Body Mass Index (BMI)

Obesity and overweight are not a particularly recent problem despite what is portrayed in the media. They are defined as abnormal or excessive fat accumulation that may impair health. Worldwide obesity has more than doubled since 1980 and nearly 43 million children under the age of 5 were overweight in 2010. Sadly, they are preventable diseases. Anorexia Nervosa requires a brief mention within this module as it also accounts for abnormal BMIs but will be covered elsewhere within your medical degree course.

The aim of this module is to facilitate learning regarding the topic of Body Mass Index (BMI). 

Clinical Skills

• Dr Eleanor Chiu
• Miss Alyssia Broomfield
• Miss Iona Taylor 

Launch this module

Hand Hygiene

Health Care Associated Infection (HCAI) is a critical patient safety issue. At any one time up to eight per cent of inpatients in England and Wales have HCAI (Smythe et al 2008).

Statistics for England and Wales show that 5,109 deaths involved MRSA and 13,189 involved Clostridium difficile during the period 2001-2006 in patient care establishments (NPSA, 2008).

Evidence shows that improving Hand Hygiene contributes significantly to the reduction of HCAI.

The aim of this module is to facilitate learning regarding the purpose and procedure of Hand Hygiene.

Clinical Skills

• Sian Williams (Clinical Skills Tutor/Manager)

Launch this module

Standard Precautions / Personal Protective Equipment

‘Standard precautions [formerly called universal precautions] are meant to reduce the risk of transmission of pathogens from both recognized and unrecognized sources. They are the basic level of infection control precautions which are used in the care of all patients’ (WHO 2007).

The aim of this module is to facilitate learning regarding the reasons for standard precautions and use of personal protective equipment (PPE) in healthcare.

Clinical Skills

• Carole Loveridge (Lecturer in Women’s Health)

Launch this module

Rinne's & Weber's Tests

In clinical practice it is common to see patients complaining of hearing loss. It is useful to be able to have a simple test that can distinguish where the site of the cause of the hearing loss is. This can help guide the need for further examination, investigation and management.

The aim of this tutorial is to understand the purpose of Rinne’s test and Weber’s test and to understand when you would use it

Clinical Skills

• Dr Alan Stone (General Practitioner and Senior Clinical Tutor)

Launch this module

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

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).

< Back to Module Categories 

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

  < Back to Module Categories

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

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.

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

Virtual Patients at Cardiff; Literature Review Abstract

Purpose
After developing a small number of experimental Virtual Patients as optional components in the undergraduate curriculum and having received very favourable feedback from students about them the School now needs to undertake a more comprehensive review of virtual patients. The review intends to uncover the pedagogic underpinnings for effective virtual patient delivery and help CU staff identify areas of the medical curriculum where they would be best suited.

Method
A literature review of how both national and international medical teaching institutions have reported the effectiveness of their VP implementation, with particular focus on elements of the educational theories which have best enhanced the intended transferable learning aspects. The results were then used with the intention of helping staff identify areas of the undergraduate curriculum where VP’s would be best suited, and to what degree they can be integrated into core teaching.

Results
Results indicated a wide variance of the ways in which VPs were integrated into core medical teaching but with common theme of pedagogic design prinicpals which were key to the effectiveness of preparing the student for ‘real’ patient encounters; authenticity was seen as a key enabling factor for this.

Conclusion
It was found that the development of competence in clinical reasoning was a key target for any VP; authenticity of clinical events and patient dialogue facilitated by appropriate media being a dominant factor in preparing the student for real patient interaction, particularly in exercising social and communication skills. VP’s can be integrated as a focal subject for use within lectures or seminars, or used as a self-directed study aid, accessed externally to core teaching; the degree of its integration should be left to the discretion of the curriculum leads.

ECG Recording

A Clinical Skills module is now available on Learning Central. The module details how to record a full, detailed tracing of the electrical activity of the heart, using an ECG (electrocardiograph) machine recorder.

Clinical Skills

• Dawn Lau

Launch this module

Clinical Skills Self-directed Resources

The Clinical Skills Centre is now located on the third floor of the Cochrane Building and is managed by Sian Williams. An expansive directory of self-directed tutorials exist for the Centre and can be found by logging in to Learning Central via the Clinical Skills section, or via the Clinical Skills microsite.