1. Welcome to The Acute/Emergency Block Dr Viviana Elliott Acute Block Lead

2. First day of the Acute Medicine Block Tuesday 15 th September 2015 0800 – 0845 Welcome and Acute Block induction Viviana Elliot & Teaching fellows 0845 – 1000 MCQ Paper 1000-1020Coffee Break 1020 - 1100 ABCDE approach to the acutely unwell patient Dr Hannah Blakey 1100 - 1130 ABCDE Demonstration Teaching fellows 1130 - 1200 Meet with teaching fellows

3. Clinical Teaching Fellows Teaching.fellows@uhcw.nhs.uk Teaching.fellows@uhcw.nhs.uk Ext 28727 CSB 2 nd floor Dr Hannah Blakey Dr Kavitkumar Dasari Dr Sarah Edwards Dr Christina Tourville Dr Hayder Hussein

4. Aim of this talk Understand how the acute block works

5. Outline Aim of the acute block Rotation Areas Teaching Clinical kills Assessments Requirements for end of block 5

6. Acute Block Aims 6 To gain confidence in the initial assessment of acutely ill patients To help you develop initial management plans for acutely ill patients To gain confidence in practical skills To have exposure to most common Emergency and Acute Medical presentations Curriculum- Learning Objectives

7. Challenges Teaching High Acuity Patient Safety Bed Pressure Personal Limitations

8. Rotation Areas UHCW Acute Medicine ITU Emergency Department Clinical Skill Department SWFT Acute Medicine Emergency Department Clinical Skill Department 8

9. UHCW-Acute Medicine Lead: Dr Nihal Abosais Areas: 1.AMU/CDU/Ward  Morning ward round  Medical on call 2.GP assessment area/ Acute clinic 3.Short stay ward 9

10. What do I do? Introduce yourself Read a case to concentrate on Attach to doctors in area 1, 2 and 3 Liaise with doctors in each area in the morning and with the on call team in the afternoon (registrar) Clerk only under senior supervision

11. ITU Location 1 st floor opposite CDU/Ward 12 LeadDr Vadim Iakimov Shift starts at 0800 h with the handover, don’t be late! Go to the seminar room on the General Critical Care Unit. The seminar room is located at the end of the admin corridor. 11

12. ITU The unit is divided into three bays and eight side-rooms. The team will be divided between the areas, attach yourself to one of these teams Microbiology variable times Attach to nurses in the afternoon Read introduction to ITU in website

13. Emergency Medicine Location:Emergency Department Lead Dr Marius Holmes ( Scott Carrington) Areas of rotation: Minors Majors Resus Obs ward On arrival introduce to sister in charge and senior doctor 13

14. Emergency Medicine Attach to SHO/ staff grades in the area Before shift think about learning objectives Share cases, cases and interesting patients Obs ward alcohol, suicidal and mental health patients Allocated bedside teaching

15. SWFT Acute Medicine LeadDr Viviana Eliott LocationFairfax ward AMU Areas for rotation AMU/Fairfax Ambulatory Emergency Care ED/Fairfax medical on call Frailty

16. SWFT AMU/Fairfax Starts at 08:00 hs with a post take ward round with the night and day team There are 2 teams attach to one each 09:30 h night team leave and ward round continues until 12:00 hs 12:00 hs handover to nurse in charge

17. What do I do in the Acute Medicine Unit? Join the ward round. Concentrate how the senior doctors make differential diagnosis, determine scores and make decision to admit or discharge. Look at the Care Bundles.

18. What do I do in the Acute Medicine Unit? In the afternoon –Go to Ambulatory Emergency Care –Attach to the Medical Nurse Practitioner (MNP) Paul or Abbey to see how to do a comprehensive geriatric assessment (CGA) –Join the respiratory pull –Help with jobs

19. What do I do when I am on call? Morning team 09:00-21:30h Reg ( most clinical teaching fellows!) SHO FY1 in AEC FY1 in AMU Twilight SHO12:00-24:00h Attach to one member of the team and review patients with them.

20. SWFT Emergency Medicine LeadDr Martin Smyth LocationMajor and See and Treat TimeTimetable Introduce to senior staff in the area Attach to SHO/ registrar in the area. Teaching sessions on Wednesday morning 09:00-12:00 h (Burns, Allergies, Epistaxis and Head Injury) IN ED SEMINAR ROOM

21. Formal Teaching Lectures Tutorials (evidence based teaching) Ethics 21

22. Lectures Thursday morning Location CSB Time 9-13 Most common presentations ATLS 1 st week 22

23. Tutorials: Evidence based teaching sessions Tuesday (see timetable) Location CSB Time Tutorial 1 - See Timetable Tutorial 2 - See Timetable Tutorial 3 - See Timetable Outstanding feedback

24. Ethics Tuesday tutorial 2 Location CSB Dates(see timetable) Time 08:00 – 12:00 Preparation needed

25. Clinical Skills Ophthalmology teaching Simulation T Doc ( according to needs)

26. Ophthalmology Teaching Lead Dr Fiona Dean CSB room 2 nd Thursday 14:00 h Practice Fundoscopy T Doc coming soon!

27. Simulation UHCW Introduction to simulation High fidelity simulation SWFT Simulation Different approach to UHCW

28. UHCW Simulation High fidelity simulation Timetable CSB 0005 Time 09:00-12:30 or 01:30-17:00 Read before the session Dress code Stethoscope Http://www.youtube.com/watch?v=u-Nryz7nPRE Sim Man Medical Students training-You tube

29. Feedback “Really good practical experience in a realistic but safe situation” “SimMan was excellent, good confidence builder” “Good learning experience and it is good to practice "team working” “Great experience I could do it all week! Fantastic and probably the most useful thing I have done this year”

30. SWFT Simulation SWFT Medical School LeadsDr Rathinavel Shanmugam Timetable Wednesday Room E Medical School

31. Assessments Formative MCQ pre and post block Clinical Assessment Portfolio OSLER (Objective Structured Long Examination Record) two assessments for the block

32. Requirements for End of Block Attendance (clinical areas only) Portfolio x1 Clinical Assessment Osler x 2 MCQ formative Block feedback

33. Feedback Student Feedback Review of teaching activity Designing possible changes Implementation of changes Teaching Activity

34. ANY QUESTIONS

35. Enjoy yourself! “You get out what you put in”