Advanced History Taking and Clinical Examination Ophthalmic and Vision Science

Details

Title

Advanced History Taking and Clinical Examination Ophthalmic and Vision Science

Type

Stage One

Module code

HPS224

Requirement

Compulsory

Module objective

By the end of this module the Clinical Scientist in HSST will be able to analyse, synthesise, evaluate and apply knowledge in taking a relevant, focused history. They will be able to perform a limited but focused, relevant and accurate clinical examination in patients with increasingly complex issues and in increasingly challenging circumstances, exercising these higher-level clinical skills as part of the wider multidisciplinary team. The Clinical Scientist in HSST will be able to record the history accurately and synthesise this with relevant and appropriate clinical examination within the scope of practice of a Consultant Clinical Scientist. They should also consistently demonstrate the attitudes and behaviours necessary for the role of a Consultant Clinical Scientist.

Knowledge and understanding

By the end of this module the Clinical Scientist in HSST will analyse, synthesise, critically evaluate and apply their expert knowledge with respect to the:

• need for a relevant and targeted examination as appropriate in the role of Consultant Clinical Scientist;
• understanding of the impact of visual impairment at different ages on patients’ psyche and behaviour;
• pathophysiology of symptoms;
• anatomical and physiological basis for clinical signs and the relevance of positive and negative physical signs;
• importance of different elements of history, including the role of smoking, occupational, environmental and domestic exposures;
• recognition that patients do not present history in structured fashion;
• likely causes and risk factors for conditions relevant to mode of presentation;
• recognition that the patient’s agenda and the history should inform examination, investigation and management;
• 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 examinations and strategies that may be used to overcome them;
• recognition of when the offer/use of a chaperone is appropriate or required;
• recognition of the limitations of examination, in particular in relation to the role of the Consultant Clinical Scientist and the need for adjunctive forms of assessment to confirm diagnosis;
• the importance of continuity of care and a holistic approach to clinical practice.

Technical and clinical skills

By the end of this module the Clinical Scientist in HSST will be expected to critically reflect and apply in practice a range of clinical and communication skills to and will:

• communicate with empathy, using an understanding of the of impact sight loss at different ages on all aspects of the patient’s wellbeing and psyche;
• identify and overcome possible barriers to effective communication;
• advise and communicate effectively with patients, relevant clinicians, patients and the public and other healthcare professionals;
• communicate effectively with patients from diverse backgrounds and those with special communication needs, including the use of interpreters where appropriate;
• 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 multiprofessional team;
• manage expectations of patients with respect to the findings and reporting of clinical investigations;
• manage the scientific investigatory team to ensure that patient safety, comfort and dignity is maintained at all times;
• assimilate history from the available information from the patient and other sources, including members of the multiprofessional team;
• facilitate balanced and mutually respectful 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 an investigation relevant to the presentation and risk factors that is valid, targeted and time efficient;
• recognise the possibility of deliberate harm (both self-harm and harm by others) in vulnerable patients and the need to report to appropriate agencies;
• actively elicit important clinical scientific findings;
• perform relevant examinations;facilitate balanced and mutually respectful decision making where values and perceptions of health and health promotion conflict;
• consider the social, cultural and religious boundaries; appropriately communicate findings and make alternative arrangements where necessary.