The Foundation Programme at a Glance E-Book

Stuart Carney

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: At a Glance
• Sprache: Englisch

Seitenzahl: 347

Veröffentlichungsjahr: 2013

Beschreibung

Providing an overview of the formative years of a junior doctor’s career, The Foundation Programme at a Glance consolidates the generic and condition-specific skills required to excel in this stage of training. Taking a simple and holistic approach to providing support for junior doctors, it integrates text and image content to suit all learning styles.

Sections include advice on making the most of your training, tips on good clinical practice, communication, and common presentations and conditions. Edited by the National Director and Deputy National Director of the UK Foundation Programme, each section is written by experts in their respective fields, presenting insights into the programme with unrivalled authority.

The Foundation Programme at a Glance:
• Uses diagrams, line drawings and flow charts to clearly illustrate concepts
• Follows the current Foundation Programme curriculum
• Integrates theory and practice

This comprehensive and practical volume contains all the vital information you need to reach excellence during the foundation years, and to get the most out of your time on the programme.

Leseprobe

Contents

Cover

QR code

Title Page

Copyright

List of contributors

Preface

Acknowledgements

List of abbreviations

How to use your textbook

Features contained within your textbook

The anytime, anywhere textbook

Chapter 1: Shadowing and induction

Shadowing and induction

Learning how to do your first F1 job

What you need to know

Who else should you meet?

Chapter 2: The e-portfolio – how to plan, manage and evidence your learning

What is the e-portfolio for?

Who has access to my e-portfolio?

What do I put in it?

Chapter 3: Supervised learning events and assessments

Supervised learning events (SLEs)

Assessments

How to use feedback

Chapter 4: Reflective learning

What is reflection?

Why is it important?

Using the e-portfolio to help your reflective practice

A model for reflection

What examples can you use in your reflective log

Chapter 5: Managing your medical career

What should I aim for in my medical career?

Career discussions and where to find career support

Exploring options in the foundation programme

Other career issues and changes to plan

Chapter 6: Applying to specialty training

Exploration of the options

Career structure of your chosen specialties

Application process timelines

Interview/selection process

Applicant etiquette

Less than full time (LTFT) training

Myths about speciality training applications

Chapter 7: Quality improvement and clinical leadership

What is quality improvement?

Improving healthcare for the benefit of patients

Leading and implementing changes

Chapter 8: Quality improvement projects

Plan, do, study, act (PDSA)

Audit

Chapter 9: Breaking bad news and handling complaints

Breaking bad news

Handling complaints

Chapter 10: Assessing capacity and informed consent

What is mental capacity?

Principles

Supporting patients to make decisions

Two-stage test of mental capacity

Acting in the patient's best interests

Chapter 11: Handover and communicating with colleagues

Effective communication with colleagues

Safe handover

Leadership and communication

Chapter 12: Communication between primary and secondary care

Written communication

Discharge letters

Referral letters and internal referrals

Clinic letters

Chapter 13: Introduction to evidence-based medicine

What is evidence-based medicine?

Why is it important?

How to practice EBM – the five steps

Chapter 14: Critical appraisal of randomized controlled trials

What is critical appraisal?

Is the RCT applicable and valid?

Are the results important?

Is it a poor quality study or a poorly reported study?

Chapter 15: Critical appraisal of systematic reviews and meta-analyses

Question – does it ask a clearly focused question?

Find – did it find all the best evidence?

Appraise – were the studies critically appraised?

Synthesis – were the results appropriately combined?

What could you tell your patient?

Chapter 16: Making the most of guidelines and protocols

What is the difference between a guideline and protocol?

How to find guidelines and protocols

How to critically appraise a guideline or protocol

How to use guidelines and protocols

Chapter 17: Running a teaching session and presentation skills

Maximising learning

Choosing the right media

Length

Emphasize key messages

Chapter 18: Assessment and feedback

Assessment methodology

Assessment tools

Assessment demonstrating cause for concern

Feedback

Chapter 19: Assessing and managing the acutely ill patient

Identifying the unwell patient

Approaching the acutely ill patient

Initial assessment

When should I call for help?

Chapter 20: Rational prescribing

First steps

Prescribing

Treatment

Compliance

External effects on prescribing

Drug reactions

Chapter 21: Medical record keeping

Why keep medical records?

What is included in medical records?

Who contributes to medical records?

What information should be recorded?

What should not be recorded in the notes?

Confidentiality

Who can view medical records?

Chapter 22: Time management

How can I maximize my time?

Protected time

Reference

Chapter 23: Fluid management

Normal body fluids

Administration and monitoring of fluid replacement

Chapter 24: Blood transfusion

Blood transfusion

Managing transfusion reactions

Reference

Chapter 25: Discharge planning

Why is discharge planning important?

What is discharge planning?

What is the foundation doctor's role in discharge planning?

How is a discharge planned?

Early supported-discharge teams

Who can discharge a patient?

Chapter 26: Nutrition

Specific malnutrition (vitamin and mineral deficiencies)

Nutritional support

Chapter 27: Health promotion and public health

Alcohol

Smoking

Drugs

Diet and nutrition

Wider public health issues

Chapter 28: Do not attempt CPR decisions

Ethical and legal considerations

When to consider making a DNACPR decision

Discussions about CPR

Practical Issues

Chapter 29: Palliative care

Pain

Terminal phase of illness

Chapter 30: Certifying death

How to complete a MCCD

When to inform the coroner or procurator fiscal

What does the coroner or procurator fiscal need to know?

What happens next?

Chapter 31: The unconscious patient

History

Examination

Investigations

Management

Chapter 32: Stridor

What is stridor?

What you see

History

Management

Chapter 33: Anaphylaxis

Mechanism

Presentation/range of symptoms

What questions to ask the patient?

Examination/anything else to look for?

Practical management

Investigations

Chapter 34: Asthma

Chapter 35: Pneumothorax and pulmonary embolism

Pneumothorax

Pulmonary embolism

Chapter 36: Chronic obstructive pulmonary disease

Chapter 37: Community-acquired pneumonia

Chapter 38: Acute chest pain

Key points

Differential diagnosis

Important diagnostic features

The acute coronary syndromes

Key investigations

Chapter 39: Palpitations

Key points

Differential diagnosis: what is the patient describing?

Important diagnostic features

Key investigations

Chapter 40: Hypotension

Definitions

Symptoms and signs

Causes

Management

Chapter 41: Severe sepsis

Definitions

Incidence and risk factors

Management

Chapter 42: Oliguria – including acute kidney injury

Presentation

Prevention

History

Examination

Investigations

Management

Chapter 43: Electrolyte derangement–hyperkalaemia

Hyperkalaemia

Chapter 44: Electrolyte derangement – hyponatraemia

Hyponatraemia

Chapter 45: Diabetic ketoacidosis

Recognition and management of DKA

Pathophysiology

Aetiology

Mortality and morbidity

Treatment

Chapter 46: Hypoglycaemia

Recognition of hypoglycaemia

Causes of hypoglycaemia in diabetes

Risk factors for hypoglycaemia in diabetes

Treatment

Follow on care

Chapter 47: Abdominal pain

History

Examination

Investigations

Red flag conditions

Chapter 48: Gastrointestinal bleeds

Causes

History

Initial assessment and management: the ABC approach

Chapter 49: Back pain and large joint pain

Back pain

Large joint pain

References

Chapter 50: Fractures and dislocations

Chapter 51: Coma

Chapter 52: Seizures

Stop the seizure

Search for a cause

Examination

Investigations

Who can go home?

Chapter 53: Meningitis and encephalitis

Meningitis

Encephalitis

Cerebral abscess

Chapter 54: Stroke/acute onset of focal neurological signs

Clinical assessment

Investigations

Stroke

Transient ischaemic attack

Chapter 55: Acute visual impairment

Vascular occlusion

Acephalgic migraine

Vitreous haemorrhage

Chapter 56: Depression

How to diagnose a major depressive episode

What are the risks associated with depression?

What else could it be?

How to manage patients with a depressive episode

What is the prognosis?

Chapter 57: Psychosis

What is psychosis?

Schizophrenia

How to assess for psychosis

Differential diagnosis for schizophrenia

How to manage a patient with schizophrenia

Prognosis and risk

Assessing and managing aggressive patients

Chapter 58: Anxiety disorders

Anxiety disorders

Panic disorder

Generalized anxiety disorder (GAD)

Chapter 59: Harmful drinking and alcohol dependence

Screening for harmful use/alcohol dependence

Detailed assessment

Management of assisted alcohol withdrawal

Alcohol withdrawal in hospital

Chapter 60: Child abuse and protection

Cause for concern – the child's injury

Parental responsibility

History

Examination

Action

Pitfalls in diagnosis

Reference

Chapter 61: The febrile child, and recognizing the seriously ill child (including UTI and meningitis)

Detection of fever

Assessment

Symptoms and signs of specific illnesses

Chapter 62: Cough and wheeze

Is it asthma?

Managing acute asthma in children

Long-term management of stable asthma

Reference

Chapter 63: Diarrhoea, vomiting and constipation in young children

Diarrhoea and vomiting (D&V)

Constipation

References

Chapter 64: Confusion, dementia and delirium

Delirium

Dementia

Chapter 65: Fits, faints and falls

Check

History

Treatment in fits and faints

Implications of a diagnosis of epilepsy

Prevention of falls

Index

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Library of Congress Cataloging-in-Publication Data

Carney, Stuart, author.   The Foundation Programme at a glance / Stuart Carney, Derek Gallen.    p. ; cm. – (At a glance series)   Includes bibliographical references and index.   ISBN 978-0-470-65737-9 (pbk. : alk. paper) – ISBN 978-1-118-73459-9 – ISBN 978-1-118-73460-5 – ISBN 978-1-118-73461-2 (emobi) – ISBN 978-1-118-73462-9 (epdf) – ISBN 978-1-118-73463-6 (epub)   I. Gallen, Derek, author.  II. Title.  III. Series: At a glance series (Oxford, England)   [DNLM: 1. Foundation Programme (Great Britain. National Health Service)  2. Clinical Medicine–methods–Great Britain.  3. Medical Staff, Hospital–education–Great Britain. 4. Inservice Training–methods–Great Britain.  5. National Health Programs–organization & administration–Great Britain.  WX 203]   RA972   362.11068′3–dc23

2013024793

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Cover image: iStockphoto © Sturti Cover design by Meaden Creative

List of contributors

Anthony BatemanFRCA Consultant in Critical Care and Long Term Ventilation ICU, Western General Hospital Edinburgh, UK Chapters 40, 41

Rhodri G. BirtchnellMBBCh BSc (Hons) FCARCSI Anaesthetic Registrar Royal Gwent Hospital Newport, UK Chapter 33

Sue CarrMB BS MMedSci MD FRCP Consultant Nephrologist/Visiting Professor of Medical Education Associate Medical Director University Hospitals of Leicester Leicester, UK Chapters 23, 42, 43, 44

Gordon FrenchFRCA FFICM MBA Consultant Anaesthetist Department of Anaesthesia and Critical Care Northampton General Hospital Northampton, UK Chapter 28

Alice GallenBSc MBBS GP Registrar Nevill Hall Hospital Abergavenny, UK Chapter 1

Peter HenriksenPhD FRCP Consultant Cardiologist Edinburgh Heart Centre Edinburgh, UK Chapter 39

Patricia HooperMBChB BSc MRCP Specialty Registrar, Gastroenterology University Hospitals of Leicester NHS Trust Leicester, UK Chapters 47, 48

Helen L. JewittMBBCh FRCA Consultant Anaesthetist Royal Gwent Hospital Newport, UK Chapter 32

Melanie J. T. JonesMB BCh FRCA MA Associate Dean for Careers and LTFT Training, Wales Retired Consultant Anaesthetist Chapters 5, 6, 31, 32, 33

M. Sian LewisMB BCh FRCP FRCPath PCME MBA Consultant Haematologist Hywel Dda Health Board Carmarthen, UK Chapter 24

Laura McGregorMBChB MRCP (UK) (Rheumatology) Consultant Rheumatologist Glasgow Royal Infirmary Glasgow, UK Chapter 49

Scott W. OliverMBChB BSc (MedSci) (Hons) MRCP (UK) MFMLM Specialty Registrar, Nephrology and General (Internal) Medicine NHS Lanarkshire Glasgow, UK Chapters 19, 21, 25

Matt OutramFRCA FFICM Consultant Anaesthetist Department of Anaesthesia and Critical Care Northampton General Hospital Northampton, UK Chapter 28

Helen A. PadfieldMBBCh FRCA Specialty Registrar, Anaesthetics University Hospital of Wales Cardiff, UK Chapter 31

Michael D. PageMD FRCP Consultant Physician Royal Glamorgan Hospital Ynysmaersdy, LLantrisant Pontyclun, UK Chapters 45 and 46

Heather PayneMRCPCH FHEA IHSM Welsh Government Cathys Park Cardiff, UK Chapters 60, 61, 62, 63

Andrew SteelFRCP Consultant Physician Kettering General Hospital NHS Foundation Trust Kettering, UK Chapters 47, 48

Peter S. TophamMB ChB MD FRCP Consultant Nephrologist John Walls Renal Unit University Hospitals of Leicester Leicester, UK Chapters 43 and 44

Rachael WestacottMB ChB BSci FRCP Consultant Nephrologist John Walls Renal Unit University Hospitals of Leicester Leicester, UK Chapters 23, 42, 43, 44

Preface

The 2-year foundation programme was introduced in 2005. Bridging the gap between medical school and specialty training, the original focus of the foundation programme was the assessment and management of the acutely ill patient in a variety of settings. The curriculum has gone through three revisions since the start of the programme and this book encompasses the latest developments. While there continues to be a high emphasis on the management of the acutely ill patient there is now greater emphasis on caring for the ‘whole patient’ including long-term physical and mental illness. This is a reflection of the needs of the National Health Service (NHS) with a growing elderly population who often have co-morbidities. It is therefore essential that all doctors have a knowledge and understanding of the management of both acute and long-term conditions.

The ‘At A Glance’ series does not seek to give a comprehensive, in-depth review of each clinical topic or subject but rather a synthesis of the key facts, including the assessment and management of patients with common conditions. The object of this book is to cover the important topics in an easy-to-read and view format. It can be used as an aide-memoir before starting a new placement or to refresh your knowledge before seeing patients with particular clinical problems. It summarizes how to identify, examine, investigate and begin to treat patients. The book also contains valuable information on making the transition from medical school to employment and preparing for specialty training. Topics include time management, dealing with colleagues and communication skills to help in your day-to-day working practice. Top tips are included in all chapters and serve as a quick reference to help ensure you think through the main issues in every case.

This book is primarily aimed at foundation doctors but will also be of benefit to final year medical students As the final year of medical school is mainly spent on the wards dealing with patients, the contents of this book will be very relevant. Educational supervisors may also wish to make reference to the guide as it covers all the key topics in the Foundation Programme Curriculum.

The foundation programme is the start of your career in the NHS and helps you build the confidence and capabilities required to safely and effectively care for patients and progress through to specialty training. We hope you find this book a useful resource in your day-to-day interactions with patients and colleagues alike.

Stuart Carney is the Dean of Medical Education at King's College London and Deputy National Director of the UK Foundation Programme Office. Since 2004 Stuart has been involved in setting up and coordinating the delivery of the foundation programme across the UK. As a psychiatrist and an academic, he has been particularly interested in how the foundation programme prepares graduates to begin to care for the whole patient.

Derek Gallen is the National Director of the UK Foundation Programme Office. He is also the Postgraduate Dean for Wales and Chair of the Conference of Postgraduate Deans UK. He set up the Foundation Programme Office in 2007 in Cardiff and has principally been involved in the recruitment and selection into the 2-year foundation programme. His main interest is in the establishment and development of innovative academic foundation placements.