The Clinical Skills Centre

About the Clinical Skills Centre
The Clinical Skills Centre is located on the third floor of the Cochrane building, on the Heath Park Campus. The skills centre is equipped with realistic, anatomically correct models to assist in the teaching and practise of a wide range of procedural clinical skills. Teaching currently takes place in Year 2, and Year 3, with a range of practical skills being taught in a relaxed and student centred approach to learning. Small groups of students are led by experienced tutors, many from the Department of Anaesthetics and Intensive Care Medicine, and formatively assessed following the practical element of the session.

Self-directed Study
Students are required to access on line e-learning modules prior to attending timetables clinical skills teaching. These attractive, easy to follow modules provide key theoretical components of the clinical procedure, prior to the student attending the practical session. The e-learning modules are found within the ‘Clinical Skills Resources’ section of Learning Central (requires login).

Clinical Skills Modules

Revision Sessions
Revision sessions are often made available to students. These sessions are particularly useful to students approaching exams, or for those who may require a little more time to practise a skill, before attempting a supervised procedure in the Clinical setting. Access to the self booking system for revision sessions is found within the ‘Clinical Skills’ section of Learning Central. Dates will be posted nearer exam time, or when enough students request a session. We are currently in the process of setting up a Self-Directed clinical skills area in Ty Dewi Sant.

Please e-mail clinical skills manager/tutor Sian Williams if you require further information.

< About Sian Williams

Links
CETL Clinical Skills Video Tutorials
Clinical Skills Online (St. George's University)

Clinical Skills Laboratories Health and Safety Brief
Year 2 Student guide to Practical Skills Teaching 2011-2012
Year 3 Student guide to Practical Skills Teaching 2011-2012

ePortfolio

Overview
The ePortfolio software currently used on the Undergraduate curriculum has been developed in-house to support the Year 5 requirements to encourage structured reflective writing, to provide a mechanism to get feedback on that writing and to provide assessment tools that allow online submission and marking. At time of development no COTS product could be identified that fulfilled these requirements.

The system has been developed with significant influence from blogging engines, but adding additional structuring and tools to facilitate the guided reflection the Year 5 programme wished to cultivate. The portfolio also has a strong concept of privacy, with student content being private unless they choose to share it. However, they are free to share their content with anyone.

The portfolio provides an online rich text editor (similar to a blogging engine) with the ability to attach files and images. To support reflective writing, the ePortfolio includes a mechanism to provide templates to the students to provide structure and guidance. The templates are loaded into the rich text editor (if a student selects one) and the student can then work within the template to create their content.

Students can organise their content using keywords (tags and groups) and can share their content with anyone else by using the person’s email address to invite them to view items of content. This use of email address allows users without Cardiff University login details to also gain access to the system.

The ePortfolio uses groups to provide organisation within the portfolio and providing a subset of students with access to specific templates, information and assignments.

System Usage
To-date the ePortfolio is only used in Year 5. It was initially introduced to support students on their Medicine in the Community placement. Since then the system has been rolled out across the whole of Year 5, with requirements to produce reflective content for all three of the Year 5 clinical placements. The system has undergone a number of revisions to support this expansion and to resolve technical problems experiences by students on placements where there is either poor or no Internet connectivity.

The Medicine in the Community placements are the only placements using the submission and marking tools built in to the ePortfolio.

System Administration & Support
System administration has become simpler and less time consuming as the system has developed and become more robust and user friendly.

Main areas of administration are:

Configuration of the Groups for each of the placements during each academic session. This is usually a matter of copying groups from the previous year and adding students to the appropriate groups.

Occasionally additional templates or resources have to be added to groups to meet the changing requirements of the course.

Support for Students
Sometimes students change the order of their rotations requiring their access to groups to be modified. Other technical problems do occur occasionally, which require investigation.

Support for NHS Staff
NHS staff access the ePortfolio through the email invitation system. When they are invited to view a student’s content they receive an email informing them of this. The first time they access the system they are required to activate their account, providing a few personal details and a password.

Once this has been completed they can log in using their email address as a user name and the password they generated during activation. This process can sometimes cause problems (missing emails, forgotten passwords, misread emails etc.), and it is necessary to diagnose and resolve problems with NHS staff accessing the site. The System Administration tools provide information on the state of an account (e.g. whether it has been activated or not) as well as the ability to reset a password (there is also an automated password rest function available from the log in screen).

Future Plans
A number of initiatives within the School will have significant impact on the future of the current ePortfolio system:

The Harmonisation programme is looking to blur the lines between the fifth year of the undergraduate course and the first year Junior Doctor programme. Use of the ePortfolio system currently used by the Junior Doctor programme within Year 5 is strongly being considered.

The C21 curriculum redesign programme is generating a lot of interest in ePortfolios across the curriculum. At present discussions are fragmented and there is need to ensure discussions about an ePortfolio and the associated requirements are curriculum-wide to ensure any solution is used and applied consistently across the curriculum and that the purpose of the portfolio is well understood by staff and students.

Along with the discussions above about use of an ePortfolio there is a real need to look at the ePortfolio from an educational and a student perspective. It is vital the purpose of the portfolio is clear and well communicated and it is not just a tool used for administrative benefits.

Questionmark Perception (QMP)

Information Services provide a centrally supported Questionmark Perception service available for formative assessments. The system is available via Learning Central through the Blackboard Connector, or through the systems own web interface.

At present the undergraduate medical curriculum makes no use of this service, but it is expected that the new curriculum will make extensive use of online assessment, and QMP will likely be the system used.

At present it is necessary to contact Information Services prior to running an assessment through QMP to ensure QMP has the necessary capacity (current licensing restricts the number of concurrent users on the system) when the assessment is run.

Practical Skills Log

Overview
The Skills Log has been developed in-house over the last 12 months. The log is an attempt to improve the way Clinical Skills teaching is managed and assessed over the five years of the undergraduate programme.

Traditionally Clinical Skills have been taught in specialist Clinical Skills labs. Skills have then been practiced, first in the skills labs, and later in the clinical environment under the supervision of a Healthcare professional.

Assessment of skills has been done using OSCE examinations, with students requiring at least one of each of the clinical skills to be observed by a Healthcare Professional in a clinical setting during the final year.

The purpose of the Skills Log is track the opportunites students have to practice their clinical skills in the clinical setting, which is where much of the real learning occurs. The purpose of this tracking is many-fold:

• To help students track their own progress and take responsibility for gaining opportunities to practices skills, allowing them to identify short comings in their own experience and competence.
• To help the School monitor the opportunities students are getting to practice skills and resolve any short comings identified
• To help the School assess the Clinical Skills teaching being provided by looking at overall student performance for each skill.

The log as a system currently comprises a paper-based log book, with tear-off sheets, and the online website, where data is eventually stored and analysed. In the clinical setting students will use the paper-based log book to capture feedback on their performance from themselves, peers and Health-care Professionals. This information is later transcribed into the online log.

Currently the system is in pilot. We have already gathered feedback from the 2011 Diagnostic Synthesis placement, where the log was first used by students. This feedback has resulted in version 2 of the log being released, which addresses a number of concerns raised.

In particular the system has moved away from attempting to verify every transcribed log entry by email. While this was requested by Honorary Senior Lecturers, the clinicians on the ground have been less receptive to this idea and have resented the volume of email being sent. We have also encountered problems with emails being filtered. To this end the system has been modified to only spot check around 10% of entries, which is being trialled now. Hopefully this will appease clinicians, make it less awkward for students to ask for feedback, and make the system more manageable for school administrators.

Future plans
There are number of areas for refinement and development, as well as a need to look at the educational philosophy associated with the tool and its use.

Use of paper-based log books
The current use of paper-based log books and the need to transcribe that data into the online log at a later time is a little clumsy. This can almost certainly improved (though not entirely removed) through the use of mobile technologies. An increasing number of students have smart phones and we have been looking to develop a mobile interface for the log to allow digital capture of the initial data in place of the paper-based log book. Currently work has started (but is on hold) on a mobile version of the Skills Log website, with support for offline access and data storage. Long term, native mobile apps may be a better option.

CUSUM analysis
CUSUM analysis is a statistical technique that can be used for demonstrating competence. This is currently being evaluated and has been implemented and enabled for tutors and administrators to view for individual students. Work will need to be done to refine the parameters being used for the analysis and to validate the outputs of the analysis against OSCE results and feedback from Health-care professionals on a student’s capability.

Educational philosophy
As a pilot this tool suffers from not being well integrated into the teaching and assessment methodology for clinical skills. We are asking students to gather lots of data and lots of signatures, and encouraging them to gain lots of practice, while still requiring them to complete traditional assessments. In short, the tool is not yet well embedded into the Clinical Skills teaching and assessment. Furthermore, the system is being sold as a student aid (to help them manage their own learning) while requiring signatures and then attempting to validate each entry with Health-care Professionals. This mixed philosophy is to be expected in the pilot but will need addressing long term. Some points to be clarified include:

• What is the log attempting to do or demonstrate?
• Is it a student aid to learning or a summative assessment tool?

Clinical Skills Modules

The Clinical Skills component of the curriculum, at present, makes most use of the School's e-learning provision. The focus on practical procedures has been successfully aided by the addition of accompanying self-directed  learning modules, for study prior to attending practical sessions, and in the lead-up to OSCE examinations.

Click on a thumbnail image to launch a module.
(PowerPoint source availability to be announced).

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Airway Management	Arterial Puncture	Basic Ward Monitoring	Blood Cultures
Blood Glucose Monitoring & Sliding Scale	Blood Pressure & Basic Physical Signs	BMI	Drug Calculation
ECG Recording	Female Catheterisation
Hand Hygiene	Handwashing, Gloving & Gowning	IV Drug Administration	IV Fluids & Pump Setup
Lumbar Puncture	Male Catheterisation	Nose, Throat & Skin Swabs	Clinical Waste Management
Pregnancy Testing	Personal Protective Equipment	Rinne's & Weber's	Safe Injection Administration
Safe Prescription Writing	Dealing With Sharps Injuries	Shock	Suturing
Urinalysis	Venepuncture	Venous Cannulation	Wound Assessment

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What is CORTEX?

Cardiff University School of Medicine
The School of Medicine is one of the largest Schools within Cardiff University, featuring numerous postgraduate courses and the largest undergraduate course in the University.

The undergraduate curriculum now has over 1500 students taught over two main campuses, and numerous clinical locations. To address many of the logistical problems associated with large student numbers and the pseudo-distance learning nature of the course, the current undergraduate curriculum is evolving to make increasing use of technology to deliver educational experiences and resources to students.

CORTEX and the C21 Project
In conjunction with the evolution of the current curriculum, the School is developing a new curriculum to go-live in Septbember 2013 for the new first year in-take. The new curriculum will be developed with technology as a much more integrated part of the curriculum and pedagogy from the off. This programme is know as the C21 project.

To facilitate the appropriate uptake of technology within both curricula the School of Medicine eLearning Team are running the CORTEX project. The CORTEX project aims to provide web-based resources to staff to enable them to select and implement technology appropriate for their teaching. The project is a corner stone of the eLearning Strategy, which aims to enable and empower staff to implement as much eLearning as necessary with as little direct involvement from the eLearning Team as possible. This prevents the eLearning Team from becoming a bottle neck, and allows the eLearning Team to focus on areas such as infrastructure, specialist technical developments, and quality assurance.

While the main focus for the project is to support the undergraduate curriculum, the School of Medicine also delivers numerous postgraduate, distance learning courses, which also make heavy use of eLearning. Many staff supporting these courses are also struggling with the adoption of technology, and so the planned CORTEX website will be developed in conjunction with PGT to ensure we cater for the School’s overall eLearning requirements as far as possible.

Wider Collaboration
A similar degree of collaboration is also required with University Learning and Teaching Support team, to ensure that we are well aligned with the University’s Technology Enhanced Education strategy, and that the resources we produce are as widely applicable across the University as possible.

FY & SCP Modules

The modules listed below have been developed as part of final year or senior clinical projects.
Click on a thumbnail image to launch a module.
(Please note: PowerPoint source files are not available for these modules).

< Back to Module Categories

Abdominal Examination	Acute Pancreatitis	Cardiovascular Examination	Emergency Oxygen Therapy
Head Injury	Pre-Eclampsia	Respiratory Examination	Systemic Hypertension
Valvular Heart Disease	Addiction

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Lumbar Puncture Update

The Lumbar Puncture module for Clinical Skills has been updated with minor content changes. The module is to be used for the Neuroscience (year 4) assessments on 30th January.

Clinical Skills

• Joe Anderson (Clinical Teaching Fellow, Department of Neurology)

Launch This Module
Launch PDF version

Enhancing Content Accessibility

MEDIC e-learning are to invest in a resources upgrade enabling the access to module content from platforms such as the iPad. The increased use of non-Adobe Flash enabled devices means focus has been directed on adapting development whilst maintaining the level of interactivity previously only possible through use of the Adobe Flash Player plugin. Students using the self directed learning area in the new Cochrane building have been making extensive use of the Clinical Skills modules for OSCE revision, with many frequently using iPads to do so.

Pregnancy Testing

The module on Pregnancy Testing (clinical skills) has been updated with images, The module aims to facilitate learning regarding the purpose and procedure of performing a urinary pregnancy test.

Clinical Skills

• Carole Loveridge (Lecturer in Women's Health)

Launch this module

IV Fluids & Pump Setup

A new Clinical Skills module is now available, focussing on IV Fluids and Pump Setup. The module covers topics including:

• When to give intravenous (IV) fluids
• Risks of IV fluid therapy
• Types of IV fluids
• How much fluid and electrolytes to give
• Assessment of a patient receiving IV fluids

Clinical Skills 

• Dr Rebecca Jones

Launch this module

Venous Cannulation

The Venous Cannulation module has now been updated to include a video tutorial. The module covers the purpose and procedures of venous cannulation, including learning outcomes such as identification of appropriate sites.

Clinical Skills

• Sian Williams (Clinical Skills Tutor/Manager)
• Brian Williams (Former Clinical Skills Manager)

Launch Module

Blood Cultures

A new clinical skills module on the need for, and how to carry out sampling for blood cultures is now available in Learning Central. The module also contains a useful video demonstration.

Clinical Skills

• Sian Williams (Clinical Skills Tutor/Manager)
• Professor Paul Bradley (Director of Clinical Skills & Simulation)
• Dr Chris Hingston (Consultant Intensive Care Medicine)

Launch this module.

Virtual Patients

Misc. 

Angela Jones
Depression

Eric Williams
Chest Pains

Thomas Smith
Sick Toddler

Ben Davies
A Wheezy Child

Adriana Panacucci
Lethargy in General Practice

Gemma
Heroin Addiction

Amanda Louise Jones
Sick Toddler

Charlotte Lloyd
Weight Loss

Robert Williams
Respiratory Complaint

Rita Williams
Post-Menopausal Bleeding

Neurology

Kate Evans
Headaches

Judy James
Funny Turns

Mrs X
Spinal Injury

Coming Soon...
Secondary Progressive MS

Coming Soon...
Cerebral Venous Sinus Thrombosis

Coming Soon...
Relapsing MS

Coming Soon...
Traumatic Brain Injury

Coming Soon...
Motor Neurone Disease

Blood Glucose Monitoring & Sliding Scale

A new clinical skills module on the subject of blood glucose monitoring and sliding scale is now available for review via CORTEX. Key topics in the module include use of insulin sliding scale in the acute care setting and sampling capillary blood using a glucometer.

Clinical Skills

• Sian Williams (Clinical Skills Tutor/Manager)
• Professor Aidan Byrne (Interim Director of Clinical Skills & Simulation)

Launch this module