2, 3 AND 4
Grade each criterion in these sections for which you have been able to assess student performance.
Use A-E for grading as follows:
A The student is performing excellently in this area for this stage of placement, acting in a highly
professional, proficient and skilled manner.
B The student is performing very well in this area for this stage of placement, showing a more than
normally expected level of proficiency and skill
C The student is performing with a level of competence and professional effectiveness normally
expected at this stage of placement.
D The student is mainly performing at a level of competence and professional effectiveness normally
expected at this stage of placement but is inconsistent in achieving this level
E The student is not performing at a level of competence and professional effectiveness normally
expected at this stage of placement.
N.B. The calculation of each section grade and overall grade will be completed at the Faculty on
return of the assessment form.
REPORT ON PERFORMANCE AND ADVICE TO STUDENTS
Please, provide feedback and comments on the student’s performance in relation to sections 1 to 4.
STUDENT SELF-ASSESSMENT
To be completed by the student at the end of each block (i.e. cardiac and respiratory).
Placement failure
At the end of the placement, i.e. full time grading, the student is deemed to have failed if either of
the following occurs:
a) Section 1 - the student is marked as ‘No’, i.e. is unsafe.
b) If two or more of the Sections 2, 3 and 4 have three or more criteria graded at E.
43 Faculty of Health Sciences. University of Southampton.
EXPLANATION OF TERMS
The following terms will be found in this or in later forms. They indicate the increasing levels of
performance expected through the course:
“With guidance from the practice educator” implies that the student is an active participant in the
process (whether in decision making or skilled activity), however the lead has come from the
practice educator.
“With prompting from the practice educator” implies that the student has taken the lead in the
process (whether in decision making or skilled activity) but has needed assistance from the practice
educator in the refinement and clarification of the idea or activity.
“Independently” implies that the student carries out the process independently (whether in decision
making or skilled activity). The practice educator may give supportive feedback during the process
but does not direct the student in any other way.
44 Faculty of Health Sciences. University of Southampton.
SECTION 1
(This section must be returned with the complete form)
1.0 SAFETY BLOCK 1 (to be completed by the placement manager)
The student:
1 Demonstrates safe professional practice with respect to patients/clients, carers, colleagues and self
YES / NO
2 Assesses risks accurately and responds appropriately YES / NO
3 Understands and complies with the Health and Safety Regulations YES / NO
Signature: ……………………………………………………….. Date: ……………………………………………………………….
1.0 SAFETY BLOCK 2 (to be completed by the placement manager)
The student:
1 Demonstrates safe professional practice with respect to patients/clients, carers, colleagues and self
YES / NO
2 Assesses risks accurately and responds appropriately YES / NO
3 Understands and complies with the Health and Safety Regulations YES / NO
Signature: ……………………………………………………….. Date: ……………………………………………………………….
NB: This section on safety and professional conduct is not graded. The student is either safe or unsafe, demonstrating appropriate professional conduct or not. If any points above have been marked “NO”, then the placement is graded “FAIL” whatever marks may have been awarded in sections 2.0, 3.0 and 4.0.
If by half-way through the placement you have a student who remains unsafe or continues to demonstrate unprofessional conduct then please contact the Locality Contact (placement Visitor) at the Faculty.
45 Faculty of Health Sciences. University of Southampton.
SECTION 2
Criteria grades
2.0 INTERPERSONAL COMPETENCIES
Half Blk 1
Full Blk 2
2.1 COMMUNICATING AS A HEALTHCARE SCIENCE PRACTITIONER. The student is able to:
(i) Demonstrate an awareness of each patient/client’s individual needs
(ii) Communicate with each patient/client about his/her needs
(iii) Demonstrate a number of strategies in order to reassure the patient while undergoing diagnostic investigations
(iv) Foster the development of a professional relationship with each patient/ client, respecting each person’s rights and dignity, with guidance from the practice educator
2.2 COMMUNICATING AS A HEALTHCARE SCIENCE EDUCATOR. The student is able to:
(i) Demonstrate they ability to explain technical data with colleagues and the practice educator
(ii) Access appropriate resources and present information clearly and at an appropriate level for the recipient
2.3 COMMUNICATING AS A PROFESSIONAL. The student is able to:
(i) Keep adequate accurate records which are available appropriately to others of the team and are maintained in accordance with the requirements of the Data Protection Act and Information Governance
(ii) Be aware of the appropriate boundary between the professional and personal self
(iii) Integrate and settle in with immediate colleagues and other members of the team
(iv) Recognise the role of all members of the multi-disciplinary team
Please enter the NUMBER of criteria at each grade in the boxes provided below (number of As, Bs, etc.)
A B C D E Total number of criteria
Half-time (end of block 1)
Full-time (end of block 2)
Three or more individual criteria graded at E means the student has failed the section.
46 Faculty of Health Sciences. University of Southampton.
SECTION 3
Criteria grades
3.0 PLACEMENT COMPETENCIES
Half Blk 1
Full Blk 2
3.1 ASSESSMENT OF PATIENT/CLIENT. The student is able to:
(i) Demonstrate relevant knowledge gained prior to this placement
(ii) Collect and record relevant information from each patient/client and or other valid sources in accordance with the requirements of the Data Protection Act and Information Governance, with guidance from the practice educator; may require an extended period of time
(iii) Carry out appropriate assessment of the patient/client within the situation, with guidance from the practice educator; may require an extended period of time
3.2 FORMULATION OF ACTION PLAN. The student is able to:
(i) Discuss the assessment findings and identify key problems, with guidance from the practice educator
(ii) Discuss the prioritisation of diagnostic procedures in conjunction with the practice educator or qualified healthcare scientist
3.3 IMPLEMENTATION OF THE ACTION PLAN (this may apply to individual or group situations). The student is able to:
(i) Select and access appropriate techniques and resources in order to implement the plan, with guidance from the practice educator
(ii) Intervene in a safe and adequate manner, with guidance from the practice educator
(iii) Demonstrate appropriate sensitivity to each patient’s/client’s comfort and privacy needs during treatment
3.4 EVALUATION OF THE ACTION PLAN: (this may apply to individual or group situations). The student is able to:
(i) Explain the effects of each intervention and modify/progress as appropriate, with guidance from the clinical/practice educator
(ii) Determine the appropriate discharge of each patient/client when measured against the goals of the action plan, with guidance from the clinical/practice educator
Please enter the NUMBER of criteria at each grade in the boxes provided below (number of As, Bs, etc.)
A B C D E Total number of criteria
Half-time (end of block 1)
Full-time (end of block 2)
Three or more individual criteria graded at E means the student has failed the section.
47 Faculty of Health Sciences. University of Southampton.
SECTION 4
Criteria grades
4.0 MANAGEMENT COMPETENCIES
Half Blk 1
Full Blk 2
4.1 MANAGING SELF. The student is able to:
(i) Carry out routine tasks adequately, without prompting and within a reasonable time
(ii) Demonstrate time management appropriate to the setting and organise his/her own time constructively
(iii) Present a professional attitude, manner and appearance appropriate to the setting
(iv) Be aware of his/her limitations and is receptive to advice/guidance
4.2 MANAGING OTHERS. The student is able to:
(i) Demonstrate responsibility for each patient/client in his/her care
(ii) Co-ordinate own patient/client contact with that of others, with guidance from practice educator
4.3 MANAGING RESOURCES. The student is able to:
(i) Identify other sources of assistance within the setting e.g. network of key people
(ii) Identify relevant supporting services available within the setting
(iii) Be aware of the cost implications of various options for patient/client care
4.4 LEGISLATION, POLICY AND QUALITY ISSUES. The student is:
(i) Aware of the relevant legislation, policy and procedures affecting the service within this setting
Please enter the NUMBER of criteria at each grade in the boxes provided below (number of As, Bs, etc.)
A B C D E Total number of criteria
Half-time (end of block 1)
Full-time (end of block 2)
Three or more individual criteria graded at E means the student has failed the section.
48 Faculty of Health Sciences. University of Southampton.
REPORT ON PERFORMANCE AND ADVICE TO STUDENTS:
Please ensure you provide specific feedback on sections 1-4 at both half-time and full-time, continuing on a separate sheet if necessary (to be completed by the placement personnel).
1.0 SAFETY:
2.0 INTERPERSONAL COMPETENCIES:
Formative (block 1)
Summative (block 2)
Formative (block 1)
Summative (block 2)
49 Faculty of Health Sciences. University of Southampton.
3.0 PLACEMENT COMPETENCIES:
4.0 MANAGEMENT COMPETENCIES:
Formative (block 1)
Summative (block 2)
Formative (block 1)
Summative (block 2)
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STUDENT SELF ASSESSMENT
REFLECTION AFTER BLOCK 1 (for completion by the student)
For the next time:
WHAT WENT WELL?
WHAT DIDN’T GO SO WELL?
WHAT HAS BEEN LEARNT?
WHAT COULD HAVE BEEN DONE DIFFERENTLY?
51 Faculty of Health Sciences. University of Southampton.
STUDENT SELF-ASSESSMENT
REFLECTION AFTER BLOCK 2 (for completion by the student)
For the next time:
WHAT WENT WELL?
WHAT DIDN’T GO SO WELL?
WHAT HAS BEEN LEARNT?
WHAT COULD HAVE BEEN DONE DIFFERENTLY?
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53 Faculty of Health Sciences. University of Southampton.
DIRECT OBSERVATION OF PRACTICAL SKILLS (DOPS)
Placement 1B
54 Faculty of Health Sciences. University of Southampton.
ASSESSMENT FRAMEWORK OF SPECIALIST SKILLS (DOPS)
Introduction
To ensure the student has reached the required level of competence, each clinical skill will be assessed. Assessments will comprise of direct observation and an oral examination. This assessment methodology will permit the work-based assessor to observe the students technical and clinical skill, in addition the oral examination will ensure the student’s knowledge supports their practice. All assessments must be documented.
Assessment documentation
All assessment documentation is to be completed on official paperwork. Photocopies or modified forms will be considered void. Each assessment requires specific documentation to be completed:
1. Assessment plan
2. Performance criteria
3. Questions and answers
4. Feedback
The assessment plan is the learning contract between the student and the assessor. It will state the clinical scenario in which the assessment will take place and outline what the assessor is expecting regarding the assessment. The student and assessor must both sign the assessment plan prior to the assessment.
The performance criterion outlines each competency that must be achieved during the assessment. Those performance criteria that are not achieved during the assessment must be satisfied with a question from the assessor. Comments should be entered by the assessor against the relevant performance criteria. In the event that 25% of the performance criteria cannot be met by practice the assessment will be considered void.
On completion of the practical skill the student and assessor should relocate to a more appropriate location in which to hold an oral examination. The assessor will use the performance criteria and what they have observed as a guide to which questions are asked. The assessor will record the student’s answers on the questions and answers sheet. The assessor will ask a minimum of two and a maximum of five questions.
On completion of the assessment the assessor will inform the student of the outcome of the assessment. Feedback will be provided and documented to guide the student into areas which were completed satisfactorily and those areas in which require more work. All assessments must be documented.
Method of assessment
Direct Observation – The work based assessor directly observes the student performing a particular clinical skill and assesses the student against the performance criteria for that particular procedure.
Questioning - All clinical skills will be assessed by questioning on completion of the clinical skill being observed. Questioning is used to assess the student’s knowledge of that particular skill. More importantly it is used to ensure their knowledge supports their practice. In addition where specific performance criteria cannot be achieved a question must be used to achieve that specific performance criterion. The level of questioning must increase with each assessment to demonstrate progression in that area.
55 Faculty of Health Sciences. University of Southampton.
FACULTY OF HEALTH SCIENCES
SUMMARY MASTERSHEET OF SPECIALIST SKILLS (DOPS) FOR PLACEMENT 1B
Competency Reviewer Date Summative assessment (pass/fail)
Comments/Evidence
Cardiac
Routine electrocardiogram in an adult patient.
Measurement of blood pressure in an adult patient using a manual & an automatic device.
Respiratory
Dynamic Lung Volumes (spirometry) in an adult patient.
Measurement of oxygen saturation (Sp02).
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57 Faculty of Health Sciences. University of Southampton.
12-LEAD ELECTROCARDIOGRAPHY
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care and routine non-invasive investigations, performing the recording of 12-lead electrocardiography (ECG) on the adult patient. During this period of work based training students will apply their learning from the academic modules undertaken throughout their first year of training.
SCOPE
On completion of this placement the student will be able to competently perform 12-lead ECG recording on the adult patient. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
1. Understand their own level of competence, authority and knowledge base. 2. Explain their role and responsibilities. 3. Adhere to national and departmental guidelines and protocols. 4. Understand the principles of the anatomy and physiology of the cardiovascular system. 5. Maintain a professional attitude and appearance at all times.
Clinical experiential learning
Critically apply the scientific principles covered in the academic modules to this work-based
specialist skill and appraise the evidence base underpinning at least one of the routine
investigations and one treatment plan.
Prepare a portfolio of evidence containing 12-lead ECG recordings (anonymised) that you
have obtained recordings from.
All of these experiences should be recorded in your portfolio of evidence.
Note: Please attach an anonymised, countersigned copy of the 12-lead ECG recording including the
student’s initials and basic patient information (i.e. gender, age, outpatient, inpatient).
58 Faculty of Health Sciences. University of Southampton.
12-LEAD ELECTROCARDIOGRAPHY ASSESSMENT PLAN To be completed by the word-based assessor prior to the assessment. Student to agree and countersign.
Key points and instructions
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
59 Faculty of Health Sciences. University of Southampton.
12-LEAD ELECTROCARDIOGRAPHY PERFORMANCE CRITERIA
PC Task Y/N Assessor’s comments
1 Obtain a suitably completed request form, greet patient, check patient ID and recent clinical history.
2 Treat patient in a way which respects their dignity, rights, privacy and confidentiality.
3 Explain the procedure to the patient and gain consent.
4 Identify electrode sites on the patient according to current AHA/SCST* guidelines.
5 Prepare the patients skin in order to ensure adequate electrode contact.
6 Apply suitable electrodes firmly to the patient to minimise artefact.
7 Choose machine settings appropriate to the ECG recording requested/required.
8 Make an ECG recording ensuring that an accurate, artefact-free tracing is obtained.
9 Take steps to modify the procedure if a suitable recording cannot be made and re-record if necessary.
10 Remove electrodes and ensure that the patient and/or carer are informed of next steps.
11 Check the ECG recording for abnormalities and inform a senior staff member if necessary.
12 Demonstrate that ECG recordings are accurate, complete, legible and forwarded to the correct person in an appropriate timescale.
13 Annotate all ECG recordings with the correct patient details and store safely.
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
60 Faculty of Health Sciences. University of Southampton.
12-LEAD ELECTROCARDIOGRAPHY ASSESSMENT QUESTIONS (Related to performance criteria)
Questions Answers
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
61 Faculty of Health Sciences. University of Southampton.
ASSESSMENT FEEDBACK ON STUDENT’S PERFORMANCE OF 12-LEAD ELECTROCARDIOGRAPHY
Provide a description of the clinical scenario and feedback (to be completed by the WBA).
WBA signature: ……………..……….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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63 Faculty of Health Sciences. University of Southampton.
NON-INVASIVE BLOOD PRESSURE RECORDING
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care and routine non-invasive investigations, performing the recording of non-invasive blood pressure (BP) on the adult patient. During this period of work based training students will apply their learning from the academic modules undertaken throughout their first year of training.
SCOPE
On completion of this placement the student will be able to competently perform non-invasive BP recording on the adult patient. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
1. Understand their own level of competence, authority and knowledge base. 2. Explain their role and responsibilities. 3. Adhere to national and departmental guidelines and protocols. 4. Understand the principles of the anatomy and physiology of the cardiovascular system. 5. Maintain a professional attitude and appearance at all times.
Clinical experiential learning
Critically apply the scientific principles covered in the academic modules to this work-based
specialist skill and appraise the evidence base underpinning at least one of the routine
investigations and one treatment plan.
Prepare a portfolio of evidence containing BP recordings (anonymised) that you have
obtained recordings from.
All of these experiences should be recorded in your portfolio.
64 Faculty of Health Sciences. University of Southampton.
NON-INVASIVE BLOOD PRESSURE RECORDING ASSESSMENT PLAN
To be completed by the word-based assessor prior to the assessment. Student to agree and countersign.
Key points and instructions
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
65 Faculty of Health Sciences. University of Southampton.
NON-INVASIVE BLOOD PRESSURE RECORDING PERFORMANCE CRITERIA
PC Task Y/N Assessor’s comments
1 Obtain a suitably completed request form, greet patient, check patient ID and recent clinical history.
2 Treat patient in a way which respects their dignity, rights, privacy and confidentiality.
3 Explain the procedure to the patient and gain consent.
4 Choose the correct cuff size for the patient.
5 Locate the pulse in the cubital fossa. Ensure the posture and position of the arm is correct.
6 Estimate systolic BP by palpation.
7 Inflate the cuff at least 30mmHg above the estimated systolic blood pressure and reduce the pressure smoothly.
8 Make an accurate recording of blood pressure.
9
Identify any difficulties in obtaining an accurate BP recording for the patient and take remedial action and re-measure if necessary.
10 Check the results and consult senior staff if necessary.
Student recorded value: ________ /________ WBA recorded value: ________ / ________
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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NON-INVASIVE BLOOD PRESSURE RECORDING ASSESSMENT QUESTIONS (Related to performance criteria)
Questions Answers
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
67 Faculty of Health Sciences. University of Southampton.
ASSESSMENT FEEDBACK ON STUDENT’S PERFORMANCE OF NON-INVASIVE BLOOD PRESSURE RECORDING
Provide a description of the clinical scenario and feedback (to be completed by the WBA).
WBA signature: …………..………….………….…………….. Student signature: ……….………………….……………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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69 Faculty of Health Sciences. University of Southampton.
DYNAMIC LUNG VOLUMES RECORDING
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care and routine investigations, performing the recording of dynamic lung volumes on the adult patient. During this period of work based training students will apply their learning from the academic modules undertaken throughout their first year of training.
SCOPE
On completion of this placement the student will be able to competently perform dynamic lung volumes recording on the adult patient. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
1. Understand their own level of competence, authority and knowledge base. 2. Explain their role and responsibilities. 3. Adhere to national and departmental guidelines and protocols. 4. Understand the principles of the anatomy and physiology of the respiratory system. 5. Maintain a professional attitude and appearance at all times.
Clinical experiential learning
Critically apply the scientific principles covered in the academic modules to this work-based
specialist skill and appraise the evidence base underpinning at least one of the routine
investigations and one treatment plan.
Prepare a portfolio of evidence containing dynamic lung volume recordings (anonymised)
that you have obtained recordings from.
All of these experiences should be recorded in your portfolio.
Note: Please attach an anonymised, countersigned copy of the spirometry recording including the
student’s initials and basic patient information (i.e. gender, age, outpatient, inpatient).
70 Faculty of Health Sciences. University of Southampton.
ASSESSMENT PLAN OF DYNAMIC LUNG VOLUMES RECORDING
To be completed by the word-based assessor prior to the assessment. Student to agree and countersign.
Key points and instructions
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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PERFORMANCE CRITERIA OF DYNAMIC LUNG VOLUMES RECORDING
PC Task Y/N Assessor’s comments
1 Prepare equipment and patient
2 Give patient clear and concise instructions on the test requirements
3
Obtain accurate recordings of VC, FVC, FEV, PEF and MFVC in accordance with recommended procedures and patient capability
4 Recognise reasons to stop the dynamic lung volume recordings to maintain the safety of the patient during the test
5 Identify and correct errors in patient technique
6 Distinguish between poor patient performance, technical faults or deterioration in clinical status
7
At the end of the test remove equipment, mouthpieces, nose clips, etc., reassure patient and give appropriate time to recover from the test
8 Inform the patient of the procedure for notification of the results
9 Decontaminate equipment and leave in a suitable condition for reuse
10
Record the results accurately in an appropriate format together with any technical comments that may influence the test outcomes
11 Generate a suitable report
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
72 Faculty of Health Sciences. University of Southampton.
ASSESSMENT QUESTIONS DYNAMIC LUNG VOLUMES RECORDING (Related to performance criteria)
Questions Answers
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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ASSESSMENT FEEDBACK ON STUDENT’S PERFORMANCE OF DYNAMIC LUNG VOLUMES RECORDING
Provide a description of the clinical scenario and feedback (to be completed by the WBA).
WBA signature: ………………….………….…….………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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75 Faculty of Health Sciences. University of Southampton.
OXYGEN SATURATION RECORDING
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care and routine investigations, performing the recording of oxygen saturation on the adult patient. During this period of work based training students will apply their learning from the academic modules undertaken throughout their first year of training.
SCOPE
On completion of this placement the student will be able to competently perform oxygen saturation recording on the adult patient. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
1. Understand their own level of competence, authority and knowledge base. 2. Explain their role and responsibilities. 3. Adhere to national and departmental guidelines and protocols. 4. Understand the principles of the anatomy and physiology of the respiratory system. 5. Maintain a professional attitude and appearance at all times.
Clinical experiential learning
Critically apply the scientific principles covered in the academic modules to this work-based
specialist skill and appraise the evidence base underpinning at least one of the routine
investigations and one treatment plan.
Prepare a portfolio of evidence containing dynamic lung volume recordings (anonymised)
that you have obtained recordings from.
All of these experiences should be recorded in your portfolio.
76 Faculty of Health Sciences. University of Southampton.
OXYGEN SATURATION RECORDING ASSESSMENT PLAN
To be completed by the word-based assessor prior to the assessment. Student to agree and countersign.
Key points and instructions
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
77 Faculty of Health Sciences. University of Southampton.
OXYGEN SATURATION RECORDING PERFORMANCE CRITERIA
PC Task Y/N Assessor’s comments
1 Give patient clear and concise instructions on the test requirements
2 Obtain accurate recordings of SpO2 and pulse rate in accordance with recommended procedures and patient’s clinical condition
3 Distinguish between technical faults or deterioration in clinical status
4 At the end of the test/s remove equipment and reassure patient
5 Inform the patient of the procedure for notification of the results
6 Decontaminate equipment and leave in a suitable condition for reuse
7
Record the results accurately in an appropriate format together with any technical comments that may influence the test outcome
8 Generate a suitable report
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
78 Faculty of Health Sciences. University of Southampton.
OXYGEN SATURATION RECORDING ASSESSMENT QUESTIONS (Related to performance criteria)
Questions Answers
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
79 Faculty of Health Sciences. University of Southampton.
ASSESSMENT FEEDBACK ON STUDENT’S PERFORMANCE OF OXYGEN SATURATION RECORDING
Provide a description of the clinical scenario and feedback (to be completed by the WBA).
WBA signature: ………………….………….……………….... Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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81 Faculty of Health Sciences. University of Southampton.
CASE BASED DISCUSSIONS (CBD)
Placement 1B
82 Faculty of Health Sciences. University of Southampton.
CASE BASED DISCUSSIONS (CBD)
Description
CBDs are designed to provide structured teaching and feedback in a particular area of clinical or technical practice by evaluating decision making, interpretation and application of evidence. CBD enable the discussion of the context, professional, ethical and governance framework of practice, and in all instances, they allow students to discuss why the acted as they did.
CBDs are structured assessments used to evaluate the student’s clinical cognitive ability during a technical procedure. Either prospectively or retrospectively, the assessor, in consultation with the student, will select a particular case on whom to perform the CBD. The student will, under supervision, perform either a non-invasive blood pressure or a 12 lead resting ECG (if in a cardiac setting) or a recording of dynamic lung volumes or oxygen saturation (if in a respiratory setting). The results of the procedure, along with accompanying data, will be interpreted in context, clinically. Accompanying data can include:
Demographics
Social circumstances
Previous medical history
Pharmacological history
Current signs and symptoms
The outcome of the CBD is the development of the student’s clinical reasoning based on a technical procedure performed in the context of a clinical episode. In order to achieve a pass, all the performance criteria must be addressed and minimum requirements met in one spoken interaction (discussion). Should the student fail to achieve a pass, this assessment must be repeated in the recoup period. The assessment of CBDs should be appropriate to the students’ level of study.
A CBD should take approximately 20-30 minutes. The CBD should be conducted away from patients and staff, ideally in a quiet room away from interruptions.
A formative CBD assessment should be undertaken at the end of the first block of practice; one single CBD summative assessment should be carried out at the end of the second block of practice, regardless of the specialism.
Note: Prior to the CBD, the student is required to record their experience in the aforementioned specialist skills. The evidence will provide an insight to the assessor of the diversity of clinical settings and pathologies
the student has experienced.
83 Faculty of Health Sciences. University of Southampton.
CBD ASSESSMENT FORM Formative
Clinical setting: ……………………………………………….. Specialist skill: ………………………………………………… Brief description of output and focus of the scenario:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
No Performance criteria Comments
1 Shows knowledge and understanding of clinical and/or scientific principles relevant to scenario
2 Recognises and discusses relevant health and safety issues
3 Recognises and discusses the procedures used to obtain the results
4 Recognises and discusses the quality control procedures to ensure the result is accurate
5 Shows knowledge and understanding of relevant “Best Practice” guidelines and other policies relevant to the scenario
6 Recognises and discusses the significance of routine patient results with reference to the reason for referral
7 Shows knowledge and understanding of, and begins to use, appropriate resources to aid in the interpretation of results
8 Is aware of the importance of audit trail
9 Recognises and is aware of the limits of responsibility and when to seek advice
10 Demonstrates sound professional values and attitudes
WBA signature: …………………………………………………. Student signature: ………………………………………..
Date of assessment: …………………………………………..
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Feedback and documentation of learning needs
Agreed actions
WBA signature: ……………………….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
85 Faculty of Health Sciences. University of Southampton.
CBD ASSESSMENT FORM Summative
Clinical setting: ……………………………………………….. Specialist skill: ………………………………………………… Brief description of output and focus of the scenario:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
No Performance criteria Examples
1 Shows knowledge and understanding of clinical and/or scientific principles relevant to scenario
2 Recognises and discusses relevant health and safety issues
3 Recognises and discusses the procedures used to obtain the results
4 Recognises and discusses the quality control procedures to ensure the result is accurate
5 Shows knowledge and understanding of relevant “Best Practice” guidelines and other policies relevant to the scenario
6 Recognises and discusses the significance of routine patient results with reference to the reason for referral
7 Shows knowledge and understanding of, and begins to use, appropriate resources to aid in the interpretation of results
8 Is aware of the importance of audit trail
9 Recognises and is aware of the limits of responsibility and when to seek advice
10 Demonstrates sound professional values and attitudes
WBA signature: …………………………………………………. Student signature: ………………………………………..
Date of assessment: …………………………………………..
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Feedback and documentation of learning needs
Agreed actions
WBA signature: ……………………….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
87 Faculty of Health Sciences. University of Southampton.
RECORD OF EXPERIENCE AND ATTENDANCE
Please, record your attendance and interventions/procedures observed throughout your observational placement in the table provided following
the below.
EXPERIENCE KEY ATTENDANCE KEY RECORD OF ABSENCES MADE UP
BP Blood pressure X Did not attend Date Number of made up hours
ECG Electrocardiogram (IP / OP) S Student off sick
A-BP Ambulatory BP O Other (specify)
A-ECG Ambulatory ECG BH Bank holiday
TH Tape hook up
TH Tape analysis
ETT Exercise tolerance testing
Cath Left heart catheterisation
PPM Pacemaker implantation
Echo Echocardiography
Uni University
ID Independent study
DS Directed study / assessment
O Other (specify)
88 Faculty of Health Sciences. University of Southampton.
BLOCK 1
WEEK 1 WEEK 2
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
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PE signature
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WEEK 3 WEEK 4
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
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PE signature
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BLOCK 2
WEEK 1 WEEK 2
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
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PE signature
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WEEK 3 WEEK 4
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
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PE signature
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VERIFICATION OF ATTENDANCE TO PLACEMENT 1B
I verify that this is an accurate account
OUTSTANDING HOURS CARRIED FORWARD
Student signature
Work-based assessor signature
91 Faculty of Health Sciences. University of Southampton.
PLACEMENT DOCUMENTATION
Placement 2
PLACEMENT 2
Hospital
Department
Work-Based Assessor Name Signature
Practice Educator Name Signature
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FACULTY OF HEALTH SCIENCES
RECORD OF STATUTORY AND MANDATORY TRAINING PRIOR TO PLACEMENT 2
Observed sessions Date Facilitator name and signature
Moving and Handling
Basic Life Support
Standard Precautions and Observations (Infection Prevention)
Online sessions Date completed Student signature
Fire
Health and Safety
Equality and Diversity
Conflict Resolution
Safeguarding
PRE-PLACEMENT LABORATORY-BASED SPECIALIST SKILLS
Specialist skill Date completed Trainer signature
Resting 12-Lead Electrocardiography
Resting Blood Pressure
Ambulatory Electrocardiography
Ambulatory Blood Pressure
Cardiac Exercise Stress Testing
94 Faculty of Health Sciences. University of Southampton.
INDUCTION SIGN OFF
All students need to have basic induction information. Can the Placement Educator discuss and
direct the Student to the following information during their induction period. Both Placement
Educator and Student need to sign and date the below document to indicate that they have given
and received the following information. If an area does not relate to your practice please indicate
with a N/A in the appropriate box.
PLACEMENT 2 Topics to be covered Signatures Date
Personal issues Discuss any adjustments regarding health or learning needs e.g. latex free gloves, dyslexia, disability
Introduction to key staff
Include all staff working within the practice area and staff responsible for H&S activities
Orientation to practice area
Include: • Staff toilets • Staff rest room/canteen • Where to keep personal belongings • Meal breaks • Relevant link areas and who to contact for visits • Inform of university link – name and contact details
Professional Conduct and Appearance
Discuss: • Dress code • Professional conduct specific to the practice e.g. working guidelines, use of mobile phones, e-mail, internet use
ID Badge Explain policy for ID badges
Confidentiality Discuss importance of maintaining confidentiality and data protection
Fire Policy/Procedure
Discuss: • Local policy & emergency numbers • Location of fire points, exits, fire extinguishers, fire blankets & Fire Policy • Explain procedure for evacuation & alarm tones • Awareness of risks associated with practice areas
Moving & Handling
Discuss: • Local policy and relation to practice area • Location of local moving & handling equipment
Organisational Policy Folders
Student should be aware of the following policies/procedures: • Health & Safety • Infection Control • Professional Behaviour • Human Resources e.g. Harassment, Equal Opportunities, Complaints, etc.
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• Occupational Health • Other policies specific to practice area e.g. Lone Working • Smoking
Accident & Clinical Incidents
Explain: • Procedure for reporting accidents/near misses • Procedure for reporting adverse incidents/near misses
Resuscitation
Explain: • Procedure in event of an emergency e.g. cardiac arrest • Emergency contact numbers
Working patterns
Discuss: • Location, distance and if/when lone working, any travel issues • Supervision when educator unavailable • Finishing at the end of the day • Procedures/expectations for nights/weekends/evenings (unsocial hours) work patterns Following current guidance from the University of Southampton, Faculty of Health Sciences
Sickness & Absence
Explain policy for reporting in the event of sickness or absence including notification to Allocations department (University of Southampton, Faculty of Health Sciences)
Transport Issues Discuss issues related to car parking, hospital transport across sites, public transport
Telephone
Discuss: • Contact details for key educator, team members’ mobiles • Student contact details • Bleep/pager system/emergency system
Equipment Explain: • Basic function of appropriate equipment and where and how to access
Infection Control
The student should be made aware of policies with specific reference to: • Needle stick injury • MRSA • Hand washing
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PRACTICE PLACEMENT 2 RÉSUMÉ FORM Placement 2: From ___________ to ___________
BSc HEALTHCARE SCIENCE CARDIAC PHYSIOLOGY
Student name: ……………………………………………………… Student ID number: ……………………………………………….
Placement educator(s) name: ……………………………………………………………………………………………………………..…….
Student signature: ……………………………………………….. Date: ……………………………………………………………………..
Educator signature: ……………………………………………... Date: …………………………………………………………………….. Where more than one person is involved in supervising the student, the supervisors must collaborate in
agreeing the final grades and the feedback to the student and should complete a single assessment form to be returned to the Faculty.
Department/hospital/service: ……………………………………………………………….......
Is this student working your standard full time working week? (Please circle) Yes / No
If not, how many days per week? ………………………………………………………………….…
Has the student been unable to work due to sickness/other reason? (Please circle) Yes / No
If so, please indicate on how many occasions:
Sickness: Sickness days in total:
Other: Other days in total:
Has the student been involved in a recorded accident/incident whilst on placement? If Yes, please attach a copy of the completed accident/incident form Yes / No Have you had a clinical briefing either for this placement or previously? If ‘no’, please visit our website to book on one of the next briefing dates: www.sohp.soton.ac.uk/practiceeducators/
Yes / No
Please return this form within one week of end of placement to:
HCS Practice Placement Assistant Faculty of Health Sciences Phone: 023 8059 8835 University of Southampton, Building 67 Fax: 023 8059 7900 Highfield E-mail: sohpcpot@soton.ac.uk
SOUTHAMPTON SO17 1BJ
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CORE COMPETENCIES
Placement 2
100 Faculty of Health Sciences. University of Southampton.
FACULTY OF HEALTH SCIENCES
CLINICAL/PRACTICE PLACEMENT 2
CORE COMPETENCIES ASSESSMENT FORM
GENERAL AIMS:
During this placement the student will:-
Develop their communication and interpersonal skills with patients/clients and colleagues.
Apply aspects of theoretical study to clinical practice.
Develop skills in the assessment and treatment/management of patients/clients and in the
evaluation of the effectiveness of their intervention with guidance from the clinical
educator.
Develop self-management skills and an appreciation of the expectations of professional
practice.
Begin to reflect on aspects of practice in the light of experience and advice.
This form is the second of a series of 4 forms for assessing students on Practice Placements 1A, 1B, 2
and 3. The forms have been designed to show the student’s progression and development during
his/her practice experience throughout their degree course.
PROCESS OF ASSESSMENT
The assessment form has 4 sections. The student is assessed formally on each section twice during
the placement. The first assessment is half-way through the placement and is formative, the second
occurs at the end of the placement, is summative and provides the placement mark.
In addition to the formal assessment it is expected that the practice educator and student will meet
on a regular basis to discuss his/her performance to date. In the light of this discussion, the student
and the practice educator will negotiate and set specific objectives to be achieved during the
following week(s).
Please also complete the “ADVICE TO STUDENT” sections at both formal assessment times, i.e. half-
time and full-time to confirm the rationale for the grades given and give recommendations for the
student’s future performance.
101 Faculty of Health Sciences. University of Southampton.
GUIDELINES FOR USING THIS FORM
SECTION 1
This section on safety is not graded. The student is either safe or unsafe.
SECTIONS 2, 3 AND 4
Grade each criterion in these sections for which you have been able to assess student performance.
Use A-E for grading as follows:
A The student is performing excellently in this area for this stage of placement, acting in a highly
professional, proficient and skilled manner.
B The student is performing very well in this area for this stage of placement, showing a more than
normally expected level of proficiency and skill
C The student is performing with a level of competence and professional effectiveness normally
expected at this stage of placement.
D The student is mainly performing at a level of competence and professional effectiveness normally
expected at this stage of placement but is inconsistent in achieving this level
E The student is not performing at a level of competence and professional effectiveness normally
expected at this stage of placement.
N.B. The calculation of each section grade and overall grade will be completed at the Faculty on
return of the assessment form.
REPORT ON PERFORMANCE AND ADVICE TO STUDENTS
Please, provide feedback and comments on the student’s performance in relation to sections 1 to 4.
STUDENT SELF-ASSESSMENT
To be completed by the student at the end of each block (i.e. cardiac and respiratory).
Placement failure
At the end of the placement, i.e. full time grading, the student is deemed to have failed if either of
the following occurs:
c) Section 1 - the student is marked as ‘No’, i.e. is unsafe.
d) If two or more of the Sections 2, 3 and 4 have three or more criteria graded at E.
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EXPLANATION OF TERMS
The following terms will be found in this or in later forms. They indicate the increasing levels of
performance expected through the course:
“With guidance from the practice educator” implies that the student is an active participant in the
process (whether in decision making or skilled activity), however the lead has come from the
practice educator.
“With prompting from the practice educator” implies that the student has taken the lead in the
process (whether in decision making or skilled activity) but has needed assistance from the practice
educator in the refinement and clarification of the idea or activity.
“Independently” implies that the student carries out the process independently (whether in decision
making or skilled activity). The practice educator may give supportive feedback during the process
but does not direct the student in any other way.
103 Faculty of Health Sciences. University of Southampton.
SECTION 1
(This section must be returned with the complete form)
1.0 SAFETY and PROFESSIONAL CONDUCT (to be completed by the placement manager)
The student:
1 Demonstrates safe healthcare practice with respect to patients/clients, carers, colleagues and self
YES / NO
2 Assesses risks accurately and responds appropriately YES / NO
3 Understands and complies with the Health and Safety Regulations YES / NO
4 Demonstrates appropriate professional practice as defined by the relevant professional and statutory bodies’ rules of professional conduct
YES / NO
Signature: ……………………………………………………….. Date: ……………………………………………………………….
NB: This section on safety and professional conduct is not graded. The student is either safe or unsafe, demonstrating appropriate professional conduct or not. If any points above have been marked “NO”, then the placement is graded “FAIL” whatever marks may have been awarded in sections 2.0, 3.0 and 4.0.
If by half-way through the placement you have a student who remains unsafe or continues to demonstrate unprofessional conduct then please contact the Locality Contact (placement Visitor) at the Faculty.
104 Faculty of Health Sciences. University of Southampton.
SECTION 2
Criteria grades
2.0 INTERPERSONAL COMPETENCIES
Half Full 2.1 COMMUNICATING AS A HEALTHCARE SCIENCE PRACTITIONER. The student is able to:
(i) Identify each patient/client’s individual needs
(ii) Communicate with each patient/client about his/her needs
(iii) Implement appropriate strategies to address each patient/client’s needs and increase his/her motivation
(iv) Foster the development of a professional relationship with each patient/ client, respecting each person’s rights and dignity
2.2 COMMUNICATING AS A HEALTHCARE SCIENCE EDUCATOR. The student is able to:
(i) Identify the differing learning needs of a number of groups (e.g. patient/client, carers, colleagues)
(ii) Access appropriate resources and present information clearly in an appropriate manner at an appropriate level for the recipient
2.3 COMMUNICATING AS A HEALTHCARE SCIENCE PROFESSIONAL. The student is able to:
(i) Keep detailed accurate records which are available appropriately to others of the team and are maintained in accordance with the requirements of the Data Protection Act and Information Governance
(ii) Develop an appropriate boundary between the professional and personal self
(iii) Foster good working relationships with immediate colleagues and other members of the team, briefing them as appropriate
(iv) Participate in interdisciplinary decision-making
Please enter the NUMBER of criteria at each grade in the boxes provided below (number of As, Bs, etc.)
A B C D E Total number of criteria
Half-time (from week 7)
Full-time (in week 15)
Three or more individual criteria graded at E means the student has failed the section.
105 Faculty of Health Sciences. University of Southampton.
SECTION 3
Criteria grades
3.0 PLACEMENT COMPETENCIES
Half
Full
3.1 ASSESSMENT OF PATIENT/CLIENT. The student is able to:
(i) Demonstrate an ability to integrate prior knowledge and experience during this placement
(ii) Collect and record relevant information from each patient/client and or other valid sources in accordance with the requirements of the Data Protection Act and Information Governance
(iii) Carry out appropriate assessment of each patient/client within the situation
3.2 FORMULATION OF ACTION PLAN. The student is able to:
(i) Analyse the assessment findings and identify key problems, with prompting from the practice educator
(ii) Prioritise problems in conjunction with each patient/client and formulate an overall treatment/action plan, with prompting from the practice educator
3.3 IMPLEMENTATION OF THE ACTION PLAN (this may apply to individual or group situations). The student is able to:
(i) Select and access appropriate techniques and resources in order to implement the plan, with prompting from the practice educator
(ii) Intervene in efficient and coordinated manner, with prompting from the practice educator
(iii) Demonstrate appropriate sensitivity to each patient’s/client’s comfort and privacy needs during treatment
3.4 EVALUATION OF THE ACTION PLAN: (this may apply to individual or group situations). The student is able to:
(i) Evaluate the effects of each intervention and modify/progress as appropriate, with prompting from the practice educator
(ii) Determine the appropriate discharge of each patient/client when measured against the goals of the action plan, with prompting from the practice educator
Please enter the NUMBER of criteria at each grade in the boxes provided below (number of As, Bs, etc.)
A B C D E Total number of criteria
Half-time (from week 7)
Full-time (in week 15)
Three or more individual criteria graded at E means the student has failed the section.
106 Faculty of Health Sciences. University of Southampton.
SECTION 4
Criteria grades
4.0 MANAGEMENT COMPETENCIES
Half
Full
4.1 MANAGING SELF. The student is able to:
(i) Carry out routine tasks independently and efficiently
(ii) Demonstrate time management appropriate to the setting and organise his/her own time constructively
(iii) Present a professional attitude, manner and appearance appropriate to the setting
(iv) Be confident in his/her abilities, while being aware of his/her limitations; be receptive to the introduction of new skills
(v) Take responsibility for keeping his/her professional, technical and scientific knowledge and skills up to date
4.2 MANAGING OTHERS. The student is able to:
(i) Demonstrate responsibility for each patient/client in his/her care
(ii) Co-ordinate own patient/client contact with that of others
4.3 MANAGING RESOURCES. The student is able to:
(i) Demonstrate a working knowledge of other sources of assistance within the setting (e.g. network of key people)
(ii) Demonstrate a working knowledge of relevant supporting services available within the setting (e.g. stock systems, transport)
(iii) Demonstrate a knowledge of the cost implications of various options for patient/client care
4.4 LEGISLATION, POLICY AND QUALITY ISSUES. The student:
(i) Has knowledge of, and complies with, the relevant legislation, policy and procedures affecting the service within this setting including those relating to research ethics and governance, patient confidentiality, data protection, equality and diversity, use of chaperones and informed consent.
Please enter the NUMBER of criteria at each grade in the boxes provided below (number of As, Bs, etc.)
A B C D E Total number of criteria
Half-time (after week 7)
Full-time (in week 15)
Three or more individual criteria graded at E means the student has failed the section.
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REPORT ON PERFORMANCE AND ADVICE TO STUDENTS:
Please ensure you provide specific feedback on sections 1-4 at both half-time and full-time, continuing on a separate sheet if necessary (to be completed by the placement personnel).
1.0 SAFETY:
2.0 INTERPERSONAL COMPETENCIES:
Formative (from week 7)
Summative (in week 15)
Formative (from week 7)
Summative (in week 15)
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3.0 PLACEMENT COMPETENCIES:
4.0 MANAGEMENT COMPETENCIES:
Formative (from week 7)
Summative (in week 15)
Formative (from week 7)
Summative (in week 15)
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STUDENT SELF ASSESSMENT
REFLECTION AFTER FORMATIVE ASSESSMENT (for completion by the student)
For the next time:
WHAT WENT WELL?
WHAT DIDN’T GO SO WELL?
WHAT HAS BEEN LEARNT?
WHAT COULD HAVE BEEN DONE DIFFERENTLY?
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STUDENT SELF ASSESSMENT
REFLECTION AFTER SUMMATIVE ASSESSMENT (for completion by the student)
For the next time:
WHAT WENT WELL?
WHAT DIDN’T GO SO WELL?
WHAT HAS BEEN LEARNT?
WHAT COULD HAVE BEEN DONE DIFFERENTLY?
111 Faculty of Health Sciences. University of Southampton.
DIRECT OBSERVATION OF PRACTICAL SKILLS (DOPS)
Placement 2
112 Faculty of Health Sciences. University of Southampton.
ASSESSMENT FRAMEWORK OF SPECIALIST SKILLS (DOPS)
Introduction
To ensure the student has reached the required level of competence, each clinical skill will be assessed. Assessments will comprise of direct observation and an oral examination. This assessment methodology will permit the work-based assessor to observe the students technical and clinical skill, in addition the oral examination will ensure the student’s knowledge supports their practice. All assessments must be documented.
Assessment documentation
All assessment documentation is to be completed on official paperwork. Photocopies or modified forms will be considered void. Each assessment requires specific documentation to be completed:
1. Assessment plan 2. Performance criteria 3. Questions and answers 4. Feedback
The assessment plan is the learning contract between the student and the assessor. It will state the clinical scenario in which the assessment will take place and outline what the assessor is expecting regarding the assessment. The student and assessor must both sign the assessment plan prior to the assessment.
The performance criterion outlines each competency that must be achieved during the assessment. Those performance criteria that are not achieved during the assessment must be satisfied with a question from the assessor. Comments should be entered by the assessor against the relevant performance criteria. In the event that 25% of the performance criteria cannot be met by practice the assessment will be considered void.
On completion of the practical skill the student and assessor should relocate to a more appropriate location in which to hold an oral examination. The assessor will use the performance criteria and what they have observed as a guide to which questions are asked. The assessor will record the student’s answers on the questions and answers sheet. The assessor will ask a minimum of two and a maximum of five questions.
On completion of the assessment the assessor will inform the student of the outcome of the assessment. Feedback will be provided and documented to guide the student into areas which were completed satisfactorily and those areas in which require more work. All assessments must be documented.
Method of assessment
Direct Observation – The work based assessor directly observes the student performing a particular clinical skill and assesses the student against the performance criteria for that particular procedure.
Questioning - All clinical skills will be assessed by questioning on completion of the clinical skill being observed. Questioning is used to assess the student’s knowledge of that particular skill. More importantly it is used to ensure their knowledge supports their practice. In addition where specific performance criteria cannot be achieved a question must be used to achieve that specific performance criterion. The level of questioning must increase with each assessment to demonstrate progression in that area.
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FACULTY OF HEALTH SCIENCES
SUMMARY MASTERSHEET OF SPECIALIST SKILLS (DOPS) FOR PLACEMENT 2
Competency Reviewer Date Summative assessment (pass/fail)
Comments/Evidence
Resting blood pressure
Demonstrate the ability to measure and interpret resting BP on a range of patients, using analogue and digital equipment.
Resting electrocardiography
Demonstrate the ability to record the resting ECG on patients in a range of clinical settings including adults and children.
Demonstrate the ability to interpret the resting ECG.
Ambulatory blood pressure
Demonstrate the ability to fit and remove ambulatory BP devices and produce clinical data in an appropriate format.
Ambulatory electrocardiography
Demonstrate the ability to fit and remove ambulatory ECG devices.
Demonstrate the ability to interpret and analyse routine ambulatory ECG recording (excluding pacing, inherited disease and paediatrics).
Provocative electrocardiography
Demonstrate the ability to assist (2nd person) in cardiac exercise stress testing. Demonstrate intermediate life support in accordance with current Resuscitation Council (UK) guidelines.
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NON-INVASIVE RESTING BLOOD PRESSURE RECORDING AND INTERPRETATION ON A RANGE OF PATIENTS
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care and routine non-invasive investigations, performing the recording of resting blood pressure (BP) on a range of patients. During this period of work based training students will apply their learning from the academic modules undertaken throughout their two years of training.
SCOPE
On completion of this placement the student will be able to competently perform resting BP recording on a range of patients. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
1. Understand his/her own level of competence, authority and knowledge base.
2. Explain his/her role and responsibilities.
3. Understand the principles of the anatomy and physiology of the cardiovascular system.
4. Measure and interpret resting BP on a range of patients, using analogue and digital
equipment.
5. Adhere to appropriate standards of professional practice as defined in Good Scientific
Practice.
Clinical experiential learning
Critically apply the scientific principles covered in the academic modules to this work-based
specialist skill and appraise the evidence base underpinning at least one of the routine
investigations and one treatment plan.
Prepare a portfolio of evidence containing BP recordings (anonymised) from a range of
patients that you have obtained recordings from and your report on each BP recording.
Attend a clinic (primary or secondary care) where patients with hypertension attend and
discuss with your supervisor the role of resting BP recording in the diagnosis and treatment
of patients with hypertension.
Review the pharmacological treatment of a series of patients with treated hypertension and
discuss the mechanisms of action of each treatment, indications, contra-indications and
potential side effects.
All of these experiences should be recorded in your portfolio. Evidence required includes a range of
patients including inpatients, outpatients, geriatric, medical, surgical and technically challenging
patients.
116 Faculty of Health Sciences. University of Southampton.
ASSESSMENT PLAN OF NON-INVASIVE RESTING BLOOD PRESSURE RECORDING AND INTERPRETATION ON A RANGE OF PATIENTS
To be completed by the word-based assessor prior to the assessment. Student to agree and countersign.
Key points and instructions
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
117 Faculty of Health Sciences. University of Southampton.
PERFORMANCE CRITERIA OF NON-INVASIVE RESTING BLOOD PRESSURE RECORDING AND INTERPRETATION ON A RANGE OF PATIENTS
PC Task Y/N Assessor’s comments
1 Control infection risks in accordance with departmental protocols.
2 Minimise risks and hazards in compliance with Health and Safety policies.
4 Obtain a suitably completed request form, greet patient, check patient ID and recent clinical history.
5
Prepare the environment for resting BP recording, set up and calibrate equipment ready for use including, if appropriate, resuscitation equipment.
6 Treat patient in a way which respects their dignity, rights, privacy and confidentiality.
7 Explain the procedure to the patient and gain informed consent.
8 Choose the correct cuff size for the patient.
9 Locate the pulse in the cubital fossa and ensure the posture and position of the arm is correct.
10 Estimate systolic BP by palpation.
11 Inflate the cuff at least 30mmHg above the estimated systolic BP and reduce the pressure smoothly.
12 Make an accurate recording of BP.
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13
Evaluate the technical quality of BP recordings, identify sub-optimal BP recordings, and take remedial action and re-measure if necessary.
14 Check and interpret the results in the clinical context.
15 Keep accurate records in accordance with current guidelines and the legal framework for data security.
16 Undertake routine maintenance and calibration procedures for BP recording.
17 Clean BP recording equipment in accordance with departmental protocol.
Student recorded value: ________ /________ WBA recorded value: ________ / ________
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
119 Faculty of Health Sciences. University of Southampton.
NON-INVASIVE RESTING BLOOD PRESSURE RECORDING AND INTERPRETATION ON A RANGE OF PATIENTS ASSESSMENT QUESTIONS
(Related to performance criteria)
Questions Answers
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
120 Faculty of Health Sciences. University of Southampton.
ASSESSMENT FEEDBACK ON STUDENT’S PERFORMANCE OF NON-INVASIVE RESTING BLOOD PRESSURE RECORDING AND INTERPRETATION ON A RANGE OF PATIENTS
Provide a description of the clinical scenario and feedback (to be completed by the WBA).
WBA signature: ……………..……….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
121 Faculty of Health Sciences. University of Southampton.
12-LEAD RESTING ELECTROCARDIOGRAPHY RECORDING ON A RANGE OF PATIENTS INCLUDING ADULTS AND CHILDREN
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care, performing the recording of 12-lead resting electrocardiography (ECG) in a range of clinical settings on a range of patients, including adults and children. During this period of work based training students will apply their learning from the academic modules undertaken throughout their two years of training.
SCOPE
On completion of this placement the student will be able to competently perform resting 12-lead ECG recording in a range of clinical settings on a range of patients, including adults and children. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
1. Understand his/her own level of competence, authority and knowledge base.
2. Explain his/her role and responsibilities.
3. Understand the principles of the anatomy and physiology of the cardiovascular system.
4. Record the resting ECG in a range of settings on a range of patients including adults and
children.
5. Adhere to appropriate standards of professional practice as defined in Good Scientific
Practice.
Clinical experiential learning
Critically apply the scientific principles covered in the academic modules to this work-based
specialist skill and specifically appraise the evidence base underpinning electrocardiography.
Prepare a portfolio of evidence containing ECG recordings (anonymised) from a series of
patients that you have obtained recordings from demonstrating the normal and abnormal
ECG changes and your report on each ECG.
Observe the care pathway for acute chest pain and discuss with your practice educator the
role of ECG in myocardial infarction or suspected angina.
All of these experiences should be recorded in your portfolio.
122 Faculty of Health Sciences. University of Southampton.
ASSESSMENT PLAN OF 12-LEAD RESTING ELECTROCARDIOGRAPHY RECORDING ON A RANGE OF PATIENTS INCLUDING ADULTS AND CHILDREN
To be completed by the word-based assessor prior to the assessment. Student to agree and countersign.
Key points and instructions
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
123 Faculty of Health Sciences. University of Southampton.
PERFORMANCE CRITERIA OF 12–LEAD RESTING ELECTROCARDIOGRAPHY RECORDING ON A RANGE OF PATIENTS INCLUDING ADULTS AND CHILDREN
PC Task Y/N Assessor’s comments
1 Control infection risks in accordance with departmental protocols when undertaking ECG.
2 Minimise risks and hazards in compliance with Health and Safety policies when undertaking ECG.
4 Obtain a suitably completed request form, greet patient, check patient ID and recent clinical history.
5
Prepare the environment for resting ECG recording, set up and calibrate equipment including, if appropriate, resuscitation equipment.
6 Treat patient in a way which respects their dignity, rights, privacy and confidentiality.
7 Explain the procedure to the patient and gain informed consent.
8 Identify electrode sites on the patient according to current AHA/SCST guidelines.
9 Prepare the patients skin in order to ensure adequate electrode contact.
10 Apply suitable electrodes firmly to the patient to minimise artefact.
11 Choose machine settings appropriate to the ECG recording requested/required.
12
Make an ECG recording on a range of patients, including adults and children, ensuring that an accurate, artefact-free tracing is obtained.
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13 Take steps to modify the procedure if a suitable recording cannot be made and re-record if necessary.
14 Remove electrodes and ensure that the patient and/or carer are informed of next steps.
15 Check the ECG recording for abnormalities and inform a senior staff member if necessary.
16
Demonstrate that ECG recordings are accurate, complete, legible and forwarded to the correct person in an appropriate timescale.
17
Annotate all ECG recordings with the correct patient details and store safely in accordance with current guidelines and the legal framework for data security.
18 Clean ECG equipment in accordance with departmental protocol.
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
Note: Please attach an anonymised, countersigned copy of the 12-lead ECG recording including the student’s initials and basic patient information (i.e. gender, age, outpatient, inpatient).
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12-LEAD RESTING ELECTROCARDIOGRAPHY RECORDING ON A RANGE OF PATIENTS INCLUDING ADULTS AND CHILDREN ASSESSMENT QUESTIONS
(Related to performance criteria)
Questions Answers
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
126 Faculty of Health Sciences. University of Southampton.
ASSESSMENT FEEDBACK ON STUDENT’S PERFORMANCE OF 12-LEAD RESTING ELECTROCARDIOGRAPHY RECORDING ON A RANGE OF PATIENTS INCLUDING ADULTS AND
CHILDREN
Provide a description of the clinical scenario and feedback (to be completed by the WBA).
WBA signature: ……………..……….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
127 Faculty of Health Sciences. University of Southampton.
APPLICATION OF AMBULATORY BLOOD PRESSURE DEVICES AND PRODUCTION OF CLINICAL DATA
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care and routine non-invasive investigations, fitting and removing ambulatory blood pressure (BP) monitors, and producing clinical data in an appropriate format. During this period of work based training students will apply their learning from the academic modules undertaken throughout their two years of training.
SCOPE
On completion of this placement the student will be able to competently fit and remove ambulatory BP devices, and produce clinical data in an appropriate format. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
1. Understand his/her own level of competence, authority and knowledge base.
2. Explain his/her role and responsibilities.
3. Understand the principles of the anatomy and physiology of the cardiovascular system.
4. Understand the principles and application of ambulatory monitoring.
5. Fit and remove ambulatory BP devices and produce clinical data in an appropriate format.
6. Adhere to appropriate standards of professional practice as defined in Good Scientific
Practice.
Clinical experiential learning
Critically apply the scientific principles covered in the academic modules to this work-based
specialist skill and appraise the evidence base underpinning at least one of the routine
investigations and one treatment plan.
Prepare a portfolio of evidence containing ambulatory BP recordings (anonymised) from a
range of patients and your report on each BP recording.
Attend a clinic (primary or secondary care) where patients with hypertension attend and
discuss with your supervisor the role of ambulatory BP recording in the diagnosis and
treatment of patients with hypertension.
All of these experiences should be recorded in your portfolio of evidence. Evidence required includes
a range of patients including inpatients, outpatients, geriatric, medical, surgical and technically
challenging patients. Please, ensure that the report contains all appropriate traces to support the
analysis.
Note: Please, attach an anonymised, countersigned copy of the referral form confirming the
application of the device.
128 Faculty of Health Sciences. University of Southampton.
ASSESSMENT PLAN OF APPLICATION OF AMBULATORY BLOOD PRESSURE DEVICES AND PRODUCTION OF CLINICAL DATA
To be completed by the word-based assessor prior to the assessment. Student to agree and countersign.
Key points and instructions
Fitting and removal of ambulatory BP devices
Production of clinical data
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
129 Faculty of Health Sciences. University of Southampton.
PERFORMANCE CRITERIA OF APPLICATION OF AMBULATORY BLOOD PRESSURE DEVICES
PC Task Y/N Assessor’s comments
1 Control infection risks in accordance with departmental protocols.
2 Minimise risks and hazards in compliance with Health and Safety policies.
4 Obtain a suitably completed request form, greet patient, check patient ID and recent clinical history.
5
Prepare the environment for fitting of ambulatory BP devices, set up and calibrate equipment ready for use including battery check.
6 Programme the BP recorder appropriately for each patient.
7 Treat patient in a way which respects their dignity, rights, privacy and confidentiality.
8 Explain the procedure to the patient and gain informed consent.
9 Identify the site and choose and apply the correct size of cuff.
10 Measure baseline BP manually and identify potential recording difficulties.
11 Connect the patient to the recorder minimising artefact.
12 Check that the monitor is recording/working correctly by performing a recording.
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13
Review the device instructions with the patient, including safety advice and completion of the diary, and arrange a follow up appointment (if necessary)
14 Remove monitor safely.
15
Download the patient’s BP data and keep accurate records in accordance with current guidelines and the legal framework for data security.
16 Undertake routine maintenance and calibration procedures for ambulatory BP recording.
17 Clean BP recording equipment in accordance with departmental protocol.
18 Produce the results in the appropriate format, based on findings and diary entries (with evidence), and in line with local policy.
19 Check the results and consult senior staff if necessary.
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
131 Faculty of Health Sciences. University of Southampton.
APPLICATION OF AMBULATORY BLOOD PRESSURE DEVICES AND PRODUCTION OF CLINICAL DATA ASSESSMENT QUESTIONS
(Related to performance criteria)
Questions Answers
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
132 Faculty of Health Sciences. University of Southampton.
ASSESSMENT FEEDBACK ON STUDENT’S PERFORMANCE OF APPLICATION OF AMBULATORY BLOOD PRESSURE DEVICES AND PRODUCTION OF CLINICAL DATA
Provide a description of the clinical scenario and feedback (to be completed by the WBA).
Please note the student must pass both parts of this assessment, namely fitting and removal of ambulatory BP devices and production of clinical data, in order to achieve a pass.
WBA signature: ……………..……….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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DESCRIPTION OF APPLICATION OF AMBULATORY ELECTROCARDIOGRAPHY DEVICES
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care, performing ambulatory electrocardiography (ECG) monitoring. During this period of work based training students will apply their learning from the academic modules undertaken throughout their two years of training.
SCOPE
On completion of this placement the student will be able to competently perform and ambulatory ECG monitoring. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
1. Understand his/her own level of competence, authority and knowledge base.
2. Explain his/her role and responsibilities.
3. Understand the principles of the anatomy and physiology of the cardiovascular system.
4. Fit and remove ambulatory ECG devices.
5. Adhere to appropriate standards of professional practice as defined in Good Scientific
Practice.
Clinical experiential learning
Critically apply the scientific principles covered in the academic modules to this work-based
specialist skill and specifically appraise the evidence base underpinning the use of
ambulatory ECG monitoring.
Attend outpatient clinics where patients with suspected cardiac arrhythmias are referred
and discuss with the practice educator the diagnostic pathways linked to the use of
ambulatory ECG monitoring.
All of these experiences should be recorded in your portfolio. Evidence must include a variety of
patients including inpatients, outpatients, geriatric, medical, surgical and technically challenging
patients.
134 Faculty of Health Sciences. University of Southampton.
ASSESSMENT PLAN OF APPLICATION OF AMBULATORY ELECTROCARDIOGRAPHY DEVICES To be completed by the word-based assessor prior to the assessment. Student to agree and countersign.
Key points and instructions
Type of device: _____________________________________________________________________
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
135 Faculty of Health Sciences. University of Southampton.
PERFORMANCE CRITERIA OF APPLICATION OF AMBULATORY ELECTROCARDIOGRAPHY DEVICES
PC Task Y/N Assessor’s comments
1 Control infection risks in accordance with departmental protocols.
2 Minimise risks and hazards in compliance with Health and Safety policies.
4 Obtain a suitably completed request form, greet patient, check patient ID and recent clinical history.
5 Prepare the environment, set up and calibrate equipment ready for use including battery check.
6 Treat patient in a way which respects their dignity, rights, privacy and confidentiality.
7
Explain the procedure to the patient giving detailed instructions and checking the patient’s understanding, and gain informed consent.
8 Choose an ambulatory ECG device most suited to the patient and his/her symptoms.
9 Choose the most appropriate electrodes for the ambulatory ECG device.
10 Choose the optimal electrode position and prepare the patient’s skin and apply electrodes.
11 Prepare the ambulatory ECG recorder for connection to the patient.
12 Connect the leads (if appropriate) and recorder in such a way that artefact is minimised and to ensure patient comfort.
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13 Check that the monitor is recording/working correctly.
14 Explain the use of the patient diary and how to activate the device as necessary.
15 Remove the equipment from the patient, clarify symptoms and explain the procedure for receiving results.
16 Undertake routine maintenance and calibration procedures for ambulatory ECG recording.
17 Clean ambulatory ECG recording equipment in accordance with departmental protocol.
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
137 Faculty of Health Sciences. University of Southampton.
APPLICATION OF AMBULATORY ELECTROCARDIOGRAPHY DEVICES ASSESSMENT QUESTIONS
(Related to performance criteria)
Questions Answers
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
138 Faculty of Health Sciences. University of Southampton.
ASSESSMENT FEEDBACK ON STUDENT’S PERFORMANCE OF APPLICATION OF AMBULATORY ELECTROCARDIOGRAPHY DEVICES
Provide a description of the clinical scenario and feedback (to be completed by the WBA).
WBA signature: ……………..……….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
139 Faculty of Health Sciences. University of Southampton.
ANALYSIS AND INTERPRETATION OF ROUTINE AMBULATORY ELECTROCARDIOGRAPHY RECORDING
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care, performing ambulatory electrocardiography (ECG) monitoring. During this period of work based training students will apply their learning from the academic modules undertaken throughout their two years of training.
SCOPE
On completion of this placement the student will be able to competently perform and ambulatory ECG monitoring. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
1. Understand his/her own level of competence, authority and knowledge base.
2. Explain his/her role and responsibilities.
3. Understand the principles of the anatomy and physiology of the cardiovascular system.
4. Understand the principles and application of ambulatory monitoring.
5. Analyse and interpret routine ambulatory ECG recording (excluding pacing, congenital
disease and paediatrics).
6. Adhere to appropriate standards of professional practice as defined in Good Scientific
Practice.
Clinical experiential learning
Critically apply the scientific principles covered in the academic modules to this work-based
specialist skill and specifically appraise the evidence base underpinning the use of
ambulatory ECG monitoring.
Attend outpatient clinics where patients with suspected cardiac arrhythmias are referred
and discuss with the practice educator the diagnostic pathways linked to the use of
ambulatory ECG monitoring.
All of these experiences should be recorded in your portfolio. Evidence must include a variety of
patients including inpatients, outpatients, geriatric, medical, surgical and technically challenging
patients. Please ensure the report contains all appropriate traces to support the analysis.
140 Faculty of Health Sciences. University of Southampton.
ASSESSMENT PLAN OF ANALYSIS AND INTERPRETATION OF ROUTINE AMBULATORY ELECTROCARDIOGRAPHY RECORDING
To be completed by the word-based assessor prior to the assessment. Student to agree and countersign.
Key points and instructions
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
141 Faculty of Health Sciences. University of Southampton.
PERFORMANCE CRITERIA OF ANALYSIS AND INTERPRETATION OF ROUTINE AMBULATORY ELECTROCARDIOGRAPHY RECORDING
PC Task Y/N Assessor’s comments
1 Operate a playback/analyser system.
2 Check automated evaluations for accuracy and use to inform the final interpretation.
3 Recognise, analyse and interpret the ECG features seen during playback.
4 Correlate patient symptoms with ECG findings.
5 Review the entire recording.
6 Select ECG tracings sufficient to illustrate and support the final evaluation.
7 Produce a factual report reviewing with senior staff when appropriate.
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
142 Faculty of Health Sciences. University of Southampton.
ANALYSIS AND INTERPRETATION OF ROUTINE AMBULATORY ELECTROCARDIOGRAPHY RECORDING ASSESSMENT QUESTIONS
(Related to performance criteria)
Questions Answers
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
143 Faculty of Health Sciences. University of Southampton.
ASSESSMENT FEEDBACK ON STUDENT’S PERFORMANCE OF ANALYSIS AND INTERPRETATION OF ROUTINE AMBULATORY ELECTROCARDIOGRAPHY RECORDING
Provide a description of the clinical scenario and feedback (to be completed by the WBA).
WBA signature: ……………..……….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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145 Faculty of Health Sciences. University of Southampton.
PRACTICAL CARDIAC EXERCISE STRESS TESTING
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care, assisting in cardiac exercise stress testing. During this period of work based training students will apply their learning from the academic modules undertaken throughout their two years of training.
SCOPE
On completion of this placement the student will be able to assist with more complex investigations. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
1. Understand his/her own level of competence, authority and knowledge base.
2. Explain his/her role and responsibilities.
3. Understand the principles of the anatomy and physiology of the cardiovascular system.
4. Assist (2nd person) in cardiac exercise stress testing.
5. Demonstrate intermediate life support in accordance with current Resuscitation Council
(UK) guidelines.
6. Adhere to appropriate standards of professional practice as defined in Good Scientific
Practice.
Clinical experiential learning
Observe the use of cardiac ultrasound and discuss the role of this test in the diagnosis and
management of patients.
Attend a heart failure or cardiac rehabilitation clinic where patients with cardiac disease are
treated and discuss the role of nutrition or other non-pharmacological strategies in the
management of cardiac disease.
Attend a multidisciplinary meeting and reflect on the way the multidisciplinary team
contributes to the care of patients with disorders of the cardiovascular system.
All of these experiences should be recorded in your portfolio. Evidence must include ECG traces (one
per stage; more if relevant to report) and report.
Note: Please attach an anonymised, countersigned copy of the report including the student’s initials
and basic patient information (i.e. age, gender, outpatient, inpatient).
146 Faculty of Health Sciences. University of Southampton.
ASSESSMENT PLAN OF CARDIAC EXERCISE STRESS TESTING To be completed by the word-based assessor prior to the assessment. Student to agree and countersign.
Key points and instructions
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
147 Faculty of Health Sciences. University of Southampton.
PERFORMANCE CRITERIA OF CARDIAC EXERCISE STRESS TESTING
PC Task Y/N Assessor’s comments
1 Control infection risks for diagnostic and therapeutic invasive procedures in accordance with departmental protocols.
2 Minimise risks and hazards in compliance with Health and Safety policies.
3
Check all resuscitation equipment in the room. Undertake intermediate life support in accordance with current Resuscitation Council (UK) guidelines (if necessary).
4 Obtain a suitably completed request form, greet patient, check patient ID.
5 Under supervision, review the clinical history of the patient for suitability to perform the test.
6 Prepare the environment, set up and calibrate equipment ready for use including battery check.
7 Treat patient in a way which respects their dignity, rights, privacy and confidentiality.
8
Explain the procedure to the patient giving detailed instructions and checking the patient’s understanding, and gain informed consent.
9 Confirm that the patient has adhered to any pre-test instructions.
10 Ensure that the patient is suitably dressed and wearing appropriate footwear.
11 Prepare electrode sites and apply electrodes to the patient to obtain accurate and artefact-free recordings.
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12 Record the patient’s resting ECG and BP and compare these with the last set of patient recordings.
13 demonstrate walking technique to ensure that he/she understands how to perform the procedure safely.
14 Encourage the patient to reach a level of activity which would achieve his/her optimal result.
15 Monitor and record the ECG and BP throughout the test.
16 Record any adverse or unexplained changes and take appropriate action.
17 Identify when to end the test, in accordance with current guidelines.
18 Provide a recovery period in line with local and national guidelines, and support the patient throughout.
19 Produce ECG tracings of sufficient accuracy to assist in producing a factual report.
20 Undertake routine maintenance and calibration procedures.
21 Clean equipment in accordance with departmental procedures.
22 Keep accurate records in accordance with current guidelines and the legal framework for data security.
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
149 Faculty of Health Sciences. University of Southampton.
CARDIAC EXERCISE STRESS TESTING ASSESSMENT QUESTIONS (Related to performance criteria)
Questions Answers
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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ASSESSMENT FEEDBACK ON STUDENT’S PERFORMANCE OF CARDIAC EXERCISE STRESS TESTING
Provide a description of the clinical scenario and feedback (to be completed by the WBA).
WBA signature: ……………..……….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
151 Faculty of Health Sciences. University of Southampton.
CASE BASED DISCUSSION (CBD)
Placement 2
152 Faculty of Health Sciences. University of Southampton.
CASE BASED DISCUSSIONS (CBD)
Description
CBD are designed to provide structured teaching and feedback in a particular area of clinical or
technical practice by evaluating decision making, interpretation and application of evidence. CBD
enable the discussion of the context, professional, ethical and governance framework of practice,
and in all instances, they allow students to discuss why the acted as they did.
CBD are structured assessments used to evaluate the student’s clinical cognitive ability. The
assessor, in consultation with the student, will select a particular case on which to base the CBD. The
results of the procedure, along with accompanying data, will be interpreted in context, clinically.
Accompanying data can include:
Demographics
Social circumstances
Previous medical history
Pharmacological history
Current signs and symptoms
The outcome of the CBD is the development of the student’s clinical reasoning based on a technical
procedure performed in the context of a clinical episode. In order to achieve a pass, all the
performance criteria must be addressed and minimum requirements met in one spoken interaction
(discussion). Should the student fail to achieve a pass, this assessment must be repeated in the
recoup period. The assessment of CBD should be appropriate to the students’ level of study.
A CBD should take approximately 20-30 minutes. The CBD should be conducted away from patients
and staff, ideally in a quiet room away from interruptions.
Formative CBD assessment should be undertaken at mid-point of placement; CBD summative
assessment should be carried out towards the end of placement.
Assessment of CBD at level 5
Level 5 CBD will take place around a 12-lead ECG showing at least two comorbidities, which the
student has previously recorded.
The student is required to demonstrate understanding and perform a differential diagnosis,
justifying the morphology of the ECG in the context of the clinical presentation.
Note: Prior to the CBD, the student is required to record their experience in the aforementioned specialist
skills. The evidence will provide an insight to the assessor of the diversity of clinical settings and pathologies
the student has experienced.
153 Faculty of Health Sciences. University of Southampton.
CASE BASED DISCUSSION (formative) 12-lead resting electrocardiography interpretation
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care, accurately interpreting the 12-lead resting electrocardiogram (ECG). During this period of work based training students will apply their learning from the academic modules undertaken throughout their two years of training.
SCOPE
On completion of this placement the student will be able to interpret the 12-lead resting ECG on a range of patients and common abnormalities. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
1. Understand his/her own level of competence, authority and knowledge base.
2. Explain his/her role and responsibilities.
3. Understand the principles of the anatomy and physiology of the cardiovascular system.
4. Interpret the 12-lead resting ECG.
5. Adhere to appropriate standards of professional practice as defined in Good Scientific
Practice.
Clinical experiential learning
Critically apply the scientific principles covered in the academic modules to this work-based
specialist skill and specifically appraise the evidence base underpinning electrocardiography.
Prepare a portfolio of evidence containing ECG recordings (anonymised) from a series of
patients that you have obtained recordings from demonstrating the normal and abnormal
ECG changes and your report on each ECG.
Observe the care pathway for acute chest pain and discuss with your practice educator the
role of ECG in myocardial infarction or suspected angina.
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CBD ASSESSMENT FORM Formative
Brief description of output and focus of the scenario:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
No Performance criteria Comments
1 Shows knowledge and understanding of clinical and/or scientific principles relevant to scenario.
2 Recognises and discusses relevant health and safety issues.
3 Recognises and discusses the procedures used to obtain the results.
4 Recognises and discusses the quality control procedures to ensure the result is accurate.
5 Shows knowledge and understanding of relevant “Best Practice” guidelines and other policies relevant to the scenario.
5 Demonstrates an understanding of the derivation of the ECG.
7 Demonstrates an understanding of the relationship between the ECG and the cardiac cycle.
8 Identifies and measures all amplitudes and intervals form the ECG.
9 Recognises normal findings and variations related to the patient age, gender, activity and ethnic origin.
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10
Identifies life threatening/serious changes the ECG associated with:
11 Recognises and discusses the significance of routine patient results with reference to the reason for referral.
12 Shows knowledge and understanding of, and begins to use, appropriate resources to aid in the interpretation of results.
13 Recognises and is aware of the limits of responsibility and when to seek advice.
WBA signature: …………………………………………………. Student signature: ………………………………………..
Date of assessment: …………………………………………..
157 Faculty of Health Sciences. University of Southampton.
Feedback and documentation of learning needs
Agreed actions
WBA signature: ……………………….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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CBD ASSESSMENT FORM Summative
Brief description of output and focus of the scenario:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
No Performance criteria Comments
1 Shows knowledge and understanding of clinical and/or scientific principles relevant to scenario.
2 Recognises and discusses relevant health and safety issues.
3 Recognises and discusses the procedures used to obtain the results.
4 Recognises and discusses the quality control procedures to ensure the result is accurate.
5 Shows knowledge and understanding of relevant “Best Practice” guidelines and other policies relevant to the scenario.
5 Demonstrates an understanding of the derivation of the ECG.
7 Demonstrates an understanding of the relationship between the ECG and the cardiac cycle.
8 Identifies and measures all amplitudes and intervals form the ECG.
9 Recognises normal findings and variations related to the patient age, gender, activity and ethnic origin.
160 Faculty of Health Sciences. University of Southampton.
10
Identifies life threatening/serious changes the ECG associated with:
11 Recognises and discusses the significance of routine patient results with reference to the reason for referral.
12 Shows knowledge and understanding of, and begins to use, appropriate resources to aid in the interpretation of results.
13 Recognises and is aware of the limits of responsibility and when to seek advice.
WBA signature: …………………………………………………. Student signature: ………………………………………..
Date of assessment: …………………………………………..
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Feedback and documentation of learning needs
Agreed actions
WBA signature: ……………………….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
162 Faculty of Health Sciences. University of Southampton.
MINI CLINICAL EXAMINATION (Mini-Cex)
Placement 2
163 Faculty of Health Sciences. University of Southampton.
MINI-CLINICAL EXAMINATION (Mini-Cex)
Description
Mini-Cex is a short snapshot of student-patient interaction. They are designed to assess the clinical
skills, attitudes and behaviours of students essential to providing high quality care, around a specific
procedure.
In agreement with his/her practice educator, the student chooses the clinical interaction, which
should be representative and allow him/her to meet their learning outcomes. This student-patient
interaction
A Mini-Cex should take approximately 20-30 minutes.
Mini-Cex includes five performance criteria (see below), and a feedback and agreed actions section
for the practice educator to identify strengths, areas for development and an action plan.
Question area Positive indicators: The student…
History taking
Facilitates patient telling their story Effectively uses appropriate questions to obtain accurate and adequate information Responds appropriately to verbal and non-verbal cues
Communication skills
Explores patient’s perspective Shows an open and honest attitude Demonstrates empathy Provides jargon-free, clear information
Clinical reasoning
Makes appropriate clinical decisions and formulates a suitable management plan Selectively organises/performs appropriate diagnostic studies Considers risks and benefits
Professionalism
Shows respect, compassion, empathy, establishes trust Attends to patient’s needs of comfort Respects confidentiality Behaves in an ethical manner Is aware of legal frameworks Is aware of own limitations
Organisation and efficiency Prioritises tasks Is timely and succinct Summarises
In order to maximise the educational impact of using Mini-Cex, both the student and practice
educator need to identify strengths, areas for development, and an action plan. This should be done
sensitively and in a suitable environment.
Assessment
The outcome of the Mini-Cex is the development of the student’s clinical skills, attitudes and
behaviours essential to providing high quality care in the context of a clinical episode. In order to
achieve a pass, all the performance criteria must be addressed and minimum requirements met in
164 Faculty of Health Sciences. University of Southampton.
one interaction. Should the student fail to achieve a pass, this assessment must be repeated in the
recoup period.
Formative Mini-Cex assessment should be undertaken at mid-point of placement; Min-Cex
summative assessment should be carried out towards the end of placement.
The assessment of Mini-Cex should be appropriate to the students’ level of study.
Assessment of the Mini-Cex will be conducted by the work based assessor and an academic from the University of Southampton (locality visitor) as part of routine placement visit.
165 Faculty of Health Sciences. University of Southampton.
Mini-Cex ASSESSMENT FORM Formative
Clinical setting: ……………………………………………….. Pathology: …..………………………………………………… Brief description of output and focus of the scenario:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
No Performance criteria Assessor’s comments
1 History taking
2 Communication skills
3 Clinical reasoning
4 Professionalism
5 Organisation and efficiency
WBA signature: …………………………………………………. Academic signature: ……………………………………..
Student signature: ……………………………………………. Date of assessment: ……………………………………...
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Feedback and documentation of learning needs
Agreed actions
WBA signature: ……………………….………….…………….. Academic signature: ………….……………………………
Student signature: ….…………………. Date of assessment: ……………………. Please circle: Pass / Fail
167 Faculty of Health Sciences. University of Southampton.
Mini-Cex ASSESSMENT FORM Summative
Clinical setting: ……………………………………………….. Pathology: …..………………………………………………… Brief description of output and focus of the scenario:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
No Performance criteria Assessor’s comments
1 History taking
2 Communication skills
3 Clinical reasoning
4 Professionalism
5 Organisation and efficiency
WBA signature: …………………………………………………. Academic signature: ……………………………………..
Student signature: ……………………………………………. Date of assessment: ……………………………………...
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Feedback and documentation of learning needs
Agreed actions
WBA signature: ……………………….………….…………….. Student signature: ……….…………………………………
Student signature: ….…………………. Date of assessment: ……………………. Please circle: Pass / Fail
169 Faculty of Health Sciences. University of Southampton.
RECORD OF EXPERIENCE AND ATTENDANCE
Please, record your attendance and interventions/procedures observed throughout your observational placement in the table provided following
the below.
EXPERIENCE KEY ATTENDANCE KEY RECORD OF ABSENCES MADE UP
BP Blood pressure X Did not attend Date Number of made up hours
ECG Electrocardiogram (IP / OP) S Student off sick
A-BP Ambulatory BP O Other (specify)
A-ECG Ambulatory ECG BH Bank holiday
TH Tape hook up
TH Tape analysis
ETT Exercise tolerance testing
Cath Left heart catheterisation
PPM Pacemaker implantation
Echo Echocardiography
Uni University
ID Independent study
DS Directed study / assessment
O Other (specify)
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WEEK 1 WEEK 2
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
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PE signature
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WEEK 3 WEEK 4
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
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WEEK 5 WEEK 6
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
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WEEK 7 WEEK 8
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
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WEEK 9 WEEK 10
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
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WEEK 11 WEEK 12
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
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WEEK 13 WEEK 14
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
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WEEK 15 Extra week to make up hours
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
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Extra week to make up hours Extra week to make up hours
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
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VERIFICATION OF ATTENDANCE TO PLACEMENT 2
I verify that this is an accurate account
OUTSTANDING HOURS CARRIED FORWARD
Student signature
Work-based assessor signature
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PLACEMENT DOCUMENTATION
Placement 3
PLACEMENT 3
Hospital
Department
Work-Based Assessor Name Signature
Practice Educator Name Signature
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FACULTY OF HEALTH SCIENCES
RECORD OF STATUTORY AND MANDATORY TRAINING PRIOR TO PLACEMENT 3
Observed sessions Date Facilitator name and signature
Moving and Handling
Basic Life Support
Standard Precautions and Observations (Infection Prevention)
Online sessions Date completed Student signature
Fire
Health and Safety
Equality and Diversity
Conflict Resolution
Safeguarding
PRE-PLACEMENT LABORATORY-BASED SPECIALIST SKILLS
Online sessions Date completed Trainer signature
Resting 12-Lead Electrocardiography
Cardiac Exercise Stress Testing
Diagnostic Left Heart Catheterisation
Permanent Pacemaker Implantation
178 Faculty of Health Sciences. University of Southampton.
INDUCTION SIGN OFF
All students need to have basic induction information. Can the Placement Educator discuss and
direct the Student to the following information during their induction period. Both Placement
Educator and Student need to sign and date the below document to indicate that they have given
and received the following information. If an area does not relate to your practice please indicate
with a N/A in the appropriate box.
PLACEMENT 3 Topics to be covered Signatures Date
Personal issues Discuss any adjustments regarding health or learning needs e.g. latex free gloves, dyslexia, disability
Introduction to key staff
Include all staff working within the practice area and staff responsible for H&S activities
Orientation to practice area
Include: • Staff toilets • Staff rest room/canteen • Where to keep personal belongings • Meal breaks • Relevant link areas and who to contact for visits • Inform of university link – name and contact details
Professional Conduct and Appearance
Discuss: • Dress code • Professional conduct specific to the practice e.g. working guidelines, use of mobile phones, e-mail, internet use
ID Badge Explain policy for ID badges
Confidentiality Discuss importance of maintaining confidentiality and data protection
Fire Policy/Procedure
Discuss: • Local policy & emergency numbers • Location of fire points, exits, fire extinguishers, fire blankets & Fire Policy • Explain procedure for evacuation & alarm tones • Awareness of risks associated with practice areas
Moving & Handling
Discuss: • Local policy and relation to practice area • Location of local moving & handling equipment
Organisational Policy Folders
Student should be aware of the following policies/procedures: • Health & Safety • Infection Control • Professional Behaviour • Human Resources e.g. Harassment, Equal Opportunities, Complaints, etc.
179 Faculty of Health Sciences. University of Southampton.
• Occupational Health • Other policies specific to practice area e.g. Lone Working • Smoking
Accident & Clinical Incidents
Explain: • Procedure for reporting accidents/near misses • Procedure for reporting adverse incidents/near misses
Resuscitation
Explain: • Procedure in event of an emergency e.g. cardiac arrest • Emergency contact numbers
Working patterns
Discuss: • Location, distance and if/when lone working, any travel issues • Supervision when educator unavailable • Finishing at the end of the day • Procedures/expectations for nights/weekends/evenings (unsocial hours) work patterns Following current guidance from the University of Southampton, Faculty of Health Sciences
Sickness & Absence
Explain policy for reporting in the event of sickness or absence including notification to Allocations department (University of Southampton, Faculty of Health Sciences)
Transport Issues Discuss issues related to car parking, hospital transport across sites, public transport
Telephone
Discuss: • Contact details for key educator, team members’ mobiles • Student contact details • Bleep/pager system/emergency system
Equipment Explain: • Basic function of appropriate equipment and where and how to access
Infection Control
The student should be made aware of policies with specific reference to: • Needle stick injury • MRSA • Hand washing
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PRACTICE PLACEMENT 3 RÉSUMÉ FORM Placement 2: From ___________ to ___________
BSc HEALTHCARE SCIENCE CARDIAC PHYSIOLOGY
Student name: ……………………………………………………… Student ID number: ……………………………………………….
Placement educator(s) name: ……………………………………………………………………………………………………………..…….
Student signature: ……………………………………………….. Date: ……………………………………………………………………..
Educator signature: ……………………………………………... Date: …………………………………………………………………….. Where more than one person is involved in supervising the student, the supervisors must collaborate in
agreeing the final grades and the feedback to the student and should complete a single assessment form to be returned to the Faculty.
Department/hospital/service: ……………………………………………………………….......
Is this student working your standard full time working week? (Please circle) Yes / No
If not, how many days per week? ………………………………………………………………….…
Has the student been unable to work due to sickness/other reason? (Please circle) Yes / No
If so, please indicate on how many occasions:
Sickness: Sickness days in total:
Other: Other days in total:
Has the student been involved in a recorded accident/incident whilst on placement? If Yes, please attach a copy of the completed accident/incident form Yes / No Have you had a clinical briefing either for this placement or previously? If ‘no’, please visit our website to book on one of the next briefing dates: www.sohp.soton.ac.uk/practiceeducators/
Yes / No
Please return this form within one week of end of placement to:
HCS Practice Placement Assistant Faculty of Health Sciences Phone: 023 8059 8835 University of Southampton, Building 67 Fax: 023 8059 7900 Highfield E-mail: sohpcpot@soton.ac.uk
SOUTHAMPTON SO17 1BJ
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183 Faculty of Health Sciences. University of Southampton.
CORE COMPETENCIES
Placement 3
184 Faculty of Health Sciences. University of Southampton.
FACULTY OF HEALTH SCIENCES
CLINICAL/PRACTICE PLACEMENT 3
CORE COMPETENCIES ASSESSMENT FORM
GENERAL AIMS:
During this placement the student will:-
Develop their communication and interpersonal skills with patients/clients and colleagues.
Apply aspects of theoretical study to clinical practice.
Develop skills in the assessment and treatment/management of patients/clients and in the
evaluation of the effectiveness of their intervention with guidance from the clinical
educator.
Develop self-management skills and an appreciation of the expectations of professional
practice.
Begin to reflect on aspects of practice in the light of experience and advice.
This form is the second of a series of 4 forms for assessing students on Practice Placements 1A, 1B, 2
and 3. The forms have been designed to show the student’s progression and development during
his/her practice experience throughout their degree course.
PROCESS OF ASSESSMENT
The assessment form has 4 sections. The student is assessed formally on each section twice during
the placement. The first assessment is half-way through the placement and is formative, the second
occurs at the end of the placement, is summative and provides the placement mark.
In addition to the formal assessment it is expected that the practice educator and student will meet
on a regular basis to discuss his/her performance to date. In the light of this discussion, the student
and the practice educator will negotiate and set specific objectives to be achieved during the
following week(s).
Please also complete the “ADVICE TO STUDENT” sections at both formal assessment times, i.e. half-
time and full-time to confirm the rationale for the grades given and give recommendations for the
student’s future performance.
185 Faculty of Health Sciences. University of Southampton.
GUIDELINES FOR USING THIS FORM
SECTION 1
This section on safety is not graded. The student is either safe or unsafe.
SECTIONS 2, 3 AND 4
Grade each criterion in these sections for which you have been able to assess student performance.
Use A-E for grading as follows:
A The student is performing excellently in this area for this stage of placement, acting in a highly
professional, proficient and skilled manner.
B The student is performing very well in this area for this stage of placement, showing a more than
normally expected level of proficiency and skill
C The student is performing with a level of competence and professional effectiveness normally
expected at this stage of placement.
D The student is mainly performing at a level of competence and professional effectiveness normally
expected at this stage of placement but is inconsistent in achieving this level
E The student is not performing at a level of competence and professional effectiveness normally
expected at this stage of placement.
N.B. The calculation of each section grade and overall grade will be completed at the Faculty on
return of the assessment form.
REPORT ON PERFORMANCE AND ADVICE TO STUDENTS
Please, provide feedback and comments on the student’s performance in relation to sections 1 to 4.
STUDENT SELF-ASSESSMENT
To be completed by the student at the end of each block (i.e. cardiac and respiratory).
Placement failure
At the end of the placement, i.e. full time grading, the student is deemed to have failed if either of
the following occurs:
e) Section 1 - the student is marked as ‘No’, i.e. is unsafe.
f) If two or more of the Sections 2, 3 and 4 have three or more criteria graded at E.
186 Faculty of Health Sciences. University of Southampton.
EXPLANATION OF TERMS
The following terms will be found in this or in later forms. They indicate the increasing levels of
performance expected through the course:
“With guidance from the practice educator” implies that the student is an active participant in the
process (whether in decision making or skilled activity), however the lead has come from the
practice educator.
“With prompting from the practice educator” implies that the student has taken the lead in the
process (whether in decision making or skilled activity) but has needed assistance from the practice
educator in the refinement and clarification of the idea or activity.
“Independently” implies that the student carries out the process independently (whether in decision
making or skilled activity). The practice educator may give supportive feedback during the process
but does not direct the student in any other way.
187 Faculty of Health Sciences. University of Southampton.
SECTION 1
(This section must be returned with the complete form)
2.0 SAFETY and PROFESSIONAL CONDUCT (to be completed by the placement manager)
The student:
1 Demonstrates safe healthcare practice with respect to patients/clients, carers, colleagues and self
YES / NO
2 Assesses risks accurately and responds appropriately YES / NO
3 Understands and complies with the Health and Safety Regulations YES / NO
4 Demonstrates appropriate professional practice as defined by the relevant professional and statutory bodies’ rules of professional conduct
YES / NO
Signature: ……………………………………………………….. Date: ……………………………………………………………….
NB: This section on safety and professional conduct is not graded. The student is either safe or unsafe, demonstrating appropriate professional conduct or not. If any points above have been marked “NO”, then the placement is graded “FAIL” whatever marks may have been awarded in sections 2.0, 3.0 and 4.0.
If by half-way through the placement you have a student who remains unsafe or continues to demonstrate unprofessional conduct then please contact the Locality Contact (placement Visitor) at the Faculty.
188 Faculty of Health Sciences. University of Southampton.
SECTION 2
Criteria grades
2.0 INTERPERSONAL COMPETENCIES
Half Full 2.1 COMMUNICATING AS A HEALTHCARE SCIENCE PRACTITIONER. The student is able to:
(i) Vary his/her approach towards each patient/client according to identified needs
(ii) Communicate with each patient/client about his/her needs
(iii) Use appropriate strategies and be successful (in so far as is possible) in increasing each patient/client’s motivation
(iv) Develop a professional relationship with each patient/ client, respecting each person’s rights and dignity
2.2 COMMUNICATING AS A HEALTHCARE SCIENCE EDUCATOR. The student is able to:
(i) Select and use the appropriate teaching strategies to address identified learning needs of a number of (e.g. patient/client, carers, colleagues)
(ii) Access appropriate resources and give a highly proficient presentation at an appropriate level for the recipient
2.3 COMMUNICATING AS A HEALTHCARE SCIENCE PROFESSIONAL. The student is able to:
(i) Keep comprehensive accurate records which are available appropriately to others of the team and are maintained in accordance with the requirements of the Data Protection Act and Information Governance
(ii) Maintain an appropriate boundary between the professional and personal self, independently
(iii) Achieve constructive working relationships with immediate colleagues and other members of the team, briefing them as appropriate
(iv) Appropriately handle differences of professional opinion during interdisciplinary decision making
Please enter the NUMBER of criteria at each grade in the boxes provided below (number of As, Bs, etc.)
A B C D E Total number of criteria
Half-time (from week 12)
Full-time (in week 25)
Three or more individual criteria graded at E means the student has failed the section.
189 Faculty of Health Sciences. University of Southampton.
SECTION 3
Criteria grades
3.0 PLACEMENT COMPETENCIES
Half
Full
3.1 ASSESSMENT OF PATIENT/CLIENT. The student is able to:
(i) Demonstrate an ability to integrate and build on knowledge and experience gained both prior and during this placement
(ii) Collect and record relevant information from each patient/client and or other valid sources in accordance with the requirements of the Data Protection Act and Information Governance, independently
(iii) Carry out appropriate assessment of each patient/client within the situation, independently, being aware of factors influencing the reliability and validity of the assessment
3.2 FORMULATION OF ACTION PLAN. The student is able to:
(i) Interpret the assessment findings and identify key problems, independently
(ii) Prioritise problems in conjunction with each patient/client and formulate an overall treatment/action plan, independently, taking into account the economic and social factors of the plan
3.3 IMPLEMENTATION OF THE ACTION PLAN (this may apply to individual or group situations). The student is able to:
(i) Select, with justification, and access appropriate techniques and resources in order to implement the plan, independently
(ii) Intervene in proficient, coordinated and confident manner, independently
(iii) Demonstrate appropriate sensitivity to each patient’s/client’s comfort and privacy needs during treatment
3.4 EVALUATION OF THE ACTION PLAN: (this may apply to individual or group situations). The student is able to:
(i) Evaluate the effects of each intervention and modify/progress as appropriate, independently
(ii) Determine the appropriate discharge of each patient/client when measured against the goals of the action plan, independently
Please enter the NUMBER of criteria at each grade in the boxes provided below (number of As, Bs, etc.)
A B C D E Total number of criteria
Half-time (from week 12)
Full-time (in week 25)
Three or more individual criteria graded at E means the student has failed the section.
190 Faculty of Health Sciences. University of Southampton.
SECTION 4
Criteria grades
4.0 MANAGEMENT COMPETENCIES
Half
Full
4.1 MANAGING SELF. The student is able to:
(i) Carry out routine tasks independently and proficiently
(ii) Demonstrate time management appropriate to the setting and organise his/her own time constructively
(iii) Present a professional attitude, manner and appearance appropriate to the setting
(iv) Be confident in his/her abilities, while being aware of his/her limitations; use initiative in actively seeking to further his/her knowledge and skills base
(v) Take responsibility for keeping his/her professional, technical and scientific knowledge and skills up to date.
4.2 MANAGING OTHERS. The student is able to:
(i) Demonstrate responsibility for each patient/client in his/her care
(ii) Co-ordinate own patient/client contact with that of others
4.3 MANAGING RESOURCES. The student is able to:
(i) Develop and use other sources of assistance within the setting (e.g. network of key people)
(ii) Use relevant supporting services available within the setting (e.g. stock systems, transport)
(iii) Justify his/her decisions for patient/client care in terms of cost implications
4.4 LEGISLATION, POLICY AND QUALITY ISSUES. The student:
(i) Understands the implications of the relevant legislation, policy and procedures affecting the service provided to the purchaser and consumer
Please enter the NUMBER of criteria at each grade in the boxes provided below (number of As, Bs, etc.)
A B C D E Total number of criteria
Half-time (after week 12)
Full-time (in week 25)
Three or more individual criteria graded at E means the student has failed the section.
191 Faculty of Health Sciences. University of Southampton.
REPORT ON PERFORMANCE AND ADVICE TO STUDENTS:
Please ensure you provide specific feedback on sections 1-4 at both half-time and full-time, continuing on a separate sheet if necessary (to be completed by the placement personnel).
1.0 SAFETY:
2.0 INTERPERSONAL COMPETENCIES:
Formative (from week 12)
Summative (in week 25)
Formative (from week 12)
Summative (in week 25)
192 Faculty of Health Sciences. University of Southampton.
3.0 PLACEMENT COMPETENCIES:
4.0 MANAGEMENT COMPETENCIES:
Formative (from week 12)
Summative (in week 25)
Formative (from week 12)
Summative (in week 25)
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STUDENT SELF ASSESSMENT
REFLECTION AFTER FORMATIVE ASSESSMENT (for completion by the student)
For the next time:
WHAT WENT WELL?
WHAT DIDN’T GO SO WELL?
WHAT HAS BEEN LEARNT?
WHAT COULD HAVE BEEN DONE DIFFERENTLY?
194 Faculty of Health Sciences. University of Southampton.
STUDENT SELF ASSESSMENT
REFLECTION AFTER SUMMATIVE ASSESSMENT (for completion by the student)
In preparation for your preceptorship period:
WHAT WENT WELL?
WHAT DIDN’T GO SO WELL?
WHAT HAS BEEN LEARNT?
WHAT COULD HAVE BEEN DONE DIFFERENTLY?
195 Faculty of Health Sciences. University of Southampton.
DIRECT OBSERVATION OF PRACTICAL SKILLS (DOPS)
Year 3 / Level 6
196 Faculty of Health Sciences. University of Southampton.
ASSESSMENT FRAMEWORK OF SPECIALIST SKILLS (DOPS)
Introduction
To ensure the student has reached the required level of competence, each clinical skill will be assessed. Assessments will comprise of direct observation and an oral examination. This assessment methodology will permit the work-based assessor to observe the students technical and clinical skill, in addition the oral examination will ensure the student’s knowledge supports their practice. All assessments must be documented.
Assessment documentation
All assessment documentation is to be completed on official paperwork. Photocopies or modified forms will be considered void. Each assessment requires specific documentation to be completed:
1. Assessment plan 2. Performance criteria 3. Questions and answers 4. Feedback
The assessment plan is the learning contract between the student and the assessor. It will state the clinical scenario in which the assessment will take place and outline what the assessor is expecting regarding the assessment. The student and assessor must both sign the assessment plan prior to the assessment.
The performance criterion outlines each competency that must be achieved during the assessment. Those performance criteria that are not achieved during the assessment must be satisfied with a question from the assessor. Comments should be entered by the assessor against the relevant performance criteria. In the event that 25% of the performance criteria cannot be met by practice the assessment will be considered void.
On completion of the practical skill the student and assessor should relocate to a more appropriate location in which to hold an oral examination. The assessor will use the performance criteria and what they have observed as a guide to which questions are asked. The assessor will record the student’s answers on the questions and answers sheet. The assessor will ask a minimum of two and a maximum of five questions.
On completion of the assessment the assessor will inform the student of the outcome of the assessment. Feedback will be provided and documented to guide the student into areas which were completed satisfactorily and those areas in which require more work. All assessments must be documented.
Method of assessment
Direct Observation – The work based assessor directly observes the student performing a particular clinical skill and assesses the student against the performance criteria for that particular procedure.
Questioning - All clinical skills will be assessed by questioning on completion of the clinical skill being observed. Questioning is used to assess the student’s knowledge of that particular skill. More importantly it is used to ensure their knowledge supports their practice. In addition where specific performance criteria cannot be achieved a question must be used to achieve that specific performance criterion. The level of questioning must increase with each assessment to demonstrate progression in that area
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FACULTY OF HEALTH SCIENCES
SUMMARY MASTERSHEET OF SPECIALIST SKILLS (DOPS) FOR PLACEMENT 3
Competency Reviewer Date Summative assessment (pass/fail)
Comments/Evidence
Resting electrocardiography
Demonstrate the ability to record the resting ECG on patients in a range of clinical settings including adults and children.
Provocative electrocardiography
Demonstrate the ability to assist (2nd person) in cardiac exercise stress testing. Demonstrate intermediate life support in accordance with current Resuscitation Council (UK) guidelines.
Pacing and diagnostic invasive procedures
Demonstrate the ability to assist at diagnostic left-heart catheterisation.
Demonstrate the ability to assist at the implant of bradycardia management devices.
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12-LEAD RESTING ELECTROCARDIOGRAPHY RECORDING ON A RANGE OF PATIENTS INCLUDING ADULTS AND CHILDREN
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care, performing the recording of 12-lead resting electrocardiography (ECG) in a range of clinical settings on a range of patients, including adults and children. During this period of work based training students will apply their learning from the academic modules undertaken throughout their two years of training.
SCOPE
On completion of this placement the student will be able to competently perform resting 12-lead ECG recording in a range of clinical settings on a range of patients, including adults and children. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
6. Understand his/her own level of competence, authority and knowledge base.
7. Explain his/her role and responsibilities.
8. Understand the principles of the anatomy and physiology of the cardiovascular system.
9. Record the resting ECG in a range of settings on a range of patients including adults and
children.
10. Adhere to appropriate standards of professional practice as defined in Good Scientific
Practice.
Clinical experiential learning
Critically apply the scientific principles covered in the academic modules to this work-based
specialist skill and specifically appraise the evidence base underpinning electrocardiography.
Prepare a portfolio of evidence containing ECG recordings (anonymised) from a series of
patients that you have obtained recordings from demonstrating the normal and abnormal
ECG changes and your report on each ECG.
Observe the care pathway for acute chest pain and discuss with your practice educator the
role of ECG in myocardial infarction or suspected angina.
All of these experiences should be recorded in your portfolio.
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ASSESSMENT PLAN OF 12-LEAD RESTING ELECTROCARDIOGRAPHY RECORDING ON A RANGE OF PATIENTS INCLUDING ADULTS AND CHILDREN
To be completed by the word-based assessor prior to the assessment. Student to agree and countersign.
Key points and instructions
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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PERFORMANCE CRITERIA OF 12–LEAD RESTING ELECTROCARDIOGRAPHY RECORDING ON A RANGE OF PATIENTS INCLUDING ADULTS AND CHILDREN
PC Task Y/N Assessor’s comments
1 Control infection risks in accordance with departmental protocols when undertaking ECG.
2 Minimise risks and hazards in compliance with Health and Safety policies when undertaking ECG.
4 Obtain a suitably completed request form, greet patient, check patient ID and recent clinical history.
5
Prepare the environment for resting ECG recording, set up and calibrate equipment including, if appropriate, resuscitation equipment.
6 Treat patient in a way which respects their dignity, rights, privacy and confidentiality.
7 Explain the procedure to the patient and gain informed consent.
8 Identify electrode sites on the patient according to current AHA/SCST guidelines.
9 Prepare the patients skin in order to ensure adequate electrode contact.
10 Apply suitable electrodes firmly to the patient to minimise artefact.
11 Choose machine settings appropriate to the ECG recording requested/required.
12
Make an ECG recording on a range of patients, including adults and children, ensuring that an accurate, artefact-free tracing is obtained.
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13 Take steps to modify the procedure if a suitable recording cannot be made and re-record if necessary.
14 Remove electrodes and ensure that the patient and/or carer are informed of next steps.
15 Check the ECG recording for abnormalities and inform a senior staff member if necessary.
16
Demonstrate that ECG recordings are accurate, complete, legible and forwarded to the correct person in an appropriate timescale.
17
Annotate all ECG recordings with the correct patient details and store safely in accordance with current guidelines and the legal framework for data security.
18 Clean ECG equipment in accordance with departmental protocol.
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
Note: Please attach an anonymised, countersigned copy of the 12-lead ECG recording including the student’s initials and basic patient information (i.e. gender, age, outpatient, inpatient).
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12-LEAD RESTING ELECTROCARDIOGRAPHY RECORDING ON A RANGE OF PATIENTS INCLUDING ADULTS AND CHILDREN ASSESSMENT QUESTIONS
(Related to performance criteria)
Questions Answers
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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ASSESSMENT FEEDBACK ON STUDENT’S PERFORMANCE OF 12-LEAD RESTING ELECTROCARDIOGRAPHY RECORDING ON A RANGE OF PATIENTS INCLUDING ADULTS AND
CHILDREN
Provide a description of the clinical scenario and feedback (to be completed by the WBA).
WBA signature: ……………..……….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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DESCRIPTION OF CARDIAC EXERCISE STRESS TESTING
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care, assisting in cardiac exercise stress testing. During this period of work based training students will apply their learning from the academic modules undertaken throughout their two years of training.
SCOPE
On completion of this placement the student will be able to assist with more complex investigations. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
1. Understand his/her own level of competence, authority and knowledge base.
2. Explain his/her role and responsibilities.
3. Understand the principles of the anatomy and physiology of the cardiovascular system.
4. Assist (2nd person) in cardiac exercise stress testing.
5. Demonstrate intermediate life support in accordance with current Resuscitation Council
(UK) guidelines.
6. Adhere to appropriate standards of professional practice as defined in Good Scientific
Practice.
Clinical experiential learning
Observe the use of cardiac ultrasound and discuss the role of this test in the diagnosis and
management of patients.
Attend a heart failure or cardiac rehabilitation clinic where patients with cardiac disease are
treated and discuss the role of nutrition or other non-pharmacological strategies in the
management of cardiac disease.
Attend a multidisciplinary meeting and reflect on the way the multidisciplinary team
contributes to the care of patients with disorders of the cardiovascular system.
All of these experiences should be recorded in your portfolio. Evidence must include ECG traces (one
per stage; more if relevant to report) and report.
Note: Please attach an anonymised, countersigned copy of the report including the student’s initials
and basic patient information (i.e. age, gender, outpatient, inpatient).
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ASSESSMENT PLAN OF CARDIAC EXERCISE STRESS TESTING To be completed by the word-based assessor prior to the assessment. Student to agree and countersign.
Key points and instructions
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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PERFORMANCE CRITERIA OF CARDIAC EXERCISE STRESS TESTING
PC Task Y/N Assessor’s comments
1 Control infection risks for diagnostic and therapeutic invasive procedures in accordance with departmental protocols.
2 Minimise risks and hazards in compliance with Health and Safety policies.
3
Check all resuscitation equipment in the room. Undertake intermediate life support in accordance with current Resuscitation Council (UK) guidelines (if necessary).
4 Obtain a suitably completed request form, greet patient, check patient ID.
5 Under supervision, review the clinical history of the patient for suitability to perform the test.
6 Prepare the environment, set up and calibrate equipment ready for use including battery check.
7 Treat patient in a way which respects their dignity, rights, privacy and confidentiality.
8
Explain the procedure to the patient giving detailed instructions and checking the patient’s understanding, and gain informed consent.
9 Confirm that the patient has adhered to any pre-test instructions.
10 Ensure that the patient is suitably dressed and wearing appropriate footwear.
11 Prepare electrode sites and apply electrodes to the patient to obtain accurate and artefact-free recordings.
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12 Record the patient’s resting ECG and BP and compare these with the last set of patient recordings.
13 demonstrate walking technique to ensure that he/she understands how to perform the procedure safely.
14 Encourage the patient to reach a level of activity which would achieve his/her optimal result.
15 Monitor and record the ECG and BP throughout the test.
16 Record any adverse or unexplained changes and take appropriate action.
17 Identify when to end the test, in accordance with current guidelines.
18 Provide a recovery period in line with local and national guidelines, and support the patient throughout.
19 Produce ECG tracings of sufficient accuracy to assist in producing a factual report.
20 Undertake routine maintenance and calibration procedures.
21 Clean equipment in accordance with departmental procedures.
22 Keep accurate records in accordance with current guidelines and the legal framework for data security.
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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CARDIAC EXERCISE STRESS TESTING ASSESSMENT QUESTIONS (Related to performance criteria)
Questions Answers
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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ASSESSMENT FEEDBACK ON STUDENT’S PERFORMANCE OF CARDIAC EXERCISE STRESS TESTING
Provide a description of the clinical scenario and feedback (to be completed by the WBA).
WBA signature: ……………..……….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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DESCRIPTION OF DIAGNOSTIC LEFT HEART CATHETERISATION
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care, assisting at diagnostic left-heart catheterisation. During this period of work based training students will apply their learning from the academic modules undertaken throughout their three years of training.
SCOPE
On completion of this placement the student will be able to assist with more complex investigations. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
1. Understand his/her own level of competence, authority and knowledge base.
2. Explain his/her role and responsibilities.
3. Understand the principles of the anatomy and physiology of the cardiovascular system.
4. Understand the principles of pressure recording.
5. Assist at diagnostic left-heart catheterisation.
6. Adhere to appropriate standards of professional practice as defined in Good Scientific
Practice.
Clinical experiential learning
Observe left and right heart catheterisation and angiography including blood sampling, and
discuss the role of invasive cardiology in the diagnosis, treatment and management of
patients with cardiac disease.
Attend outpatients clinics and/or inpatient ward rounds to gain experience of the linkages
between Cardiac Physiology and other clinical specialisms in the investigation of
cardiovascular diseases.
All of these experiences should be recorded in your portfolio. Evidence must include pressure traces,
and ECG and summary of case.
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ASSESSMENT PLAN OF DIAGNOSTIC LEFT HEART CATHETERISATION To be completed by the word-based assessor prior to the assessment. Student to agree and countersign.
Key points and instructions
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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PERFORMANCE CRITERIA OF DIAGNOSTIC LEFT HEART CATHETERISATION
PC Task Y/N Assessor’s comments
1 Control infection risks for diagnostic and therapeutic invasive procedures in accordance with departmental protocols.
2 Minimise risks and hazards in compliance with Health and Safety policies.
3 Treat patient in a way which respects their dignity, rights, privacy and confidentiality.
3
Perform preliminary checks:
Check all recording and resuscitation equipment prior to procedure.
Greet patient, check patient ID and recent clinical history.
Check the patient has adhered to any pre-investigation instructions.
5
Explain the procedure to the patient giving detailed instructions and checking the patient’s understanding, and gain informed consent.
6 Comply with hand hygiene in accordance with the aseptic technique and asepsis measures during the procedure.
3
Assist at diagnostic left-heart catheterisation and angiography:
Assemble the pressure transducers and monitoring lines to ensure a sterile, fluid-filled and air-free system.
Check the calibration of the transducer.
Identify mid-chest position on the patient and correctly align the transducer.
Choose equipment appropriate to the investigation.
Zero pressure to ensure a correct patient baseline reading.
Take recordings appropriate to the investigation, make recordings from these and change the range and paper
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speed to suit the pressures recorded.
Recognise artefacts which might affect the quality of the tracing and rectify these.
Evaluate pressures from all cardiac chambers and structures, and inform medical staff of the values and any abnormalities in line with local policy.
Collect patient blood samples and analyse as appropriate to the investigation.
Make haemodynamic recordings in line with overall patient investigations.
7 Check ECG, BP and patient status throughout the procedure and report any adverse changes as necessary.
8 Produce accurate ECG and haemodynamic tracings and a record of the procedure in accordance with departmental policy.
9 Keep accurate records in accordance with current guidelines and the legal framework for data security.
10 Undertake routine maintenance and calibration procedures.
11 Clean the equipment in accordance with departmental protocol.
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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DIAGNOSTIC LEFT HEART CATHETERISATION ASSESSMENT QUESTIONS (Related to performance criteria)
Questions Answers
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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ASSESSMENT FEEDBACK ON STUDENT’S PERFORMANCE OF DIAGNOSTIC LEFT HEART CATHETERISATION
Provide a description of the clinical scenario and feedback (to be completed by the WBA).
WBA signature: ……………..……….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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DESCRIPTION OF PERMANENT PACEMAKER IMPLANTATION
AIM
The aim of this assessment is to ensure that the student develops his/her skills with respect to patient-centred care, assisting at the implant of bradycardia management devices. During this period of work based training students will apply their learning from the academic modules undertaken throughout their three years of training.
SCOPE
On completion of this placement the student will be able to assist with more complex investigations. He/she will be expected to build his/her professional practice and practise safely in the work place. Students will be expected to use critical reflection to review and improve their performance in the work place and develop skills to promote continuous personal development.
Learning outcomes
On successful completion of this module the student will:
1. Understand his/her own level of competence, authority and knowledge base.
2. Explain his/her role and responsibilities.
3. Understand the principles of the anatomy and physiology of the cardiovascular system.
4. Assist at the implant of bradycardia management devices.
5. Adhere to appropriate standards of professional practice as defined in Good Scientific
Practice.
Clinical experiential learning
Attend outpatient clinics and/or follow-up clinics to gain experience of the linkages between
Cardiac Physiology and other clinical specialisms in the investigation of cardiovascular
diseases.
Work within a multidisciplinary team; review the outcome of a clinical audit, research,
innovation or service development is presented, and discuss with your practice educator
how evidence-based practice is implemented with respect to invasive cardiac investigations.
All of these experiences should be recorded in your portfolio. Evidence must include pre- and post-
implant ECG and the implant sheet.
Note: Please, attach an anonymised and countersigned copy of the implant sheet including basic
patient information (i.e. age, gender, brief clinical history).
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ASSESSMENT PLAN OF PERMANENT PACEMAKER IMPLANTATION
To be completed by the word-based assessor prior to the assessment. Student to agree and countersign.
Key points and instructions
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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PERFORMANCE CRITERIA OF PERMANENT PACEMAKER IMPLANTATION
PC Task Y/N Assessor’s comments
1 Control infection risks for diagnostic and therapeutic invasive procedures in accordance with departmental protocols.
2 Minimise risks and hazards in compliance with Health and Safety policies.
3 Treat patient in a way which respects their dignity, rights, privacy and confidentiality.
3
Perform preliminary checks:
Check all recording and resuscitation equipment prior to procedure.
Greet patient, check patient ID and recent clinical history.
Check the patient has adhered to any pre-investigation instructions.
5 Explain the procedure to the patient giving detailed instructions and ensuring that s/he understands your role.
6 Comply with hand hygiene in accordance with the aseptic technique and asepsis measures during the procedure.
7 Select and prepare the appropriate device and leads for the patient.
8 Under direct supervision, make appropriate recordings.
9 Check ECG, BP and patient status throughout the procedure and report any adverse changes as necessary.
10
Perform diagnostic tests to ensure the device is implanted correctly, and report any abnormal recordings to the implanting physician.
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11 Ensure device is functioning correctly before the procedure is completed.
12 Advice patient on subsequent pacing check before discharge and follow-up.
13 Keep accurate records in accordance with current guidelines and the legal framework for data security.
14 Undertake routine maintenance and calibration procedures.
15 Clean the equipment in accordance with departmental protocol.
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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PERMANENT PACEMAKER IMPLANTATION ASSESSMENT QUESTIONS (Related to performance criteria)
Questions Answers
WBA signature: …………………………………………………. Student signature: ……………………………………………..
Date of assessment: …………………………………………..
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ASSESSMENT FEEDBACK ON STUDENT’S PERFORMANCE OF PERMANENT PACEMAKER IMPLANTATION
Provide a description of the clinical scenario and feedback (to be completed by the WBA).
WBA signature: ……………..……….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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CASE BASED DISCUSSIONS (CBD)
Placement 3
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CASE BASED DISCUSSIONS (CBD)
Description
CBDs are designed to provide structured teaching and feedback in a particular area of clinical or
technical practice by evaluating decision making, interpretation and application of evidence. CBD
enable the discussion of the context, professional, ethical and governance framework of practice,
and in all instances, they allow students to discuss why the acted as they did.
CBDs are structured assessments used to evaluate the student’s clinical cognitive ability. The
assessor, in consultation with the student, will select a particular case on which to base the CBD. The
results of the procedure, along with accompanying data, will be interpreted in context, clinically.
Accompanying data can include:
Demographics
Social circumstances
Previous medical history
Pharmacological history
Current signs and symptoms
The outcome of the CBD is the development of the student’s clinical reasoning based on a technical
procedure performed in the context of a clinical episode. In order to achieve a pass, all the
performance criteria must be addressed and minimum requirements met in one spoken interaction
(discussion). Should the student fail to achieve a pass, this assessment must be repeated in the
recoup period. The assessment of CBDs should be appropriate to the students’ level of study.
A CBD should take approximately 20-30 minutes. The CBD should be conducted away from patients
and staff, ideally in a quiet room away from interruptions.
Formative CBD assessment should be undertaken at mid-point of placement; CBD summative
assessment should be carried out towards the end of placement.
Assessment of CBD at level 6
Level 6 CBD will take place around provocative electrocardiography AND permanent pacemaker
implantation OR diagnostic left heart catheterisation , which the student has previously
recorded/undertaken.
The student is required to demonstrate understanding and perform a differential diagnosis,
justifying the morphology of the ECG in the context of the clinical presentation.
Note: Prior to the CBD, the student is required to record their experience in the aforementioned specialist
skills. The evidence will provide an insight to the assessor of the diversity of clinical settings and pathologies
the student has experienced.
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CBD ASSESSMENT FORM Formative
Brief description of output and focus of the scenario:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
No Performance criteria Comments
1 Shows knowledge and understanding of clinical and/or scientific principles relevant to scenario
2 Recognises and discusses relevant health and safety issues
3 Recognises and discusses the procedures used to obtain the results
4 Recognises and discusses the quality control procedures to ensure the result is accurate
5 Shows knowledge and understanding of relevant “Best Practice” guidelines and other policies relevant to the scenario
6 Recognises and discusses the significance of routine patient results with reference to the reason for referral
7 Shows knowledge and understanding of, and begins to use, appropriate resources to aid in the interpretation of results
8 Recognises and is aware of the limits of responsibility and when to seek advice
WBA signature: …………………………………………………. Student signature: ………………………………………..
Date of assessment: …………………………………………..
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Feedback and documentation of learning needs
Agreed actions
WBA signature: ……………………….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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CBD ASSESSMENT FORM Summative
Brief description of output and focus of the scenario:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
No Performance criteria Comments
1 Shows knowledge and understanding of clinical and/or scientific principles relevant to scenario
2 Recognises and discusses relevant health and safety issues
3 Recognises and discusses the procedures used to obtain the results
4 Recognises and discusses the quality control procedures to ensure the result is accurate
5 Shows knowledge and understanding of relevant “Best Practice” guidelines and other policies relevant to the scenario
6 Recognises and discusses the significance of routine patient results with reference to the reason for referral
7 Shows knowledge and understanding of, and begins to use, appropriate resources to aid in the interpretation of results
8 Recognises and is aware of the limits of responsibility and when to seek advice
WBA signature: …………………………………………………. Student signature: ………………………………………..
Date of assessment: …………………………………………..
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Feedback and documentation of learning needs
Agreed actions
WBA signature: ……………………….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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CBD ASSESSMENT FORM Formative
Brief description of output and focus of the scenario:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
No Performance criteria Comments
1 Shows knowledge and understanding of clinical and/or scientific principles relevant to scenario
2 Recognises and discusses relevant health and safety issues
3 Recognises and discusses the procedures used to obtain the results
4 Recognises and discusses the quality control procedures to ensure the result is accurate
5 Shows knowledge and understanding of relevant “Best Practice” guidelines and other policies relevant to the scenario
6 Recognises and discusses the significance of routine patient results with reference to the reason for referral
7 Shows knowledge and understanding of, and begins to use, appropriate resources to aid in the interpretation of results
8 Recognises and is aware of the limits of responsibility and when to seek advice
WBA signature: …………………………………………………. Student signature: ………………………………………..
Date of assessment: …………………………………………..
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Feedback and documentation of learning needs
Agreed actions
WBA signature: ……………………….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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CBD ASSESSMENT FORM Summative
Brief description of output and focus of the scenario:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
No Performance criteria Comments
1 Shows knowledge and understanding of clinical and/or scientific principles relevant to scenario
2 Recognises and discusses relevant health and safety issues
3 Recognises and discusses the procedures used to obtain the results
4 Recognises and discusses the quality control procedures to ensure the result is accurate
5 Shows knowledge and understanding of relevant “Best Practice” guidelines and other policies relevant to the scenario
6 Recognises and discusses the significance of routine patient results with reference to the reason for referral
7 Shows knowledge and understanding of, and begins to use, appropriate resources to aid in the interpretation of results
8 Recognises and is aware of the limits of responsibility and when to seek advice
WBA signature: …………………………………………………. Student signature: ………………………………………..
Date of assessment: …………………………………………..
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Feedback and documentation of learning needs
Agreed actions
WBA signature: ……………………….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
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MINI CLINICAL EXAMINATION (Mini-Cex)
Placement 3
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MINI-CLINICAL EXAMINATION (Mini-Cex)
Description
Mini-Cex is a short snapshot of student-patient interaction. They are designed to assess the clinical
skills, attitudes and behaviours of students essential to providing high quality care, around a specific
procedure.
In agreement with his/her practice educator, the student chooses the clinical interaction, which
should be representative and allow him/her to meet their learning outcomes. This student-patient
interaction
A Mini-Cex should take approximately 20-30 minutes.
Mini-Cex includes five performance criteria (see below), and a feedback and agreed actions section
for the practice educator to identify strengths, areas for development and an action plan.
Question area Positive indicators: The student…
History taking
Facilitates patient telling their story Effectively uses appropriate questions to obtain accurate and adequate information Responds appropriately to verbal and non-verbal cues
Communication skills
Explores patient’s perspective Shows an open and honest attitude Demonstrates empathy Provides jargon-free, clear information
Clinical reasoning
Makes appropriate clinical decisions and formulates a suitable management plan Selectively organises/performs appropriate diagnostic studies Considers risks and benefits
Professionalism
Shows respect, compassion, empathy, establishes trust Attends to patient’s needs of comfort Respects confidentiality Behaves in an ethical manner Is aware of legal frameworks Is aware of own limitations
Organisation and efficiency Prioritises tasks Is timely and succinct Summarises
In order to maximise the educational impact of using Mini-Cex, both the student and practice
educator need to identify strengths, areas for development, and an action plan. This should be done
sensitively and in a suitable environment.
Assessment
The outcome of the Mini-Cex is the development of the student’s clinical skills, attitudes and
behaviours essential to providing high quality care in the context of a clinical episode. In order to
achieve a pass, all the performance criteria must be addressed and minimum requirements met in
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one interaction. Should the student fail to achieve a pass, this assessment must be repeated in the
recoup period.
Formative Mini-Cex assessment should be undertaken at mid-point of placement; Min-Cex
summative assessment should be carried out towards the end of placement.
The assessment of Mini-Cex should be appropriate to the students’ level of study.
Assessment of the Mini-Cex will be conducted by the work based assessor and an academic from the University of Southampton (locality visitor) as part of routine placement visit.
236 Faculty of Health Sciences. University of Southampton.
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237 Faculty of Health Sciences. University of Southampton.
Mini-Cex ASSESSMENT FORM 1 Formative
Clinical setting: ……………………………………………….. Pathology: …..………………………………………………… Brief description of output and focus of the scenario:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
No Performance criteria Assessor’s comments
1 History taking
2 Communication skills
3 Clinical reasoning
4 Professionalism
5 Organisation and efficiency
WBA signature: …………………………………………………. Student signature: ………………………………………..
Date of assessment: …………………………………………..
238 Faculty of Health Sciences. University of Southampton.
Feedback and documentation of learning needs
Agreed actions
WBA signature: ……………………….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
239 Faculty of Health Sciences. University of Southampton.
Mini-Cex ASSESSMENT FORM 1 Summative
Clinical setting: ……………………………………………….. Pathology: …..………………………………………………… Brief description of output and focus of the scenario:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
No Performance criteria Assessor’s comments
1 History taking
2 Communication skills
3 Clinical reasoning
4 Professionalism
5 Organisation and efficiency
WBA signature: …………………………………………………. Student signature: ………………………………………..
Date of assessment: …………………………………………..
240 Faculty of Health Sciences. University of Southampton.
Feedback and documentation of learning needs
Agreed actions
WBA signature: ……………………….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
241 Faculty of Health Sciences. University of Southampton.
Mini-Cex ASSESSMENT FORM 2 Formative
Clinical setting: ……………………………………………….. Pathology: …..………………………………………………… Brief description of output and focus of the scenario:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
No Performance criteria Assessor’s comments
1 History taking
2 Communication skills
3 Clinical reasoning
4 Professionalism
5 Organisation and efficiency
WBA signature: …………………………………………………. Student signature: ………………………………………..
Date of assessment: …………………………………………..
242 Faculty of Health Sciences. University of Southampton.
Feedback and documentation of learning needs
Agreed actions
WBA signature: ……………………….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
243 Faculty of Health Sciences. University of Southampton.
Mini-Cex ASSESSMENT FORM 2 Summative
Clinical setting: ……………………………………………….. Pathology: …..………………………………………………… Brief description of output and focus of the scenario:
………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
No Performance criteria Assessor’s comments
1 History taking
2 Communication skills
3 Clinical reasoning
4 Professionalism
5 Organisation and efficiency
WBA signature: …………………………………………………. Student signature: ………………………………………..
Date of assessment: …………………………………………..
244 Faculty of Health Sciences. University of Southampton.
Feedback and documentation of learning needs
Agreed actions
WBA signature: ……………………….………….…………….. Student signature: ……….…………………………………
Date of assessment: ….………………………………………. Please circle: Pass / Fail
245 Faculty of Health Sciences. University of Southampton.
RECORD OF EXPERIENCE AND ATTENDANCE
Please, record your attendance and interventions/procedures observed throughout your observational placement in the table provided following
the below.
EXPERIENCE KEY ATTENDANCE KEY RECORD OF ABSENCES MADE UP
BP Blood pressure X Did not attend Date Number of made up hours
ECG Electrocardiogram (IP / OP) S Student off sick
A-BP Ambulatory BP O Other (specify)
A-ECG Ambulatory ECG BH Bank holiday
TH Tape hook up
TH Tape analysis
ETT Exercise tolerance testing
Cath Left heart catheterisation
PPM Pacemaker implantation
Echo Echocardiography
Uni University
ID Independent study
DS Directed study / assessment
O Other (specify)
246 Faculty of Health Sciences. University of Southampton.
WEEK 1 WEEK 2
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
WEEK 3 WEEK 4
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
WEEK 5 WEEK 6
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
247 Faculty of Health Sciences. University of Southampton.
WEEK 7 WEEK 8
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
WEEK 9 WEEK 10
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
WEEK 11 WEEK 12
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
248 Faculty of Health Sciences. University of Southampton.
WEEK 13 WEEK 14
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
WEEK 15 WEEK 16
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
WEEK 17 WEEK 18
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
249 Faculty of Health Sciences. University of Southampton.
WEEK 19 WEEK 20
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
WEEK 21 WEEK 22
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
WEEK 23 WEEK 24
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
250 Faculty of Health Sciences. University of Southampton.
WEEK 25 Extra week to make up hours
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
Extra week to make up hours Extra week to make up hours
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
Extra week to make up hours Extra week to make up hours
Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun
Experience Attendance
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
PE signature
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
251 Faculty of Health Sciences. University of Southampton.
VERIFICATION OF ATTENDANCE TO PLACEMENT 3
I verify that this is an accurate account
OUTSTANDING HOURS CARRIED FORWARD
Student signature
Work-based assessor signature
252 Faculty of Health Sciences. University of Southampton.
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253 Faculty of Health Sciences. University of Southampton.
APPENDICES
254 Faculty of Health Sciences. University of Southampton.
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255 Faculty of Health Sciences. University of Southampton.
12-LEAD ELECTROCARDIOGRAM RECORD FORM
Patient details (Age, gender)
Clinical details (IP, OP, medication,
symptoms)
Criteria Measurements Criteria Measurements
Heart rate BPM R-R interval
Rhythm
P wave Height/duration P wave axis
PR interval
QRS Frontal axis Horizontal axis
QRS duration (ms) Morphology
T wave Frontal axis Horizontal axis
T wave Morphology
LVH S wave in V1 (mV) R wave in V5 (mV)
QTc QT/√R-R interval (secs)
RVH R wave in V1 (mV) S wave in V5 or V6 (mV)
ST segment
Any other findings
ECG report/conclusion in context of clinical details
256 Faculty of Health Sciences. University of Southampton.
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257 Faculty of Health Sciences. University of Southampton.
RECORD OF RESTING 12-LEAD ELECTROCARDIOGRAPHY FOR GOOD CLINICAL PRACTICE
To be completed by the student (extra forms downloadable from: www.southampton.ac.uk/alps/). Keep an anonymised copy of each ECG as evidence, number it and list it here.
Nº Patient (M/F) / referral / summary Date Verified by (signature)
258 Faculty of Health Sciences. University of Southampton.
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259 Faculty of Health Sciences. University of Southampton.
RECORD OF NON-INVASIVE BLOOD PRESSURE MEASUREMENT FOR GOOD CLINICAL PRACTICE
To be completed by the student (extra forms downloadable from: www.southampton.ac.uk/alps/).
Nº Patient (M/F) / referral / summary Date Verified by (signature)
260 Faculty of Health Sciences. University of Southampton.
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261 Faculty of Health Sciences. University of Southampton.
RECORD OF APPLICATION OF AMBULATORY ECG FOR GOOD CLINICAL PRACTICE
To be completed by the student (extra forms downloadable from: www.southampton.ac.uk/alps/). Keep an anonymised copy of each ECG as evidence, number it and list it here.
Nº Patient (M/F) / referral / summary Date Verified by (signature)
262 Faculty of Health Sciences. University of Southampton.
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263 Faculty of Health Sciences. University of Southampton.
RECORD OF APPLICATION OF AMBULATORY BLOOD PRESSURE FOR GOOD CLINICAL PRACTICE
To be completed by the student (extra forms downloadable from: www.southampton.ac.uk/alps/).
Nº Patient (M/F) / referral / summary Date Verified by (signature)
264 Faculty of Health Sciences. University of Southampton.
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265 Faculty of Health Sciences. University of Southampton.
RECORD OF CARDIAC EXERCISE STRESS TESTING FOR GOOD CLINICAL PRACTICE
To be completed by the student (extra forms downloadable from: www.southampton.ac.uk/alps/).
Nº Patient (M/F) / referral / summary Date Verified by (signature)
266 Faculty of Health Sciences. University of Southampton.
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267 Faculty of Health Sciences. University of Southampton.
RECORD OF DIAGNOSTIC LEFT HEART CATHETERISATION FOR GOOD CLINICAL PRACTICE
To be completed by the student (extra forms downloadable from: www.southampton.ac.uk/alps/).
Nº Patient (M/F) / referral / summary Date Verified by (signature)
268 Faculty of Health Sciences. University of Southampton.
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269 Faculty of Health Sciences. University of Southampton.
RECORD OF PERMANENT PACEMAKER IMPLANTATION FOR GOOD CLINICAL PRACTICE
To be completed by the student (extra forms downloadable from: www.southampton.ac.uk/alps/).
Nº Patient (M/F) / referral / summary Date Verified by (signature)
270 Faculty of Health Sciences. University of Southampton.
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271 Faculty of Health Sciences. University of Southampton.
COMMON ABBREVIATIONS
RELATED TO DRUG THERAPY AC Before Meals BD Twice Daily MAOI Monoamine Oxidaze Inhibitor Nocte At Night NSAID Non-Steroidal Anti-inflammatory
Drugs OD Once a Day/Overdose
PC After meals PRNc As Required QDS 4 Times a Day TDS 3 Times a Day TTO To Take Out TTO's To Take All (Drugs on discharge)
RELATED TO TESTS PERFORMED TO AID DIAGNOSIS A+P Anterior Posterior ABG Arterial Blood Gases AFB Acid Test Bacillus (for TB sputum
specimen) CSF Cerebro Spinal Fluid ECG Electro Cardiograph EEG Electro Encephalograph ESR Erthrocyte Sedimentation Rate FBC Full Blood Count Hb Haemoglobin HPC History Present Condition LFT Liver Function Tests
LP Lumbar Puncture MFT Mental Function Test MTS (AMT) Mental Test Score (Abbreviated
Mental Test) MID Multi Infarct Dementia PEF Peak Expiratory Flow PMH Past Medical History SDAT Senile Dementia of the Alzheimers
Type SH Social History TDQ To Direct Question ULTT Upper Limb Tension Tests
RELATED TO DIAGNOSIS AAB Abdominal Aortic Aneurysm AF Atrial Fibrillation BPn Bronchiopneumonia Ca Cancer CABG Coronary Artery Bypass Graft CAF Chronic Airflow Limitation CCF Congestive/Chronic Cardiac Failure CF Cystic Fibrosis COAD Chronic Obstructive Airways Disease CVA Cerebro Vascular Accident DVT Deep Vein Thrombosis LVF Left Ventricular Failure MH Mental Handicap MI Myocardial Infarction
MS Multiple Sclerosis NIDD Non-Insulin Dependent Diabetic NIDDM Non-Insulin Dependent Diabetes
Mellitus PE Pulmonary Embolus PND Paroxysmal Nocturnal Dyspnoea PUO Pyrexia of Unknown Origin PVD Peripheral Vascular Disease RA Rheumatoid Arthritis RTA Road Traffic Accident SAH Sub Arachnoid Haemorrhage TB Tuberculosis TIA Transient Ischaemic Attach URTI Upper Respiratory Tract Infection
RELATED TO FACTS RECORDED DURING EXAMINATION OF PATIENTS/CLIENTS BP Blood Pressure CNS Central Nervous System c/o Complained Of DH Drug History DNA Did Not Attend DOA Date of Admission
NAD Nothing Abnormal Discovered or No
Apparent Deformity/Difficulty OA On Examination PERLA Pupils Equally reacting to light &
accommodation PMH Past Medical History
272 Faculty of Health Sciences. University of Southampton.
DOB Date of Birth DOD Date of Discharge D+V Diarrhoea & Vomiting FH Family History FUA Follow-up Appointment LOC Loss of Consciousness
PNS Peripheral Nervous System SH Social History SOB Shortness of Breath SOBOE Short of Breath on Exertion TIA Transient Ischaemic Attack UTA Unable to Attend
COMMON MEDICAL TERMINOLOGY a Without Ante Before Anti Against Arthro Joints Cardio Heart Dys Malfunction Haem Blood Hemi Half Hyper Over - too much Hypo Under - too little Inter Between Intra Within - inside ... plegia Paralysis Myo Muscles Ortho Straight
Osteo Bone Para Closely related to something else Per Completely/Through ... ectomy Removal ... otomy Opening into ... itis Inflammation of ... troph growth Peri Surrounds Pneuma Air - lungs Pyo Pus Quadra Four Sub Under - below Super Excess Supra Above
Please note these lists do not cover all abbreviations you may come across. New ones and changed terms
occur all the time. You may find it useful to carry a notebook with you and record abbreviations you come
across which are relevant to the placement area in which you are working.
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