Pelvic Floor Disorders

Details

Title

Pelvic Floor Disorders

Type

Stage One

Module code

HPS300

Requirement

Compulsory

Module objective

By the end of this module the Clinical Scientist in HSST will be able to critically analyse and synthesise their understanding of the initial clinical assessment of the patient presenting with symptoms and signs suggesting a pelvic floor pathology. The Clinical Scientist in HSST will be expected to apply their knowledge in the clinical setting with respect to the management options available and discuss these with the supervising clinician based on investigation findings and demonstrate the ability to evaluate their own response to both normal and complex situations using the professional attributes and insights required of a Consultant Clinical Scientist Clinical in HSST. They will be expected to recognise, deliver and report the appropriate physiological test to address the findings from initial clinical assessment.

Knowledge and understanding

By the end of this module the Clinical Scientist in HSST will be able to critically analyse, synthesise and apply their in-depth knowledge with respect to pelvic floor disorders including the:

• anatomy and physiology of the lower GI tract in men and women.
• clinical presentation of common pelvic floor disorders including as a minimum:
  • stress incontinence;
  • urgency;
  • pelvic   organ    prolapse    including   rectal    prolapse,    rectocoele    and cystocoele;
  • anorectal sepsis.
  • fistulae.
  • fissure.
  • urinary incontinence and overactive bladder syndrome.
  • pelvic floor dyskinesia.
  • mega rectum.
• pudendal nerve neuropathy, pathophysiology of the common disorders given above.
• epidemiology, risk factors and where applicable the genetic basis of the common functional disorders given above.
• physiological investigations appropriate for assessing these disorders given above.
• possible management options for common functional urological disorders including:
  • pharmacology pertaining to the Lower GI tract.
  • drugs used in the management of lower GI tract dysfunction.
  • side effects and complications

Clinical Scientists in HSST will also be expected to outline the range of surgical/operative treatments for pelvic floor disorders

Technical and clinical skills

By the end of this module the Clinical Scientist in HSST will be able to demonstrate and critically evaluate their performance of a range of practical skills appropriate to delivery of the physiological investigations applying knowledge to improve the symptoms of pelvic floor dysfunction including:

• calibration.
• test preparation.
• performing the investigation.
• biofeedback.
• cleaning, sterilisation, disinfection.
• quality assurance.

By the end of this module the Clinical Scientist in HSST will be able to demonstrate a critical understanding of current relevant research, theory and knowledge and its application to the performance of clinical skills, applying rigorous scientific critiques to the evaluation of data related to clinical practice in the support of clinical decision making and patient management and critically reflect on their performance and be able to:

• take an appropriate clinical history and critically assess the clinical question thereby making appropriate decision about specialist investigation.
• explain and justify the rationale for the investigation, its risks and benefits to the patient.
• obtain written informed consent.
• analyse and interpret clinical data and produce diagnostic quality clinical reports.

Clinical Scientists in HSST will be required, in partnership with the clinical team, to identify areas of current practice that could be improved and design and evaluate a suitable intervention based on a critical review of evidence to improve practice.

Attitudes and behaviours

By the end of the module the Clinical Scientist in HSST will be expected to critically evaluate their own response to both normal and complex situations consistently demonstrating the professional attributes and insights required of a Consultant Clinical Scientist within the limits of professional competence referring as appropriate to senior staff and:

• maintain highest standards of professional behaviour including a prioritisation of patient’s dignity during intimate examinations.
• use effective judgement and decision-making skills.
• work within personal limitations and ask for help, especially with regard to clinical issues.
• work effectively in a multi-disciplinary team and demonstrate leadership where appropriate.
• manage time and prioritise workload eg. balance urgent and important demands.
• work in accordance with ethical principles prioritising patient safety, confidentiality and within the boundaries of informed consent.
• ensure that examination, whilst clinically appropriate and within the constraints of the role of Consultant Clinical Scientist, considers social, cultural and religious boundaries; appropriately communicate findings and make alternative arrangements where necessary.
• be committed to and support continuous improvement of gastrointestinal and urodynamic services, with particular reference to auditing practice, evidence based practice, innovation, new and improved technologies.