|Title||Advanced History Taking and Clinical Examination Audiology|
By the end of this module Clinical Scientists in HSST, in respect to audiological science, will be able to analyse, synthesise, evaluate and apply knowledge in taking a relevant focused history and be able to perform a limited but focused, relevant and accurate clinical examination in patients with increasingly complex issues and in increasingly challenging circumstances within the scope of practice of a Consultant Clinical Scientist.
Knowledge and understanding
By the end of this module Clinical Scientists in HSST will analyse, synthesise, evaluate and apply their expert knowledge with respect to the:
- need for a relevant and targeted clinical history and physical examination as appropriate in the role of Consultant Clinical Scientist.
- pathophysiology of audiovestibular disorders.
- anatomical and physiological basis for clinical signs and the relevance of positive and negative physical signs.
- recognition that patients and carers do not present history in a structured fashion.
- likely causes and risk factors for audiovestibular problems.
- recognition that the patient’s history should inform examination, investigation and management.the importance of continuity of care and an holistic approach to clinical practice.
- importance of social and cultural issues and practices that may have an impact on health.
- recognition of constraints (including those that are cultural or social) to performing clinical examination and strategies that may be used to overcome them.
- recognition of the limitations of clinical examination in relation to the role of Consultant Clinical Scientist and the need for adjunctive forms of assessment to confirm diagnosis.
- recognition of when to refer on to other appropriate professionals.
- recognition of when the offer/use of a chaperone is appropriate or required.
- the importance of continuity of care and an holistic approach to clinical practice.
Technical and clinical skills
By the end of this module Clinical Scientists in HSST will be expected to reflect critically and apply in practice a range of clinical and communication skills to advise and communicate effectively with patients, their family and carers, relevant clinicians, and other healthcare professionals and will:
- identify and overcome possible barriers to effective communication.
- communicate effectively with patients from diverse backgrounds and those with special communication needs, including using interpreters where appropriate.
- manage time and draw consultation to a close appropriately.
- recognise that effective history taking in non-urgent cases may require several discussions with the patient and other parties over time.
- recognise when to supplement history with standardised instruments or questionnaires.
- manage alternative and conflicting views from family, carers, friends and members of the multi-professional team.
- assimilate history from the available information from patient and other sources, including members of the multi-professional team.
- facilitate balanced and mutually respectful informed decision making where values and perceptions of health and health promotion conflict.
- recognise and interpret appropriately the use of non verbal communication from patients and carers.
- focus on relevant aspects of history.
- maintain focus despite multiple and often conflicting agendas.
- perform a focussed examination relevant to the presentation and risk factors that is valid, targeted and time efficient and is appropriate to the role of Consultant Clinical Scientist.
- recognise the possibility of deliberate harm (both self harm and harm by others) or safeguarding issues in vulnerable patients and the need to report to appropriate agencies.
- actively elicit important clinical findings.
- identify patients requiring referral to another professional, identifying the most appropriate professional to refer to and recognising the need for timely referral.
- communicate effectively with professional colleagues particularly with regard to patient referrals.
- reflect on the challenges of applying research to practice in relation to these areas of practice and suggest improvements, building on a critique of available evidence.
Attitudes and behaviours
By the end of this module Clinical Scientists in HSST will be expected to evaluate their own response to both normal and complex situations demonstrating 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 will:
- show respect and behave in accordance with Good Scientific Practice.
- ensure that examination, whilst clinically appropriate and within the constraints of the role of Consultant Clinical Scientist, is conducted with consideration for social, cultural and religious boundaries and that alternative arrangements are made where necessary
- appropriately communicate findings.