Overview

This module is based on the specification of core competences, procedural skills and conditions as identified within the Competence and Curriculum Framework for the Physician Associate. Students will be able to keep a copy of this document in their portfolios.

Students will learn the following skills:

1. Clerking of patients including history taking.
2. Examination of patients and diagnosis in accordance with the core competencies in the curriculum core conditions.
3. Initial management plans, including therapies.

In addition, students will undertake procedures and develop competencies as outlined in the Matrix specification of Core Clinical Conditions for the Physician Associate including, but not limited to:

Perform and interpret a 12 lead ECG. Participate in cardiopulmonary resuscitation to the level expected in Immediate Life Support Training: including oxygen with mask, bag intubation, which medication to use and when, depending upon ECG reading. Undertake respiratory function tests, including the performance of peak flow measurement. Commence and manage nebulised therapy. Commence and manage oxygen therapy. Instruct patients in the use of devices for inhaled medication. Insert a naso-gastric tube (tested in simulation). Undertake nutritional assessment. Undertake appropriate strapping and splinting for common musculoskeletal injuries. Perform fluorescein dye examination of the cornea. Remove loose foreign bodies from under lids. Obtain a cervical smear, cultures for HVS etc. Undertake male and female urinary catheterisation. Perform a urine dipstick test. Undertake simple skin suturing. Be competent in the use of local anaesthetics. Interpret written prescriptions accurately, seeking confirmation when the drug, dose or route of administration are unclear, or where the prescription as written is outside standard practice. Draw up and give intramuscular, subcutaneous, intra-dermal and intravenous injections. Take a venous blood sample, using appropriate tubes for required tests. Obtain an arterial blood gas (ABG) sample. Undertake venous cannulation and set up an infusion and infusion pump. Commence and manage a blood transfusion (in simulation). Measure body temperature. Measure pulse rate. Monitor oxygen saturation transcutaneously. Take nose, throat and skin swabs. Calculate dosage of insulin using a pre-prescribed sliding scale and administer.

The completion of these procedures will be dependent on the placements Integral to this is professionalism, communication skills and knowledge of diseases as set out in the PA curriculum core conditions.

The simulation lab will be used for developing practical clinical skills that can be taught and rehearsed safely in this environment as listed in the PA competencies. Mandatory training of equality and diversity, safeguarding of adults and children, health and safety and moving and handling will be included as part of staff induction.

During year 1 the students will undertake the following placement weeks:

Core Placements Year 1 (in Weeks) Community Medicine 2 Weeks General Hospital Medicine 6 Weeks Front Door Medicine 2 Weeks Mental Health 1 Week General Surgery 2 Weeks Obstetrics & Gynaecology 1 Week Paediatrics (acute setting) 1 Week

Paperwork contained in their portfolios will be a record that they have achieved/performed the competencies/procedures detailed above the order of achievements/performance will be placement dependent.

Assessment Strategy

-threshold -Category C (50% -59%)A threshold student should demonstrate the skills to work as a PA, but will require further reading around subjects to gain expert knowledge. -good -Category B (60%-69%)A good student should have a thorough factual knowledge across all aspects of the module, and be able to detail examples where appropriate. -excellent -Category A (70% - 100%):An excellent student should have a thorough factual knowledge across all aspects of the module, and be able to detail examples where appropriate, supported by additional reading and knowledge drawn from other modules. For the higher 'A' marks, significant demonstration of critical analysis and wider reading is essential.

Learning Outcomes

• Demonstrate a critical and reflective understanding of the clinical environment related to professionalism, confidentiality, safety and the interpersonal skills required to form an effective, understanding and compassionate relationship with patients and the patient’s carers.

• Demonstrate an understanding and effective use of communication skills in the working environment. This will include obtaining service user feedback.

• Demonstrate competence in using clinical skills to accumulate and process information and propose management plans for conditions primarily listed in 1A, but also other matrix conditions.

• Develop a critical awareness of the role of the PA in relation to collaborative team working with other health professionals and team members.

• Develop key practical skills required of a PA, including basic life support, blood pressure measurement and vein cannulation and others as listed in the PA curriculum.

• Develop the ability to appropriately request ward and laboratory tests and therapeutic procedures based the knowledge of conditions and their management.

• Will acquire detailed knowledge regarding clinical conditions and demonstrate a critical awareness of the literature that informs the evidence base of clinical assessment and chosen management plans.

• Will be competent in performing a structured clinical clerking (taking a structured history from the patient and or family/carers, and performing a competent clinical examination).