Module information

Module details

Title
Advanced Diagnostics in Respiratory and Sleep Science
Type
Specialist
Module code
S-RS-S2
Credits
10
Phase
2
Requirement
Compulsory

Aim of this module

This module aims to equip trainees with the knowledge and understanding of the range and role of advanced diagnostic testing and comprehensive reporting of investigations in either the adult or paediatric setting.

Work-based content

Competencies

# Learning outcome Competency Action
# 1 Learning outcome 1, 2, 3, 5, 6, 7 Competency

Undertake diagnostic investigations in the following range of patients/conditions and interpret the findings

  • Suspected muscle weakness
  • Suspected asthma or COPD
  • Suspected sleep disordered breathing
Action View
# 2 Learning outcome 5, 7 Competency

Interpret full lung function tests in the following range of conditions and make recommendations for further testing to aid patient management

  • Airflow obstruction
  • Intra-thoracic restrictive ventilatory defect
  • Extra-thoracic restrictive ventilatory defect
Action View
# 3 Learning outcome 1 Competency

Develop or review an existing risk assessment for a challenge testing procedure and present to the team

Action View
# 4 Learning outcome 1, 2, 3 Competency

Evaluate a local protocol for advanced diagnostic testing against national and international guidelines and make recommendations for practice

Action View
# 5 Learning outcome 3, 7 Competency

Review referrals for patients with suspected asthma and identify the most appropriate challenge testing methodology to answer the clinical question

Action View
# 6 Learning outcome 5, 7 Competency

Interpret results of sleep investigations in the following range of conditions and make recommendations for treatment/management

  • Obstructive sleep apnoea
  • Central sleep apnoea
  • Hypoventilation
Action View
# 7 Learning outcome 1 Competency

Undertake physical quality assurance of diagnostic equipment, report the findings and make recommendations

Action View
# 8 Learning outcome 5, 7 Competency

Review the results of actigraphy studies and report the findings

Action View
# 9 Learning outcome 1, 2, 4, 5, 6, 7 Competency

Undertake muscle function assessments with patients and report the findings

Action View
# 10 Learning outcome 1, 2, 4, 5, 6, 7 Competency

Undertake bronchial challenge tests with patients and provide a report of the findings

Action View

Assessments

Complete 2 Case-Based Discussions

Complete 2 DOPS or OCEs

Direct Observation of Practical Skills Titles

  • Perform seated and supine vital capacity measurements.
  • Perform a bronchial challenge test.
  • Calibrate a mouth pressure meter used for muscle function studies.
  • Calculate the mean and standard deviation of biological control quality assurance data.

Observed Clinical Event Titles

  • Communicate the results of full lung function testing to a multidisciplinary team meeting and make suggestions for future management.
  • Gather a history from a patient and use the information obtained to decide on the most appropriate investigations to answer the clinical question.
  • Explain the results of an actigraphy study, using lay terms, to a patient to allow them to understand suggested lifestyle modifications.

Learning outcomes

# Learning outcome
1

Prepare equipment and the environment in order to undertake advanced respiratory diagnostic investigations.

2

Prepare patients to undergo advanced respiratory diagnostic investigations.

3

Select the appropriate diagnostic assessment based on referral criteria.

4

Perform a range of advanced diagnostic investigations safely, including respiratory muscle function testing, bronchial challenge testing and polysomnographic sleep study.

5

Generate reports and answer clinical questions using the results of investigations, other physiological parameters and patient history.

6

Employ effective communication skills and compassion with a range of patients enabling patients to understand their treatment pathway.

7

Demonstrate a patient centered approach to practice, considering communication with patients and relatives and the patient experience.

Clinical experiences

Important information

Clinical experiences help you to develop insight into your practice and greater understanding of your specialty. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. While Clinical Experiences are not assessed, reflections and observations from your experiences can be used to support evidence for competencies to demonstrate your awareness and appreciation of your specialty and it’s impact on patient care. You may find it helpful to capture thoughts from your experiences in your reflective log.

Activities

  1. Observe a specialist consultant respiratory clinic where the test results are used to give diagnosis and discussed with the patient (e.g. ILD, neuromuscular, asthma, COPD and lung cancer) to appreciate the patient experience of their care and in the impact of the discussion.
  2. Observe a bronchoscopy on a patient with suspected lung cancer.
  3. Observe a specialist consultant sleep clinic to appreciate the patient experience of their care and the impact of the discussion.
  4. Attend a respiratory multidisciplinary team meeting to appreciate the patient’s journey both prior to and following discussion.
  5. Attend a respiratory ward round.

Academic content (MSc in Clinical Science)

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning outcomes

On successful completion of this module the trainee will be able to:

  1. Critically evaluate referral pathways and patient history in a range of respiratory, sleep and neurological disease processes.
  2. Appraise calibration, quality control, maintenance and fault finding in a range of equipment, and critically evaluate relative and absolute contraindications to performing a range of advanced tests.
  3. Critically evaluate the role different types of bronchial challenge test play in the diagnosis of asthma.
  4. Describe the role respiratory muscles play in ventilation and evaluate how respiratory muscle disease can impact the process of ventilation.
  5. Critically appraise the role of sleep investigations in a range of conditions and the interpretation of results using national and international guidelines.

Indicative content

  • Physiology of the lungs and pathways used in different pathophysiologies
  • Risk management
  • Range of available sleep tests and challenge tests
  • National and international guidelines for bronchial challenge tests
  • National and international guidelines for multichannel sleep studies
  • Different methods and reference ranges used in muscle study investigations
  • Different methods and reference ranges used in respiratory physiological measurements
  • Feasibility studies for service management and change
  • Health and safety risk considerations for staff and patients
  • Equality and diversity ensuring equal access to all
  • The impact of ethnicity, socioeconomic background and gender identification on lung function
  • Key outcome measures of investigations to include:
  • Lung function testing
    • Spirometry
    • Lung volumes (nitrogen washout/helium dilution/plethysmography
    • Transfer factor
    • Reversibility
  • Muscle function tests
    • Vital capacity changes (lying/sitting)
    • MIP/MEP
    • SNIP
    • Awareness of invasive tests
  • Bronchial challenge testing
    • Spirometry
    • Changes in FEV1 post doses
    • End of test criteria
    • Positive/negative response
  • Multichannel sleep studies
    • ODI
    • AHI
    • SpO2
    • HR
    • Abdominal/thoracic movement
  • Describe the principles of good sleep hygiene and how deviation from these principles will contribute to poor sleep
  • Understand the indications for actigraphy and select an appropriate protocol depending on the indication (duration of study and epoch length)
  • Underpinning knowledge of core disorders of the circadian rhythm and how they present clinically (delayed sleep phase and advance sleep phase)
  • Able to recognise the actigraphic features of the core circadian rhythm disorders (delayed sleep phase, advance sleep phase)

Module assigned to

Specialties

Specialty code Specialty title Action
Specialty code SPS1-3-22 Specialty title Respiratory & Sleep Science [2022] Action View