Managing Clinical Cases CVR and Neurological

Learning Outcomes

Knowledge and Understanding

Having successfully completed this module, you will be able to demonstrate knowledge and understanding of:

• Having successfully completed the module, you will be able to: Identify and explain the essential information and important bio-physical factors that need to be included in a systematic assessment of more complex cardiorespiratory and neurological case studies.

Disciplinary Specific Learning Outcomes

Having successfully completed this module you will be able to:

• Identify problems and develop appropriate management plans in partnership with patients presenting with conditions affecting the cardiorespiratory and/or neurological systems.
• Demonstrate effective communication skills to assess, treat and educate the patient, and relay appropriate information to the patient, carer and MDT.
• Demonstrate the application and modification of clinical management skills appropriate to the presentation and needs of the patient with both cardiorespiratory and/or neurological conditions.

Subject Specific Intellectual and Research Skills

Having successfully completed this module you will be able to:

• Demonstrate clinical reasoning skills by gathering appropriate information, and explaining analysis and differentiation of factors to form a clinical impression, enabling rationalisation and communication of the treatment plan.

CVR

Assessment: The initial emphasis of the module will be rehearsing the systematic assessment process: the A-E method, and students will build on this knowledge to develop greater confidence in its application to various case studies, so that students can identify the patients' problems using a bio-psychosocial approach and be able to discuss the most appropriate management.

Students will develop their knowledge and understanding of the assessment process further and develop analytical skills to interpret arterial blood gases ABG’s and chest x rays. Relevant case studies will be used to facilitate clinical reasoning so that the students’ can identify and recognise the signs of common respiratory or cardiac presentations. There will be an opportunity for students to rehearse these assessment and clinical reasoning skills using simulated learning practice and practice writing clinical records.

Treatment: Students will be taught the principles of: airway management, oxygen therapy, positioning; mobilisation; ACBT, manual techniques, nebulisers and more advanced techniques such as: Intermittent positive Pressure IPPB (Bird), CPAP, BiPAP, cough assist and clinical management of a ventilated patient with manual hyperinflation and suctioning. Students will revise level 4 skills such as positioning, exercise therapy and ACBT when considering planning for discharge and long-term management of a patient with respiratory disease. Students will discuss the impact of the disability and how these changes have affected patients lifestyle and psychological well-being

Medical management: commonly used drugs, medical management, goal setting, therapeutic techniques, MDT involvement, patient involvement and psychosocial factors and discharge planning.

Evaluation: Critique of literature and a critical understanding of evidence base for interventions and assessment measures

Neuro Content

This module will develop the principles of neurological physiotherapy assessment and treatment taught in CM 1 using a problem solving approach and the WHO-ICF structure of impairment, activity and participation, based on more complex case scenarios. This will include upper motor neurone (multiple sclerosis, Parkinson’s disease, motor neurone disease, traumatic brain injury and spinal cord injury) and lower motor neurone conditions (Guillain Barre Syndrome, nerve injuries, Charcot-Marie-Tooth) and other neuropathies.

There will be consolidation of the assessment process and development of clinical reasoning by forming multiple hypotheses, testing hypotheses, formulating detailed problem lists and treatment plans, goal setting and use of appropriate outcome measures. Differences in physical, cognitive and behavioural symptoms, and approaches to treatment in different clinical settings, between progressive and non-progressive conditions will be discussed. As far as possible service users (patients with upper and lower motor neurone conditions) will contribute to the students’ learning, through demonstration of assessment and treatment techniques, and by discussing their lived experiences of having their condition and their views on physiotherapy treatment received. Students will discuss with patients how they have coped with the impact of their disability and how these changes have affected their lifestyle and psychological well-being.

Innovative and novel therapeutic approaches and techniques will be introduced and discussed, including use of rehabilitation technologies, physical training (aerobic/strength training), balance training, and patient involvement in self-management.

There will be a development of critique of the literature and a critical understanding of evidence base for interventions and assessment measures

Neuro This module will develop the principles of neurological physiotherapy assessment and treatment taught in CM 1 using a problem solving approach and the WHO-ICF structure of impairment, activity and participation, based on more complex case scenarios. This will include upper motor neurone (multiple sclerosis, Parkinson’s disease, motor neurone disease, traumatic brain injury and spinal cord injury) and lower motor neurone conditions (Guillain Barre Syndrome, nerve injuries, Charcot-Marie-Tooth) and other neuropathies.

There will be consolidation of the assessment process and development of clinical reasoning by forming multiple hypotheses, testing hypotheses, formulating detailed problem lists and treatment plans, goal setting and use of appropriate outcome measures. Differences in physical, cognitive and behavioural symptoms, and approaches to treatment in different clinical settings, between progressive and non-progressive conditions will be discussed. As far as possible service users (patients with upper and lower motor neurone conditions) will contribute to the students’ learning, through demonstration of assessment and treatment techniques, and by discussing their lived experiences of having their condition and their views on physiotherapy treatment received. Students will discuss with patients how they have coped with the impact of their disability and how these changes have affected their lifestyle and psychological well-being.

Innovative and novel therapeutic approaches and techniques will be introduced and discussed, including use of rehabilitation technologies, physical training (aerobic/strength training), balance training, and patient involvement in self-management.

There will be a development of critique of the literature and a critical understanding of evidence base for interventions and assessment measures

Teaching and learning methods

This module will use a blended approach to learning including case based learning, key-note lectures, flipped classroom, practical sessions, A/V resources, and simulated practice.

There will be an emphasis on self-directed study activities using a range of resources such as: group discussion forums and informal presentations. It will require significant student collaboration and self-directed study utilising the on-line resources available on blackboard such as discussion forums, self-tests, links to other websites and articles.

Resources & Reading list

Textbooks

Stokes M Stack E (2013). Physical Management for Neurological Conditions.

Sheila Lennon, Geert Verheyden, Gita Ramdharry (2018). Neurological Physiotherapy Pocketbook. Elsevier.

Shumway-Cook A and Woollacott MH (2012). Motor control: translating research into clinical practice. Lippincott Williams & Wilkins.

Gillian Mead, Frederike van Wijck (2012). Exercise and Fitness Training After Stroke. Elsevier.

Higgs J., Jones M., Loftus S., and Christensen N. (2018). Clinical reasoning in the health professions. Elsevier.

Broad M.A, Quint.M, Thomas.S., Twose. P (2012). Cardiorespiratory Assessment of the Adult patient A clinicians guide. Churchill Livingstone, Elsevier.

Hough (2017). Cardiorespiratory Care: an evidence-based, problem-solving approach. Elsevier.

Carr J & Shepherd R (2010). Neurological Rehabilitation: Optimizing motor performance. Churchill Livingstone.

Edwards S (2002). Neurological Physiotherapy: a problem solving approach. Churchill Livingstone.

Sue Raine, Linzi Meadows, Mary Lynch-Ellerington (2009). Bobath Concept: Theory and Clinical Practice in Neurological Rehabilitation. Wiley-Blackwell.

Jones K (2014). Neurological Assessment. Elsevier.

Assessment strategy

Objective Structured Clinical Examination - 2 OSPE Assessments must be successfully completed and each OSCE will carry a weighting of 50%. Each OSCE exam must be passed at 40% (grade D), and one component cannot compensate for any other. Those components that are retaken will be capped at 40%.

Formative

This is how we’ll give you feedback as you are learning. It is not a formal test or exam.

Summative

This is how we’ll formally assess what you have learned in this module.

Referral

This is how we’ll assess you if you don’t meet the criteria to pass this module.

Repeat Information

Repeat type: External