|Title||Performing a Focused, Relevant Clinical Examination|
By the end of this module the Clinical Scientist in HSST, with respect to performing a focused, relevant clinical examination in adult and paediatric patients as appropriate to their clinical practice, will be able to critically analyse, synthesise, evaluate and apply knowledge, perform a range of technical procedures and clinical skills, and demonstrate the attitudes and behaviours necessary for the role of a Consultant Clinical Scientist and be able to:
- perform a focused, relevant and accurate clinical examination in patients with increasingly complex issues and in increasingly challenging circumstances;
- relate physical findings to history in order to establish diagnosis(es) and formulate a management plan.
All Clinical Scientists in HSST working in a paediatric setting or who see patients of paediatric age in their practice must be appropriately trained in child safeguarding.
Knowledge and understanding
By the end of this module the Clinical Scientist in HSST will critically analyse, synthesise, evaluate and apply their expert knowledge with respect to clinical examination, including:
- protecting patients of paediatric age and vulnerable adults from maltreatment, abuse, neglect or exploitation (safeguarding);
- the anatomical and physiological basis for clinical signs and the relevance of positive and negative physical signs;
- the need for a relevant and targeted physical examination as appropriate in the role of a Consultant Clinical Scientist, knowing when to refer to medical colleagues for further expertise.
- constraints (including those that are cultural or social) to performing physical examination and strategies that may be used to overcome them;
- the limitations of physical examination, in particular in relation to the role of a Consultant Clinical Scientist, and the need for adjunctive forms of assessment to confirm diagnosis when the offer/use of a chaperone is appropriate or required.
Technical and clinical skills
By the end of this module the Clinical Scientist in HSST will be able to undertake a range of clinical skills in adult and paediatric patients as appropriate to their clinical practice. This will include history taking, examination, decision making, diagnostic skills, interpretation of physiological and laboratory measurements, communication with the multidisciplinary team and patients. They will also demonstrate a critical understanding of current research and its application to the performance, adaptation and mastery of a range of clinical and communication skills, and will:
- perform a thorough cardiovascular examination that is valid, targeted and time efficient, and elicit physical signs that are relevant to the presentation, both positive and negative physical signs;
- ascertain the possibility of deliberate harm in vulnerable patients and report suspicions to appropriate agencies;
- elicit important clinical findings.
- identify the important signs of valvular disease and heart failure;
- elicit the signs of widespread cardiovascular atheromatous disease;
- perform the relevant adjunctive examinations;
- gain appropriate informed consent prior to undertaking examination;
- reflect on the challenges of applying research to practice in relation to these procedures and suggest improvements, building on a critique of available evidence.
Attitudes and behaviours
By the end of this module the Clinical Scientist in HSST will be expected to evaluate their own response to both normal and complex situations. They will consistently demonstrate the professional attributes and insights required of a Consultant Clinical Scientist working within the limits of professional competence, referring as appropriate to senior staff and including:
- showing respect and behaving in accordance with Good Scientific Practice;
- ensuring that examination, while clinically appropriate and within the constraints of the role of Consultant Clinical Scientist, considers social, cultural and religious boundaries;
- appropriately communicating findings and making alternative arrangements where necessary.