Cardiovascular Case Study Summary
Cardiovascular Case Study Summary
1. The initial concept
presentation - how does he look ?
pallor, sweating, signs of pain/level of discomfort, SOB - talking in sentences,
2. Generating multiple hypothesis
VIT C DE
cardiac - MI/ACS, Arrhythmias, Aortic dissection, peri/myo carditis, past surgical interventions
Respiratory - PE, Pneumonia , Pneumothorax, pleurisy, viral ,
Musculoskeletal - trauma - blunt/ stabbing, fractures , Arthritis , scoliosis
GI - GORD, ulcer, cholecystitis, gastritis, pancreatis
cancers
congenital issues
stress/ anxiety / panic attack
3. Formulating an inquiry strategy
SOCRATES
where is the pain ?when did it start? how long? describe to pain /character? radiation - is the pain anywhere else, does it spread? any associated systems ? nausea/ vomiting, sweating, dizziness, SOB,, anything make it better or worse?
Hx taking
Recent activity? Previous injury?
ask about occupation and hobbies
Surgery hx.
Pain relief, has it worked
Pain scale
Have you had it before?
Is it referred pain?
Any previous investigations?
Red flags
4. Applying appropriate clinical skills
physical exam, cardiac, respiratory, MSK
ECG, vital signs, manual pulse, bloods for fbc, u&e, lft, crp if thinking infective cause. if cardiac cause then would require admission
BP in both arms, lying and standing.
collapsing pulse.
JVP
5. Developing the problem synthesis
dependant on physical exam findings
6. Laboratory and diagnostic findings
cxr as outpatients, FBC, LFT, U&E, BNP, CRP, outpatient ECHO,
GTN spray if already taking - ? angina,
7. Diagnostic decision making (including pathophysiology)
summarising assessment and examination so far, ensuring we haven't missed anything.
Asking the patient what it is they would like to be the next step? ICE
What are their concerns?
preferred place of treatment
are they happy with the diagnoses impression or do they want further investigations.
8. Therapeutic Decision Making
formulate a care plan and management plan with the patient
cover safety nets and red flags
discuss expectations with the patients and carers
discuss the onward referrals
9. Patient Education
diet, smoking, alcohol, lifestyle, fluid intake (thinking HF), medication use and compliance, generalised education about the condition (LTC), resources of outside companies,
MSc in Advanced Clinical Practice 7NH016: Clinical Reasoning for Advanced Practice
Gastrointestinal Case Study
You are currently working in your place of work when you are ready for your next patient. You notice the following patient is next to be seen and you are assigned to see this patient.
Name Jo Evans Gender Female
Date of Birth 10th October 2000 Age 22 years old
Presenting Complaint Reports intermittent abdominal cramps
Student Task
For this case study, you are split into learning groups for this case study (list available on Canvas).
One will adopt the role of the patient, whilst the others work through the consultation.
Use the clinical reasoning model below as part of your group discussions.
Remember to explore a comprehensive list of potential multiple hypotheses using a diagnostic sieve approach such as VITAMINCDEF or an anatomical approach.
Utilise a preferred mnemonic such as SOCRATES or OPQRSTU to develop your problem focused history taking but remember to also ask leading questions related to key hypotheses.
You will be required to present your findings.
Clinical Reasoning Model Crumbie (2016)
Forming the initial concept
Generating multiple hypotheses
Formulating an inquiry strategy
Applying appropriate clinical skills
Developing the problem synthesis
Laboratory and diagnostic findings
Diagnostic decision making (including pathophysiology)
(Therapeutic decision making)
(Patient education)
7NH016 Assignment
Student Name: Student Number:
Grade 0-39%
Poor 40-49%
Insufficient 50-59%
Sufficient 60-69%
Good 70-79%
Very Good 80-89%
Excellent 90-100% Outstanding
Addresses the objectives of the assessment task and provides a
rationale for chosen topic from within the context of their role.
Maximum 8 marks Does not address the assessment task.
No objectives are identified and lacks focus.
No rationale given for chosen topic
0 - 3.12 marks Makes an adequate attempt to address the assessment task but has some digression.
Uses generalised
objectives to provide
adequate but limited
focus to the work.
Sufficient rationale given for chosen topic.
3.2 - 3.92 marks Makes a sufficient attempt to address the assessment task.
Outlines appropriate
objectives and addresses
them in a manner which gives a focus to the work.
Sufficient rationale given for chosen topic.
4 - 4.72 marks Addresses the assessment task clearly.
Defines appropriate
objectives and addresses
them coherently
throughout the work
A good rationale given for chosen topic Demonstrates creativity and independent thought.
4.8 - 5.2 marks Addresses the purpose of the assessment task in detail with some creativity.
Defines appropriate
objectives in detail and
addresses them
in a very good manner.
A very good rationale given for chosen topic Demonstrates excellent creativity and independent thought.
5.6 - 6.3 marks Addresses the purpose of the assessment task comprehensively and with some originality.
Defines appropriate
objectives in detail and
addresses them
comprehensively
An excellent rationale given for chosen topic Demonstrates excellent creativity and independent thought
6.4 - 7.1 marks Addressed the assessment task with a far-reaching approach clearly demonstrating originality.
Defines appropriate
objectives in detail and addresses them
comprehensively and
imaginatively
An outstanding rationale given for chosen topic Demonstrates outstanding creativity and independent thought.
7.2 - 8 marks
LO1
Demonstrate the ability to evaluate, apply and critically synthesize a range of theories, concepts and approaches to clinical reasoning and diagnostic decision making.
Demonstrate knowledge of pathophysiological principles for application to a range of patient presentations.
Demonstrate a coherent understanding of common acute and long-term health problems for patients across the life span, and the relevance of age to the assessment process. Demonstrate an understanding of the concept of evidence-based practice, including using clinical evidence-based resources and terminologies for advanced practice.
Maximum 20 marks Absence of relevant
theoretical content
and/or use of theory.
Demonstrates very poor /no understanding of specialised /applied knowledge of pathophysiology/ common acute and long-term health problems.
Important data is omitted, red flags are not considered.
Errors in assessment technique are evident.
Uses unreliable and /
or inappropriate
sources.
0 7.8 marks Knowledge of theory
inaccurate and/or
incomplete.
Choice of theory inappropriate.
Application and/or
understanding very
limited.
Demonstrates very limited understanding of specialised /applied knowledge of pathophysiology/ common acute and long-term health problems.
Appears confused by the clinical case study. The type or amount of data is not organised, and important data is missed.
Some use of secondary
sources, but also
draws upon unreliable
and / or inappropriate
sources.
Negligible use
of primary evidence based sources.
8- 9.8 marks Demonstrates a sufficient understanding of specialised /applied knowledge of pathophysiology/ common acute and long-term health problems.
Attempts to include a variety of subjective and objective data but is overwhelmed by the array of information due to chosen case study.
Focuses on the most obvious data, missing some important information.
Selection of theory is
Satisfactory however
application and/or
understanding limited.
Mostly relies on
secondary sources.
Use of primary evidence based sources
limited.
10 11.8 marks Demonstrates a
Good understanding of specialised/applied
knowledge of pathophysiology/ common acute and long-term health problems most or all the time.
Uses appropriate
information to evaluate options. Selection of final outcome clearly
derived from evaluation.
Good descriptive
knowledge of key
theories with some
appropriate application.
Some sound use of
primary evidence based sources, but
generally reliant on
secondary sources.
12 13.8 marks Very good demonstration and
critical insight and
ability to contrast
alternative pathophysiology.
Evidence of
independent reading
from a wide range of
appropriate sources.
Clear, accurate,
systematic application
of material.
Makes very good use of established techniques of analysis relevant to the discipline.
Assessment process is gathered from information gained via achievable, consistent to professional values
and/or code of conduct and appropriate to the
client / patient.
Uses a range of
appropriate information
to evaluate options and applies clear criteria to
demonstrate reasons for final decision and/or
choice and/or outcome.
Engages in argument and application of evidence-based practice/ literature.
14 15.8 marks Excellent demonstration of detailed, accurate understanding of pathophysiology.
Demonstrates
understanding of the complexity of the information gathering and processes it effectively.
Excellent use of a range of relevant analytic techniques, and applies these with a wide range and application of assessment and examination tools to new and/or abstract information and
situations.
Demonstrates an excellently detailed,
accurate, systematic
theoretical
understanding.
Assessment process is gathered from information gained via
achievable, consistent approach which is
within professional values and/or code of conduct and appropriate to the
rigorous argument and application of evidence-based practice.
Arguments demonstrate the ability to evaluate theories and/or concepts
and/or assumptions
and/or data.
Evidence of broad and/or
in-depth independent
reading from appropriate
sources.
Engages in argument and application of evidence-based practice/ literature.
16- 17.8 marks Outstanding sophisticated and comprehensive knowledge of the subject area.
Demonstrates outstanding understanding knowledge of pathophysiology with systematic knowledge.
Demonstrates an outstanding detailed, accurate, systematic
theoretical
understanding clearly addressing the assessment
appropriately and
consistently theoretically
informed.
Assessment process is outstanding and consistent with
professional values
and/or code of conduct and appropriate to the
client / patient. Uses a range of appropriate information,
exercising autonomy and initiative when exploring options.
Sophisticated, critical evaluation of theories and/or concepts and/or
assumptions and/or data which informs the overall approach taken.
A rigorous academic argument and application of evidence-based practice / literature.
Arguments are clear, coherent, tenable, and
demonstrate originality.
18- 20 marks
LO2
Validate clinical decisions by applying a range of theoretical principles and practical experience informing the generation of multiple hypotheses.
Analysing, interpreting and synthesising information from focused patient histories, presenting symptoms, clinical findings, investigations, in conjunction with using evidence-based resources, and underpinning relevant pathophysiological principles to develop coherent ranges of appropriate
differential diagnoses.
Critically evaluating own practice and implementing ongoing reflective strategies for development in the transition to being an expert practitioner.
Maximum 20 marks Demonstrates little or no analysis of evidence/data and makes little or no judgements about the appropriateness and the quality of the evidence and/or data.
Demonstrates little or no use of appropriate evidence / examples and therefore no integration or synthesis.
Has demonstrated no attempt to evaluate own clinical performance.
Offers no alternatives and final outcome is illogical.
0 7.8 marks Demonstrates an insufficient level of analysis and makes little or no judgement about the appropriateness and the quality of the evidence and/or data.
Demonstrates very limited integration of evidence.
Draws on insufficient evidence/ examples.
Is self-protective, and lacks ability to self-evaluate.
Misses alternatives
8 -9.8 marks Demonstrates a sufficient but limited level of analysis.
Demonstrates limited ability to judge the appropriateness and quality of the evidence and/or data.
Demonstrates sufficient integration of relevant and appropriate evidence.
Draws on limited evidence/ examples.
Even when promoted can only briefly verbalise obvious evaluations.
Has difficulty recognising alternatives.
10 11.8 marks Demonstrates a good level of analysis most of the time.
Shows good judgement in the appropriateness and the quality of the evidence and/or data most or all of the time.
Demonstrates a good level of integration and some synthesis of relevant and appropriate evidence.
Draws on a reasonable range of evidence/examples.
Able to demonstrate some evidence of analysis of own clinical performance.
Identifies some key alternatives.
12- 13.8 marks Demonstrates a very good level of analysis.
Shows very good judgement in the appropriateness and quality of the evidence and/or data.
Demonstrates a very good level of integration and synthesis of relevant and appropriate evidence drawing on a good range of evidence/ examples.
Evaluates and analyses own clinical performance.
Aware of key decision points and can identify/has considered alternatives.
14- 15.8 marks Demonstrates an excellent level of analysis.
Accurately judges the appropriateness and quality of the evidence and/or data.
Demonstrates an excellent level of integration and synthesis of relevant and appropriate evidence, drawing on a wide range of evidence/examples.
Evaluates and analyses own clinical performance.
Recognises key decision points and offers alternatives.
16- 17.8 marks Demonstrates an outstandingly sophisticated level of analysis.
Is perceptive and insightful in judging the appropriateness and quality of the evidence and/or data.
Demonstrates an outstanding level of integration and synthesis of relevant and appropriate evidence, drawing on an extensive range of evidence/ examples.
Independently evaluates and analyses own clinical performance.
Notes decisions points, elaborates on alternatives and accurately evaluates choices against alternatives.
18 - 20 marks
LO3
Appraise differential diagnoses by exercising clinical judgement to formulate a safe and evidence-based treatment and management plan.
Critically applying clinical reasoning and problem-solving processes to the assessment and management of patients with undifferentiated presenting health problems.
Accurately recording the outcomes of the clinical reasoning process and linked management and treatment plans.
Maximum 20 marks Demonstrates little or no evidence of critical appraisal/ critical thinking/clinical reasoning.
Appears to have been ineffective in seeking information.
Relies mostly on objective data.
0 7.8 marks Demonstrates insufficient evidence of critical appraisal/ critical thinking /clinical reasoning.
Focuses on only one aspect of the assessment and misses most of the patterns and deviations from data.
Unable to refine assessment as the data is collected.
8 9.8 marks Demonstrates sufficient but limited evidence of critical appraisal/ critical thinking/clinical reasoning.
Unable to focus on multiple aspects and misses patterns and deviations from expected pattern.
Misses the opportunities to use these to refine assessment.
10 11.8 marks Demonstrates good evidence of critical appraisal/ critical thinking/clinical reasoning.
Some recognition of patterns and deviations in data although appears unsure of how to utilise these in the assessment.
12 13.8 marks Demonstrates very good evidence of critical appraisal/ critical thinking/clinical reasoning.
Identifies obvious patterns and deviations in data and has demonstrated some evidence of utilising these to continue assessment.
14- 15.8 marks Demonstrates excellent evidence of critical appraisal/ critical thinking/clinical reasoning.
Recognises most obvious patterns and deviations in data and uses to provide a continuous assessment.
16- 17.8 marks Demonstrates outstanding evidence of critical appraisal/critical thinking/ clinical reasoning.
Recognises subtle patterns and deviations from expected patterns in data and uses this to guide assessment.
18 - 20 marks
LO4
Contextualize clinical and diagnostic reasoning and decision-making with reference to the underpinning epidemiology, pathophysiology and clinical measurement whilst managing patient safety.
Critical analysis of theoretical ideas related to clinical reasoning, problem-solving, and advanced practice.
Accessing and using a wide variety of information technology and related evidence-based resources.
Maximum 20 marks
Lacks a grasp of theories and concepts. Little or no evidence of independent thought or critical analysis.
Some key issues are identified, but little or no evidence of capacity to initiate and develop ideas. Errors or gaps in knowledge.
0 7.8 marks Insufficient or incorrect grasp of theories and concepts. Limited evidence of independent thought or critical analysis.
Some key issues are identified but developed insufficiently- lacks a depth and breadth. Ideas are described without sufficient analysis or application of evidence.
8- 9.8 marks Sufficient grasp of theories and concepts. Evidence of independent thought and developing critical analysis.
Key issues are identified, with some analysis, evaluation and synthesis could be developed. Sufficient breadth to demonstrate outcome.
10 11.8 marks Demonstrates some understanding of key theories concepts.
Evidence of independent exploration, critical analysis and synthesis.
Key issues identified and analysed clearly and coherently. There is evident engagement in critical dialogue.
12 13.8 marks Clear understanding of key concepts. Critical analysis and synthesis reflects the complexity of issues.
Creative identification, critical analysis and synthesis of key issues. Rigorous academic argument and application of evidence.
14-15.8 marks Clear, considered understanding of key concepts. Critical analysis and synthesis reflects the complexity of issues and approach taken.
Creative identification, critical analysis and synthesis of key issues. Rigorous academic argument and application of evidence. Enhances current professional practice
16- 17.8 marks Critical analysis and synthesis reflects the complexity of issues and approach taken.
Challenges current theory and practice.
Creative identification, critical analysis and synthesis of key issues. Rigorous academic argument and application of evidence. Challenges current professional practice
18- 20 marks
Referencing
accuracy, quality & relevance of sources
Maximum 6 marks Referencing is poor with many omissions and inconsistencies, multiple errors in use of referencing system.
Inadequate range of reading evident and/or inappropriate sources used.
0 2.3 marks Inadequate referencing technique, several errors evident. Acknowledged referencing system used.
Limited range of reading evident and/or some inappropriate
sources used.
2.4- 2.9 marks Sufficient referencing technique, some errors evident. Acknowledged referencing system used.
Acceptable range of reading evident and/or some inappropriate sources used
3- 3.5 marks Good referencing throughout, few minor errors. Acknowledged referencing system used.
Good range of reading demonstrated, and relevant academic sources used.
3.6 4.1 marks Very good referencing throughout, very few minor errors. Acknowledged referencing system used.
Wide range of reading demonstrated and contemporary academic sources used.
4.2 4.7 marks Excellent referencing technique throughout demonstrating command of the acknowledged referencing system. Very few errors. Excellent range of reading demonstrated and robust, contemporary academic sources used.
4.8 5.3 marks Outstanding referencing technique throughout demonstrating full command of the acknowledged referencing system. Fully and consistently referenced. Outstanding range of reading and robust, contemporary academic sources used.
5.4 - 6 marks
Organisation, Communication and Presentation
The assignment is well structured and logically written.
The student is organised and able to articulate.
Maximum 6 marks Demonstrates little or no structure with very poor/no
progression of discussion.
Disorganised and / or incoherent.
Work is difficult to read, distracting or irrelevant, offering no enhancement to the assessment task.
Assignment is not understandable or legible.
No obvious self-
awareness and/or
interpersonal skills.
Lack of conclusions, or
unsubstantiated and/or invalid conclusions
drawn.
Assignment is not
understandable and assignment objectives are not addressed0 2.3 marks Inconsistent or illogical structure with very limited
progression of discussion.
Insufficient organisation and presentation of the material is limited and / or basic.
Visual material is inconsistently presented and poorly integrated to enhance the assessment task.
Limited self-awareness
and/or interpersonal
skills.
Inadequate conclusions
are drawn which are derived from limited
understanding of
evidence and/or theory and/or literature.
2.4- 2.9 marks Demonstrates sufficient structure which is logical.
Sufficiently demonstrates sound,
conventional
organisation.
Presentation of the material is acceptable.
Sound conclusions are drawn which arederived from evidence and/or theory and/or
literature.
Assignment has a
sufficient structure.
Communication of work is effective and appropriate.
3 3.5 marks Demonstrates good structure which is logical.
Demonstrates logical
organisation and
coherence.
Presentation of the material is good.
Material is clearly integrated and creative in nature.
Conclusions show some development and critical insight, and relate clearly and logically to evidence and/or theory
and/or literature.
Clearly structured and addressed to audience.
Good communication which is demonstrative of knowledge.
3.6- 4.1 marks Demonstrates very good structure which is logical.
Strong logical
organisation and
coherence enhancesfulfilment of the
assignment objectives.
Material is of a very good standard,
demonstrating creativity and persuasive argument.
Conclusions well
developed, analytical,
and show some
originality. They are
thoroughly grounded in theory and/or evidence and/or literature and use appropriate forms of
conceptualisation,
forming an integrated
part of overall argument
and/or discussion.
Very good, effective communication, demonstrating a strong understanding of knowledge.
4.2 4.7 marks Demonstrates excellent structure which is logical.
Excellent organisation
and coherence clearly
enhances the work.
Excellent presentation of the material, which is creative and persuasively argued.
Conclusions excellent,
well-developed and show considerable originality. They form an integrated
part of the overall
argument and/or
discussion, reflecting
commanding grasp of
theory and/or evidence
and/or literature and
appropriate forms of
conceptualisation.
Excellent communication, demonstrating a sophisticated understanding of knowledge.
4.8 5.3 marks Demonstrates outstanding structure which is logical.
Outstanding organisation and coherence. Arguments are elegantly expressed.
Creative and confident
interpersonal skills
Outstanding conclusion demonstrating originality, creativity, and initiative.
Outstanding articulation, demonstrating a sophisticated, understanding of, knowledge and appreciation of the limitations of literature and alternative opinions.
5.4 - 6 marks
455003439795660007056755Module Leader: Phil Ward
360000Module Leader: Phil Ward
centercenter95000950004550034397952500266700Summative Assignment Brief 3700030000Summative Assignment Brief 440003326130250026670040000700004550034397956900073774303700004550034397953500037420557NH016
Clinical and Diagnostic Reasoning for Advanced Clinical Practice
36000280007NH016
Clinical and Diagnostic Reasoning for Advanced Clinical Practice
SUMMATIVE ASSESSMENT GUIDANCE
7NH016
Clinical and Diagnostic Reasoning for Advanced Clinical Practice
Summative Assessment
You are required to submit a 3000-word assignment.
This assignment should outline a patient of your choice from your role as a trainee Advanced Clinical Practitioner and should ideally be one who is pertinent to your area of advanced clinical practice that you have seen within this current semester.
The patient should present with an undifferentiated and undiagnosed problem that links to your role as a trainee Advanced Clinical Practitioner.
You should utilise the model of problem-solving presented by Crumbie (2006) and Barratt (2018) as a tool for critical analysing clinical reasoning in advanced clinical practice.
Within your work you should utilise appropriate literature and research to support your clinical and diagnostic reasoning and this poster should demonstrate your critical use of clinical reasoning. You must utilise your case study to demonstrate effective understanding and application of skills relating to clinical and diagnostic reasoning and your role as a trainee Advanced Clinical Practitioner.
Assignment format:
3000 words
Write in third person academic style.
Maintain confidentiality.
Size 12 font, double line space, Ariel or Verdana font
Ensure the poster is fully referenced using the Modified Harvard system see University of Wolverhampton website.
Points to consider:
Provide a clear overview of the undifferentiated and undiagnosed case study.
Make reference to your role as a trainee Advanced Clinical Practitioner within your organisation and your responsibilities within the case study please remember to ensure anonymity to place and person throughout the assignment.
Adopt an appropriate model of clinical reasoning.
Demonstrate wide reading and critical consideration of contemporary literature.
Apply clinical reasoning and problem-solving process to the assessment.
Demonstrate your analytic skills from gathering the focused patient history including presenting symptoms, clinical findings, investigations aiding your differential diagnosis and appropriate management plan.
Demonstrate your knowledge and applied understanding of pathophysiological principles for your chosen patient presentation.
Critically analyse and evaluate the concept of evidence-based practice, including using the most appropriate resources and terminologies for advanced practice.
Evaluate your learning from the case study by reflecting on strategies used to continue to develop as an advanced clinical practitioner.
Assessment
This assignment accounts for 100% of the module grade and therefore must be written in accordance with the principles for level 7 study.
The submission date can be found on the module timetable.
You must submit an electronic copy of your assignment no later than 2pm on the submission date.
Indicative Content Overview
Give an overview of the presenting case study and your role as an Advanced Clinical Practitioner
Evidence of the use of the problem-solving model. A brief overview of this model is provided at the end of this section.
Critically discuss elements such as Red Flags, Differential Diagnoses and additional tests.
Reflect upon the process, considering the positive areas and areas for potential improvement.
A reference list, utilising Harvard Refencing.
Overview of the problem-solving model
Introduction
In this section you should indicate the topic of your case study and the structural content of your case study. You should also introduce the context of your advanced clinical role and current workplace, followed by a brief introduction to your selected patient, including a brief overview of their past medical history. It is important that you maintain the selected patients anonymity by using a pseudonym.
Forming the initial concept
This section should detail how you developed your first impressions of the patient and / or carer. This section should include a one-sentence summary of your initial concept.
Generating multiple hypotheses
These are provisional explanations for your patients problem based on your initial concept and the patients opening statement. These multiple hypotheses should be prioritised as: likely; not likely; red flags. You are not expected to consider every conceivable multiple hypothesis for explaining the patients initial concept. You should present the hypotheses you actually considered at the time you cared for the patient, and then present other hypotheses you could have potentially considered but did not do so at the time.
Formulating an inquiry strategy
This is the patients health history section. You should present and comment on details of the patients presenting complaint as collected during your history taking. You should include rationale for asking your chosen history questions, in relation to your list of multiple hypotheses.
Incorporating the patients / carers perspective
You should use this section to show how you have attempted to discover the patients and / or carers ideas and concerns regarding their presenting problem. You should also demonstrate that you have attempted to elicit the patients and / or carers expectations for treatment. This section may also, but necessarily, consider the effects of the presenting problem on the patients life and their feelings about the problem.
Applying appropriate clinical skills
This section relates to your physical and / or psychological examination of the patient. You should explain your reasons for choosing to examine particular body systems, and you should present the interpreted details of your examination findings. This section includes general inspection of the patient and, if indicated, their vital signs.
Developing the problem synthesis
This section is where you combine the information from your history taking and physical examination in order to understand the implications of these findings in comparison to your list of multiple hypotheses. This comparison will lead you to develop a summary problem synthesis for your patient. Using this summary problem synthesis you should be able to retain or refute a number of your initially generated multiple hypotheses, whilst providing coherent rationale for doing so based on the preceding history and examination findings.
Laboratory and diagnostic findings
In this section you should discuss the selection with rationale, and results of any clinical tests you may have used such as dipstick urinalysis, laboratory tests, or imaging requests.
Diagnostic decision-making
In section you should state your selected differential diagnosis or diagnoses, whether these are tentative or final, and the reasons why you have chosen the particular diagnosis or diagnoses, with reference to underlying pathophysiology linked to observed clinical signs and symptoms.
Therapeutic decision-making
This is where in conjunction with the patient and / or carer you make a treatment decision. For example, this could be the decision to supply or prescribe a medicine. You must provide brief justification for your therapeutic choice. You should also include details of safety netting and follow-up arrangements, including actions to be taken by the patient and / or carers in the event of worsening and / or persisting signs.
Reflective conclusion
This section draws together what you have said in the main body of the assignment. It should reflectively summarise the assessment and analysis you have presented in the main text. In this section you should reflect upon your consultation and the interactions that occurred between yourself and the patient (and their carer if applicable), thinking about events that went well and those where improvements could be made. You may also find it possible to incorporate elements of reflection in the preceding sections of your case study.
Module Learning Outcomes
Remember that the assignment must pass each of the module learning outcomes:
LO1 - Demonstrate the ability to evaluate, apply and critically synthesize a range of theories, concepts and approaches to clinical reasoning and diagnostic decision making:
Demonstrate knowledge of pathophysiological principles for application to a range of patient presentations.
Demonstrate a coherent understanding of common acute and long-term health problems for patients across the life span, and the relevance of age to the assessment process.
Demonstrate an understanding of the concept of evidence-based practice, including using clinical evidence-based resources and terminologies for advanced practice.
LO2- Validate clinical decisions by applying a range of theoretical principles and practical experience informing the generation of multiple hypotheses:
Analysing, interpreting and synthesising information from focused patient histories, presenting symptoms, clinical findings, investigations, in conjunction with using evidence-based resources, and underpinning relevant pathophysiological principles to develop coherent ranges of appropriate differential diagnoses.
Critically evaluating own practice and implementing ongoing reflective strategies for development in the transition to being an expert practitioner.
LO3 - Appraise differential diagnoses by exercising clinical judgement to formulate a safe and evidence-based treatment and management plan:
Critically applying clinical reasoning and problem-solving processes to the assessment and management of patients with undifferentiated presenting health problems.
Accurately recording the outcomes of the clinical reasoning process and linked management and treatment plans.
LO4 - Contextualize clinical and diagnostic reasoning and decision-making with reference to the underpinning epidemiology, pathophysiology and clinical measurement whilst managing patient safety.
Critical analysis of theoretical ideas related to clinical reasoning, problem solving, and advanced practice.
Accessing and using a wide variety of information technology and related evidence-based resources.
