profile of learning opportunities - northumbria university · the physiotherapy department is...

Muskeloskeletal Hexham 2009

of 25 Kristin Moat Last Updated - 17 Jun 2009

Physiotherapy Department Hexham General Hospital

Corbridge Road, Hexham, NE46 1QJ

Tel 01434 655031 Fax 01434 655033

Profile of Learning Opportunities

Hexham General Hospital – Musculoskeletal Services Welcome to the physiotherapy department at Hexham General Hospital (HGH).

HGH is a general hospital serving the community of Hexham and the Tyne Valley, a district that lies

between Newcastle and Carlisle.

The Physiotherapy Department is staffed by 28 physiotherapists who work on the wards, in the

outpatient clinics, in outreach clinics and in the community

The musculoskeletal department has a staff complement of 8 staff and covers all musculoskeletal

conditions. Within these areas, we offer a variety of services, most of which are available to participate

or observe (Additional Learning Outcomes).

We strive to make the placement as enjoyable and productive as we can and we hope you enjoy your

time with us. Please feel free to feedback on any aspect of your experience.

Kristin Moat

Clinical Specialist Physiotherapist



Table of Contents

Profile of Learning Opportunities .........................................................................................................................1

HEXHAM GENERAL HOSPITAL – MUSCULOSKELETAL SERVICES .................................................................................1

Table of Contents ...................................................................................................................................................2

Introduction .............................................................................................................................................................3

Pre-Placement Information ....................................................................................................................................4

Induction Checklist .................................................................................................................................................5

Placement Development Plan ...............................................................................................................................6

CP 1 BSC PL057 FOUNDATIONS OF PHYSIOTHERAPY WITH CLINICAL PRACTICE 1 (MSC PL075 FOUNDATION

SCIENCES WITH CLINICAL PRACTICE 1, 2 AND 3) .......................................................................................................6 CP 2 (MSC PL075 FOUNDATION SCIENCES WITH CLINICAL PRACTICE 1,2 AND 3) .....................................................6 CP 3 BSC PL062 THERAPEUTIC SKILLS WITH CLINICAL PRACTICE 3 (MSC PL075 FOUNDATION SCIENCES WITH

CLINICAL PRACTICE 1, 2 AND 3) ...............................................................................................................................7 CP 4 BSC PL064 EVIDENCING PRACTICE WITH CLINICAL PRACTICE 4 (MSC PL076 CLINICAL SCIENCES 1 WITH

CLINICAL PRACTICE 4 AND 5) ...................................................................................................................................7 CP 5/6 BSC PL065 PHYSIOTHERAPY PRACTICE WITH CLINICAL PRACTICE 5, BSC PL063 PHYSIOTHERAPY SKILLS

WITH CLINICAL PRACTICE 6( MSC PL076 CLINICAL SCIENCES 1 WITH CLINICAL PRACTICE 4 AND 5) ...........................7 CP 7 BSC PL066 ELECTIVE CLINICAL PRACTICE 7(MSC PL077 CLINICAL SCIENCES 2 WITH CLINICAL PRACTICE 6

AND 7) ....................................................................................................................................................................8 CP 8/9 BSC PL067 INTEGRATED REASONING WITH CLINICAL PRACTICE 8 AND BSC PL068 DEVELOPING EFFECTIVE

CLINICAL PRACTICE WITH CLINICAL PRACTICE 9 (MSC PL077 CLINICAL SCIENCES 2 WITH CLINICAL PRACTICE 6 AND 7

AND MSC PL078 CONTEXTUAL ISSUES IN HEALTH AND SOCIAL CARE WITH CLINICAL PRACTICE 8) .............................8

Learning Zones .......................................................................................................................................................9

Learning Outcomes ............................................................................................................................................. 10

INTERPERSONAL SKILLS ....................................................................................................................................... 10 CLINICAL SKILLS .................................................................................................................................................. 11 ORGANISATIONAL/MANAGEMENT ISSUES ............................................................................................................... 12

Additional Learning Outcomes .......................................................................................................................... 13

Reflective Diary – Week 1 ................................................................................................................................... 14






Additional References ......................................................................................................................................... 20

Section 2 ............................................................................................................................................................... 21

STUDENT INFORMATION........................................................................................................................................ 21 PREVIOUS EXPERIENCE ........................................................................................................................................ 22 SNOB ANALYSIS FORM ....................................................................................................................................... 23 SNOB ANALYSIS FORM ....................................................................................................................................... 24 SNOB ANALYSIS FORM ....................................................................................................................................... 25



Introduction

Policies and Procedures On your first morning we will highlight the appropriate policies and procedures you need to be aware of throughout your placement. One of the reception staff will take a copy of your signature for legal purposes. Your supervisor will show you the following during your induction: Fire points – exits, alarms and extinguishers Resuscitation trolley and equipment Incident book (It is very important to report any accidents/incidents or near misses in relation to yourself or a patient when on placement) Further Safety Issues Do not proceed with any treatment following an initial assessment until you have discussed with your supervisor. If you are planning to change a treatment this should also be discussed with your supervisor first. Do not switch on any electrotherapy machines until a qualified member of staff has checked the setting/dosage. Mobile phones must be switched off before you enter the hospital as they interfere with medical equipment.

Musculoskeletal Out Patient Staffing Team Leader Lesley Black Clinical Specialist Kristin Moat Senior 1 John Alexander Senior 2 Static Senior II - Helen McKay

3 Rotational Senior II Junior 1 Rotational Junior Post Assistant Ailsa Wraith



Pre-Placement Information

Pre Placement Information

Placement / Specialty: Musculoskeletal Out-Patients

Static Clinical Educators: Kristin Moat, Helen Bell We also have rotational staff who may have an input into your education.

Contact Address: Physiotherapy Department Hexham General Hospital Corbridge Road, Hexham, NE46 1QJ Tel 01434 655031 Fax 01434 655033

E-mail: [email protected]

Directions: Nexus Journey Planner Google Maps

First Day: Report to designated clinical educator Where – Physiotherapy reception desk, HGH When – 08:30 (normal hours 8.30am-4.30pm, lunchtime 12:15-13:15)

Uniform requirements: White tunic, navy blue /black trousers, black shoes (long hair tied back)

Lockers: May be available, please ring to confirm. Padlock will be required.

On site parking: Available but limited.

Canteen facilities: Canteen and WRVS shops on site if needed.

Common conditions to be treated:

All Musculoskeletal conditions from chronic pain to acute soft tissue and fracture injuries, involving all sites of the locomotor system.

Suggested pre-reading: – Kesson & Atkins (1998), Orthopaedic Medicine (or something similar) (ISBN 0-7506-2543-0)

– Magee (2002) Orthopaedic Physical Assessment (ISBN – 978-0721662900)

– Kenyon & Kenyon (2004) The Physiotherapists Pocket Book (ISBN 0-443-07318-X)

– Any favourite anatomy resource – brush up on all musculoskeletal anatomy

Patient Contact Students can expect to have direct patient contact on day 1 of their placement. This will initially take the form of shadowing qualified staff until we and you feel you have the required skills and knowledge to have direct involvement.

mailto:[email protected]

http://217.23.229.206/jpclient.exe?newQuery=newQuery

http://maps.google.co.uk/maps?f=q&source=s_q&hl=en&geocode=&q=ne46+1QJ&sll=53.800651,-4.064941&sspn=17.707104,39.375&ie=UTF8&ll=54.969867,-2.09495&spn=0.002094,0.004807&t=h&z=18



Induction Checklist

Induction Task Completed

Policies and Procedures

Cardiac Arrest: procedure, equipment ,tel no. x2222 First Aid Box Location, Resus trolley location

Fire: escapes, alarms, extinguishers, tel no. x4444

Reporting Incidents: procedure and IR1 forms

Health & Safety Rep / Steward

Introduction to staff

Illness Procedure: phone reception 8am

Housekeeping: toilets, changing/lockers, general up-keep of dept

Working Hours: lunch, breaks

Diary system / appointments

Paperwork: documentation etc.

Location of exercise sheets, assessment forms etc

Computer Use

Placement Development Plan

Library Location / facilities

Name of Clinical Educator ..................................................................

Date Placement Started and Ended ..................................................................

Signed as Complete Educator ....................................................

Student ......................................................



Placement Development Plan This is a guideline of what specific content and assessment will be included in each placement. It is in addition to the core learning and assessment provided and dictated by the University.

CP 1 BSc PL057 Foundations of Physiotherapy with Clinical

Practice 1 (MSc PL075 Foundation Sciences with Clinical

Practice 1, 2 and 3) Content

Induction and observation of workplace – observing differing styles and types of subjective questioning and comparing differing models of care.

Assist in subjective examination and assist in moving and handling of patients.

Joint subjective assessment with staff and assist in objective examination.

Leading the subjective examination if the student has shown the ability to do so. Assessment

Feedback of different styles of subjective questioning and models of care used by individual staff members

Observation of subjective examination.

CP 2 (MSc PL075 Foundation Sciences with Clinical Practice

1, 2 and 3) Content

Induction and observation of workplace

Lead on subjective examination and assist in objective examination – observe different styles of questioning.

Joint objective assessment with staff and demonstration of clinical reasoning process using models of reasoning (Explanatory, Hypothetico Deductive, Pattern Recognition, Knowledge reasoning Integration)

Improve clinical reasoning skills through assessment

Increased input into clinical examination skills Assessment

Observation of subjective examination

Continuous assessment of knowledge, esp anatomy

Production of case summary



CP 3 BSc PL062 Therapeutic Skills with Clinical Practice 3

(MSc PL075 Foundation Sciences with Clinical Practice 1, 2

and 3) Content

Induction to workplace

Lead subjective assessment and joint objective assessment esp study of human movement (ie, Anatomical positions, axes/planes of movement)

Increased involvement in objective assessment

Increased demonstration of clinical reasoning skills, introducing/expanding on differential diagnosis

Assessment

Observation of full assessment (subjective and objective)

Evaluation of clinical reasoning skills

Continuous assessment of knowledge, esp. anatomy of spinal structures and function

CP 4 BSc PL064 Evidencing Practice with Clinical Practice 4

(MSc PL076 Clinical Sciences 1 with Clinical Practice 4 and 5) Content


Critical appraisal of piece of literature using tool of choice (UNN, CASP, SIGN etc)

Lead on subjective and objective examination and demonstrate effective reasoning using models from CP2

Create and implement treatment plans for all patients in discussion with qualified staff

Increase treatment ‘toolbox’ and appropriateness of each technique Assessment



Presentation of Case Study

Appraisal of relevant literature

CP 5/6 BSc PL065 Physiotherapy Practice with Clinical

Practice 5, BSc PL063 Physiotherapy Skills with Clinical

Practice 6( MSc PL076 Clinical Sciences 1 with Clinical

Practice 4 and 5) Content


Lead on assessments, progress clinical reasoning, handling skills and ‘toolbox’

Develop and independent caseload.

Reason choice of assessment and treatment techniques through sound clinical reasoning

Identify a paper of clinical relevance and appraise



Time management priorities Assessment



Presentation of Case Study


CP 7 BSc PL066 Elective Clinical Practice 7(MSc PL077

Clinical Sciences 2 with Clinical Practice 6 and 7) Content


Build on previously learned skills and knowledge from CP1-6 (MSc 1-5) Assessment



Presentation of Case Study / In service training package of student’s choice


CP 8/9 BSc PL067 Integrated Reasoning with Clinical Practice

8 and BSc PL068 Developing Effective Clinical Practice with

Clinical Practice 9 (MSc PL077 Clinical Sciences 2 with Clinical

Practice 6 and 7 and MSc PL078 Contextual Issues in Health

and Social care with Clinical Practice 8) Content


Consolidation of prior learning

Demonstrating ability to adapt provision to encompass a problem solving and goal oriented approach

Implement independent and autonomous assessment and practice

Integrate knowledge of national and local priorities and guidelines into treatment planning and progression

Assessment

Assessment of full assessment with particular emphasis on clinical reasoning, goal and objective setting.

Present case study with appraisal of the appropriate literature. Throughout the placement there will be the opportunity for self directed learning and many learning opportunities as listed overleaf. This will include attending in service training with the junior staff. You will be relating evidence based practice to the clinical workplace. You will have allocated time set aside with your clinical educator to review and reflect on your caseload and treatment progression one to one.



Learning Zones This diagram

shows all the

relationships that

you may

encounter and

build during your

placement at

HGH, depending

on the patients

that come through

the department

and your own

learning

outcomes and

interests.

Orthotics

Clinics

Clinical Educator

Physio Staff

Reception Team

Other Physiotherapy Units

Pain Manageme

nt

Rheumatol

ogy

Orthopaedi

cs

HGH

Physio



Learning Outcomes

Interpersonal Skills

Learning Opportunity Resource / Personnel

Effective communication, talking / interaction with patients / clients / carers / relatives / teaching staff in a variety of settings. Awareness of own communication skills both verbal and non-verbal. Demonstrate sensitivity for patients / carers / relatives in relation to distressing information Use of telephone / answering calls / bleep Systems. Use of computer, email and internet Demonstrate effective communication and professionalism with other relevant professionals involved in patients care. Holistic care of different groups of people (young, elderly, learning difficulties). Promotion of patients compliance with treatment/ health promotion strategies/ medications

Clinical Educator/OPD Staff/ Reception staff Clinical Educator / OPD Staff / Reception staff Clinical Educator / OPD Staff / Reception staff Clinical Educator / OPD Staff / Reception staff Consultant / GP / OT / Occupational Health Nurse / ECC Clinicians etc CSP – Rules of Professional Conduct Clinical Educator / OPD Staff Clinical Educator / OPD Staff



Clinical Skills

Learning Opportuity Resource / Personnel

Spinal / peripheral joints Chronic / acute conditions Post surgical / trauma / elective surgery Rheumatological Conditions Interactive Anatomy Sessions Dedicated teaching time Non-patient contact time

Documentation

Record keeping standards

Clinical Educator/OPD Staff/MDT OPD Staff Clinical Educator There sill be time to reflect when not attending to patients (reference material is available in dept) Library facilities, internet / intranet CSP documentation standards

Writing should be legible in black ink Every entry should be dated, timed and signed and then countersigned by clinical educator Every side of paper requires patients name / DOB and numbered



Organisational/Management Issues

Learning Opportunity Resource / Personnel

Management of workload Use of computer systems / PAS / PACS / PhysioTools / intranet. Accessing patient results – medical notes, PACS (x-rays) Interprofessional working. Effective team management including appropriate delegation of duties. Awareness of knowledge base and skill mix. Departmental policies Reporting incidences Faulty Equipment

Paper diary – this will contain allocated teaching / appraisal time on starting placement, student will then be responsible for use (booking patients / additional learning opportunities etc) 1hr for new patient, ½ hr → 1hr for review time allocated for documentation Clinical Educator / Admin. staff Clinical Educator / Admin. staff MDT These are located in Lesley’s office. Please familiarise yourself with the health and safety, manual handling and infection control policies on your first day. All ‘incidences/near misses’ must be documented on IR1 forms located in Lesley’s office. In the event of this occurring your Clinical Educator must be informed. Inform physiotherapy staff working in the area. May also need to inform works department.



Additional Learning Outcomes

Additional Learning Outcomes Interest Completed

Orthopaedic Theatre

A session in either orthopaedic or trauma theatre to observe the

orthopaedic surgeons either perform elective or trauma surgery (Eat

beforehand!)

__-__-__

Open Gym Rehabilitation

This session is led by a senior physiotherapist and is an ‘open gym’

session where patients are given an individual exercise programme

and supervised by the staff. A good experience on how to plan,

deliver and evaluate a gym based rehab programme.

__-__-__

TENS Trial Class

TENS is a modality relying on technology to help patients self

manage and control their pain. This class outlines the theory and

practice of TENS and allows the patients to loan a TENS machine for

1 week.

__-__-__

Joint Replacement Class

Patients who undergo knee joint replacement have the opportunity

to attend this class to improve their level of function and exercise

tolerance.

__-__-__

Orthopaedic Clinic

Working alongside one of the orthopaedic surgeons, you can observe

the array of patients that visit an orthopaedic clinic and how the

consultant approach differs from that of physiotherapy.

__-__-__

Rheumatology Clinic

Working alongside the rheumatologist who visits Hexham. See the

difference in the way that the rheumatologist works in comparison to

physiotherapy and how they use careful questioning and

investigations to determine a diagnosis and plan of treatment.

__-__-__

Community Musculoskeletal Physiotherapy

With Northumberland being a huge geographical area, we work not

only in the hospital but in the community and satellite clinics. Spend

a day with one of the community staff observing the differing way of

working in the community and regional centres in the treatment of

musculoskeletal patients.

__-__-__

Name of Clinical Supervisor / Rotation Coach ..................................................................

Date Placement Started and Ended ..................................................................

Signed as Complete Student ......................................................

Educator ....................................................


of 25 Kristin Moat Updated - 17-Jun-2009

Reflective Diary – Week 1 This diary is intended to be used as a reflective diary of each days experience whilst on placement, not to record appointments.

Monday Tuesday Wednesday Thursday Friday

AM

PM

Reflection Reflection Reflection Reflection Reflection





AM

PM




Additional References

University of Northumbria (http://northumbria.ac.uk)

Chartered Society of Physiotherapy (http://www.csp.org.uk)

Interactive CSP (http://www.interactivecsp.org.uk)

CSP e-portfolio (http://eportfolio.csp.org.uk)

Northumbria Healthcare NHS Foundation Trust (http://www.northumbria.nhs.uk/)

Wheeless Textbook of Orthopaedics (http://www.wheelessonline.com/)

Orthoteers (http://www.orthoteers.com/)

Anatomy Tables (http://anatomy.uams.edu/anatomyhtml/medcharts.html)

Kristin’s physio related delicious.com bookmarks (http://delicious.com/krismoat/work)

http://northumbria.ac.uk/

http://www.csp.org.uk/

http://www.interactivecsp.org.uk/

http://eportfolio.csp.org.uk/

http://www.northumbria.nhs.uk/

http://www.wheelessonline.com/

http://www.orthoteers.com/

http://anatomy.uams.edu/anatomyhtml/medcharts.html

http://delicious.com/krismoat/work



Section 2

Student Information In order to help us contact you or your next of kin if required and get a background of your previous

knowledge and experience, each student must complete the following sections and send back to the

physiotherapy department prior to starting the placement.

Personal Details

Base: Hexham General Hospital - Musculoskeletal

Name:

Address:

Telephone Number:

Emergency Contact Details

Contact Person:

Relationship:

Address:

Telephone Number

Work:

Home:

Mobile:

GP Details

GP Name:

GP Address:

GP Telephone Number



Previous Experience

Previous Placements and Experience

Previous Musculoskeletal Experience (if any) Please identify if you have had experience in the following:-

Taking a subjective history Yes / No

Objective Examination of:

o Lumbar Spine Yes / No

o Cervical Spine Yes / No

o Shoulder Yes / No

o Elbow / Wrist / Hand Yes / No

o Hip Yes / No

o Knee Yes / No

o Foot & Ankle Yes / No

Management of chronic pain Yes / No

Expectations of this placement

Other Information



SNOB Analysis Form Pre-Placement Halfway Final

Strengths What can I do really well?

Needs What do I need to develop?

Opportunities What opportunities exist or might become available to help me to achieve my goals?

Barriers What may act to inhibit my progress? Who might get in the way?

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