MSc Cardiology & Stroke: Clinical Practice in Action 7LM0156 Portfolio

This portfolio documents a student's experience in the Clinical Practice in Action Module, focusing on cardiology and stroke care within the NHS. It includes reflections on clinical placements, initial expectations, and a learning log detailing daily observations and experiences in cardiology and stroke units. The portfolio highlights the differences in healthcare practices between the student's home country and the UK, with a particular emphasis on patient care and counselling. It also explores the importance of teamwork in healthcare, emphasizing critical decision-making and professional behavior. The student reflects on the value of empathy, patience, and team working, and discusses the potential for improving patient management through enhanced teamwork in their own clinical setting. The portfolio concludes with a reflection on the overall learning experience and its impact on the student's perspective on patient care.

MSc Cardiology and Stroke
Clinical Practice in Action Module

This portfolio of learning is the assessment for Clinical Practice in Action Module
7LM0156 which 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)
When I got the information about the clinical placement at Hospital, I got very
excited as I was going to acquire hands on clinical experience of my field of
specialization and also get to know and experience the clinical procedures
here in UK and also the style of practice. My targets for the placement were
initially to have a good clinical skills and technique approach, be it the patient
interaction, how to use the best specific treatment, counselling, and also pe a
part of MDT team. Also, I was eager to see how the roles and responsibilities
being entitled to a specific person and how interprofessional behaviour, help
in refining a clinical approach. My concerns were, how will I be able to cope
up with the entire structural work pattern and understand everything that is
important to me for my clinical future as a health practitioner. Also there was a
covid19 pandemic crisis, which may result into less number of patients
coming to health department, which can directly effect our learning to a
certain extent.
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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 staff or patients
by name (confidentiality must be maintained at all times)
Learning Log Details
Day 1 On my first day of placement, I arrived at the cardiology department
where I was welcomed by the staff of medical education team. I was
hesitant in the beginning, but they were very cordial to me. My initial
thought was that in a period of 5 hours, the senior cardiologists were
given only 5 cases of perfusion scan. My point of comparison here
was my service in Karachi, where in a period of 2 hours, doctors
looked at more than 10 such cases. It was a very wholesome
experience for me.
Day 2 In first session of second day, I attended the cardiology ward round
with one of the consultant cardiologists at the hospital. I observed
multiple patients with different requirements. I learned how to
manage the procedures and medication regarding these patients
based on their medical condition and urgency of situation. Further, I
learned when and how to discharge the patient on maximum
medication. During the round there were healthy discussions related
to each patients’ conditions and requirements.
During second session, I attended catheterization laboratory. I saw
one angiography and one angioplasty. One of the senior doctors
who was performing procedure explained to me indicators of
angiography and the side effects of procedure. I learned how to take
consent from the patient before the procedure and how to explain
the patient after the procedure.
Day 3 On day three during first session, I attended multidisciplinary team
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online meeting with one of the senior consultants. I was amazed by
the idea of using technology to connect professionals at smaller
clinics with senior consultants in a large hospital. This I realized
allowed expertise of senior consultants to positively impact patients
who visited smaller clinics. It also helped reduce burden on large
hospitals.
The topic discussed was heart failure management, I learned about
the management of heart failure patients, maximisation of
medication, regular follow up from patients and seasonal
vaccinations.
Day 4 During the first session that I attended in the Stroke ward, I had a
healthy discussion with the team about different cases. I noticed
from early on that the treatment provided in Pakistan to the patients
was similar as in UK, however a lot more care and counselling is
provided to the patients in UK.
Day 5 In first session of day five, I attended Transit Ischemic Attack (TIA)
OPD. The OPD was conducted through telephone due to pandemic.
It was my first experience of conducting an online OPD. I learned
management of acute and chronic patient and how to adjust the
treatment according to symptoms and investigation.
In second session, I attended MDT meeting on thrombolysis
(seminar). I learned about the benefits of thrombolysis within and
after window period for acute stroke patients. Further, which patients
will get more benefits by this treatment.
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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)
I thoroughly enjoyed the five days of my placement. Despite pandemic, I
visited the hospital from 9 am to 5 pm every day. The consultants and the
staff on duty were extremely nice. They would explain all procedures being
carried out in great depth. I have worked in hospitals of two other countries,
and my one clear observation was that a lot of stress was being placed here
on patient care. Doctors would spend a lot of time in counselling the patient
from the first encounter and all the way to the end of the treatment. The
consent of patient was sought at every step of the treatment. A lot of the time
calls with patients were scheduled for a post treatment follow up. They were
well informed of the side effects of the medication that they were consuming.
Moreover, I was really impressed by the extent of quality health care provided
to the patients. The entire life of the patient from their routine to food and
environment was attended to. I also attended a loop recorder placement OPD
where I observed five cases. I learned how to explain the patient the purpose
to use the loop recorder (the device). Further, learned how to explain the
patient about usage of device at home and how to send ECG tracing online to
hospital for diagnosis purpose. I also attended Stroke OPD with a Stroke
Consultant. The OPD was conducted through telephone due to pandemic. It
was the first time ever that I witnessed OPD being conducted on phone. It
was a fresh experience for me. I was also amazed to know that OPD was
related to patients who had recovered, and it was a follow up call on their
health. I also learned management of chronic patient and how to adjust the
treatment according to symptoms and investigation.
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Further, I learned how to investigate patients and management of treatment
as per symptoms. Further, I learned about physiotherapy requirements and
home care required for these patients once discharged. I also attended
emergency department with one of staff on duty. I learned how to attend any
emergency case and requirements related to admission. I learned how to
investigate patients and management of treatment as per symptoms. Further,
I learned about physiotherapy requirements and home care required for these
patients once discharged. I have also able to learn understanding of empathy,
understanding patience towards individual who are seeking help from service
providers and quality of team working while practising in health care
organisation. I achieved learning in regards with person centred care which
should be provided to each individual in order to cope from illness. I have
learned to be punctual that can help me in my daily schedule as well. I am
able to learn technical skills through recording details of patient’s medical
history while serving services in my workplace. The use of technologies is
essential learn as it may utilise within each sector. I am also able to enhance
my communication skills through health care settings.
Overall, it was a very good learning experience. It invigorated in me what I
love most about the work – taking care of patients and making them healthier.
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Part 2:
Students are expected to undertake an:
2. Exploration of a particular aspect of professional practice: observed during
clinical placement that has potential to be developed in your own clinical setting
to improve management of patients e.g., clinical decision making, inter
professional team working, specialist practice, organisation of services, patient
advocacy (1000w)
2.1. Identify the area of practice you wish to explore and state why?
The area which I would like to explore in the health care sector that is
teamwork. As per my opinion, the team formulation has determined place that
has from top to bottom and also across each department of health care
sectors. As the teamwork It highly aims on the patient's medical history and
help them to provide best practise to enhance their health factor. Each team
members are termed to be built for users’ satisfaction and to improve work
procedures and to improvise performances of services. Decision making is a
essential part in team working. Most of the better opportunities for best
outcomes and for achieving goals lies in the domain in group decision making
process. It may provide ample of opportunities to each individual to share their
ideas and views. I have observed that through this process there are
numerous of strategies can be developed and areas can be improvised.
Sometimes, the team decision making may accomplish and conquer the goals
and objective by group agreement whereas, in few conditions when there is
disagreement of even one member of a group, then the solution becomes
harder to attained. The group decision making that involves number of
interventions and critical thinking of an individual and it may also promote
recovery of a person (Youthful, 2015). Also, in clinical placement, there are
essential areas which should be prioritize through health care professionals.
These areas play an important role in health care culture. The group critical
decision making also makes an individual so precise and attentive while
taking a decision where the situation being complex and critical for health care
professionals to decide what is best for patient. It is ability that may be helpful
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to overcome such conditions, where the chances of ethical dilemma might
develop and that is resolved through decision which is team based.
In order to overcome from these situations in medical filed, skill of team based
critical thinking is being implemented. It can make a person professional in
nature and being professional makes an individual to work systematically and
an individual becomes role model for others (Jaeger et al. 2019). According to
my observation, team based critical decision making is significant to improve
performances and help them to attained desired goal. Behaviour and action of
an individual comes after. The professional behaviour is directly linked to
safety and security of patients. The quality of care is provided by health care
professionals which include the dignity and respect towards each patient and
in this communication is also play a vital role. (Youthful, 2015).
Group Critical decision making may also involve the benefits of health of an
individual. It can also promote the recovery of health as well as it may also
include intervention which should be used to foster the recovery. The group
critical decision making can involve the strategies and methodologies that are
in favor of patients. It is used in chronic illness and long-term illness. The
group critical decision must establish when it appears that none of
methodologies promoting the welfare of a person. Hence, the exploration may
also characterize as new techniques and new treatment plans that can be
useful for patients.
The health care profession is termed to be difficult that also that may involve
the circumstances in which an individual may their own skills in order to carry
out best solution for any consequences. In this situation, the most wanted
skills which should be there in a trainee is decision making skills. The team
based decision-making skills that are used in chronic illness situation where
there are chances an ethical dilemma can be developed. Finally, that practical
performer speculation isn't only a managing theory of how people should
make decisions about for the present circumstance prosperity direct, however
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then again is an explaining model of how people select team-based decisions
and legitimize their exercises (Jaeger et al. 2019).
Other factor I would like to observe the communication skills of a person in a
team. It is well known that communication is significant in health care
profession. It may be helpful in establishing the trust among team members
and also empathy and can promote to establish a healthy and positive
environment. (Jaeger et al. 2019) Effective communication skills also make
transparency with team members may help to attained positive outcomes for
service user.
I like to observe teamwork quality in order to work in system and to improve
and provide best service to an individual it is required that the teamwork plays
an important role in the management and make a system to work in
systematise way. It can also provide support to each other for tackling a
difficult and risky situation. The teamwork can also improve performance and
can help each other to provide a better result. These are get-together of
individuals who are seen to, 'deliberately open themselves to prosperity risks
rather than regularly avoiding them, and consequently require more
unmistakable observation and rule, when perceived these get-together and
individuals then become subject to various prosperity progression or
'prosperity improvement' drives (Guzik and Bushnell, 2017).
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2.2. Identify the strengths and weakness of your selected area of
professional practice?
The selected area of professional practice that I have chosen is teamwork.
The strengths and weaknesses of which are mentioned below:
Strengths
Synergy
When a group determines any decision together by number of practices such
as group discussion, questionnaire, collaboration, each group members are
termed to recognise more effective and complete decision and also its
judgement should be keener.
Sharing Information
The group decision can take places that in account a board range of scope
that are attained through shared information since each one of member of
group can contribute his or her ideas, views, and expertise. Sharing
information within group can promote understanding, justify issues as well as
also facilitate movement that can mould toward a collective decision making.
Weakness
Diffusion Of Responsibilities
It has been observed by my personal experience that there are numerous of
conceits may arise while conducting a group decision making due to some
expectational group members. Sometimes people may generally diffuse to
perform their responsibilities and to obey rules for their decided roles.
Time consuming
As compared to individual decision making, group decision making can be
more time consuming. It may take time to reach out a solution in which all
group members may agree. Group decision making also takes time to excite
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any determined strategies which have been decided through groups in order
to improve problematic areas.
Being dominated
Group decision making may get dominated by one or few members in a
group. During my practice I have observed that the group decision making
can be suppressed and can be moulded towards one person's will.
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Part 3: Critical Review
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 Describe the patient interaction and why it was important to you?
The interaction with individuals that I observed and remembered about a girl
who accidental met an accident with fire, walks into room in a critical situation.
The girl's hand was affected by the incident as she informed, she lives alone
her apartment. While cooking she accidental catches fire and to safe her face,
she covered her face from the hand. As she was in pain and feeling a lot
burning feels on her hand. To asst her the health care professionals took this
incident seriously and took her to emergency room and started to assist her
and tried to ease her pain through premedical equipment. As for the safety
and record of an individual the photograph of he wound and personal details
were recorded by them. After the application of premedical interventions, she
was asked to go for further treatment, and took her to emergency room. The
patient interaction is good to develop as it can build a bond and also promote
the ability to collect knowledge and information in order to provide accurate
and exact required treatments and diagnosis. The good communication with
doctor- patient debits enough potential to help and also regulate emotions of
an individuals, to provide facilities and also medical information, also
promotes a better identification of needs and demands of patients and also
numerous of expectations. The effective communication that are requited on
health care sector are generally through bedside manner or pattern.
Moreover, After the completion of process, the other clinical professionals
asked her not to allow wound from the atmosphere contact. As per the studies
reference, it has been stated that interaction as well as communication may
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