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The Cardio-respiratory System 2

  • Module code: PY6030
  • Year: 2018/9
  • Level: 6
  • Credits: 30
  • Pre-requisites: PY5040
  • Co-requisites: None

Summary

This module builds on relevant basic scientific knowledge acquired in other modules and integrates it to cover the presentation, clinical features and management of cardiovascular, respiratory and renal diseases in patients. This module will provide you with an insight into the management of these conditions in primary and secondary care as well as dealing with aspects of public health associated with these conditions.

Aims

  • To further develop the student's knowledge and understanding of the clinical presentation, complications and relevant investigations of cardiovascular, respiratory and renal conditions including the symptoms and relevant important physical signs associated with them and the ability to distinguish between common presentations of such conditions and determine accurate differential diagnoses for these conditions
  • To review the therapeutic strategies employed to prevent and/or treat such diseases.
  • To discuss the practical management of patients with these conditions in primary and secondary care and be able to make decisions to ensure optimum care

Learning outcomes

On successful completion of the module, students will be able to:

  • Critically evaluate the aetiology, epidemiology and pathology of common diseases of the cardiovascular, respiratory and renal systems as well as cardiovascular risks including smoking, hyperlipideamia, hypertension, diabetes and chronic kidney disease and cardiovascular diseases such as stroke and transient ischaemic attacks
  • Apply advanced knowledge about such conditions and analyse the presentation and clinical features of such conditions in order to establish an accurate differential diagnosis and to inform safe and appropriate treatment
  • Evaluate the therapeutic strategy used to prevent and treat these conditions and associated complications, indicating the rationale for use of particular drugs in relevant situations
  • Explain the rationale and be able to deliver important public health activities for patients with cardiovascular and respiratory diseases, eg. smoking cessation.
  • Fully understand the science and principles of inhalation therapy and apply that in the care of individual patients

Curriculum content

  • Chest pain, syncope and breathlessness; angina, acute coronary syndrome, acute and chronic heart failure;
  • Common cardiac arrhythmias including atrial fibrillation, supraventricular tachycardias, heart block and ventricular tachycardias;
  • Deep vein thrombosis and pulmonary embolism, peripheral vascular disease; transient ischaemic attacks and stroke.
  • Management of anticoagulants
  • Cardiovascular risk factors including: hypertension, diabetes mellitus, hyperlipidaemia, chronic kidney disease, obesity and smoking.
  • Primary and secondary prevention of cardiac disease
  • CV stents
  • Breathlessness, cough, chest pain, haemoptysis; asthma, chronic obstructive pulmonary disease, lung cancer, sarcoidosis, cystic fibrosis, interstitial lung disease, pneumonia, obstructive sleep apnoea, type I and II respiratory failure
  • Inhaler technology and the use of inhaler devices
  • TDM of theophyline and digoxin
  • Smoking cessation
  • Kidney disease including: proteinuria, haematuria, renal impairment and chronic kidney disease, electrolyte disturbances, glomerular diseases, renal calculi, renal failure and replacement therapy
  • Management of drug therapy in renal disease
  • Dispensing of medicines for cardiovascular and respiratory conditions

Teaching and learning strategy

Core concepts are discussed in keynote lectures by the module team. Other lectures will be given by experienced clinicians active in respective fields and will introduce topics in accordance with aims of the module. They will provide information and an overview on topics and to guide students in directed reading and self-directed learning. Practicals, tutorials, workshops and seminars will be used to discuss and present relevant material; and, to further develop communication skills and enhance student-student, student-instructor and student-patient interaction. Practicals will involve patient/actor demonstration and dispensing simulation; tutorials will involve problem-based learning from case-based studies; and, workshops will present practical aspects of patient care. A series of tutorials will examine situations where patients present with a seemingly minor condition which on further investigation may be indicative of a more serious condition; a so called 'red flag' situation. In addition, seminar sessions will be hosted to provide direct experience of patient issues and opportunity to patient experiences and perspectives. Problem-based learning within these formats will facilitate application of knowledge to real-life situations; and, to reinforce and assess student learning. Directed work in small tutorial groups will support peer-learning and develop skills in small group working and other employability skills. Students will be directed to further reading to support their learning. Self-directed learning includes preparation for tests, the end-of-module examination and associated work. Independent study will inculcate life-long habits of independent and sustained self-learning.

Breakdown of Teaching and Learning Hours

Definitive UNISTATS Category Indicative Description Hours
Scheduled learning and teaching Lectures, workshops, practicals and tutorials 130
Guided independent study 154
Study abroad / placement Placement 16
Total (number of credits x 10) 300

Assessment strategy

There is no end of module exam in this module.

Assessment will be through an in module assessment, in the form of an in class test, and a series of practical assessments. The in module assessment not only provides a measure of student progress and an opportunity to provide feedback but also ensures that students maintain their learning throughout the module rather than learning purely for an end of module exam.

Summative practical assessment will assess the student's ability to dispense typical prescriptions safely and effectively. Dispensing practicals have feedback embedded into them both during and at the end so students will continually be provided with feedback. Four prescriptions during the series will be assessed; each prescription is worth 5% providing a portfolio of summatively assessed prescriptions worth 20% of the module total. This will enable students to demonstrate that they can meet General Pharmaceutical Councils outcome standard 10.2.2.j Supply medicines safely and efficiently, consistently within legal requirements and best professional practice at least at the required 'Shows how' standard.

The summative 'red flag' OSCE will assess students' ability to differentiate between a minor condition that can be effectively managed by the pharmacist in the community pharmacy or primary care and a serious condition that requires referral to specialist or hospital treatment. These enable students to meet the fundamental requirements that they will be safe and effective future pharmacist, one of the regulator's key standards for pharmacist education. A series of 'red flag' tutorials with feedback will support and provide feeding forward for the 'red flag' OSCE, while in dispensing practicals feedback and formative assessment will feed forward to the assessed prescriptions.  There will also be formative assessment in a practical investigating the use of Metered Dose Inhalers (MDIs) which will feed forward to the synoptic assessments outlined below. Formative assessment will also include a workshop reflecting case based learning and dealing with clinical scenarios. Independent learning skills will be developed through directed reading, to supplement formal teaching.

Level 6 MPharm students are required to pass a synoptic OSCE style assessment and a synoptic calculations test before they can progress to Level 7. These are to assure that even at this Level the student is demonstrating the appropriate skills, knowledge, understanding and attributes to become a future pharmacist. In addition there is a synoptic exam covering the material in all four Level 6 modules, underpinned by learning from Levels 4 and 5. At level 6 the clinically themed modules have considerable cross module application and resonance to reflect the integrated nature of the course. To promote deeper learning, application and judgement as well as discourage silo learning a synoptic approach is more appropriate to assess the potential abilities of a future pharmacist. In addition it should facilitate in students the ability to ability to focus on a patient as a whole considering not only the prime condition but also co-morbidities.

 Learning in this module feeds forward into all three of these synoptic assessments. In addition the formative assessment and feedback from workshops and tutorials will feed forward into the synoptic assessment and OSCE. The 'red flag' OSCE will also give students further experience of OSCE style assessments and the feedback from this assessment will not only address the content but also the critical appraisal, problem solving and effective communication skills and competences that an OSCE also assesses.

Mapping of Learning Outcomes to Assessment Strategy (Indicative)

Learning Outcome Assessment Strategy
1) Critically evaluate the aetiology, epidemiology and pathology of common diseases of the cardiovascular, respiratory and renal systems as well as cardiovascular risks including smoking, hyperlipideamia, hypertension, diabetes and chronic kidney disease and cardiovascular diseases such as stroke and transient ischaemic attacks In class test Feeds forward to synoptic OSCE
2) Apply advanced knowledge about such conditions and analyse the presentation and clinical features of such conditions in order to establish an accurate differential diagnosis and to inform safe and appropriate treatment In class test ‘red flag' OSCE Feeds forward to synoptic exam and synoptic OSCE
3) Evaluate the therapeutic strategy used to prevent and treat these conditions and associated complications, indicating the rationale for use of particular drugs in relevant situation In class test ‘Red flag' OSCE Assessed practicals Feeds forward to synoptic exam and synoptic OSCE
4) Explain the rationale and be able to deliver important public health activities for patients with cardiovascular and respiratory diseases, eg. smoking cessation. In class test Practical assessment – formative Workshop activities - formative Feeds forward to synoptic OSCE
5) Fully understand the science and principles of inhalation therapy and apply that in the care of individual patients In class test Assessed practicals Formative in MDI Practical Feeds forward to synoptic exam and synoptic OSCE

Elements of Assessment

Description of Assessment Definitive UNISTATS Categories Percentage
Written examination In class test (In module assessment) 40%
Practical examination ‘Red flag' OSCE 40%
Practical examination Portfolio of assessed prescriptions 20%
Total (to equal 100%) 100%

Achieving a pass

It IS NOT a requirement that any element of assessment is passed separately in order to achieve an overall pass for the module.

Bibliography core texts

  • Clinical Medicine (7th ed). Kumar and Clark. Elsevier Health Sciences (2009). ISBN 0702029939
  • British National Formulary (latest edition). Also available at the BNF website.

Bibliography recommended reading

  • Drugs in Use: Clinical case studies for pharmacists (4th Ed), Dodds. Pharmaceutical Press (2009). ISBN 0853697914
  • Drugs in Cardiology. A Comprehensive Guide to Cardiovascular Pharmacotherapy. OUP (2010). 978-0-19-955746-2
  • Clinical Pharmacy & Therapeutics (4th Ed), Walker and Whittlesea. Churchill Livingstone (2007). ISBN 0443102856
  • Pathology and therapeutics for pharmacists: A basis for clinical practice (3rd Ed), Greene and Harris. Pharmaceutical Press, (2008). ISBN 978 0 85369 6902
  • Rang, Dale, Ritter and Moore. Pharmacology 5th edition. Churchill Livingstone, ISBN: 0443071454.
  • Levick. R. Introduction to cardiovascular physiology. 4th edition. Blackwell. ISBN: 0340809213.
  • Pulmonary Physiology, Seventh Edition (Lange Physiology Series) by Michael G. Levitzky (1 Feb 2007)
  • Oxford Textbook of Clinical Pharmacology and Drug Therapy (3rd ed). Grahame-Smith and Aronson. OUP Oxford (2002). ISBN 0192632345
  • British National Formulary, Latest Edition, edited by the Joint Formulary Committee. Pharmaceutical Press. ISBN 0853697760
  • Saunder's Pocket Essentials of Clinical Medicine (3rd ed), Ballinger and Patchett. Saunders (W.B.) Co Ltd (2003). ISBN 070202645X

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