Domain 1 and 2 Flashcards
How do you maintain professional performance?
domain 1 (knowledge, skills and performance)
domain 1 (knowledge, skills and performance)
Maintain professional performance
-making sure you are competent in all areas of work (research, clinical work, teaching). Questions on what to do if you are not competent in something. Worst thing will be to do something you are not competent in.
-make sure that you actively engage in activities to develop skills and competence, for e.g. teaching
-important to keep professional knowledge and skills up-to-date
What is important when applying knowledge to practice as FY1?
What is important when it comes to managing patients/prescribing medication?
domain 1 (knowledge, skills and performance)
Applying knowledge to practice
-make sure you know own limitations of competence
Managing patients or prescribing medication
-based on best available evidence
-compatible with other medication
-always alleviate pain first regardless of whether there is a cure
-do not prescribe medication for yourself or other family members
What is important in gathering patient information for research purposes (e.g audits)?
It is important to get patient’s consent in using their information for research
What do clinical records include?
Clinical records include:
1. patient’s clinical information
2. details about investigations, treatment or drugs prescribed
3. consent obtained, decisions made and who is making decisions
4. details of recorder and time/date of record
5. information given to patients
What should you do when you can’t read documentation when the handwriting is messy?
Domain 1-Knowledge, skills and performace
Recording your work clearly, accurately legibly
BEDCA
It is important to record any clinical information about patient clearly, accurately and legibly. It is also important to record it at the same time of the event or immediately after.
Not being able to read notes can cause errors in management plan. If you can’t read notes:
1. important that notes are understood
2. find other ways to find out about management plan
3. provide constructive feedback to colleague about handwriting
Domain 1-knowledge, skills and performance
CBEDA
When you don’t receive any response from your educational/clinical supervisor, it is best to:
1. contact their secretary
2. contact the FYP director, as delayed meetings may potentially reflect badly and affect your progress through FP
3. contact their mobile (though not advisable)
4. asked to be assigned a new supervisor
5. not contact them at all (least appropriate)
What is the main principle in this question when it comes to trying to improve knowledge, skills and performance (Domain 1)
Domain 1-knowledge, skills and performance
CBAED
When it comes to receiving feedback from a senior registrar/colleague, it’s important to reflect on it to improve knowledge, skills:
1. ask and clarify with senior registrar or person that gave you feedback
2. ask clinical supervisor
3. ask other peers in the same ward/department
You are working in the emergency department and a 19 year old comes because of trauma to the eye from football. You examine her and find she has broken eye socket. She requires surgery but refuses and wants to go home
Rate appropriateness .(1=Veryappropriate;4=Inappropriate).
A) It is up to you to go home
B) Is there a particular reason why you do not want to have surgery
C) do you have any family members or friends who can come support you
Link this to “safety and quality domain” and “communication, partnership and teamwork domain)
Domain 2- Safety and Quality; Domain 3 communication, partnership and teamwork domain
-Key principle in this question is about responding risks to safety. By:
-promoting a culture that encourages people to raise concerns openly and safely: risks to safety
-if a colleague poses a risk to patients (drunk/alcoholic), seeking help from senior
-if patient does not have basic care to meet needs, seeking help from someone in position
-if there is inadequate equipment and resources, seeking help
-also responding to emergencies outside clinical setting; in public
A)-4 as it is your responsibility as a doctor to act in the best interest of the patient
B)-1: important to ICE patients and explore, listen and take into account their views
C)-1: 1: important to ICE patients and explore, listen and take into account their views
How do you contribute to systems to maintain patient’s safety? (domain 2-safety and quality)
domain 2-safety and quality
It is important to contribute to systems to maintain patient’s safety by:
1. regularly doing reviews and quality assurance/quality improvement projects
2. taking part in clinical audits to help make sure healthcare standards are met and identify whether improvements need to be made
3. reviewing patient’s feedback
4. responding to confidential inquiries
5. responding to requests from organisations monitoring public health (still making sure that patient’s info is confidential!)
It is also important to report any adverse events:
1. adverse events involving medical devices where there is a potential risk to patient’s safety
2. adverse drug reactions
How do you manage risks posed to patient’s safety? (domain 2-safety and quality) Provide examples of this.
What is the definition of being “vulnerable”? Who do you refer vulnerable people to?
domain 2-safety and quality
Managing risks posed to patient’s safety
It is important to raise concerns if patient’s safety, dignity or comfort is compromised:
-alert senior colleague if basic care needs are not met
-challenge colleague’s fitness to practise if they are drunk or being disrespectful (e.g patient’s religious beliefs)… pull them aside in private to ask them, ask them to stop what they are doing atm, alert consultant. least appropriate-> allow them to continue working
Definition of person that is vulnerable:
-age: children or young people under 18
-circumstances: vulnerable because of recent bereavement/sexual or domestic abuse
-illness, disability etc.
Refer vulnerable people to nurse in charge-> will be able to contact social services. Next best will be to alert senior colleague/consultant
You are an FY2 working 111 a GP surgery, and a 15-year-old girl has come to
see you requesting contraception. She says she has been in a stable relationship with her 10-year-old boyfriend for two years and would like to start having sexual intercourse. She has investigated the different options and would like your help in deciding which contraceptive to choose. On questioning her, she appears to understand the situation well and is mature for her age. She says she doesn’t want her parents to be informed because they wouldn’t approve. When asked 1f she would have sexual intercourse without contraception, she shrugs her shoulders and says ‘maybe’.
Choose the THREE most appropriate actions to rake in this siruarion.
A Ask the patient to hook an appointment wirh her mother and come ro see
you together.
B Ask your patient to book an appointment with a senior doctor, who will be
able to provide more accurate advice.
C Attempt to persuade her ro inform her parents and provide the necessary
support bur still supply contraception if she refuses.
D Document your conversation and seek advice from a senior doctor during
the consultation.
E Provide contraception only if she informs her parents.
F Provide rhe girl with condoms for contraception and ask the patient to
book an appointment in a week’s time, then seek help from your educational supervisor about the correct course of action.
G Provide the girl with contraception bur inform her mother during her next
appointment.
I I Suggest that the girl should refrain from sexual intercourse until
she is of the legal age for consent and refuse to provide her with
contraception.
What are Fraser’s guidelines?
What do you do as a FY doctor if you see this case in GP?
At what age is considered illegal for sexual activity and who should you refer to?
C, D, F
Fraser’s guidelines
-assessing whether it is appropriate to prescribe contraception for those under 16
Guidelines:
-if they cannot be persuaded to tell their parents
-if they are likely to continue sexual intercourse with or without contraception
-if they feel that this will have a big effect on their physical or mental health
-if they are able to understand advice given
Best to:
-consult a senior doctor about this
-seek advice from educational supervisor about next course of action
-should try to persuade them to tell their parents
Children <13 that engage in sexual activity-> illegal-> should be referred to child protection services
