HLTH6074 Diagnostic Assessment and Decision Making
This is module is designed for practitioners moving into clinical roles which require diagnostic skills. It critically explores both the concepts of clinical diagnosis and diagnostic reasoning, and the components of safe and accurate diagnosis in clinical practice.
Aims and Objectives
This is a core module within the MSc Advanced Clinical Practice: Advanced Nurse Practitioner/Advanced Practitioner pathway. It is one of two alternative choices of core decision making module within the MSc Advanced Clinical Practice Standard Pathway, Children and Young People’s Pathway and Critical Care Pathway. It enables students to progress from history taking and physical examination to selecting appropriate investigations, analysing clinical findings and diagnostic decision making.
Having successfully completed this module you will be able to:
- Critically explore the concept of clinical diagnosis with reference to history, culture and professional identity.
- Demonstrate the ability to articulate diagnostic reasoning with due reference to underpinning clinical science
- Critically appraise the contribution, accuracy and costs of clinical tests to inform differential diagnoses.
- Demonstrate critical analysis with regard to diagnostic thinking and decision making in complex clinical situations with reference to: a. pathophysiology b. clinical measurement c. epidemiology d. uncertainty e. probability, risk and safety
- Critically appraise the contribution of decision support tools in diagnostic reasoning and decision making for improved health outcomes.
You will have completed the history taking and physical assessment module which considers health assessment from a broad multi-professional viewpoint, focusing on discrimination of ‘normal’ vs ‘abnormal’ findings. This module will focus more specifically on variants from the normal (the pathophysiological) and explore concepts of diagnosis. Through a variety of learning methods it will bring you into contact with active clinicians and with researchers who are engaged in constructing diagnostic tools. The module is based on the hypothesis that both a quantitative and a qualitative understanding of clinical reasoning and decision making makes for a better diagnostician. • Definitions and models of clinical diagnosis – historical, cross professional and cross cultural perspectives • Decision making theory and its application to diagnostic reasoning • The role of clinical testing within a consultation: history, examination and laboratory • Analysing the costs and benefits of clinical testing • The accuracy of diagnostic testing: sensitivity, specificity, predictive value, risk and probability. (Subject expert and researcher: Dr Mathew Hankin, Senior Lecturer in Public Health) • Applied clinical life science with a focus on pathophysiology Subject expert • : Dr David Voegeli, Senior Lecturer in Continence Technology & Skin Health Cluster • Clinical testing: haematology, clinical chemistry, microbiology, principles of imaging, pathology, functional measurement and cardiovascular investigations • (Subject experts: Dr B Lwaleed, Lecturer in researcher on human physiology and haematology.) • Designing clinical tools. (Subject Expert: Dr Lucy Brindle. Research and teaching areas include: Improving earlier cancer diagnosis and understanding early symptom interpretation research.) • Critically exploring the importance of clinical context in diagnostic decision making with reference to service users’ perceptions, beliefs, aspirations, concerns, expectations and views.
Students will benefit if they can work with a clinical mentor in their practice area to apply their learning on the module. Normally this will be a medical practitioner. It is recognised that not all students will be able to avail themselves of this and as such it is not a course requirement.
Learning and Teaching
Teaching and learning methods
• On line materials for life science preparation • Lectures on key themes • Study groups • Blackboard and other on-line materials • Case based clinical scenarios using laboratory results • Clinical mentors in students’ work base (where possible) • Problem solving workshops designing clinical tools • Facilitated discussion online/Professional conversations delivered in the classroom • Locating and using web based resources • Networking with other students via e-mail/discussion board • Work based activities • Literature retrieval and analysis • Guided reading
|Completion of assessment task||30|
|Wider reading or practice||50|
|Preparation for scheduled sessions||50|
|Total study time||247|
Resources & Reading list
Higgins C (2013). Understanding Laboratory Investigations: A guide for nurses and health professionals.
Llewelyn, H., Ang,H., Lewis,K. and Al-Abdullah,A (2009). Oxford Handbook of Clinical Diagnosis.
Rossiter K, Cooper AJ, Voegeli D, Lwaleed BA (2010). Honey promotes angiogeneic activity in the rat aortic ring assay. Journal of Wound Care. ,19 , pp. 440-446.
Dains,J., Ciofu L , Scheibel,P (2011). Advanced Health Assessment and Clinical Diagnosis in Primary Care.
Hunt K, Walsh B, Voegeli D, Roberts H, (2010). Inflammation in Aging Part 1: Physiology and immunological mechanisms. Biological Research for Nursing. ,11 , pp. 245-252.
Elsevier (2012). The Patient History: Evidence Based Approach.
Katz, D. (2001). Clinical Epidemiology and Evidence Based Medicine. Fundamental principles of clinical reasoning and research.
Campbell J (2009). Campbell’s Physiology Notes.
Bickley, L. (2012). Bates Guide to Physical Examination and History Taking.
Brindle L, Pope C, Corner J, Leydon G, Banerjee A (2012). Eliciting symptoms interpreted as normal by patients with early-stage lung cancer: could GP elicitation of normalised symptoms reduce delay in diagnosis? Cross-sectional interview study.
Thompson,C. and Dowding,D (2009). Essential Decision making and Clinical Judgement for Nurses.
Crosskerry P, Cosby K, Schenkel S, Wears R (2009). Patient Safety in Emergency Medicine.
McGee S (2012). Evidence Based Physical Diagnosis.
Kumar,P. and Clark,M (2012). Clinical Medicine.
Summative components may be repeated once
|Essay (2500 words)||70%|
Repeat type: Internal & External