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School of Health & Social Care

Module Code: CCH 4035- N Module Title: The Principles and Practice of

Advanced Management of Long-term Health Conditions

Academic Level: Level 7 Credits: 20 Module Leader: Jules Downs

Module Guide January 2015

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Welcome by Module Leader

Hello & welcome to The Principles and Practice of Advanced Management of

Long-term Health Conditions. This module is suitable for nurses,

physiotherapists and occupational therapists, who are engaged in advanced

clinical practice, who have clinical experience in caring for and managing

those with long-term conditions. It can be accessed either as an individual

module or within a programme of study and runs one day per week over 11

weeks.

The module aims to develop knowledge of anatomy, pathology and

physiology as applied to the diagnostic process. This theory and practice will

encapsulate the key skills necessary for safe and effective decision-making

that considers individual client, families and carers perspective. There will be

some interactive lectures and shared teaching with students studying the

Level 6 module; however learning sets and tutorials will focus on the

application of knowledge pertinent to mastery.

A variety of teaching and learning activities will facilitate the integration of a

systems approach to the management of multiple long-term health conditions

through clinical reasoning and building on experiential knowledge from

academia and practice. Interactive lectures, alongside physical assessment

skills workshops, student-led seminars utilising a case study and problem

solving approach will further develop the student's knowledge in their own and

utilise shared learning from their peers' expertise in their area of practice. The

diverse student body allows inter-professional learning to be fully integrated

into the module’s teaching and learning strategy.

Direct contact time is supplemented with the Virtual Learning Environment

(VLE), e-learing@tees signposting to a broad range of resources. The VLE

will be utilised on this module to support the student's development through

provision of access to module documentation and an opportunity for

communication and tutor/peer support. All staff involved in supporting the

module will have access to this site and be able to add learning resources to

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complement the lectures and seminars.

working in this field.

I hope that you enjoy the module and I wish you well with your studies.

Best wishes Jules

Jules Downs | Senior Lecturer - Community & Childhood Studies |

01642 384997

Jules.Downs @tees.ac.uk Centuria H1.40 Middlesbrough, Tees Valley TS1 3BA UK

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Module Aims The module aims to enable registered healthcare practitioners to advance their knowledge, confidence and skills when managing clinical care and management for clients with one or more long-term conditions, their families and carers. Module Outcomes

On successful completion of this module you will be able to:

Knowledge & Understanding

1. Demonstrate a systematic and critical understanding of the breadth and depth of knowledge in long-term conditions.

2. Demonstrate critical awareness of current problems and current guidelines and management options in long-term conditions.

3. Critically evaluate the provision of care and access

Cognitive & Intellectual Skills

1. Systematically appraise evidence to make sound clinical decisions through integration and synthesis of evidence informed practice in the field of clinical assessment and management of long-term health conditions disease processes.

2. Critically evaluate information obtained during patient assessment and develop a strategic plan for management, demonstrating critical thinking and diagnostic reasoning skills in clinical decision-making.

3. Integrate, synthesise and critically evaluate literature, research reports and clinical guidelines that underpin the management of long-term conditions.

4. Demonstrate a systematic and critical awareness of the role of the practitioner in the management of

Practical & Professional Skills

1. Demonstrate the ability to communicate complex issues in a range of ways, to service users, specialist and non-specialist audiences.

2. Plan and critically evaluate proposed strategies for health care interventions for patients with long-term conditions, using appropriate tools.

3. Critically evaluate their own scope of practice and acknowledge when a problem exceeds their knowledge and autonomy to refer on for expert opinion.

4. Ensure all interventions are underpinned by the ethical and legal

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frameworks which support professional and advanced practice.

Key Transferable Skills

1. Demonstrate critical evaluation skills when effectively engaging in academic and clinical discussions, presenting arguments in a logical and professional manner.

2. Assimilate, communicate and evaluate a range of data sources.

Learning and Teaching Strategies The one day per week delivery over 11 weeks will follow a systems approach to anatomy, physiology and pathology. Students will participate in a variety of shared teaching, with those on the Level 6 undergraduate module, with specific learning sets for the Level 7 students. The teaching and learning activities will include a series of interactive lectures, seminars, discussion groups, peer workshops and learning sets. Seminars will be utilised to explore the diagnostic reasoning and clinical management of long-term health conditions. Interactive skills laboratory workshops will explore patient/clinical assessment and factors which are unique to long-term conditions as opposed to acute illness. Interactive lectures will build on the patho-physiological processes involved in the development and progression of long-term conditions adjuvant with common investigations and assessments used to establish the diagnosis and impact of long-term conditions. The evidence for management of common long-term illnesses will be addressed, whilst discussion groups will facilitate case study analysis critical understanding and integration and synthesis with practice in relation to key issues. Key concepts and themes are introduced during the sessions, therefore active participation and engagement in the learning activities throughout the module should enable the students to accept and value the contributions of peers, foster belief in their own ability, thus building self-esteem and demonstrate the application of the theoretical content of the module. Weekly Breakdown The course timetable is given to a systems approach to learning, there will be anatomy and physiology revision; principles of history taking and clinical examination of each specific system week by week. Please see timetable Appendix 1 for specific sessions. This will also be on the E@Tees site where each session will be uploaded following the delivery of it wherever possible. It will assist you in your learning if you would consider pre-reading basic anatomy and physiology pertaining to each weekly focus.

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Academic Support and Guidance You will be able to access a number of sources of support as you progress through this module. Time for group tutorials will be built into the module and you will be able to access a member of the programme team for guidance and support as indicated in the Student Charter. You can access a tutorial with the Senior Lecturers for this module booking electronically via the student intranet. Further to this the learning Hub can provide you with additional support for your studies. These support sessions are also available online. The library staff are a valuable resource and they have several informative “take away” handouts, which will assist you in your studies. Assessment Strategy / Assessment Criteria

Formative assessment of your development will be based upon your ability to

synthesise and critically appraise the module content, evidenced through peer

group discussion and case study analysis.

Summative assessment, which will take place in Week 11 of the student's learning will be through: A 45-minute OSCE, which consists of three consecutive elements, lasting 15 minutes each. Element 1 & 2 is based upon the case history, issued 7 days prior, and clinical assessment of a client with multiple long-term health conditions. Element 3 will consist of a 15-minute Viva Voce. This will enable the practitioner to articulate a systematic and critical understanding of the depth and breadth of knowledge underpinning the practitioners' practice. It will demonstrate the practitioners’ critical evaluative skills and informed decision-making and necessary skills of empowering patients in the management of their condition.

Objective Structured Clinical Examination (100%)

The student must complete the designated OSCE stations. Practitioners’ will demonstrate the ability to: gather, assimilate and critically evaluate patient data and exercise clinical judgement in the synthesis of an evidence-based case management plan.will be based on the module content.

In the first 2 elements the practitioner will be expected to:

Obtain an appropriate 'patient' history, perform a focused examination and critically evaluate investigative data presented

Formulate a clinical opinion on the basis of history, exam and investigative data

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Formulate a patient-centred, holistic and evidence-based management plan

Practitioners must demonstrate a comprehensive, critical understanding of the breadth and depth of knowledge in their own field and safe approach in the following criteria:

Interpret and critically evaluate information gathered during history-taking in a structured and logical way

Synthesise and critically evaluate the knowledge and skills developed within the module and apply these to given situations

Critically evaluate the information on which to base a probable diagnosis

Act autonomously, communicating effectively, the holistic needs using a variety of techniques to elicit the information on which to base their differential diagnosis and their provisional diagnosis

Have a systematic and critical knowledge and understanding of the need to consider an appropriate strategy

Demonstrate a systematic and critical understanding of how to proceed safely and effectively and the need to review the patient appropriately

During the Viva Voce, the student will be expected to synthesise and critically evaluate and demonstrate a critical understanding of the following:

Clinical decision-making strategy employed

The patho-physiology related to the condition

The contemporary literature underpinning management strategy

ASSESSMENT SUBMISSION DATE

OSCE’s are scheduled for Tuesday 17/03/15

You will be given brief unratified feedback via telephone from Jules

Downs by Friday 20/03/15

Resubmission date scheduled for Tuesday 14/04/15

You will be given brief unratified feedback via telephone from Jules

Downs by Thursday 17/04/15

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Evaluation Strategy In addition to the distribution of the standard School of Health & Social Care evaluative questionnaire you will have the opportunity to provide feedback throughout the module. This feedback is very welcome and actively encouraged throughout the module, as we believe that feedback should not be seen as only an end of module activity.

There will be various methodologies used to encourage constructive evaluation of the module. This will occur throughout the programme, with direct observation, structured group feedback, tutor feedback and other methods. This has been found very useful in challenging and changing the module to promote a better student experience.

Student Feedback The School of Health & Social Care relies on student feedback as a key method of assuring and enhancing the quality of its learning and teaching. Your feedback is very important to us and we will invite you to give constructive feedback on your learning experiences both formally with the University Generic Feedback/Evaluation sheet and informally at various points in your programme of study as stated in the paragraph above. This is also time when you will be given feedback from your Programme Team and it is expected that as adult learners you to take note of and act upon feedback received.

Please note that feedback is not limited to comments on your assessed work, though of course you will receive feedback on this. It also includes feedback on your ongoing progress on the module, as well actions that have been taken as a result of your evaluation of your programme of study, and actions taken as a result of the evaluations made by previous student cohorts

The E@T site for this module contains a chart, the Student Lifecycle Feedback Map, which describes those points, the type of feedback you will receive and who is likely to give you the feedback.

Indicative Resources

Allan, M.J. & Spencer, J.A. (2008) History and Examination. 3rd ed. London: Mosby. Bickley, L. & Sziglagyi, P.G. (2009) Bates' Pocket Guide to Physical Examination and History-taking. 5th ed. London: Lippincott. Bishop, T. (2007) Advanced Practice Nurse. London: Elsevier. Cross, S. & Rimmer, M. (2007) Nurse Practitioner Manual of Clinical Skills. Edinburgh. London:

Balliere Tindall. Ford, M.J., Hennessey, I. & Japp, A. (2005) Introduction to Clinical Examination. 8th ed. Edinburgh: Elsevier Churchill Livingstone. Brain, J. (2008) Crash Course - History and Examination. 3rd ed. London: Mosby. Davey, P. (2011) Medicine at a Glance. 3rd ed. Wiley-Blackwell.

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Douglas, G., Nicol, F. & Robertson, C. (eds.) (2009) MacLeod's Clinical Examination. 12th ed.

Edinburgh: Churchill Livingstone. Ford, M.J., Hennessey, I. & Japp, A. (2005) Introduction to Clinical Examination. 8th ed. Edinburgh: Elsevier Churchill Livingstone. Gleadle, J. (2012) History and Clinical Examination at a Glance. 3rd ed. Wiley-Blackwell.

Recommended

Bickley, L. & Szilagyi, P.G. (2009) Bates' Guide to Physical Examination and History Taking. 10th ed. London: Lippincott. Bradley, J.R., Gurnell, M. & Wood, D. (2012) Lecture Notes: Clinical Medicine. 8th ed. John Wiley and

Sons Ltd; Wiley-Blackwell. British Thoracic Society (2001) The Burden of Lung Disease: A Statistics Report from the British Thoracic Society. London: British Thoracic Society. Cohan, B.J. (2012) Memmler’s The Human Body in Health & Disease. 11th ed. London: Lippincott. Dakin, J., Kourteli, E.N. & Winter, R.J.D. (2003) Making Sense of Lung Function Tests - A Hands-on Guide. London: Arnold. Dimond, B. (2004) Legal Aspects of Nursing. 4th ed. Harlow: Longman. Dornan, T. & O'Neill, P. (2006) Core Clinical Skills for OSCEs in Medicine. 2nd ed. London: Churchill

Livingstone. Epstein, O., Perkin, G.D. & Cookson, J. (2004) Pocket Guide to Clinical Examination. 3rd ed. London: Mosby. Fox, C. & MacKinnon, M. (2002) Vital Diabetes: Your Essential Reference for Diabetes Management in Primary Care. 2nd ed. London: Class Health. Furze, G., Donnison, J. & Lewin, R.J.P. (2008) The Clinicians Guide to Chronic Disease Management for Long-term Conditions. A Cognitive Behavioural Approach. M & K Publishing. Groer, M., (ed.) (2001) Advanced Pathophysiology: Application to Clinical Practice. Philadelphia:

Lippincott. Hatton, C. & Blackwood, R. (2003) Lecture Notes on Clinical Skills. 4th ed. Oxford: Blackwell Science. Higgins, C. (2007) Understanding Laboratory Investigations for Nurses and Health Professionals.

2nd ed. Oxford: Blackwell Science. Hope, T. (2003) Medical Ethics and Law The Core Curriculum. London: Churchill Livingstone. Johnson, K. & Rawlings-Anderson, K. (2007) Oxford Handbook of Cardiac Nursing. Oxford:

University Press. Kumar, P. & Clark, M. (2005) Kumar and Clark Clinical Medicine. 6th ed. Edinburgh: Elsevier

Saunders. Longmore, J.M. (2004) The Oxford Handbook of Clinical Medicine. 6th ed. Oxford: University Press. Lumley, J. (2004) Surface Anatomy. Edinburgh: Churchill Livingstone. Lumley, J.S.P. (2002) Surface Anatomy: The Anatomical Basis of Clinical Examination. 3rd ed.

Edinburgh: Churchill Livingstone. MacKinnon, M. (2002) Providing Diabetes Care in General Practice: A Practical Guide for the Primary Care Team. 4th ed. London: Class Publishing. McCance, K.L. & Heuther, S.E. (2006) Pathophysiology - The Biologic Basis for Disease in Adults and Children. 5th ed. St. Louis: Elsevier Mosby. McGee, P. (2009) Advanced Practice in Nursing and the Allied Health Professions. 3rd ed. Wiley-

Blackwell. McLatchie, G.R., Borley, N. & Leaper, D.J. (2002) The Oxford Handbook of Clinical Surgery. 2nd ed.

Oxford: Oxford University Press. Moore, K.L., Dalley, A.F. & Agur, A.M.R. (2010) Clinical Oriented Anatomy. 6th ed. London: Lippincott

Williams & Wilkins. Muncey T. & Parker, A. (2002) Chronic Disease Management. A Practical Guide. Basingstoke:

Palgrave. National Council for Palliative Care (2006) Neurological Conditions: from Diagnosis to Death –Exploring the Interface Between Palliative Care, Neurology and Rehabilitation in the Management of Long-term Neurological Conditions. London: National Council for Palliative Care. Nicholl, C.G. & Wilson, K.J. (2011) Lecture Notes: Elderly Care Medicine. 8th Revised edition. John Wiley and Sons Ltd; Wiley-Blackwell. Payne, S., Seymour, J. & Ingleton, C. (2004) Palliative Care Nursing, Principles and Practice.

Maidenhead: Open University Press. Presho, P. (2008) Managing Long-term Conditions. A Social Model for Community Practice. Wiley

Blackwell. Simon, C., Everitt, H. & Kendrick, T. (2005) The Oxford Handbook of General Practice. 2nd ed.

Oxford: University Press. Stevens, A. & Lowe, J. (2000) Pathology: Illustrated Review in Colour. 2nd ed. London: Mosby. Tadman, M. & Roberts, D. (2007) Oxford Handbook of Cancer Nursing. Oxford: University Press.

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Thomas, N. (2008) Renal Nursing. 3rd ed. Edinburgh: Bailliere Tindall. Tortora, G.J. & Derrickson, B. (2013) Essentials of Anatomy and Physiology. 9th ed. John Wiley &

Sons. Turner, R., Hatton, C. & Blackwood, R. (2002) Lecture Notes on Clinical Skills. 4th ed. John Wiley and Sons Ltd; Blackwell Science Ltd. Wakley, G. & Chambers, R. (2005) Chronic Disease Management in Primary Care: Quality & Outcomes. Abingdon: Radcliffe Medical Press. Watkins, P.J. (2003) ABC Diabetes. 5th ed. London: BMJ Publishing Group. Williams, C. (2003) Overcoming Anxiety: A Five Areas Approach. London: Hodder Arnold.

Journals

A range of journals will be recommended as the students commence the programme. Some of the more useful are: Journal of Advanced Nursing British Journal of Nursing Nurse Prescribing Professional Case Management The Nurse Practitioner

Electronic

There are a huge range of resources available on the internet and electronically. Students will be directed to relevant current resources at the start of the module. One source which should be essential for information to support learning about long-term chest conditions if the British Thoracic Society website (www.brit-thoracic.org.uk). They have a clinical information section giving pertinent information to support the assessment and management of a range of chest disorders. It is strongly recommended that students access this resource. The Department of Health (www.dh.gov.uk) should also be accessed for relevant National Service Frameworks. The Scottish Intercollegiate Guidelines Network (SIGN) is another excellent resource offering concise evidence-based guidelines (www.sign.ac.uk). *Site addresses are correct at time of submission but are subject to change.

Car parking Information

1. ALL-DAY UNIVERSITY CAR-PARKING:

(a) Students may apply for FREE all-day car-parking on Council land at Cannon

Park Way - around ten minutes walking time from the main site. A free bus

service operates twice an hour on week-days from 08.00 to 17.30 (term time only). First year students may apply to the Campus Facilities Office (M2.08). A valid driving Licence and TUSC are required to be shown. Returning students may apply on line via e-vision from mid-September onwards.

(b) The University provides two all-day Pay & Display car-parks with a fixed charge of £2.00 all day – the Penn car-park, East Parkside Village car-park and a limited amount (approx 50) all day parking spaces in the Middletown car-park along the rear of Granville Road. Prior application

must be made to the Campus Facilities Office (M2.08). A TUSC activated for access to Penn/Parkside East car-parks also gives access to Middletown/Students’ Union short-term car-parks (£1.50 up to 4 hours).

(c) The University also provides one other Staff & Student all-day Pay & Display car park, the Dartmouth car-park, with a fixed charge of £2.00 all day.

2. SHORT-TERM UNIVERSITY CAR-PARKING:

The University campus has two car-parks designated for short-term student “Pay & Display” parking – Middletown and the Students’ Union. The maximum stay

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permitted is 4 hours, for which the charge is £1.50. Prior application must be made to the Campus Facilities Office (M2.08) 3. OTHER CAR-PARKING Some Council “Pay and Display” parking is available in the streets around the campus. Students are strongly advised not to park in streets where parking is reserved for residents.

4. CAR-PARKING FOR RESIDENTIAL STUDENTS:

(a) All resident students who apply for a resident student parking permit will be allocated parking at East Parkside Village or West Parkside Village only. Students living at any residence on campus may apply for a permit to use these facilities, subject to availability. The annual charge for a permit is £264 to be paid in full on application.

(b) Students who rent private accommodation in a residential parking zone may apply to the Council for free permits to park vehicles in the streets where they live. Advice on the application process is available from Middlesbrough Council (Tel: 726003).

5. CAR-PARKING AT DARLINGTON CAMPUS:

A limited number of car-parking spaces are available for students at the Darlington Campus on the basis of “Pay and Display”. Prior application must be

made at the Darlington Campus Reception Centre; access to the car-park requires TUSC activation.

6. BICYCLE PARKING: The University has a limited number of covered bicycle stores for which there is an annual charge of £5. There are several other places around the campus where bicycles can be secured at no charge during the day. Register at M2.08 7. MOTORCYCLE PARKING:

Motorcyclists are asked to contact the Campus Facilities Office to register their

motorcycles and identify an appropriate parking location, for which there is currently no charge.

8. DISABLED PARKING: Students who hold national blue badges are eligible for free parking at the University, contact M2.08 for more information. Breach of any parking conditions will result in fines and may result in Student Disciplinary Procedures being invoked.

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Appendix 1 Timetable for CCH4035-N We apologise but on occasion this timetable may need to be changed due to unforeseen circumstances

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UNI

WK

MOD

WK

DATE TIME ROOM

AM 0930 – 1200

PM 1300 – 1600

TUTOR

TITLE OF SESSION

26 1

06/01/15

AM

C1.12

HS3.04

Jules Downs

Welcome to the module & Introduction to LTHC

PM

Jules Downs

Context & Theory of LTHC

27 2

14/01/15

AM

GPT

TBA

HS3.04

Jules Downs

Principles & Practice of Medical History Taking

PM

Jules Downs

Diagnostic Reasoning

Learning sets

28 3

20/01/15

AM

H2.36

HS3.04

Jules Downs

Principles & Practice of CVS

Discuss Joint seminar

PM

Jules Downs

Principles & Practice of CVS

29 4

27/01/15

AM

H2.36

HS3.04

PBL/JD

Paula Hodge

Principles & Practice of RS

Learning sets

PM

30 5

03/02/15

AM

H2.36

HS3.04

Jules Downs

Principles & Practice of Neurological Systems

PM

31 6

10/02/15

AM

H2.36

H2.36

Jules Downs

Musculo-Skeletal System & Joint Seminar

Learning sets

PM

32 7

17/02/15

AM

PM

H2.36

H2.36

Jules Downs

Self Management Strategies/Anxiety & Depression

Discuss PM session 25/02/14

Jules Downs

GIS as a complication of LTHC’s

33 8

24/02/15

AM

PM

H2.36

H2.36

Jules Downs

Health Promotion & Ill Health Prevention

Jules Downs

Palliative Care/Symptom Control

Learning sets

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Timetable for CCH4035-N We apologise but on occasion this timetable may need to be changed due to unforeseen circumstances

Appendix 2

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03/03/15

AM

C1.12

Need

skills lab

pm

Jules Downs

Guided Clinical Practice/Theory of Clinical

Assessment

PM

Jules Downs

OSCE Prep

(First hour exam conditions)

35 10

10/03/15

AM

C1.12

Need

skills lab

pm

Jules Downs &

The Team

OSCE & Evaluation

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STUDENT CONSENT FOR PRACTICAL AND CLASSROOM EXPERIENTIAL ACTIVITIES

As part of your programme you will be expected to take part in some practical based sessions and some classroom experiential activities, which will develop your

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professional knowledge and understanding. As these sessions are an important component of your learning you will normally be expected to fully participate in these sessions. You may also have practical assessments where you demonstrate your professional and practical skills. These assessments may be recorded to ensure that they are available for external scrutiny. During these assessments you may also be expected to act as a model for your peers. Please read this form carefully and complete the required information. This information will be treated as confidential will be in accordance with the University Data Protection Act Policy

1. I confirm that;

a. I am willing to participate in activities as a volunteer subject. b. I will behave in a professional manner in accordance with the relevant

discipline specific Professional Code of Conduct throughout any activity. c. I will act in accordance to the instructions given to me by the academic

staff. d. I will inform academic staff of concerns that I have about a particular

session. e. I will terminate any tests or activities if academic staff feel it is advisable to

do so.

2. I understand that; a. Academic staff will explain the nature and purpose of the activity and will

inform me of any potential risk to my health as a result of my participation. b. I am free to withdraw from an activity at any time after discussion with

academic staff. c. It will be my responsibility to report any adverse reactions and to act upon

advice given. d. Academic staff could advise me to see my general practitioner or

occupational health as a result of any concerns that an activity could identify.

e. I have a responsibility to seek medical advice if advised to do so. f. In order to ensure my well being it is in my interest to discuss in confidence

with my personal tutor or programme/pathway leader any health issues or prior experiences which may impact upon my ability to participate in an activity.

g. It is my responsibility to inform academic staff of any personal physical or psychological issues which may mean that it is unsafe for me to participate in an activity.

h. Academic staff may relate any issues of concern in confidence to the programme/pathway leader.

i. Practical assessments may be recorded and made available to other academic staff and external examiners to ensure rigour in the assessment process

Please complete the below in full

Student name (please print)

Student Number

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Signature

Date

Cohort

Undergraduate / Postgraduate (delete as appropriate)

Programme

Please complete in full and return to:

Information Desk

School of Health and Social Care