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The purpose of this case study is to describe a simulation-based assessment designed to assure student readiness for a first full-time clinical experience in an entry-level Doctor of Physical Therapy program that transitioned to mixed-mode instruction during the COVID-19 pandemic.

A cohort of 40 second-year physical therapy students whose content delivery mode, assessment methods and curricular sequence deviated from the curricular plan participated in a new assessment using standardized patients. The assessment was developed to preferentially address the knowledge, skills, abilities and professional behaviors (KSAs) that were typically assessed with other methods before the pandemic.

The assessment was useful in identifying students who required additional learning experiences to meet expected levels of competence before transition to a first full-time clinical experience. It also identified KSAs that needed to be strengthened within the entire cohort of students.

This case study provides an example of feasible implementation of an assessment of student readiness for clinical education that may guide future development of standardized assessments in health profession education (HPE) programs that have or plan to transition to mixed-mode content delivery.

This case study highlights the need and process for developing and implementing additional assessments in HPE programs when planned changes or unexpected variations in curriculum delivery occur. This evidence-based assessment preferentially addresses the affective domain of learning and includes competency standards that have recently been developed for physical therapy education in the USA.

The UK National Clinical Assessment Service (NCAS) provides local NHS bodies with advice and support in relation to concerns about individual doctors and dentists and in some cases also conducts a detailed assessment of practitioner performance. The purpose of this paper is to identify the contribution of NCAS performance assessment to clarifying concerns about clinical performance through comparison of concerns suspected at initial referral with those identified at assessment.

In the paper a sample of 50 NCAS medical cases, performance issues reported at the point of referral to NCAS and those identified at assessment were grouped into five broad domains (clinical care, behaviour, health, education and training, organisation). Concerns identified at assessment were compared with those reported at referral for each domain of concern. Conclusions and recommendations following assessment were also reviewed.

Within each domain, some concerns noted at referral were confirmed; others were challenged or redefined. In all areas, but particularly in respect of the work environment, new concerns were identified for the first time at assessment. In 20 percent of cases, the concerns identified at referral were not borne out at assessment. In 12 percent of cases the issues revealed at assessment were more serious than anticipated.

Findings indicate that the NCAS assessment process provides a more accurate and comprehensive “diagnosis” of performance issues, enabling more appropriate recommendations for “treatment” and helping to differentiate between potentially remediable and more fundamental problems.

There is currently little published evidence about the contribution of this type of performance assessment programme to clarifying performance issues.

The introduction of clinical governance in the “new NHS” means that National Health Service (NHS) organisations are now accountable for the quality of the services they provide to their local communities. As part of the implementation of clinical governance in the NHS, Trusts and health authorities had to complete a baseline assessment of their capability and capacity by September 1999. Describes one Trust’s approach to developing and implementing its baseline assessment tool, based upon its existing use of the European Foundation for Quality Management (EFQM) Excellence Model. An initial review of the process suggests that the model provides an adaptable framework for the development of a comprehensive and practical assessment tool and that self‐assessment ensures ownership of action plans at service level.

Failure to rescue events, or events involving preventable deaths from complications, are a significant contributor to inpatient mortality. While many interventions have been designed and implemented over several decades, this patient safety issue remains at the forefront of concern for most hospitals. In the first part of this study, the development and implementation of one type of highly studied and widely adopted rescue intervention, algorithm-based patient assessment tools, is examined. The analysis summarizes how a lack of systems-oriented approaches in the design and implementation of these tools has resulted in suboptimal understanding of patient risk of mortality and complications and the early recognition of patient deterioration. The gaps identified impact several critical aspects of excellent patient care, including information-sharing across care settings, support for the development of shared mental models within care teams, and access to timely and accurate patient information.

This chapter describes the use of several system-oriented design and implementation activities to establish design objectives, model clinical processes and workflows, and create an extensible information system model to maximize the benefits of patient state and risk assessment tools in the inpatient setting. A prototype based on the product of the design activities is discussed along with system-level considerations for implementation. This study also demonstrates the effectiveness and impact of applying systems design principles and practices to real-world clinical applications.

This critical review considers the limitations and advantages of the clinical, actuarial and structured clinical judgement approaches as they are applied to the assessment of risk in general and sex‐offenders in particular. It concludes by endorsing an inclusive approach, acknowledging that a central ethic of clinical practice is that it should be based on a current knowledge of the research literature (Singer, cited in Douglas et al. 1999).

Clinicians working in UK child mental health services are faced with several challenges in providing accurate assessment and diagnosis of attention deficit hyperactivity disorder (ADHD). Within the South London & Maudsley (SLaM) NHS Trust, community Child & Adolescent Mental Health Services (CAMHS) are developing structured pathways for assessing and diagnosing ADHD in young people. To date, these pathways have not been formally evaluated. The main aims of this evaluation are to evaluate all ADHD referrals made to the service in an 18-month period, including the number of completed assessments and proportion of children diagnosed with ADHD; and investigate adherence to the National Institute for Clinical Excellence (NICE) guideline for diagnosing ADHD in children and young people.

Retrospective data analysis was performed using service databases and electronic patient records. Adherence to the clinical guideline was measured using the NICE data collection tool for diagnosing ADHD in children and young people. All completed ADHD assessments were compared to four key recommendation points in the guideline.

Within the time frame, 146 children aged 4-17 years were referred and accepted for an ADHD assessment. Of these, 92 families opted in and were seen for an initial appointment. In total, 36 ADHD assessments were completed, of which 19 children received a diagnosis of ADHD and 17 did not. Aside from structured recording of ADHD symptoms based on ICD-10 criteria (69%) and reporting of functional impairment (75%), adherence to all guidance points was above 90%. The study also found that although a greater proportion of children referred to the service were male and identified as White, these differences narrowed upon receipt of ADHD diagnosis.

Relationship to the existing literature is discussed in relation to the assessment process, demographic characteristics and rates of co-occurrence.

The findings demonstrate that in child mental health services, gold standard practice for diagnosing ADHD should be the adoption of clear, protocol-driven pathways to support appropriate access and treatment for young people and their families.

This article is unique in that it is, to the best of the authors’ knowledge, the first to describe and report clinician-adherence to a structured pathway for diagnosing ADHD in young people within a community CAMHS service in South London.

Standards of care and care pathways for younger people with dementia vary greatly, making clinical development and service planning challenging. Staff working in dementia services identify that they use biographical knowledge of families to influence clinical decision making. This information is not collected or implemented in a formal manner; highlighting an important knowledge-practice gap. The paper aims to discuss these issues.

The development of a family-centred assessment for use in dementia care has three core components: first, thematic development from qualitative interviews with younger people with dementia and their families; second, clinical input on a preliminary design of the tool; and third, feedback from an external panel of clinical and methodological experts and families living with young-onset dementia.

The 12-item Family Assessment in Dementia (Family-AiD) tool was developed and presented for clinical use. These 12 questions are answered with a simple Likert-type scale to determine areas of unmet need and identify where families may need additional clinical support. Also included is a series of open-ended questions and a biographical timeline designed to assist staff with the collection and use of biographical and family functioning information.

A dementia-specific clinical family assessment tool, which also collects background biographical data on family units may be a useful way to document information; inform clinical decision making; and address otherwise unmet needs. Family-AiD has potential to improve clinical care provision of people with dementia and their families. Evaluation of the feasibility and acceptability of its implementation in practice are now required.

Intervention for young people engaging in harmful sexual behaviour has been largely based on individual-level conceptualisations and assessment. Prevention efforts reflect this individual-focus, relying primarily on offender management and justice responses. Risk of sexual abuse, however, is often situated outside the individual, within the broader social and physical systems in which young people are embedded. Lack of recognition for how contextual factors contribute to sexual abuse narrows the focus of prevention and intervention, overlooking the very contexts and circumstances in which this behaviour occurs. This paper aims to demonstrate the utility of contextual practice with young people who sexually harm, and implications for prevention.

An Australian case study is used to showcase the “why”, “what” and “how” of a contextual approach to assessment and treatment of young people who sexually harm.

Contextual approaches extend the focus of clinical practice beyond the individual to include the physical and social contexts that may contribute to risk. Adding a contextual lens broadens the approach to assessment, affording new opportunities to tailor the intervention to local contextual dynamics, and identifying new targets for primary and secondary prevention.

This is the first known attempt to extend understanding of contextual approaches to clinical assessment and intervention for young people who sexually harm, using a case study method. The case study showcases contextual assessment and intervention processes that challenge traditional thinking and practice in this field. Importantly, the case study also reveals new opportunities for primary and secondary prevention that emerge through this contextual clinical practice.

The School of Nursing and Midwifery at De Montfort University has been consistently successful in producing student midwives who are, by the end of their chosen programme, fit for practice, purpose and award according to the DMU. This paper aims to investigate this claim.

The paper looks at De Montfort University where an innovative tripartite assessment process has been developed to support midwifery students in practice. This involves the student, his/her personal tutor and his/her clinical midwife mentor. All three are involved in the planning of appropriate learning experiences to facilitate the student in meeting the clinical learning outcomes, utilising a personal professional portfolio.

The paper finds that the close working relationships between the placement providers and the university have improved the assessment of practice and enhanced the student experience. Clinical midwife mentors have commented on how well the tripartite approach works and they appreciate the clear lines of communication that this relationship provides. The personal tutor role is well established in the School of Nursing and Midwifery and the midwifery team have developed this role to include the assessment of students within the tripartite structure. This is beneficial from a quality perspective; while clinical midwife mentors will obviously change due to differing student placements, the personal tutor is the variable that is the constant through the student's progression on the programme.

The tripartite approach to the practice assessment of pre‐registration midwifery education investigated in this paper has proved to be a robust approach to ensuring students are fit for practice, purpose and award at the point of qualification and eligible to register as a midwife with the Nursing and Midwifery Council.

The purpose of this paper is to explore the experience and possibilities for misdiagnosis of women with ASD in secure and forensic hospitals, via the medium of a lived experience case study. To consider the clinical value of the patient perspective of and insight into their disorder. The case study is supplemented by relevant associations to the MHA Code of Practice, the CQC report, Monitoring the Mental Health Act (MHA) 2016–2017, published on 27 February 2018 and current research findings in the fields of service provision, quality of care and treatment of female patients with a diagnosis of ASD.

A review and commentary of the author’s lived experience of a formal diagnostic assessment for ASD as a female patient in a secure and forensic hospital. In reviewing aspects of the author’s clinical assessment, the author has made contextual reference to the MHA Code of Practice, the CQC report, Monitoring the MHA 2016–2017, published on 27 February 2018, and current research findings. The account focuses on aspects of the author’s recent experience assessment and treatment for ASD which the author believes may be of use in informing clinical practice.

Open-ended exploration of a lived experience account/case study of a diagnostic assessment of an adult female patient for ASD, demonstrating the possible ambiguity of responses to questionnaire-based assessment tools and other deficiencies inherent to the assessment process and care and treatment of adult female ASD sufferers in secure and forensic hospitals.

The author uses the lived experience as a patient to review and provide commentary on the clinical assessment for ASD. This review is, therefore, informed by an authentic patient perspective and not clinical perspectives. This paper highlights the need for further research into the diagnostic assessment of females for ASD in a secure and forensic hospitals.

First, to encourage practitioners to extend their range of thinking to be more inclusive of the patient perspective when performing a diagnostic assessment. Second, to increase practitioner awareness of the deficiencies in the current service provision for adult female patients diagnosed with ASD in secure and forensic hospitals.

To improve patient experience of diagnostic assessment for ASD and the quality of the assessment and patient outcomes in secure and forensic hospitals.

The paper is original in concept in that it considers the inclusion of patient experience/views in assessment and formulation and links them to wider social policy and practice guidance. The case study is an authentic patient account informed by the author’s experience of secure and forensic psychiatric hospitals. The value of the paper may be determined by the extent to which the paper encourages practitioners to consider the patient perspective and experience of the diagnostic assessment and how this and subsequent care and treatment may affect the adult female patient in secure and forensic hospitals.