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

This portfolio of learning is for MSc Cardiology and Stroke - Clinical Practice in Action Module 7LM0156. It includes reflection on practice, learning log, exploration of team work and retrospective review of an observed patient consultation during the placement.

MSc. Clinical Medicine
Clinical Practice in Action Module
Portfolio of learning
Cardiology and Stroke Placements
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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)
Expectations before the start of the placement
The expectation before the placement is that good and healthy work culture such as equal
opportunities will be provided in the placement organisation while selecting, promoting
employees in the firm. In another words, there is no discrimination between people on basis
of age, gender and religion. 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.
Concern before start of placement
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.
Target and hope to learn from experience
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 and get better experience to work with other
team members.
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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 what did you learn each day? Write it down in each day
Day 1 On the first, day, I learned about the organisation, task that need to be
completed as professional, value and principle that has to be follow while
working in firm. All these were clearly learned by me so that the desired
outcome can be achieved. Along with I get knowledge about the team member
with whom I need to work and outcome need to be achieved.
Day 2 On the second day of ward rounds, I learn the way patients and consultants
converse, and how they ask patients questions about their past conditions and
ensure that everything is proceeding according to the plan they establish for
each patient. I have provided guideline related to the way patient suffering from
stroke can be treated through different method, this has helped me in learning
treatment method to cure patient.
Day 3 On the third day, I asked some questions that I had written down during ward
rounds, and the consultant helped me understand how to change the
management plan based on the patient’s current condition and which
investigations were needed for some very specific and critical patients. There
was one call from A&E for a patient they suspected was a stroke patient, and
they took me with them to help me understand the difference between cardio
and stroke patients, and I learned various methods to differentiate between the
two.
Day 4 On the fourth day, During ward rounds with the consultant, I observed a cardiac
patient, and in clinical that day, I learned how to follow guidelines when
dismissing a patient, as well as how to prepare a report before discharge so that
other doctors or GPs are aware of the patient’s previous condition. They handed
me some ECGs to read and asked me some questions to help me gain
confidence in reading them.
Day 5 While on the fifth day, I have been taught about more new method Concerning
intervention They taught me how contrast quantity matters during all of these
intervention methods, and they helped me understand some different pacemaker
devices and the procedure they used to change and monitor all of these readings
to ensure the patient was stable after these interventions. They also taught me
which of the specific measurements I should focus on during this procedure.
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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 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? Please be specific – 1st identify the team work such as
multidisciplinary teamworking, inter-professional team working or both
I would like to explore the inter professional teamwork in the clinical placement, as it
is consider one of the most effective approach in providing quality services to the patients
(Kusumoto and et.al., 2019). It an approach that helps in improving the health processes,
patient outcomes and increasing the level of satisfaction. With the inculcation of this type of
approach, duplication of assessments is being avoided 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. It will not only help me in enhancing my
knowledge in specific field but also provide 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 including 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.
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 that there if effective
coordination among the professional so that effective delivery of care can be given to the
patients. Teamwork is demonstrated in the stroke ward by physiotherapists, pharmacists,
dietitians, nurses, and neurologist. These professionals were needed in the case of a stroke
patient.
One of the cases I saw during my placement was a patient who was experiencing
numbness in his right leg, and the doctor requested that a physiotherapist assist him. The
physiotherapist assisted the patient with some exercises, while a neurologist checked the
patient’s brain scan to ensure there was no bleeding or clot.
The inter professional 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. It involve specialist of more than two disciplines with therapists, social workers,
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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.
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
diagnosing the problems and offering the best treatment with the consultation of every
discipline involved.
For example: One patient was coming in for intervention and had cardiac arrest just before
entering the cath lab, so nurses, doctors, consultants, and emergency staff came over to
help him. It was a very stressful situation, but thanks to teamwork, they were able to handle
it and save the patient. After stabilising the patient, they performed the intervention, but all
other team members stayed until the intervention was completed.
2.2. Identify the strengths and weakness of your chosen areas of teamworking.
In last section, you explored that inter professional teamwork so identify strength and
weakness of inter professional teamwork
Strengths- The strength of inter professional teamwork is that all have more knowledge,
experience and specialisation to treat the patient that helps in better outcome. Such as
therapist is specialised in provide a particular therapy for treatment of patient, social
workers provide necessary support to the patient suffering from cardiovascular diseases
and many more. Thus it lead in enhancing the quality of services offer to patient.
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Weakness- For example: while we are working in inter professional teamwork to treat
patient suffering from cardiovascular disease have conflict due to difference in point of view
and opinion. Such as Therapists, social workers, home care providers have worked as inter
professional teamwork that have different perspective related to treatment provided to the
patient.
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 service 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.
However, it can be analysed there at times there 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 elements while providing a
health care services to the patients (Ommen and et.al., 2020).
During each ward tour, the interaction between the consultant and the patient was precise
and kind. Such as it has allow the patient to feel at ease with the doctor and effectively
explaining the symptoms the patient it was experiencing. Along with that the manner in
which the consultant’s management can help in improving the patient’s health. I notice that
consultants help patients in understanding the disease it has been suffering and the
outcome of that disease so that necessary steps can be taken by patients to manage risk
factors.
For example, there was one patient who was a heavy smoker with a cardiac condition, and
doctors were explaining how smoking can worsen the condition of the patient’s cardiac
condition. The interaction between doctors and patients helps patients improve not only
through doctors but also by themselves (Whelton and Carey, 2017). This interaction has
played role in enhancing knowledge of the patient that why to avoid smoking, its negative
impact on body and the way it can be overcome.
Doctors also suggested lifestyle changes to help patients improve. All of this is taking place
as a result of patient-doctor interaction, which is critical. 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. There was a patient who came in with palpitation and
arm pain, and the consultant has requested me to accompany him. The consultant started
asking some questions about his history, and when the patient said he had a party the
night before, the consultant started asking about the party. Furthermore, I saw that the
patient was comfortable with the doctor and was explaining all of his symptoms very well,
and his ECGs report arrived, which the doctor checked and showed us, and we decided
ECG was normal therefore, while providing health care services interaction with the patient
is very important for providing quality care to the patients.
3.1. 2. What have you learnt from this experience?
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As I previously indicated, how the consultant interacted with the patient who had palpitation
and arm pain taught me that we need to be nice with patients so they feel comfortable with
us and can describe their problem without fear. From the experience of interacting with the
patients I gathered useful insight related to the patient condition. Such as, 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
or interacting with patients is complicated (Wilson and et.al., 2019). For communicating
with patients it is very important that an individual keeps certain things in mind such as
show empathy and kindness, transparency, listening to what is said by the patient. 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 (Tallman and et.al., 2019). 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 (Reboussin and et.al., 2018). 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 (Ommen and et.al., 2020). These non-verbal
clues include facial expressions, eye contact, demeanour etc. of the patients. 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 (Koh and et.al., 2018).
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). What I learned during my placement was very
effective and knowledgeable. There are a few things I'd like to discuss here about applying
these experiences in my workplace. In comparison, I believe here health care is more
focused on patients and letting them know more about their disease (Harjola amd et.al.,
2018). For example, in the stroke ward, there was a simple guideline I read that was FAST.
It was a very easy way to understand whether a patient had a stroke or not. It is generally
recommended that they see a doctor so that they can improve and determine what is wrong
with them before deciding to go to the hospital, although small issues can occasionally be
handled at home (Coit and et.al., 2019)
Also at times issues like patients are not comfortable in sharing their medical history with
anyone thus it becomes a major barrier in interacting with the patients. Moreover, the
patients might feel their privacy is being hampered therefore they do not engage in the
interaction (Bonneau and et.al., 2019).
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(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. The healthy environment can be created by
ensuring safety of patient, providing all necessary resources, facilities, treatment, support
and care so that it can easily overcome from the health issue (Harjola amd et.al., 2018).
Thus, this will help in building a relationship of trust between the patient and the health care
providers that will help in effective communication (Kim and et.al., 2019).
3.1. 4. Consider the wider implications for practice and organization of specialist services
and make firm recommendations to improve this.
It what 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). I
recommend that my workplace should improve patient-doctor interaction, which is quite
impressive, and create guidelines for each protocol so that they are easy to follow.
Because In my workplace, all management and investigation is done by consultants, which
is effective, but some modification in the treatment has been made by keeping up record of
the latest research. Also with the integration of GP'S and specialists into the
interdisciplinary teamwork. 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). Recommendation
for workplace in some areas, are- we need to hire multiple professional medical equipment
operators. As during my placement, I observed that physiologists in cath labs while
providing treatment face challenge of lack of medical equipment knowledge. Furthermore, I
recommend that my workplace to improve with advances in technology because
development in medical science lead to new versions every year, which is outstanding.
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).
Part 4:
Please write a critical review using the following questions as triggers: (2300 words).
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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? This section needs to be improved with evidence. You need to read more
articles
1. 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). During my placement, I noticed the
following three things that I'd like to discuss here
1. Diagnosing
2. Investigation approach
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). For
example, when a patient is admitted to a ward, doctors examine them, ask them questions,
and try to determine why the patient was there. Then there are other important things to
look at during doctor-patient interactions, such as checking the patient’s past medical
history, which can help you understand what problems the patient had in the past and if the
patient has any new ones. I don’t recall the doctor calling their GPs to inquire on the patient
in the meanwhile. Doctors keep records of their patients’ information and inform them about
their condition and why they are suffering. Importance of documentation is because it helps
in ensures consistency, efficiency and standardization. Likewise, it helps in clarifying what
need to be done by specific individuals in the organisation or what the firm actually expect
from them.
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. The
manner in which the patient is able to easily learn and take step to improve its overall
health. It is 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 (Otto and et.al., 2021). active listening also
plays a crucial role in the clinical decision making (Piepoli and et.al., 2020). 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).
Every clinical decision depends on investigation approach. If I compare my workplace to
my placement experience, there was one case where a patient was confused and couldn't
answer properly, and the doctor requested a CT scan and MRI, and later on when the CT
scan revealed that the patient had an ischemic stroke. This is fast service I observed during
placement, but it's slow at my workplace due to a lack of efficiency and lack of knowledge
among staff that are performing function so they have a difficult time finding diagnosis.
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However, there are certain factors that influence the clinical decision making are
type of practice, availability of health resource, key issue face by patient management
policies and many more. 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 (Seferovic and et.al.,
2019). In reality, this is not always possible. During the management, there was one chart
that every team member of that ward should follow so they can easily understand which
medication patients are on right now and what further approach should be considered
according to that. It is called as medication administration safety. Every consultant checks
that chart and changes medication during ward rounds according to patient condition. Some
cases I observed were critical long-term patients, so consultants were very careful to
change any medication with those patients. 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 the patient for making an informed decision (Tallman and
et.al., 2019).These decisions include a variety of knowledge and information sources. Thus,
there are various factors such as the interaction with the patient and procedure with
employment that influences this decision. One of the major factor that influence clinical
decision is the interaction with the patients. Patient interactions with doctors regarding
medicine were quite outstanding, as I noticed in placement where patients followed up with
doctors to help them better grasp the problem, which can help other team members better
understand and enhance the patient’s health. I was contemplating on this procedure with
my employment, where patients are not particularly forthcoming about the illness they are
experiencing, and the doctors bear the responsibility. In certain cases, 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.
2. How were roles and responsibilities for patient management divided in this placement?
Please read the question again and answer. I have added one sample project on the
canvas.
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
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interpersonal skill so that there could be effective interaction with the patients for insightful
information (Whelton and Carey., 2017). 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.
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.
four domain consists of
 Knowledge and skills of the practitioner: the practitioners that is offering services
must have key skill, knowledge and capabilities to treat the patient and delivered
better medication. 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 knowledge and
experience that will help in providing quicker and faster relief to the patients.
 Safety and quality: All steps and measure need to be undertaken to ensure safety
and quality of services that are offered to the patient. Such as, 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
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incidents involving devices or drugs that could put the patient’s life at risk are
reported so that the risk could be properly analysed and assessed.
 Communication and teamwork: There should be open and clearly communication
between the inter team and group member so that there are minimum chance of
confusion in future circumstances. Each and every individual must be clearly about
their respective roles and responsibilities within the organisation and motivated to
work for its growth.
 Maintaining trust: The four domains for good medical practices is trust should be
maintained between the professional, patient and interworking team. Through
effectively transparently and consistently sharing all of the information from one
individual to another. Likewise, outcome of the problem need to be clearly share to
patient.
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 knowledge and experience that will
help in providing quicker and faster relief to the patients.
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
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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REFERENCES
Books and journal
Araki and et.al., 2020. Japanese clinical practice guideline for diabetes 2019. Diabetology
international. 11. pp.165-223.
Arnett and et.al., 2019. 2019 ACC/AHA guideline on the primary prevention of
cardiovascular disease: a report of the American College of Cardiology/American
Heart Association Task Force on Clinical Practice Guidelines. Journal of the
American College of Cardiology. 74(10). pp.e177-e232.
Bonneau and et.al., 2019. How close are miRNAs from clinical practice? A perspective on
the diagnostic and therapeutic market. Ejifcc. 30(2). p.114.
Coit and et.al., 2019. Cutaneous melanoma, version 2.2019, NCCN clinical practice
guidelines in oncology. Journal of the National Comprehensive Cancer
Network. 17(4). pp.367-402.
Flaig and et.al., 2020. Bladder cancer, version 3.2020, NCCN clinical practice guidelines in
oncology. Journal of the National Comprehensive Cancer Network. 18(3). pp.329-
354.
Grundy and et.al., 2019. 2018
AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the
management of blood cholesterol: executive summary: a report of the American College
of Cardiology/American Heart Association Task Force on Clinical Practice
Guidelines. Journal of the American College of Cardiology. 73(24). pp.3168-3209.
Haneda and et.al., 2018. Japanese clinical practice guideline for diabetes 2016. Diabetology
international. 9(1). pp.1-45.
Harjola amd et.al., 2018. Comprehensive in‐hospital monitoring in acute heart failure:
applications for clinical practice and future directions for research. A statement
from the Acute Heart Failure Committee of the Heart Failure Association (HFA) of
the European Society of Cardiology (ESC). European journal of heart
failure. 20(7). pp.1081-1099.
Hoogendijk and et.al., 2019. Frailty: implications for clinical practice and public health. The
Lancet. 394(10206). pp.1365-1375.
January and et.al., 2019. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS
guideline for the management of patients with atrial fibrillation: a report of the
American College of Cardiology/American Heart Association Task Force on
18

Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the
American College of Cardiology. 74(1). pp.104-132.
Kim and et.al., 2019. 2019 Clinical practice guidelines for type 2 diabetes mellitus in
Korea. Diabetes & metabolism journal. 43(4). pp.398-406.
Koh and et.al., 2018. Uterine neoplasms, version 1.2018, NCCN clinical practice guidelines
in oncology. Journal of the National Comprehensive Cancer Network. 16(2).
pp.170-199.
Kusumoto and et.al., 2019. 2018 ACC/AHA/HRS guideline on the evaluation and
management of patients with bradycardia and cardiac conduction delay: a report of
the American College of Cardiology/American Heart Association Task Force on
Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the
American College of Cardiology. 74(7). pp.e51-e156.
Ommen and et.al., 2020. 2020 AHA/ACC guideline for the diagnosis and treatment of
patients with hypertrophic cardiomyopathy: a report of the American College of
Cardiology/American Heart Association Joint Committee on Clinical Practice
Guidelines. Journal of the American College of Cardiology. 76(25). pp.e159-e240.
Otto and et.al., 2021. 2020 ACC/AHA guideline for the management of patients with
valvular heart disease: executive summary: a report of the American College of
Cardiology/American Heart Association Joint Committee on Clinical Practice
Guidelines. Journal of the American College of Cardiology. 77(4). pp.450-500.
Pfister and et.al., 2020. Head and neck cancers, version 2.2020, NCCN clinical practice
guidelines in oncology. Journal of the National Comprehensive Cancer
Network. 18(7). pp.873-898.
Piepoli and et.al., 2020. Update on cardiovascular prevention in clinical practice: a position
paper of the European Association of Preventive Cardiology of the European
Society of Cardiology. European journal of preventive cardiology. 27(2). pp.181-
205.
Reboussin and et.al., 2018. Systematic review for the 2017
ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline
for the prevention, detection, evaluation, and management of high blood pressure in
adults: a report of the American College of Cardiology/American Heart
Association Task Force on Clinical Practice Guidelines. Hypertension. 71(6).
pp.e116-e135.
19

Rochwerg and et.al.,, 2020. Remdesivir for severe covid-19: a clinical practice
guideline. Bmj. 370.
Seferovic and et.al., 2019. Clinical practice update on heart failure 2019: pharmacotherapy,
procedures, devices and patient management. An expert consensus meeting report
of the Heart Failure Association of the European Society of Cardiology. European
journal of heart failure. 21(10). pp.1169-1186.
Stout and et.al., 2019. 2018 AHA/ACC guideline for the management of adults with
congenital heart disease: a report of the American College of Cardiology/American
Heart Association Task Force on Clinical Practice Guidelines. Journal of the
American College of Cardiology. 73(12). pp.e81-e192.
Tallman and et.al., 2019. Acute myeloid leukemia, version 3.2019, NCCN clinical practice
guidelines in oncology. Journal of the National Comprehensive Cancer
Network. 17(6). pp.721-749.
Thomas and et.al., 2020. Physiotherapy management for COVID-19 in the acute hospital
setting: clinical practice recommendations. Journal of Physiotherapy. 66(2). pp.73-
82.
Von Mehren and et.al., 2018. Soft tissue sarcoma, version 2.2018, NCCN clinical practice
guidelines in oncology. Journal of the National Comprehensive Cancer
Network. 16(5). pp.536-563.
Whelton, P.K. and Carey, R.M., 2017. The 2017 clinical practice guideline for high blood
pressure. Jama. 318(21). pp.2073-2074.
Wilson and et.al., 2019. Systematic review for the 2018
AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA
guideline on the management of blood cholesterol: a report of the American
College of Cardiology/American Heart Association Task Force on Clinical Practice
Guidelines. Circulation. 139(25). pp.e1144-e1161.
Wolff and et.al., 2018. Human epidermal growth factor receptor 2 testing in breast cancer:
American Society of Clinical Oncology/College of American Pathologists clinical
practice guideline focused update. Archives of pathology & laboratory
medicine. 142(11). pp.1364-1382.
Writing Committee Members and et.al., 2021. 2020 ACC/AHA guideline for the
management of patients with valvular heart disease: a report of the American
College of Cardiology/American Heart Association Joint Committee on Clinical
20

Practice Guidelines. Journal of the American College of Cardiology. 77(4). pp.e25-
e197.
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