Advanced Clinical Practice Apprenticeship MSc

Project details including description, rationale and aims are specified in the Project Learning Agreement. 

The aims of this module are:

1. To provide an opportunity for learning to be achieved in the work context.
2. To facilitate strategic development within the work place for the mutual benefit of employer and employee.
3. To enable students to use the knowledge and skills gained through theoretical study in a practical situation.
4. To provide a mechanism that enables HE to work in partnership with external organisations to design and deliver modules, which meet specific needs efficiently and economically.
5. To engender in students a sympathetic understanding of the method of operation of the reflective practitioner.

Negotiation of tripartite agreement of learning experience(s) based on in-service staff development activities cited in the agreement. Specific content will relate to area of practice stated within the tripartite agreement. Generic content areas will include: Generic content areas will include:  Critical analysis and interpretation, critical reflection, evaluation and assessment, critical self evaluation and personal awareness, strategy and policy development; multi-disciplinary working; professional accountability..

In response to national and local initiatives aimed at widening access to higher education and improving levels of service and capability within organisations, (e.g. NHS, local authorities, public and private sector agencies), there is a significant amount of taught and work-related learning materials and short programme provision to enable practitioners to develop and enhance their roles.  These materials are being utilised in traditional and non-traditional methods and may include e-learning, open learning and in-house service programmes.  These resources can offer a significant response to change and development initiatives, individual pathways of competence building and developing skills in the practice environment.  To support these developing skills there is an opportunity for academic credits to be gained through these learning experiences where they are linked into, and supported by, formal academic mechanisms so providing academic veracity to learning.  To provide maximum potential for study in specialised areas, whilst providing a rigorous and structured framework for learning. To give students the opportunity to apply and develop subject specific skills and knowledge required for their individual progress.  ~.

Module content will include:

1. Defining the topic area; Rationale for choice. 
2. Learning contract negotiation, Action planning and goal setting, Assignment guidance.
3. Guidance for critical analysis of topic area, and the implications for clinical practice 
4. Literature and information retrieval, the use of the literature for critical analysis, evaluation and synthesis.
5. Management of self-directed study; time management.
6. Currency of literature sources, the meaning of creative and innovative practice; contemporaneous thinking.
7. Application of theory to practice; suggestions for future development, strategies for future practice.

The aims of this module are:

1. To enable students to critically analyse a topic relevant to their practice area in depth, using an action plan, and to justify strategies for future practice. 
2. To enable the student to expand and develop their knowledge of an area of interest relevant to their clinical practice.

The RPS (2021) generic Prescribing Competency Framework forms the basis of the curriculum and has been used to inform the design and delivery of the programme acting as a contextual framework to structure learning and assessment for all students regardless of their professional background.

THE CONSULTATION (COMPETENCIES 1-6)

1: ASSESS THE PATIENT
Undertakes an appropriate clinical assessment, including a medical, social and medication history including allergies and intolerances and refers to or seeks guidance from another member of the team, a specialist or a prescribing information source when necessary.

Accesses and interprets all available and relevant patient records including relevant investigations necessary to inform treatment options by systematically considering a working or final diagnosis. Understands the condition(s) being treated, their natural progression and how to assess their severity, deterioration and anticipated response to treatment including adherence to and effectiveness of current medicines.

2: CONSIDER THE OPTIONS
Considers both non-pharmacological (including no treatment) and pharmacological approaches to modifying disease and promoting health, including pharmacological treatment options such as optimising doses as well as stopping treatment (appropriate polypharmacy, de-prescribing). Assessing the risks and benefits to the patient/service user of taking or not taking a medicine or treatment. Applies understanding of the mode of action and pharmacokinetics of medicines and how these may be altered taking into account any relevant patient factors and the potential impact on route of administration and formulation of medicines.

Identifies, accesses, and uses reliable and validated sources of information and critically evaluates other information. Stays up-to-date in own area of practice and applies the principles of evidence-based practice, including clinical and cost-effectiveness, taking into account the wider perspective including the public health issues related to medicines and their use and promoting health and understanding of antimicrobial resistance and the roles of infection prevention, control.

3: REACH A SHARED DECISION
Works with the patient/carer in partnership to make informed choices, agreeing a plan that respects patient preferences including their right to refuse or limit treatment, identifying and respects the patient/service user in relation to diversity, values, beliefs and expectations about their health and treatment with medicines.

Routinely assesses adherence in a non-judgemental way and understands the different reasons non-adherence can occur and how best to support patients/carers. Building a relationship which encourages appropriate prescribing which explores the patient/service users/ carers understanding of a consultation and aims for a satisfactory outcome for the patient/carer and prescriber.

4: PRESCRIBE
Prescribes a medicine with up-to-date awareness of its actions, indications, dose, contraindications, interactions, cautions, and unwanted effects. Understands the potential for adverse effects and takes steps to avoid/minimise, recognise and manage them. Prescribes within relevant frameworks for medicines use as appropriate. Prescribes generic medicines where practical and safe for the patient and knows when medicines should be prescribed by branded product.

Understands and applies relevant national frameworks for medicines use to own prescribing practice. Accurately completes and routinely checks calculations relevant to prescribing and practical dosing. Considers the potential for misuse of medicines, Uses up-to-date information about prescribed medicines. Only prescribes medicines that are unlicensed, ‘off-label’, or outside standard practice if satisfied that an alternative licensed medicine would not meet the patient’s clinical needs.

Electronically generates or writes legible unambiguous and complete prescriptions and contemporaneous records and clinical notes of prescribing decisions. Communicates information about medicines and what they are being used for when sharing or transferring prescribing responsibilities/ information.

5: PROVIDE INFORMATION
Checks the patient/service user/carer’s understanding of and commitment to the patient’s management, monitoring and follow-up giving clear and accessible information about their medicines, and how to identify reliable sources of information about their medicines and treatments.

Ensures that the patient/service user/carer knows what to do if there are any concerns about the management of their condition, if the condition deteriorates or if there is no improvement in a specific time frame and where possible, encourages and supports patients/service users/carers to take responsibility for their medicines and self-manage their conditions.

6: MONITOR AND REVIEW
Establishes and maintains a plan for reviewing the patient’s/service user treatment, ensuring that the effectiveness of treatment and potential unwanted effects are monitored. Detects and reports suspected adverse drug reactions using appropriate reporting systems, adapting management plans in response to on-going monitoring and review of the patient’s/service users condition and preferences.

PRESCRIBING GOVERNANCE (COMPETENCIES 7-10)

7: PRESCRIBE SAFELY
Prescribes within own scope of practice, recognising any limitations of own knowledge and skill including common types and causes of medication errors and how to prevent, avoid and detect them. Identifies the potential risks associated with prescribing via remote technology taking steps to minimise risk to support safe prescribing. Reporting prescribing errors, near misses and critical incidents, reviewing practice to prevent recurrence.

8: PRESCRIBE PROFESSIONALLY
Maintains confidence and competence to prescribe, accepting accountability and responsibility for prescribing, understanding legal and ethical implications including regulatory frameworks.

Makes prescribing decisions based on the needs of patients, recognising and dealing with factors that might unduly influence prescribing by working within the NHS/organisational/regulatory and other codes of conduct when interacting with the pharmaceutical industry.

9: IMPROVE PRESCRIBING PRACTICE
Reflects on own and others prescribing practice, and acts upon feedback and discussion, including colleagues’ inappropriate or unsafe prescribing practice using appropriate mechanisms. Understands and uses available tools to improve prescribing.

10: PRESCRIBE AS PART OF A TEAM
Acts as part of a multidisciplinary team to ensure that continuity of care across care settings is developed and not compromised, establishing relationships with other professionals based on understanding, trust and respect. Negotiates the appropriate level of support and supervision for role as a prescriber and provides support and advice to other prescribers or those involved in administration of medicines.

The aim of this module is to enable the autonomous professional to attain the competencies as identified by the Royal Pharmaceutical Society (2021) Framework for safe effective prescribing practice.

1. Local, national policies and procedures within scope of students own area of practice, professional and regulatory codes of own and others practice, professional boundaries, range of physical, psychological, pharmacological, diagnostic and therapeutic interventions applied to scope of students own practice.
2. History taking, holistic examination, requesting and interpreting diagnostic tests, physical, psychological and population based assessment methods
3. Risk assessment and risk management techniques, communication strategies, principles and practice pf health promotion and prevention, appropriate risk assessment and management tools and their application to own area of practice.
4. Care planning and evaluation, care pathways, discharge and referral, multi and inter agency communication, local and national policies, regulatory frameworks, guidelines for prescribing
5. Clinical supervision, reflection, motivational theory applied to self and others, leadership theories, importance of peer review and evaluation
6. Application of teaching and learning theories and models of care, organisational and professional roles and responsibilities
7. Change management approaches, identifying , critiquing and applying relevant literature to own area of practice, service evaluation and audit.

The aim of this module is to enable students to demonstrate achievement of the Advanced Clinical Practitioner Apprenticeship Standards (Institute for Apprenticeships, 2018) and prepare and undertake the end point assessment (the final part of the Integrated Degree Apprenticeship for the Advanced Clinical Practitioner).

The module content will include: 

Portfolio development which will include key systems / conditions as applied to own clinical area, decision making as an Advanced Practitioner, critical reflection 

Apply research pillar to own clinical area by exploring how to identify gaps in evidence, evaluate clinical practice, address gaps and disseminate findings 

Apply education pillar to own clinical area by identifying way to facilitate learning and assessment through role modelling and team working 

Apply leadership pillar to own clinical area by evaluating self, others and service effectiveness to influence practice and enhance quality. Consider service redesign solutions implementation methods. 

This module aims to provide students with an opportunity to demonstrate achievement and critically reflect upon  the four pillars of Advanced practice, clinical, leadership, research and education contextualised to their own clinical practice.

The module content will include: 

History of Advanced Clinical Practice, increased level of responsibility, self- awareness and team working, key documents, legal frameworks (including HEE framework to promote person centered approaches in health and care, Introduction to the four pillars of advanced clinical practice -   

• Critiquing evidence to aid clinical practice (research pillar) 
• Influencing clinical practice to enhance quality and adoption of best practice (leadership) 
• Critical reflection to aid individual and wider team developmental needs (education) 
• Exploration of why advanced A&P and pathophysiology knowledge important for advanced level practice (clinical) 

Legal and professional consideration in advance clinical practice.  Professional requirements for lifelong learning and for promoting learning in others. 

Principles of evidence-based practice, types of knowledge.  literature searching.  Constructing an argument. Service user as expert and shared decision making, person centred care. 

 Anatomy, Physiology and & Pathophysiology of the major body systems – considering application to practice. 

Individual and population influencing factors eg lifestyle, ethnicity.  Impact of health inequalities.  Health promotion and disease prevention. 

The aim of this module is to enable the trainee advanced clinical practitioner to develop the core knowledge required for advanced level clinical practice.  

The module content will include: 

 

• Formulating differential diagnosis (Ear Nose & Throat, Respiratory, Cardiovascular, Gastrointestinal, Mental Health) using advanced communication, history taking, clinical examination, diagnostics, – to develop patient centred management plans  including safety netting and collaboration with others (Health Education England’s framework to promote person-centered approaches in health and care.) 

 

• Interpreting the evidence to justify clinical decisions made and to ensure best practice is delivered and shared widely in day to day Advanced Clinical Practitioner (ACP) roles. Be able to identify gaps within the evidence available and consider how these may be addressed 

 

• Working in partnership to understand the influences of individuals, society and communities on health and access to health care services 

 

 

• Explore role modelling to ensure care that is delivered by all is safe and evidence-based

The aims of the module are: 

To prepare the learner to perform clinical consultations to determine and justify differential diagnosis 

To prepare the learner to ensure decisions made and care given is evidence based ensuring any gaps in evidence are identified and addressed 

Work collaboratively with service users to understand the factors that affect their individual health care needs 

The module content will include: 

 

• Formulating differential diagnosis (Integumentary, Musculoskeletal, Neurology, Endocrine, Renal) using advanced communication, history taking, clinical examination, diagnostics, – to develop patient centred management plans  including safety netting and collaboration with others (Health Education England’s framework to promote person-centered approaches in health and care.) 

 

• Interpreting the evidence to justify clinical decisions made and to ensure best practice is delivered and shared widely in day to day Advanced Clinical Practitioner (ACP) roles. Be able to identify gaps within the evidence available and consider how these may be addressed 

 

• Explore how to evaluate the impact of the ACP role and clinical decisions made on the service as a whole and on quality of care provided 

The aims of the module are: 

To prepare the learner to perform clinical consultations to determine and justify differential diagnosis 

To prepare the learner to ensure decisions made and care given is evidence based ensuring any gaps in evidence are identified and addressed 

To understand the impact of the ACP role on quality of services delivered