The University of Southampton
Courses

HLTH6113 Assessment and Examination of the New-born 

Module Overview

A module enabling experienced professionals to undertake assessment and examination of the newborn. Students must have completed the self-directed pre-module Basic Science Package which provides the Basic physiological underpinning for this module. Students must have registration with an appropriate professional body within the UK and access to clinical practice where newborn examinations are being performed. Students must have A learning contract with A clinical mentor who will agree to supervise and assess the required clinical practice requirements. If the mentor is not A Consultant Neonatologist/ Paediatrician then the mentor Must have completed A recognised examination of the newborn course or hold an equivalent qualification. They Must have demonstrated They are using this knowledge and experience on an ongoing basis.

Aims and Objectives

Module Aims

To provide you as an experienced clinician with the specific knowledge and skills needed to obtain, synthesise, interpret, critically analyse and evaluate a structured history, comprehensive physical examination and assessment of the newborn.

Learning Outcomes

Learning Outcomes

Having successfully completed this module you will be able to:

  • Use your communication and advanced clinical skills to obtain, record, interpret and evaluate the significance of a comprehensive physical and psycho-social health history of a neonate and their family. 
  • Conduct a detailed and thorough systematic,  clinical, and physical examination of the newborn recognising deviations from the normal and actual or potential risk factors. 
  • Demonstrate your ability to apply this knowledge to inform your assessment of the needs of the neonate and their family.  
  • Critically evaluate and integrate the clinical information and other evidence obtained in order to inform subsequent management decisions. 
  • Articulate and justify your findings and management plans to parents and other members of the multi-disciplinary team. 
  • Demonstrate knowledge and awareness of when referral to others is required and of the appropriate mechanisms for referral. 
  • Critically appraise aspects of role transition, understanding the responsibility associated with examining and assessing the newborn and any potential changes to lines of accountability.  

Syllabus

The current module has been in progress since 2004 and to ensure that the syllabus and learning outcomes were robust and fit for purpose an online evaluation was conducted. A sample of 50 advanced neonatal nurse practitioners who have graduated since 2004 were surveyed in July 2012. Of these 37 (74%) responded and their comments and suggestions regarding this module have been reviewed and have informed the further development of this module. In addition to the online survey a number of key stakeholders throughout the UK including midwives and senior neonatologists were consulted regarding the education provision and clinical experience offered by the neonatal programme. This data suggested there should be minimal changes to the module. The syllabus has retained the physiological underpinning and the emphasis on providing a high standard of applied teaching and learning. It is expected that with this knowledge and the required standard of clinical competence you will be enabled to assume responsibility for assessment and examination of the newborn in a range of clinical contexts. The syllabus is underpinned and informed by current evidence relating to examination of the newborn. This includes the latest guidelines and evidence produced by the NHS Newborn and Infant Physical Examination (NIPE) Programme and any screening recommendations from the UK National Screening Committee (UKNSC). The NIPE benchmarking standards for the newborn examination have been integrated within the syllabus. Core content will include: * Fetal development and assessment of the transitional events in the neonatal period. * Applied pathophysiology of specific body systems. * Principles of obtaining and recording a comprehensive history * Normal morphology of the newborn and deviations from normal. * Birth trauma * Normal biochemical, haematological and microbiological values * Detailed comprehensive clinical & physical assessment and examination of the newborn related to all body systems and including orthopaedics, ophthalmology and dermatology * Neurological assessment of the newborn * Psycho-social assessment of the needs of the neonate and their family * Nutritional assessment and requirements of the healthy newborn * Aspects of screening the neonate * Problem solving and diagnostic reasoning * Principles of how to make a differential diagnosis * Discussion and evaluation of current evidence and policies relating to the identification, assessment and management of sepsis * Discharge process * Communication with parents regarding health education and immunisations * Record keeping and referral systems * Professional autonomy and accountability and exploration of the legal, professional and ethical issues relating to the changing role boundaries in professional practice. * Critical consideration of the evidence base underpinning examination of the newborn

Special Features

Although this is a required module of the neonatal pathway the focus of this module is on healthy newborn babies and therefore it is an ideal clinical module for midwives or other professionals who are working with neonates and wish to increase their knowledge and develop their clinical practice. You must have access to a clinical area where the skills of examination of the newborn neonate can be acquired and assessed. In order to do this you will need to have professional registration with either the Nursing and Midwifery Council or an alternative professional board. You will also need to fulfil any specific employment requirement of the NHS Trust in which you will be based. You must have the agreement of a suitably qualified mentor to support and assess you in practice during this unit. If you are a midwife you will need to liaise with and gain the support of your Supervisor of Midwives. Whilst undertaking this module you will have access to the authors of the neonatal textbook “A Foundation for Neonatal Care – A Multidisciplinary Guide” (Hall 2008). Dr Hall is the medical co-ordinator for the neonatal programme and this module, Dr Noble is the primary physiologist and S Smith is the module lead for the Neonatal Studies Programme.

Learning and Teaching

Teaching and learning methods

The theoretical principles of adult learning (Knowles 1990) underpin the approach to the teaching and learning and you will need to engage in self-directed learning. In order to meet a range of learner needs and styles and to take account of the complexity of the different clinical contexts, additional approaches to learning have been included, for example the values and principles associated with transformational learning (Mezirow 1991), constructive alignment and reflection (Kolb 1994). This multifaceted balanced approach will enable you to continue to reflect independently on your prior knowledge and the ways in which you can apply your new knowledge and experiential learning to improve service delivery and standards within the practice settings. A variety of learning and teaching methods will be used including: * a self-directed pre-module Basic Science learning package which enables you to review and develop your basic science foundation prior to the start of the module. This learning will provide the underpinning knowledge on which the module syllabus will be based. It is recommended that you study between 2-4 hours per week for 12 weeks and that you ensure that you have covered the learning outcomes that are linked to each of the 12 weeks. In addition there are key physiology references that provide the opportunity for you to broaden and deepen your knowledge base. * lectures- specialist subject lecturers will enable you to acquire a breadth and depth of appropriate clinically knowledge and experience * small group tutorials * online resources including listening to heart sounds, examination of the neurological system, quizzes and Blackboard * recommended key physiology podcasts * practical sessions including the use of ophthalmoscopes and hip models * video and slide sets focussed on examination of the newborn * clinical group discussions facilitated by experienced neonatal practitioners * problem-based case scenarios where you will have the opportunity to discuss and explore cases both within groups and individually. These sessions will provide the opportunity for you to demonstrate your integration of knowledge, understanding and clinical experience. In addition your clinical mentor will have received a specifically developed mentorship guideline, including assessment documentation, which will clearly outline the role and responsibilities of a mentor with regard to clinical learning and teaching in clinical practice. In this context you will have the opportunity to learn from and with your mentor the skills required to undertake this role. This will not only include the physical examination but also key transferable skills such as communication, problem solving and collaborative working within the multi-disciplinary team. References: Kolb, D (1984) Experiential Learning: Experience as a source of learning. Englewood Cliffs:Prentice Hall Knowles, M. (1990) The Adult Learner: A Neglected Species. 4th Edition London, Gulf Mezirow, J. (1991). Transformative Dimensions of Adult Learning. San Francisco, CA: Jossey-Bass

TypeHours
Preparation for scheduled sessions100
Wider reading or practice80
Lecture36
Follow-up work24
Completion of assessment task10
Total study time250

Resources & Reading list

Educational strategies to promote clinical diagnostic reasoning.. ,355 , pp. 355 (21).

Lissauer, T. (2011). Neonatology at a glance. 

Hall M., Noble A., Smith S., (2008). A Foundation for Neonatal Care: a Multidisciplinary Guide.. 

Rennie, M.J. Ed (2012). Roberton’s Textbook of Neonatology. 

Douglas, G., Nicol,F., Robertson,C. (2009). Macleod's Clinical Examination. 

Antibiotics for early-onset sepsis.

Dubowitz, L.S. (2000). The Neurological Assessment of the Preterm and Full-term Newborn Infant. 

Bickley,L.S., Szilaygi,P.G. (2012). Bates’ Guide to Physical Examination and History Taking. 

Gomella, T.L. (2009). Neonatology management, procedures, on-call problems, disease drugs. 

Tappero, E.P. and Honeyfield, M.E. (2010). Physical Assessment of the Newborn: A Comprehensive Approach to the Art of Physical Examination,. 

Marieb, E. and Hoehn,K (2012). Human Anatomy and Physiology. 

Tortora, G. and Derrickson,B. (2011). Principles of Anatomy and Physiology. 

Assessment

Formative

Multiple choice Test

Summative

MethodPercentage contribution
Clinical assessment %
Exam  ( hours) 100%

Referral

MethodPercentage contribution
Clinical assessment %
Exam 100%

Repeat Information

Repeat type: Internal

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