|Title||Concepts of Gastrointestinal and Urological Physiology|
The aim of this module is to enable Clinical Scientists in HSST to further develop their knowledge, skills and experience of both gastrointestinal physiology and urodynamics. By the end of this module Clinical Scientists in HSST will have consolidated and extended their knowledge of the practice of gastrointestinal and urodynamic science, and the patients referred to these services. They will critically analyse, synthesise and apply their knowledge as they develop the skills to perform and interpret the outcomes of a range of technical procedures and clinical skills undertaken in both areas of practice, responding to complexity and ambiguity using professional expertise. Clinical Scientists in HSST will be expected to respond to the challenges of applying research to practice in relation to these procedures and suggest improvements to practice, building on a critique of available evidence.
Knowledge and understanding
The content of this module will be focussed and aligned to the practice of gastrointestinal physiology and urodynamics and the patients referred to these services. By the end of this module the Clinical Scientist in HSST will be able to critically analyse and synthesise their knowledge whilst planning and evaluating their professional practice in gastrointestinal physiology and urodynamic science across a range of investigations in routine situations including:
- anatomy and physiology relevant to the specialisms of gastrointestinal and urodynamic sciences including the muscular origins of peristalsis and the Hill equation. This will include the lower urinary tract and the entire gastrointestinal tract and encompass the requirement that the Clinical Scientist in HSST gains a multi-level understanding of all the relevant organs, including the molecular and cellular level, including the key receptors linked to drug pathways, and cell signalling pathways
- congenital disorders, relevant to the specialisms of GI physiology and urodynamics the genetic basis of GI and urinary tract diseases.
- risk factors that predispose a patient to GI and urinary tract diseases.
- the incidence, prevalence and other epidemiological factors affecting GI and urinary tract diseases.
- the wider sociological issues that affect GI and urinary tract diseases.
- the role of primary care and screening programmes in the detection and management of GI and urinary tract diseases.
- principles of nutrition, dietary and nutrition assessment, public health and eating behaviour.
- acute and long term conditions typically resulting in referral to a gastrointestinal and/or urodynamic service.
- key symptoms arising from the alimentary system and how changes in the normal anatomy and physiology bring about these symptoms.
- symptom patterns of alimentary disorders which aid in diagnosis and the evidence base underlying these symptoms.
- key symptoms arising from the genital system and how changes in the normal anatomy and physiology bring about these symptoms.
- symptom patterns of genital disorders which aid in diagnosis and the evidence base underlying these symptoms.
- when it may be appropriate to solicit a sexual history, key features of a planned approach and identification of common barriers and mistakes.anatomy and physiology relevant to the specialisms of gastrointestinal and urodynamic sciences including the muscular origins of peristalsis and the Hill equation. This will include the lower urinary tract and the entire gastrointestinal tract and encompass the requirement that the Clinical Scientist in HSST gains a multi-level understanding of all the relevant organs, including the molecular and cellular level, including the key receptors linked to drug pathways, and cell signalling pathways.
- principles and purpose of abdominal and genital examination including digital rectal examination prior to undertaking physiological measurements.
- promoting patient self-care in long term conditions.
- range of clinical history taking frameworks.
Technical and clinical skills
By the end of this module the Clinical Scientist in HSST will be expected to reflect and apply in practice a range of clinical and communication skills to advise and communicate effectively with patients, relevant clinicians and other healthcare professionals and will:
- introduce oneself clearly to patients and indicate your professional role and place in the team/practice.
- obtain a relevant focussed clinical history from patients referred to a gastrointestinal or urodynamic physiological service.
- target the patient’s history to differentiate between likely clinical diagnoses relevant to gastrointestinal or urology.
- write a comprehensive, focussed written record of the information obtained accurately and informatively.
- summarise the details of patient notes and present findings to a senior colleague.
- perform a focussed clinical examination directed to presenting complaint.
- explain all elements of any examination or diagnostic procedure.
- make an accurate record of prescribed medication and ensure this is shared with clinical colleagues appropriately.
- discuss with patients others factors which could influence their personal health.
- resolve communication difficulties, involving others as necessary; establishes excellent rapport.
- counsel patients on the need for information distribution between members of the immediate healthcare team and seek the patient’s consent for disclosure of identifiable information.
- discuss with the patient with whom they would like information about their health to be shared.
- communicate appropriately, as the clinical scientist in the healthcare team, with all relevant members of the healthcare team ensuring findings of relevance to the clinical condition of the patient.
- lead the discussion of causes of clinical incidents in relation to physiological investigations with staff and support colleagues and teams to reflect on the causes and improve systems.
- gain informed or appropriate consent in relation to physiological investigations
- consult with colleagues if in doubt about a patient’s competence and ability to consent.
- construct and use a personal model of professionalism in the work place, critically reflect on your practice.
Clinical Scientists in HSST will be expected to 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 critically evaluate their own response to both normal and complex situations consistently demonstrating the professional attributes and insights required of a Consultant Clinical Scientist in HSST within the limits of professional competence referring as appropriate to senior staff and will:
- respond honestly and promptly to patient questions but knows when to refer for senior help and always take account of patients’ beliefs.
- seek senior help and advice always when one does not know how to answer to patients’ queries.
- ask patients always if there is anything else they need to know or ask.
- involve patients wherever possible in decision making.
- apologise to the patient for any failure as soon as it is recognised, however small.
- act promptly when a patient’s condition deteriorates and always attend to? concerns promptly.
- rectify an error immediately and/or reportit and learn from errors.
- lead team discussions on risk assessment and risk management and work with the team to make organisational changes that will reduce risk and improve the safety of a gastrointestinal physiology and urodynamic service.
- promote patient safety to more junior colleagues.
- apply the skills of deep reflection to identify personal development needs to transform and maintain performance.