Neuro gastroenterology

Details

Title

Neuro gastroenterology

Type

Stage Two

Module code

HPS323

Requirement

Compulsory

Module objective

By the end of this module the Clinical Scientist in HSST will be able to demonstrate a detailed knowledge of neuro-anatomy and neuro-physiology as relevant to the GI tract and critically evaluate the anatomy and resulting pathophysiological data to form a full clinical assessment of the patient presenting with symptoms and signs suggesting a neurological GI dysfunction. They will be expected to interpret, recognise, deliver and report the appropriate physiological tests to address the findings from initial clinical assessment and display a thorough knowledge of management options available to the supervising clinician based on investigation findings using the professional attributes and insights required of a Consultant Clinical Scientist.

Knowledge and understanding

By the end of this module the Clinical Scientist in HSST will be able to critically analyse, synthesise and apply their knowledge with respect to neuro-anatomy and neurophysiology as relevant to the GI tract including:

• relationship of the anatomy and physiology of the central nervous system.
• cellular-level function of muscles, including Hill equation.
• the neuro-anatomy and neuro-physiology, relevant to the GI tract and contextualised with common neurological diseases or trauma and the findings in the GI physiological measurements.
• investigation   and treatment of   the   complications   of neurological GI dysfunction.
• pathologies affecting the nervous system including:
  • multiple sclerosis.
  • motor neurone disease.
  • diabetes.
  • stroke.
  • pudendal nerve neuropathy.
  • spinal injuries.
  • cauda equina.
  • mitochondrial neurogastrointestinal encephalopathy.
  • achalasia.
  • Hirschsprung’s trauma.
  • Eosinophilic oesophagitis
• management options available including:
  • percutaneous tibial nerve stimulation.
  • sacral nerve stimulation.
  • self irrigation.
  • stoma.
  • biofeedback.
  • botox.
  • oesophageal dilatation.
• physiological investigations appropriate for assessing the disorders described above.
• the specific needs of special needs patients.

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 of the following technical skills to ensure the quality delivery of investigations including:

• calibration.
• appropriate test preparation.
• quality assurance performance of test.
• accurate analysis of the data acquired.

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:

• recognise the particular difficulties experienced by patients with concomitant neurological disease. Particular emphasis should be placed on practical difficulties associated with carrying out invasive and undignified physiological measurements.
• take appropriate clinical history and critically assess the clinical question. thereby making appropriate decisions about specialist investigation.
• explain and justify the rationale for the investigation, the risks and benefits to the patient or carer, using appropriate language or communication with respect for the cognitive abilities of the patient to obtain written informed consent or assent.
• interpret clinical data and produce diagnostic quality clinical reports.
• 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 the module the Clinical Scientist in HSST will be expected to critically evaluate their own response to both normal and complex situations demonstrating the professional attributes and insights required of a Consultant Clinical Scientist consistently working within the limits of professional competence referring as appropriate to senior staff and:

• respond to the particular needs of special needs patients.
• develop higher awareness of integrative issues as many if not all neurological diseases have cross-disciplinary links.
• define and maintain the highest standards of professional behaviour including a prioritisation of the patient’s dignity during intimate examinations.
• display awareness of personal limitations and know when to ask for help, especially with regard to clinical issues.
• use effective judgement and decision-making skills.
• work effectively in a multi-disciplinary team and demonstrate leadership where appropriate.
• manage time and prioritise workload e.g. balance urgent and important demands.
• work within ethical principles, safely, respecting confidentiality and the need for and limitations of consent.define and maintain the highest standards of professional behaviour including  a prioritisation  of the patient’s dignity during intimate examinations.
• be committed to and support continuous improvement of gastrointestinal services, with particular reference to auditing practice, evidence based practice, innovation, new and improved technologies.