Advanced Practice

Code

MEDS4030

School

Medical Education Centre

Level

4

Credits

200

Semesters

Full Year UK

Summary

Advanced Practice

This final phase of the course is divided into two components: Advanced Practice 1 and Advanced Practice 2.

This part of the course is intended to prepare students for the transition to working as a Foundation doctor and enable appropriate preparation for the GMC Medical Licensing Assessment.

Advanced Practice will consist of an introductory week followed by a series of clinical placements including a formative assessment mid-way through between Advanced Practice 1 and 2. Topics covered will include: Health Care of Later Life; Leadership and Management training; Intermediate Medicine including Rheumatology; Cancer and Palliative Care; Child Health, Obstetrics and Gynaecology; Advanced Primary Care; Critical Illness; Advanced Medicine and Surgery. Upon completion of these clinical placements, a revision week will be held followed by the final summative examinations.

Target Students

Students on the BMBS programme

Classes

• Ten 4-hour placements each week for 57 weeks

Advanced Practice. This module has an introductory week followed by three separate blocks of attachments with a formative assessment week in the middle of the first two and summative assessments prior to final transition block prior to graduation. Advanced Practice 1: The first block consists of four attachments, each six weeks in length: in Heath Care of Later Life including Leadership and Management training; Intermediate Medicine including Rheumatology, Cancer and Palliative Care; Child Health; and Obstetrics & Gynaecology. There will be a formative assessment week after this block of attachments. Advanced Practice 2 consists of a three week block of Transition to Professional Practice followed by four attachments, each four weeks in length: Primary Care; Critical Illness; Medicine; and Surgery and Perioperative Medicine. After students have completed this, there will be a revision week followed by a summative assessment period. Advanced Practice 3 follows summative assessments, students will have a thirteen week block involving a senior assistantship and six weeks of elective.

Assessment

• 50% Inclass Exam (Practical) 1: Objective Structured Clinical Examination
• Inclass Exam (Practical) 2: Pass minimum number of stations (OSCE)
• Practical 1: Successful completion of eight attachments
• 50% Exam 1 (4-hour): Knowledge based assessment

Assessed by end of designated period

Educational Aims

Learning Outcomes

On qualification, doctors receiving the Bachelor of Medicine and Bachelor of Surgery degrees from Nottingham University should have achieved the outcomes set out in the GMC document Outcomes for Graduates (OfG) https://www.gmc-uk.org. 

This sets out the overarching outcomes for graduates that:

Medical students are tomorrows doctors. In accordance with Good medical practice, newly qualified doctors must make the care of patients their first concern, applying their knowledge and skills in a competent, ethical and professional manner and taking responsibility for their own actions in complex and uncertain situations.

The outcomes required within the document are collated under a three main headings; 

Professional Values and Behaviours 
Professional Skills
Professional Knowledge

Professional Values and Behaviours  

1. Make the care of patients their first concern, applying their knowledge and skills in a competent, ethical and professional manner and taking responsibility for their own actions in complex and uncertain situations.
2.    Behave according to ethical and professional principles.
3.    Demonstrate awareness of the importance of their personal, physical and mental wellbeing and incorporate compassionate self-care into their personal and professional life.
4.    Demonstrate knowledge of the principles of the legal framework in which medicine is practised in the jurisdiction in which they are practising, and have awareness of where further information on relevant legislation can be found
5.    Demonstrate that they can practise safely. They must participate in and promote activity to improve the quality and safety of patient care and clinical outcomes.
6.    Be able to recognise complexity and uncertainty. And, through the process of seeking support and help from colleagues, learn to develop confidence in managing these situations and responding to change.
7.    Be able to recognise and identify factors that suggest patient vulnerability and take action in response
8.    Recognise the role of doctors in contributing to the management and leadership of the health service.
9.    Learn and work effectively within a multi-professional and multi-disciplinary team and across multiple care settings. This includes working face to face and through written and electronic means, and in a range of settings where patients receive care, including community, primary, secondary, mental health, specialist tertiary and social care settings and in patients homes

Professional Skills
10.    Be able to communicate effectively, openly and honestly with patients, their relatives, carers or other advocates, and with colleagues, applying patient confidentiality appropriately.
11.    Be able to carry out an effective consultation with a patient
12.    Be able to work collaboratively with patients and colleagues to diagnose and manage clinical presentations safely in community, primary and secondary care settings and in patients homes. Be able to support and facilitate patients to make decisions about their care and management.
13.    Be able to perform a range of diagnostic, therapeutic and practical procedures safely and effectively, and identify, according to their level of skill and experience, the procedures for which they need supervision to ensure patient safety.
14.    Be able to work collaboratively with patients, their relatives, carers or other advocates to make clinical judgements and decisions based on a holistic assessment of the patient and their needs, priorities and concerns, and appreciating the importance of the links between pathophysiological, psychological, spiritual, religious, social and cultural factors for each individual.
15.    Demonstrate that they can make appropriate clinical judgements when considering or providing compassionate interventions or support for patients who are nearing or at the end of life. They must understand the need to involve patients, their relatives, carers or other advocates in management decisions, making referrals and seeking advice from colleagues as appropriate.
16.    Be able to give immediate care to adults, children and young people in medical and psychiatric emergencies and seek support from colleagues if necessary.
17.    Be able to recognise when a patient is deteriorating and take appropriate action.
18.    Be able to prescribe medications safely, appropriately, effectively and economically and be aware of the common causes and consequences of prescribing errors.
19.    Be able to use information effectively and safely in a medical context, and maintain accurate, legible, contemporaneous and comprehensive medical records
20.    Demonstrate how patient care is delivered in the health service

Professional Knowledge

21.    Be able to apply biomedical scientific principles, methods and knowledge to medical practice and integrate these into patient care. This must include principles and knowledge relating to anatomy, biochemistry, cell biology, genetics, genomics and personalised medicine, immunology, microbiology, molecular biology, nutrition, pathology, pharmacology and clinical pharmacology, and physiology
22.    Recognise that there are differences in healthcare systems across the four nations of the UK and know how to access information about the different systems, including the role of private medical services in the UK
23.    Explain and illustrate by professional experience the principles for the identification, safe management and referral of patients with mental health conditions
24.    Be able to apply social science principles, methods and knowledge to medical practice and integrate these into patient care
25.    Be able to apply the principles, methods and knowledge of population health and the improvement of health and sustainable healthcare to medical practice.
26.    Be able to apply scientific method and approaches to medical research and integrate these with a range of sources of information used to make decisions for care

Conveners

• Prof Kwok-leung Cheung