Cardiac Core —
Training activity: 17

Details

Review and evaluate the clinical pathways for patients with the following presentations and present to colleagues:

• Chest pain
• Dyspnoea
• Palpitations
• Syncope

Type

Developmental training activity (DTA)

Evidence requirements

Evidence the activity has been undertaken by the trainee​.

Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.

An action plan to implement learning and/or to address skills or knowledge gaps identified.

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

• What is the intended outcome of being able to review and evaluate clinical pathways for common cardiac presentations and present your findings to colleagues? What are the key components of a clinical pathway?
• What are the typical clinical pathways for patients presenting with chest pain, dyspnoea, palpitations, and syncope? What are the different diagnostic tests and treatments involved at each stage? What are the national guidelines and best practices that inform these pathways? How can pathways be evaluated for efficiency, effectiveness, and patient experience?
• What do you anticipate learning about the systematic approach to patient management and the role of evidence-based practice in developing clinical pathways? How will you develop your skills in critical appraisal and presentation?
• How will you prepare by researching the relevant national guidelines and local clinical pathways? Will you discuss your initial evaluation with your supervisor and plan the structure and content of your presentation?

In action

• What specific stages and decision points within the clinical pathways are you focusing on? Why are these critical junctures?
• What evidence or guidelines are you using to evaluate the appropriateness and efficiency of the pathways?
• How are you identifying potential bottlenecks or areas for improvement within the existing pathways?
• How are you structuring your evaluation and preparing your presentation for your colleagues?
• Are you anticipating any questions or challenges from your colleagues regarding your evaluation? How are you preparing to address these?
• Are there alternative pathways or models of care that you are considering for comparison?

On action

• What key stages and decision points within the clinical pathways did you identify as particularly important or potentially problematic? What evidence or guidelines did you use to inform your evaluation?
• What did you learn about the structure and rationale behind these clinical pathways for common cardiac presentations? Did you identify any potential areas for improvement or inefficiency? How did your review process influence the content of your presentation? How does this relate to critically appraising the role of cardiac diagnostic procedures?
• What will you take from this experience to enhance your skills in evaluating clinical pathways and presenting your findings to colleagues? What further information or data would strengthen your evaluation? What strategies will you use to effectively present your recommendations?

Beyond action

• Have you revisited the clinical pathways you initially reviewed for these presentations? How has your understanding of the optimal diagnostic and management strategies within these pathways deepened?
• How has observing patients progress through these pathways in clinical practice provided further insights into the practical application and potential limitations of these guidelines?
• What aspects of pathway evaluation (e.g., evidence-based practice, resource utilisation, patient outcomes) do you now consider to be most important?
• Reflecting on your presentations to colleagues, what did you learn about effectively communicating your analysis of clinical pathways and engaging in constructive discussion?
• How will your ability to critically evaluate and present on clinical pathways contribute to service improvement initiatives and the delivery of high-quality patient care?

Relevant learning outcomes

#	Outcome
# 1	Outcome Perform and interpret 12-lead and ambulatory ECG monitoring to construct a detailed report and make recommendations regarding further investigations and/or clinical management.
# 2	Outcome Perform a trans-thoracic echocardiogram by acquiring and interpreting the standard images to prepare a report for a patient with a structurally normal heart.
# 7	Outcome Critically appraise the role of cardiac diagnostic procedures within a range of patient presentations and pathways.
# 8	Outcome Demonstrate the ability to communicate effectively with patients, carers and the wider multidisciplinary team.