Advanced Clinical Reasoning in Primary Care
Module title | Advanced Clinical Reasoning in Primary Care |
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Module code | HPDM163 |
Academic year | 2023/4 |
Credits | 30 |
Module staff | Dr Rob Daniels (Lecturer) |
Duration: Term | 1 | 2 | 3 |
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Duration: Weeks | 0 | 8 | 0 |
Number students taking module (anticipated) | 30 |
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Module description
This module will help you as an experienced clinician working in primary care to develop your consultation and clinical reasoning skills to manage complex patients in a primary care setting. You will cover theory of advanced clinical assessment, combined with practical and workplace learning around advanced consultation skills, motivational interviewing, and managing challenging patients. This course is most suitable for clinicians who have several years experience post- qualification working in a first contact role, such as GP’s or experienced Advanced Clinical Practitioners who wish to develop their skills to manage complex patients. This module involves you learning in a clinical workplace , so is not appropriate if you do not work in these roles.
Module aims - intentions of the module
This module will cover the theoretical basis of clinical reasoning, living with uncertainty and human and system factors that affect clinical reasoning. You will work in small group sessions to develop practical skills, followed by workplace learning and application of these skills to build expertise in managing the most complex patients and support development of advanced roles in primary care, such as managing complex frailty and multimorbidity.
Intended Learning Outcomes (ILOs)
ILO: Module-specific skills
On successfully completing the module you will be able to...
- 1. Demonstrate critical understanding of the theory underpinning clinical reasoning, diagnostic error and living with uncertainty
- 2. Demonstrate expertise in the theory of advanced consultation skills to manage complex presentations and behaviour
- 3. Critically appraise and apply the principles of rational use of investigations to support the diagnostic process
ILO: Discipline-specific skills
On successfully completing the module you will be able to...
- 4. Apply critical thinking skills to analyse and reflect on diagnostic processes
- 5. Demonstrate advanced consultation, motivational interviewing and coaching skills for patient care
- 6. Demonstrate advanced skills in the use of technology (including investigations) to support clinical reasoning
ILO: Personal and key skills
On successfully completing the module you will be able to...
- 7. Demonstrate advanced skills in clinical assessment to facilitate management of complex patients
- 8. Understand and deploy critical thinking skills to improve reliability of patient assessment within health systems
Syllabus plan
Whilst the module’s precise content may vary from year to year, an example of an overall structure is as follows:
1. Self-directed learning around theory of dual process cognition as applied to healthcare
2. Self-directed learning around uncertainty tolerance as applied to healthcare
3. Self-directed learning around advanced consultation and coaching skills
4. Contact days providing small group learning on practical application of theory, in multidisciplinary groups
5. Small group and workplace learning
Learning activities and teaching methods (given in hours of study time)
Scheduled Learning and Teaching Activities | Guided independent study | Placement / study abroad |
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44 | 256 | 0 |
Details of learning activities and teaching methods
Category | Hours of study time | Description |
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Guided independent study | 76 | Seminar preparation for course using ELE: Interactive, pre-course reading of online material |
Guided independent study | 180 | Workplace learning, small group preparation, preparing portfolio for submission |
Scheduled learning and teaching activities | 24 | Mixture of mini-lectures, small group work and interactive arena sessions |
Scheduled learning and teaching activities | 20 | Small group, case based discussion |
Formative assessment
Form of assessment | Size of the assessment (eg length / duration) | ILOs assessed | Feedback method |
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Completion of online interactive pre-course material via ELE | 6 hours | 1-6 | Online feedback |
Case presentations in small groups | Ongoing through CBD groups | 1-8 | Peer and faculty feedback |
Summative assessment (% of credit)
Coursework | Written exams | Practical exams |
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100 | 0 | 0 |
Details of summative assessment
Form of assessment | % of credit | Size of the assessment (eg length / duration) | ILOs assessed | Feedback method |
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Reflective account of a case study involving complex presentation | 50 | 2000 words | 1-8 | Written feedback |
Portfolio | 50 | 5000 words | 1-8 | Written feedback |
Details of re-assessment (where required by referral or deferral)
Original form of assessment | Form of re-assessment | ILOs re-assessed | Timescale for re-assessment |
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Reflective account of a case study involving complex presentation (50%) 2000 words | Reflective account of a case study | 1-8 | 6 weeks after initial assessment |
Portfolio (50%) 5000 words | Portfolio | 1-8 | 6 weeks after initial assessment |
Re-assessment notes
Please refer to the TQA section on Referral/Deferral: https://as.exeter.ac.uk/academic-policy-standards/tqa-manual/aph/consequenceoffailure/
Indicative learning resources - Basic reading
- Macleod's clinical examination by Robert Britton; Ethan Danielson 2018
- Symptom sorter by Keith Hopcroft; Vincent Forte 2020
- Psychosocial Assessment in Mental Health by Steve Trenoweth; Nicola Moone 2017
- Thinking Fast and Slow by Daniel Kahneman, 1st edition, Penguin 2012
- Risk and Reasoning in Clinical Diagnosis by Cym Ryle, 1st edition, OUP 2019
- The Cognitive Autopsy: A Root Cause Analysis of Medical Decision Making by Pat Croskerry, 1st edition, OUP 2020
Indicative learning resources - Web based and electronic resources
- ELE – Faculty to provide hyperlink to appropriate pages – tbc but will closely resemble: https://vle.exeter.ac.uk/auth/saml2/sp/saml2-acs.php/vle.exeter.ac.uk
Indicative learning resources - Other resources
- Virtual primary care (https://www.medschools.ac.uk/our-work/education/virtual-primary-care)
Credit value | 30 |
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Module ECTS | 15 |
Module pre-requisites | None |
Module co-requisites | None |
NQF level (module) | 7 |
Available as distance learning? | No |
Origin date | 05/01/2023 |
Last revision date | 03/02/2023 |