|Title||Gastrointestinal Physiology and Urodynamics in Practice|
This module aims to develop the breadth of the Clinical Scientist in HSST’s knowledge, skills and experience in both gastrointestinal physiology and urodynamic science. This will prepare the student for the higher training programme and allow them to operate at scientist level in urodynamics and GI, looking towards creating a consultant scientist with cross disciplinary skills. By the end of this module the Clinical Scientist in HSST will be able to critically analyse, synthesise, evaluate and apply their knowledge, to perform a range of technical procedures and clinical skills undertaken in gastrointestinal physiology and urodynamics responding to complexity and ambiguity using professional expertise as a Consultant Clinical Scientist. 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. It is vitally important that the challenging of established practices is handled sensitively and diplomatically.
Knowledge and understanding
By the end of this module the Clinical Scientist in HSST will be able to analyse and synthesise their knowledge whilst planning and evaluating their professional practice in gastrointestinal physiology and urodynamics across a range of investigations in routine situations including:
- health and safety including patient safety.
- routine tests:
- conventional urodynamics.
- upper GI manometry.
- pH and impedence metry.
- ano-rectal manometry.
- Endo anal ultraound
- hydrogen and methane, breath test
- 13C Urea and MTG breath test.
- indications for each test.
- principles of operation underpinning the instrumentation for each test.
- risk, benefits and contraindications of undertaking the range of investigations.
- interpretation and clinical reporting.
- planning further investigations for difficult test results, especially equivocal results.
- discussion with expert colleagues.indications for each test.
- highly specialised tests relevant to the specialism as appropriate for example:
- video or ambulatory urodynamics.
- 3D HRM Anorectal and Oesophageal manometry.
- sphincter of Oddi manometry.
- small bowel manometry.
- Endo-rectal ultrasound.
NB: These specialist tests will be covered in more detail in the specialist curriculum
Technical and clinical skills
By the end of this module the Clinical Scientist in HSST will be able to demonstrate a critical understanding of current research and its application to the performance and mastery of the following technical skills:
- conventional urodynamics.
- Gastrointestinal manometry.
- Endoanal and endorectal ultrasound.
- pH and impedance-metry.
- hydrogen and methane breath tests.
- 13C Urea and MTG breath tests.
Reflect on the challenges of applying research to practice in relation to these procedures and suggest improvements, building on a critique of available evidence.
Clinical Scientists in HSST will also be expected to plan, prepare and perform less common, difficult and/or intrusive tests including catheterisation and intubation, where appropriate under supervision.
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 advise and communicate effectively with patients, relevant clinicians and other healthcare professionals and will:
- explain and if necessary justify the recommendation for routine tests to a patient and gain informed consent.
- obtain a clinical history and critically assess the clinical question.
- evaluate risk factors, benefits and contraindications for tests.
- choose and adapt the appropriate diagnostic test for the patient. Judge the need for risk control measures such as prophylactic antibiotic cover.
- explain and if necessary justify the rationale for the test, its risks and benefits to the patient.
- interpret clinical data and produce diagnostic quality clinical reports from routine tests.
- critically review previous results and determine the need for further tests, including referral to other disciplines where appropriate.
- discuss complex cases with a clinical colleague when further advice from an expert source is necessary to complete the final clinical advice.
- in partnership with the clinical team, 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.
Clinical Scientists in HSST will be expected to reflect on the challenges of applying research to practice in relation to these clinical skills 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 within the limits of professional competence referring as appropriate to senior staff and:
- empathise with the needs of people in typical care pathways for a patient with GI or lower urinary tract disease.
- provide leadership regarding service and professional issues.
- maintain highest standards of professional behaviour.
- recognise the limits of professional competence, and refer as appropriate to senior staff.