Module - Peripheral Arterial Screening and Microvasculature Diagnostics (SPS131)
Clinical experiential learning is the range of activities trainees may undertake in order to gain the experience and evidence to demonstrate their achievement of module competencies and assessments. The list is not definitive or mandatory, but training officers should ensure, as best training practice, that trainees gain as many of these clinical experiences as possible. They should be included in training plans, and once undertaken they should support the completion of module assessments and competencies within the e-portfolio.
Clinical experiential learning
- Observe a series of patients reviewed as new and follow-up patients in the National Abdominal Aortic Aneurysm Screening Programme (NAAASP) and critically appraise the process of screening and treatment options, including the range of healthcare professionals who contribute to the care of each patient and how the inter-professional team work together.
- Identify a patient with an AAA requiring repair and, with permission, follow the progress of the patient from the initial consultation through investigation, intervention and follow-up appointment, and reflect on your learning from this process.
- Attend a meeting at which the outcome of a clinical audit, research, innovation or service development is presented and discuss with your training supervisor how evidence-based practice is implemented with respect to vascular science.
- Prepare a portfolio of case studies and images and diameter measurements from a series of patients that demonstrate the normal and aneurysmal characteristics of the abdominal aorta on ultrasound, including any variations in anatomy.
- Critically appraise the role of ultrasound in the assessment of AAA and reflect on the effect technique and probe positioning have on the images and artefacts. A portfolio of evidence should include images obtained from the aorta and clearly demonstrate the relationship with other structures used as landmarks (e.g. the vertebra, the vena cava, superior mesenteric artery) and the effects of probe positioning (e.g. anterior/sagital or decubitus/coronal views) and artefacts (e.g. bowel gas).
- Critically appraise inner-to-inner (iti) versus outer-to-outer (oto) measurements of aortic diameter and reflect on the significance of each method. A portfolio of evidence should include images and diameter measurements (iti and oto) obtained from a variety of aortic sizes (<3.0 cm, >3.0 cm) in both transverse and longitudinal views.
- Identify two patients with lower limb peripheral arterial disease requiring intervention and critically reflect on the effect on the lifestyle of the patient and the role of the healthcare scientist in the diagnosis and treatment of patients.
- Prepare a portfolio of case studies with resting and post-exercise ABPI measurements (where appropriate) on a series of patients with a range of symptoms (e.g. claudication, critical limb ischaemia, ulcers).
- Critically appraise the role of ABPI measurements in the diagnosis/exclusion of peripheral arterial disease, in particular the TASC II recommendations, and reflect on your learning from this process. A portfolio of evidence should include ABPI reports for a range of values (<0.5, 0.5–0.8, 0.8–1.3, >1.3) with a range of Doppler signals (monophasic, biphasic, triphasic).
- Prepare a portfolio of TCD spectra and/or images from a series of volunteers that demonstrate the normal characteristics of the intracranial circulation and critically reflect on the process of screening outlined in the NHS Sickle Cell and Thalassaemia Screening Programme.
- Prepare a portfolio of measurements of the microvascular system from volunteers or patients using at least two of thermography, laser Doppler, transcutaneous O2 or nailfold capillaroscopy, and critically appraise how the techniques are used to aid diagnosis.
- Keep a portfolio/logbook of all clinical scans performed/observed, noting challenges and risks encountered with reflections on learning achievements.