MSc Cardiology and Stroke: Clinical Practice in Action Module Portfolio of Learning

This portfolio of learning is the assessment for Clinical Practice in Action Module 7LM0156 for MSc Cardiology and Stroke. It includes reflection on practice, learning log, exploration of team work, and critical review of patient interaction.

MSc. Clinical Medicine
Clinical Practice in Action Module
Portfolio of learning
Cardiology and Stroke Placements
Student Name:
Student number:
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This portfolio of learning is the assessment for Clinical Practice in Action Module 7LM0156
It is divided into four parts:
Part 1: Reflection on Practice
During your time on placement you are required to keep a reflective diary. This should consist of
the following:
1.1. An Initial Statement: This should contain your concerns and expectations before the
start of the placement, includes targets for learning whilst on this placement; what do you
hope to experience and learn? (200 words)
The expectation before the placement is that good and healthy work culture, opportunities
will be provided in the placement organisation so that I can make best use of my available
skills, knowledge and capabilities. Along with that I expect that proper training and guidance
will be provided related to the manner in which task need to be completed for better
outcome. At the same time, I expect that I will learn method that are used to work in team
rather than individuals in order to provide services to patient for their overall health and
well-being. While the major concern before start of placement whether I would able to
accountably performed the assigned responsibilities or not. Moreover, I am concerned
about whether I would able to adapt myself as per the culture, value and ethics of
organisation or not. So, that they I can easily complete my assigned task in limited time
frame. The target of learning during placement is that I want to get more and more
knowledge related to the manner in which patient needs to be provided treatment in context
of Cardiology and Stroke Placements. Learn about the key treatment method that could be
used to treat the patient in effective manner.
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1.2 Learning Log: You are required to record key aspects of your observational
placement experience. It is not necessary to describe what you did every minute of
each day. A brief description of your experience & first thoughts. DO NOT mention any
hospitals or clinics, staff or patients by name (confidentiality must be maintained at all
times)
Learning Log Details
Day 1 On the first, day, I have been provided with some introduction about the
organisation, task that need to be completed, value and principle that has to be
follow while working in firm are clearly mentioned so that the desired outcome
can be achieved. Along with provide introduction about the team member with
whom I need to work and outcome need to be achieved.
Day 2 While on the second I have provide guideline related to the way patient
suffering from cardiology and stroke can be treated through different method.
Thus given chance of learning intervention that could be used to treat patient in
effective manner.
Day 3 Third day, I have been kept under the guidance of senior professional that have
high experience and knowledge related to the manner in which cardiology and
stroke patient need to be treated.
Day 4 On the fourth day, I was told to examine of the patient through checking its
heart rates, early diagnosis of stroke and other issue face by the patient.
Day 5 While on the fifth day, I have been taught about more new method that could be
used to treat patient associated with cardiac disease.
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1. Final Review after the placement:
Record your overall thoughts about this placement and any differences between
organisation of care and patient services in the country where you practice and the NHS.
Take into account the whole placement and the outcomes you wanted to achieve. (word
limit 500 words)
The overall record of the placement is that I have learned lot of things related to points
that needs to be considered by me while dealing with patient that has been suffering from
cardiology and stroke. I have overall positive though about the placement as through this I
would be provided opportunities to learn more about the manner in which patient can be
treated in effective manner. It has helped me in giving practical experience related to what
all type of issue or problem that are face by people in context of Cardiology and Stroke,
what was the actual reason that cause the same and the manner in which they can be
provided proper treatment. Yes, there is somewhat difference between the placement I
have worked with and NHS in terms of care and services need to be offered to the patient.
Likewise, the National health services have more skilled, knowledgeable employees as
compared to other placement that contribute in delivering more qualitative services to
patient. In addition to this the resources and other facilities are more present within
professional that helps them in effectively judging about key health issue they are facing
and the manner in which it can be diagnosed for health and well-being of patient. On the
other hand, it can be stated that the during the placement, there were time in which I have
become stress that whether I would be able to complete the task or not. Or the suggestion
medicine, intervention for appropriate for the condition of patient. I was nervous at initial
stage of my placement because of lack of direction related to the manner in which task
need to be completed. But, as time goes on, I learn numerous things related to the work
culture, its value, the manner in which individuals need to complete task to delivered
qualitative services to patient.
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Part 2:
Students are expected to undertake an:
2. Exploration of team work: observed during clinical placement. This might be
multidisciplinary teamworking, inter-professional team working or both. (1000w)
2.1. Identify the area(s) of teamworking you wish to explore and state why, giving some
observed examples?
Collaboration and teamwork are considered two important element that considered
in the changing health care systems in the hospital in the clinical placements (Seferovic and
et.al., 2019). That is to provide quality health care it is important hat there if effective
coordination among the professional so that effective delivery of care can be given to the
patients. Therefore exploration of team work among the clinical placements becomes very
vital. There are different types of team works that are prevailing in the clinical placement
such as inter professional or multidisciplinary team work. Thus, it becomes very necessary
to explore all these team work for better understanding and enhancing the skills of the
professionals.
The inter professional teamwork refers to a group of experts from every department
who work together for treating the injury, ailment, chronical heath condition etc. are called
the inter professional teams (Harjola amd et.al., 2018). It is also known as interdisciplinary
teamwork. The size of these teams depends on accordingly that is it can include a small
collaboration of PCP that includes only a single specialist, assistant physician and nurse
practitioner. On the other hand, it can involve specialist of more than two disciplines with
therapists, social workers, home care providers etc. In other words it can be said it is a
team that functions in a manner which is non hierarchical so that best approach can be
provided for creation of plan for assessing and diagnoses can be shared by all. Thus, with
the complexity in the needs of patients, it is very important that a consultative and a
collaborative approach is inculcated by bringing several disciplines together in a way that is
effective and efficient in providing the treatment.
On the other hand, a multidisciplinary teamwork consists of the professionals and
practitioners allied disciplines in the heath care who works in accordance to provide the
patients with a person centred (Reboussin and et.al., 2018), holistic approach of care that is
well coordinated and supported. The composition of the multidisciplinary team varies
depending upon the setting and delivery of includes but mainly it includes: nurses,
specialist, pharmacists, social workers, doctors etc. Often it involves line workers and care
navigators that supports the social prescribing with local community services. Thus, it plays
an important role in the healthcare services by bridging the boundaries of professionalism
and helps in breaking down the barriers between the organizational differences and
competing cultures.
Also, while exploring the teamwork in the clinical placement, it has been identified
that there is a collaboration of teams that interdisciplinary with multidisciplinary teamwork
(Wilson and et.al., 2019). With the collaboration of these teams it helps the healthcare
providers in providing effective services to the patients with effectively analysing and
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diagnosing the problems and offering the best treatment with the consultation of every
discipline involved.
I would like to explore the inter professional teamwork in the clinical placement. As
it is considered one of the most effective approach that helps in providing quality services to
the patients (Kusumoto and et.al., 2019). Furthermore, reason for working in team is that
it has helped in working with different healthcare professional that have diverse knowledge,
skill and talented individuals towards the achievement of end goals. It an approach that
helps in improving the health processes, patient outcomes and thus, helps in increasing the
level of satisfaction. With the inculcation of this type of approach it helps in avoiding
duplication of assessments that may further lead to complications and holistic records for
care. Therefore, I would like to explore the interdisciplinary teamwork in the clinical
placement as it will help me in learning from different experts in the various discipline that
will not only help in enhancing my knowledge in my field but also provide me with a broader
viewpoint. It will help name in exploring other fields and will help me to acquire knowledge
from other departments as well.
For example, an interdisciplinary team treating a trauma patient who met with motor vehicle
accident is the observed example of multi-disciplinary working in team. It includes
surgeons, Ortho specialist, cardiologist, physicians, nurses, etc. all working together with a
shared goal of treating a patient and its recovery. Thus, it can be seen from the example if I
join the interdisciplinary team work it will not only help in increasing my knowledge in my
department but also it will help me in learning and gaining knowledge in other fields of the
health care.
2.2. Identify the strengths and weakness of your chosen areas of teamworking.
from the exploration of the different team that are prevailing the healthcare facilities
it can be identified that there are several benefits of the inter professional teamwork. That is
an interdisciplinary teamwork helps in establishing coordination among the various
disciplines associated with the health care (Grundy and et.al., 2019) . That is with effective
communication and coordination among these inter disciplinarians it helps in providing the
patients with a quality services with providing and offering treatments with
recommendations of every disciplinary that are involved in the treatment. Also, it has an
advantage that it helps in preventing breakdown in the communication between various
departments which are considered a common reason for error that further leads in adverse
events.
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However, it can be analysed there at times thee are certain weaknesses of the inter
professional team working as because there are so many experts of different disciplines
working together, there are chances of arising conflicts (Stout and et.al., 2019). That is with
so many expert opinions it becomes difficult for choosing the appropriate treatment for the
patients. Thus, it also raises conflicts among the team members that affects the
coordination among the staff and members in the team. Thus, with lack of coordination it
affects the unity of the team and with lack of coordination and unity among the team it
becomes difficult for the to provide effective and quality treatment to the patients.
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Part 3: Critical Review
3.1. Retrospective Review: You are required to undertake a reflective analysis of an
observed patient consultation during your placement. This review should consider
what could be learnt from this patient interaction and how it could be applied in your
own workplace. (Total this section ; 1000w)
You may wish to discuss with placement staff or academic staff several patient
interactions so that you make an informed choice.
3.1. 1. Describe the patient interaction and why it was important to you?
Patient interaction are considered one of the most important element while providing a
health care services to the patients (Ommen and et.al., 2020). That is with interacting with
the patients it helps in identifying and assessing the issues and problems that are faced by
the patients so that treatment could be provided to them accordingly. So that fast and quick
relief could be provided to them. It is considered while interacting with the patient, a patient
centred approach should be used as it will help in better understanding of the needs and
requirements of the patients care (Otto and et.al., 2021). With this approach it will help in
providing effective care and treatment with keeping in mind the patient's preferences and
values. Also, with a patient centred approach while interacting with the patients will help in
expanding their roles also in the decision making, self management. As nowadays it is very
important the patient makes their own decision what they want. Thus, interaction with
patient plays a vital role in deciding the treatment and care services that needs to be
provided to the patients. Also, with effective communication with the patients it helps in
achieving higher quality health care.. Also it supports in exchanging of relevant and
accurate information with each other, therefore, while providing health care services
interaction with the patient is very important for providing quality care to the patients.
As per the view of placement staff the patient interaction is important because it contribute
in making informed choice related to what all key issue face by patient, the manner in
which it can be overcome. The patient through interaction can easily share information
about what it is currently feeling, whether the particular treatment is good or effective or
not.
For example: I as healthcare professional has interact with the patient that has been
suffering from Cardiovascular disease in order to know about what all key health issue that
are being face by it and the manner in which it can be overcome.
From the experience it has been learned that positive interaction between the patients and
the health care providers, it helps in building relationship and thus, helps in establishing
trust between them. It has also contributed in knowing about why patient interaction is
crucial and the way it will helps in improving the condition of patient.
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3.1. 2. What have you learnt from this experience?
From the experience of interacting with the patients I got to learn many things. It turned out
to be very useful in enhancing my knowledge in my filed of cardiology and also got to
enhance my knowledge in other fields of health care as well. From my experience, I learned
that is it not very easy to communicate with patients that is in other words interacting with
patients is complicated. For communicating with patients it is very important that an
individual keeps certain things in mind. That is one of the most important element while
interacting with a patient is to empathize with the patient that is to show empathy and
kindness. This will help in building a relationship of trust between the doctor and the patient
and this is important because then only a patient will feel free and comfortable in sharing
their intimate details of their certain health concerns with the doctor. Also, while interacting
with the patients I have learned that it is important to pay attention to the body language of
the patients, because at times it acts as a non verbal clue that provides a wealth of
information that helps in interacting. These non verbal clues include facial expressions, eye
contact, demeanour etc. of the patients.
3.1.3. How could this learning be applied to your own workplace setting? Consider do you
face similar issues or are they different, please explain why?
It is very important that an effective interaction with the patient must be inculcated in the
workplace setting (Arnett and et.al., 2019). That is in other words a patient centred
approach must be used in the workplace setting as it will help the organisation in
understanding the needs and requirements of the patients more effectively and efficiently.
With the interaction in between the patient and the health care providers, it will help the
healthcare service providers in gathering insightful information that is necessary for
providing quality services to its patients . But sometimes there are certain issue faced while
interacting with the patients that is in certain cases patients are very sensitive that is they
are sensitive to certain medication and treatments that are against their values and
preferences. Also at times issues like discomfort that is patients are not very comfortable in
sharing their medical history with anyone becomes a major barrier in interacting with the
patients. Also at times the patients feel their privacy is being hampered therefore they do
not engage in the interaction (Writing Committee Members and et.al., 2021). Thus, these
are the similar issue that I have faced in my experience. Therefore, it becomes very
important that the health care providers take every step and precaution before interacting
with a patient and create an positive environment where patients feel comfortable in sharing
their personal details that is helpful in providing them with quality treatment. Thus, this will
help in building a relationship of trust between the patient and the health care providers that
will help in effective communication.
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Thus, from my experience it can be said, that communicating with patients is complicated
but on the other hand it is incredibly fulfilling that is it provides every detail that is important
for providing quality services. This can be applied to my work place setting through learning
method that could be used to communicate with the patient to know what all exact problem
it is facing and finding intervention for better outcome. The issue of complication can be
eradicating through physical taking with the patient about the problem as it helps in
understanding the facial expression, gesture and posture. They are same in issue in
communication due to lack of interaction between patient and healthcare.
From my placement I have learned the manner an healthcare professional needs to
communicate and work with inter team to provide range of services to patient for
improvement in their health and well-being. It is important because it has helped me in
knowing the manner in which a healthcare professional work with multi disciplinary team for
good health of patient.
3.1. 4. Consider the wider implications for practice and organization of specialist services
and make firm recommendations to improve this.
It can be analysed that with the wider implication of the specialist service in the field of
cardiology will help the patient as well as the organisation (Piepoli and et.al., 2020). That is
with providing a wider platform for treatment and care of patients with cardiological and
chronic disease it will prove beneficial for the organization in terms of profitability and for the
patients in terms of better care services. Also with the integration of GP'S and specialists
into the interdisciplinary teamwork, also helped the organization in providing cost effective
treatment with higher patient preferences. Thus, in other words it can be analysed that with
the broadening the scope of specialist services it will help the organisation in dealing with
more speciality cases that they have experience for and will help the organisation in
increasing its visibility in the community that will help them in reaching out to more patients
and will help the organisation in providing health care services on a larger bases (Koh and
et.al., 2018). To inculcate specialist services, it is recommended that appropriate training
and development sessions are organised by the organisation so that there is enhancement
of the skills and knowledge of the staff member so that they can perform their duties
efficiently, also brainstorming sessions can be organised that will help in widening the
knowledge of specialist and will help them in coming up with new treatments that will be
beneficial for the patients. Also, use of advance technology can be made that will help in
providing cost effective services and treatment to the patients (Wolff and et.al., 2018).
From my experience organisation want to improve communication method so that
healthcare professional can make use of proper language, method to exchange
information in order to effectively treat the patient. Furthermore, it is recommended to
improve team working skill for fruitful outcome.
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Part 4:
Please write a critical review using the following questions as triggers: (2300 words).
You are expected to critically reflect on differences / similarities between clinical practice in
your placement and clinical practice in your own working environment
1. What were the key factors influencing clinical decision making in your observed
placement?
Clinical decision making refers to a process of problem solving by analysing, gathering and
examining the information from the impairment and functional categories (Whelton and
Carey, 2017). In other words it refers to the gathering of information that will help in the
process of problem solving. The key factors influencing clinical decision making observed in
the placement are as follows:
1. Diagnosing.
2. Assessment of severity.
3. Management.
For making appropriate clinical decision it is important that one conducts a precise
diagnose and the cost associated with it as well (Von Mehren and et.al., 2018. Also, it these
decision to be effective it is very important the risk are assessed that is risk of inappropriate
management, harmful effects, costs etc. if in case of adverse outcomes. thus, there are
certain skills that are required by the a practitioner in making effective clinical decision. That
is one of the most important element to keep in mind is the recognition of pattern which
means that while making decision it is necessary to review the pattern of the learning
experience. Another element in the clinical decision making is the critical thinking that is it
is important for a practitioner to be sceptical and making decision firmly with clarity and
open mind and carefully examine all the attributes. On the other hand, active listening also
plays a crucial role in the clinical decision making. That is it is the ability of the practitioner
to listen to the patients carefully so that accordingly decisions can be made that will be
beneficial for the patients (Araki and et.al., 2020). Most importantly, every clinical decision
should be backed up by appropriate evidences for effective decision making. Thus, for
making a effective clinical decision all the attributes must be looked out by the practitioner
so that there can be proper evaluation and assessment of the information for decision
making.
However, there are certain factors that influence the clinical decision making and the
each skill has the potential in making effective decision making (Flaig and et.al., 2020). It is
assumed that in an ideal world, clinical decision would be made with objectivity, no time
pressure, information backed up by evidences, support tools, minimal interruptions for
handling decision making in any time. But on the other hand in reality, this is not always
possible. Clinical decisions are referred as the balance of the practices of research and
evidence, awareness of the environment and the situations prevailing and the knowledge of
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the patient for making an informed decision. These decisions include a variety of knowledge
and information sources. Thus, there are various factors that influences these decision that
is one of the major factor that influence clinical decision is the interaction with the patients.
There are number of things that has been observed during the placement such as
interacting with patients helps the practitioner in analysing every minute detail that is
important for making clinical decision and with communicating with the patients it provides
them with insightful information that is beneficial in making informed decision regarding the
treatment that should be followed for the cure. Along with it patient interaction in a crucial
factor that can influence the decision making positively or negatively. As if there is no
patient interaction and there is non-disclosure of certain information that is vital for clinical
decision. It can lead to non effective clinical decision.
For example: I Have observed that in effective interaction between the multi disciplinary
team has lead in creating confusion and conflict related to the manner in which task is being
performed or who is delivering services to patient.
2. How were roles and responsibilities for patient management divided in this placement?
While providing health care services there are certain roles and responsibilities that a health
care practitioner should keep in mind while performing his duties with due care and
diligence. It very important that the practitioner undertakes there responsibilities
diligently and with at most care (Coit and et.al., 2019). Thus, while on my clinical
placement the responsibilities of the practitioners and professional were divided on the
basis of providing quality care services. Following things were kept in mind while
performing their responsibility that is emotional stability and empathy for the patient so
that a relationship could be built between them. Also, the practitioner should have
efficient communication and interpersonal skill so that there could be effective
interaction with the patients for insightful information. On the other hand, it can be
evaluated that healthcare service providers plays a critical role in the management of
patient. That is they play a vital role in providing the patients with preventive medication
so that it helps the patients in fast and quick reliefs. They also helps in preventing the
disease from spreading that is with there effective clinical decision on the basis of
information provided they prescribe treatment that help in preventing the disease to
spread across the body of an individual. Also, in my clinical placement I learnt that they
play a role of educator, that is with their immense experience and knowledge that they
have gained from their past experience and practice (Haneda and et.al., 2018). They
educate other about the cures and prevention that could be useful in curing a disease
or at least avoiding it to become severe. Thus, it can be analysed that roles and
responsibility of a health care service provider in the patient management is divided
into many parts. Which in turn helps them in providing effective care services with due
diligence and care.
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3. Critical Reflection: how well were the indicators of Good Medical Practice (General
Medical Council (2013) met during your observational placement and how does this
compare to professional standards (published or upheld) and practice in your own
workplace?
According to the guidelines of the good medical practices it can be analysed that there are
four domains for providing quality care services to the patient with effective medical
practices. These four domain consists of knowledge and skills of the practitioner, safety and
quality, communication and teamwork, and maintaining trust (Hoogendijk and et.al., 2019.
Thus, from the observation of my clinical placement it can be critically evaluated that the
placement meets all the requirement of the domains given under the good medical
practices. It can be critically evaluated, that the placement appropriately applies the
experience and knowledge for clinical decision making and thus, clearly records the work
clearly and accurately. Also, it takes due care and diligence while assessing a patient
condition and takes into account their medical history, there preferences and values and
according prescribe the treatment according to their know;edge and experience that will
help in providing quicker and faster relief to the patients. On the other hand, it complies and
contributes with the systems so that the confidentiality of the patients can be maintained.
That is there are regular audits and reviews of the teams working and adequate training is
provided for maintaining and promoting the safety of the patients. However, it can be
analysed at times to keep the patients safe adverse incidents involving devices or drugs
that could put the patients life at risk are reported so that the risk could be properly
analysed and assessed.
Also, it can be critically evaluated that on my clinical placement there was effective
communication and teamwork that help in providing quality care services to the
patients(Pfister and et.al., 2020). That is with effective interaction with the patients it helped
the practitioners in analysing and assessing the diagnosis efficiently and making clinical
decision effectively that provides quicker relief also, with the interdisciplinary teamwork
there was effective coordination and cooperation between the different disciplines that
helped in leading to faster analysis of the diagnosis and providing the treatment for cure
with new techniques and ideas.
Thus it can be analysed that at NHS high professional standards are met that is they
take into consideration each and every aspects and aims at maintaining high quality
services so that there can be effective provision of care services provided to the patients.
While comparing the professional standards with the good medical practices it can be
analysed that NHS maintains its professional with accordance to the domains provided
under the good medical practices. That is it set standards that help in achieving those
domains so that quality services can be provided with high professionalism. It been
analysed that even at times of urgent concerns the NHS do not lower it standards that is it
maintaining high standards with keeping the safety of the patients a priority and providing
them with the treatment that are in accordance with their values and preferences (Tallman
and et.al., 2019). Also, it can be analysed that it while inculcating the inter disciplinary team
work it maintains high professional standards that is its builds relationship among the
different disciplines that leads in higher coordination and cooperation that helps in faster
clinical decision making with higher accuracy. However, it can be critically evaluated that in
certain cases and at certain there are conflicts among the inter-professional team work but
with effective coordination and team unity the problems are solves with an ease and there
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is no compromise in providing the quality care services to the patients. Thus, it can be
analysed that it is very important to maintain the professional standards in the workplace
environment so as to provides quality health care services. And also to maintain a positive
and effective unity among the team members and staff in the workplace environment.
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