Learning Outcomes –Spinal Injuries/Rehabilitation Medicine
The learning outcomes take into account the requirements of the GP Curriculum.
The curriculum has a number of domains which are common throughout for all specialities. Within each domain there are specific objectives which trainees are expected to have attained by the end of their post.
The domains are as follows:
Primary care management
Be aware of the co-ordinated approach with other health care professionals, such as OT, Physiotherapist and District Nurse to enable chronic disease management and rehabilitation.
Understand the indications for referral to a Neuro-rehabiltation Specialist(although this is more likely to be a secondary care to secondary care process).
Skills to effectively liaise and cooperate with the many different disciplines and persons in primary and secondary care
Person centred care
Be able to communicate prognosis truthfully and sensitively to patients with incurable neuro-disability.
Demonstrate empathy/compassion towards patients.
Understand the importance of continuity of care for patients with neuro-disability.
Specific problem solving
The knowledge base should include management of symptoms such as tremor, neuropathies, abnormal movements, seizures, loss of consciousness/coma.
Common and important conditions apart from spinal injury-SAH, infections, MS, head injury, trauma, congenital conditions(Cerebral Palsy, Spina Bifida).
Knowledge of secondary care investigations-EEG, CT and MRI scanning.
Comprehensive approach
Counsel patients appropriately regarding medications, interactions and side-effects.
Describe the increased risk of acute events in patients with chronic and co-morbid disease.
Identify co-morbid diseases.
Describe the modifying effect of chronic or co-morbid disease and its treatment on the presentation ofacute illness.
Community orientation
Knowledge of social benefits and services available to patients and their carers.
Holistic approach
Recognise that neuro-disability often affects patients during their working lives and consequently has a large impact on a family’s social and economic wellbeing.
Recognise the stigma associated with neuro-disability.
Contextual aspects
Recognize the central role of the multi-disciplinary team.
Attitudinal aspects
Knowledge of the ethical principals involved when treating an incompetent patient(unconscious) and when treating a patient who is unable to communicate.
Ensure that a patient’s neurological disability does not prejudice the doctor’s attitude towards the information communicated to the patient.
Identify patients for whom resuscitation or intensive care might be inappropriate and take advice from carers and colleagues.
Demonstrate a balanced view of benefits and harms of medical treatment.
Scientific aspects
Understand and implement the key national guidelines that influence healthcare provision for neuro-disability patients.
Psychomotor skills
Be able to demonstrate a complete neurological examination of cranial nerves, peripheral nervous system including visual acuity, visual fields and fundoscopic examination.