Early Professional Experience: Concept Checklist
Concepts covered across the module lectures, grouped by lecture. Tick each once you can explain it from memory.
L1 Diagnosing and managing somatisation (2 Mar) L1 Early Professional Experience Diagnosing and managing somatisation
- Definition of somatisation, its spectrum with and without organic pathology, and the mind-body basis
- Body systems commonly affected by somatisation
- Making a positive rather than a negative diagnosis of somatisation
- Five patterns suggesting functional illness, including sensitisation
- Setting the scene for psychosocial history: empathise, non-blaming comment, normalise, explain
- The four standard questions for diagnosing somatisation
- Approach to investigation, and the patient as co-investigator
- Management of somatisation: empathy, explanation, addressing fears, lifestyle, treating anxiety and depression, referral, relaxation, medication
L2 Insights into ME_ CFS and long COVID (4 Mar) L2 Early Professional Experience Insights into ME_ CFS and long COVID
- Post-viral/stressor syndromes: susceptible proportion, recovery in the rest of the population, prevalence of ME/CFS and Long COVID
- History and naming of ME/CFS, non-viral triggers, and NZ’s Tapanui flu outbreak
- Long COVID: names, WHO case definition, core symptoms, heterogeneous subgroups, overlap with ME/CFS
- Symptoms and course of ME/CFS, including post-exertional malaise and proportion housebound
- Multi-omic pathophysiological model: peripheral inflammation, BBB permeability, gateway and inflammatory reflexes, fluctuating neuroinflammation, relapse with stressors
- Emerging genetic susceptibility and epigenetic diagnostic research
- Challenges patients face: lack of professional understanding, disbelief, limited access to social support
- Patient-reported treatment effectiveness, including pacing and fluids, and harm reported from graded exercise therapy
- What patients ask of doctors and how to support ME/CFS and Long COVID patients
- Integrated view of overlapping chronic conditions (fibromyalgia, EDS, MS) and comorbidities (MCAS, POTS)
L5 Exercise and green prescriptions (12 Jun) L5 Early Professional Experience Exercise and green prescriptions
- Role of Sport Otago and its Healthy Lifestyles programmes
- Physical activity, diet, sleep and screen time guideline adherence in NZ adults and children
- Green Prescription: what it provides, referral criteria and referral routes
- Active Families: what it provides and referral criteria for children and whānau
- TINANA ORA framework for whānau lifestyle advice: meals together, water, portions, activity, screen time, breakfast, takeaways, sleep, vegetables
L6 Introduction to Hospice Care (27 Jul) L6 Early Professional Experience Introduction to Hospice Care
- Evolution of Otago Community Hospice from inpatient to community-based care
- Aims of specialist palliative care and hospice access criteria
- Referral and assessment pathway into hospice care
- Members of the hospice multidisciplinary team, and the ongoing role of the patient’s GP
- Role, capacity, limitations and admission criteria of the hospice inpatient unit
- Te Whare Tapa Whā as a framework for holistic palliative care
L7 Spiritual care in clinical practice (31 Jul) L7 Early Professional Experience Spiritual care in clinical practice
- Consensus definition of spirituality and its existential, value-based and religious dimensions
- Why spirituality matters in healthcare: coping, decision-making, evidence, NZ policy recognition of taha wairua
- Whole-person frameworks: bio-psycho-social-spiritual model, Te Whare Tapa Whā, Fonofale
- Changing religious landscape and the numinous in clinical practice
- Three tiers of spiritual care: screening, history-taking and assessment, and who performs each
- FICA spiritual history tool and conversation openers
- Ethical guidelines for providing spiritual care
- Spiritual distress: definition and common sources; spiritual suffering and its three disruptions
- Advance care planning resources
- Chaplaincy and other spiritual care resources for referral
L8 Quality and safety in clinical practice (17 Sep) L8 Early Professional Experience Quality and safety in clinical practice
- Incidence of adverse events in healthcare, proportion causing permanent harm, proportion preventable
- Why motivation does not determine error rates
- Distinguish slips and lapses from errors, and why confident errors are most dangerous
- How branching clinical decisions multiply opportunities for error
- Pattern-matching as a source of slips; HALT states that increase error
- Examples of system-caused errors: look-alike ampoules, wrong-side surgery, notes mix-ups, rapid IV potassium
- Swiss cheese model of accident causation
- Outcome bias in judging clinicians after errors
- Engineered solutions, checklists and healthcare examples (red relaxant syringes, CVL bundle) vs policies and posters
- Safety culture: see it, say it, fix it; crew resource management; teamwork; flawed lone-hero culture
- Responding to error: system vs personal deficit, open disclosure, self-care after being involved in an error