Stroke Simulation Course

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Course Objectives:
1 To understand stroke pathway and thereby to reduce door-to-needle time and door-to-puncture time for stroke thrombolysis and thrombectomy respectively to improve stroke outcome.
2.Clinically differentiate stroke/ TIA from stroke mimics
3.Clinical assessment of stroke, competency in performing NIHSS
4.To better understand parallel working approach and get it right first time in the assessment of hyperacute stroke.
5.Neuroanatomy of stroke
6.Bamford classification of stroke
7. Approach to management of Ischaemic stroke
8. Approach to management of haemorrhagic stroke
9. Management of stroke under special circumstance i.e pregnancy, young patients
10. Approach to transient focal neurological episodes

UKSF Reg. No.
19883
Is there a charge for attending this course?
How is this training best described?
One day course
Is the course open to anyone?
Course Online

online

Course leader

Dr Binu Pushpan

Address

Blackpool Teaching Hospitals NHS Foundation Trust
Whinney Heys Road, Blackpool

Postcode

FY3 8NR

How the course is taught
  • Face-to-face - Classroom
Exit awards
  • Continuing Professional Development (CPD) points - 0 points
  • Certificate of attendance / completion
Who can benefit from the course?
  • Junior Doctor
  • Doctor
  • GP
  • Medical Student
  • Physician
  • Stroke Physician

Course breakdowns

E1Awareness raisingCourse Level
Knowledge and understanding of…
e1k_1the signs and symptoms of stroke and transient ischaemic attack4
e1k_2the anatomy and physiology of the central nervous system5
e1k_3stroke mimics and how they present4
e1k_4features of less common (atypical) presentation of stroke4
e1k_5the need for emergency response to stroke and transient ischaemic attack4
e1k_6the investigations, interventions, and treatments for stroke and transient ischaemic attack and their timeframes4
e1k_7the timeframe for the physiological and neurological changes during the stroke event (time is brain)5
Skills and ability to…
e1s_1initiate emergency protocol for stroke and transient ischaemic attack5
e1s_2communicate current event and need for emergency treatment5
e1s_3identify the need for and apply screening tests for stroke and transient ischaemic attack, and how to act on the results5
e1s_4identify the need for and apply vascular risk assessment tools for stroke and transient ischaemic attack, and how to act on the results5
e1s_5identify and appropriately treat stroke mimics, and any other clinical effects of stroke5
e1s_6identify emergency investigations, interventions, and treatments for stroke and transient ischaemic attack available locally, and refer patients efficiently and effectively4
E2Managing riskCourse Level
Knowledge and understanding of…
e2k_1the risk factors for stroke and transient ischaemic attack5
e2k_2stroke sub-types and their aetiologies5
e2k_3the risk of further stroke depending on type and aetiology5
e2k_4who provides interventions for primary and secondary prevention of stroke4
e2k_5pharmacological and non-pharmacological interventions for primary and secondary prevention of stroke, and side effects of treatment4
Skills and ability to…
e2s_1take and interpret a thorough medical history, including information from carers, family, and other agencies where possible, and carry out decision-specific mental capacity assessments as appropriate3
e2s_2identify risk factors and apply vascular risk assessment tools for transient ischaemic attack and screening tests for stroke4
e2s_3determine, plan, and initiate the appropriate screening, assessments and investigations, and interventions and treatments for risk reduction4
e2s_4recognise stroke-related communication difficulties and adapt methods of communication to discuss with the patient, carer, and family: current event; risk of future vascular event; need for and timeframes of assessments and investigations; rationale for interventions and treatments, their timeframes, and possible side effects; and provide timely information, advice and support4
e2s_5identify the full range of local and national resources and services available for those affected by stroke, including: health, social, voluntary, and independent; assess their relevance and suitability for the patient, carer, and family; liaise with services, working across agencies and sharing information where appropriate; communicate referral arrangements, availability and waiting times3
e2s_6monitor progress and agree or change a maintenance or management plan in conjunction with those at risk of stroke or secondary stroke3
e2s_7assess medication adherence and facilitate improved engagement3
E3InformationCourse Level
Knowledge and understanding of…
e3k_1stroke sub-types and their aetiologies5
e3k_2the risk factors for further vascular events5
e3k_3pharmacological and non-pharmacological interventions for primary and secondary prevention of stroke, and side effects of treatment5
e3k_4who provides interventions for primary and secondary prevention of stroke5
e3k_5the full range of local and national resources and services available for those affected by stroke, including: health, social, voluntary, and independent; how to facilitate access and length of referral time3
e3k_6the range of potential impacts of stroke on the patient, carer, and family3
e3k_7the implications of stroke for lifestyle; driving; occupation, including voluntary work or education; and social participation3
e3k_8how to assess and overcome physiological, neurological, and psychological challenges3
Skills and ability to…
e3s_1recognise stroke-related communication difficulties and adapt methods of communication to discuss with the patient, carer, and family: current event; risk of future vascular event; need for and timeframes of assessments and investigations; rationale for interventions and treatments, their timeframes, and possible side effects; and provide timely information, advice and support4
e3s_2identify the full range of local and national resources and services available for those affected by stroke; assess their relevance and suitability for the patient, carer, and family; liaise with services, working across agencies and sharing information where appropriate; communicate referral arrangements, availability and waiting times3
e3s_3Implement information sharing methods and reflect on effectiveness of information sharing3
e3s_4monitor progress and agree or change a maintenance or management plan in conjunction with those affected by stroke, identifying resources to facilitate participation and inclusion3
E4User involvementCourse Level
Knowledge and understanding of…
e4k_1the full range of local and national resources and services available for those affected by stroke, including: health, social, voluntary, and independent; how to facilitate access and length of referral time3
e4k_2how to assess and overcome physiological, neurological, and psychological challenges3
e4k_3factors that influence people's ability to be involved in care and service planning, with particular consideration of under-represented groups3
e4k_4methods that can be used to involve those affected by stroke in service planning3
e4k_5methods that can be used to capture patient and carer views3
e4k_6how service planning and decision making processes work and how they can be influenced3
e4k_7methods for using stakeholder views, including patient, carer, public & clinical, to influence services3
e4k_8methods of feeding back to stakeholders regarding how their contributions have influenced services3
Skills and ability to…
e4s_1create an open and honest environment that is not intimidating and offers patients and their carers the opportunity to freely give their views3
e4s_2identify under-represented groups and ensure that their views are included0
e4s_3overcome the factors that prevent those affected by stroke from being involved in care and service planning3
e4s_4ensure sensitive engagement with people who have physiological, neurological, and/or psychological post-stroke challenges3
e4s_5translate the views of those affected by stroke into service planning, development, delivery, and monitoring3
e4s_6identify local opportunities and appropriate formats for formal and informal feedback regarding how their contributions have influenced services (e.g. PALS, PPI)0
e4s_7handle complaints to the satisfaction of all parties0
E5Assessment (TIA)Course Level
Knowledge and understanding of…
e5k_1the anatomy and physiology of the central nervous system5
e5k_2risk factors for stroke and transient ischaemic attack5
e5k_3the signs and symptoms of transient ischaemic attack5
e5k_4how to distinguish between stroke and transient ischaemic attack5
e5k_5the features of atypical presentation of transient ischemic attack, stroke, and mimics; and when to exclude identified mimics from the stroke care pathway5
e5k_6the investigations, interventions, and treatments for transient ischaemic attack5
e5k_7local protocols for imaging and reporting4
e5k_8the indications, contraindications, and limitations for imaging, investigations, and interventions5
e5k_9any complications of surgical procedures3
e5k_10the results of investigations4
e5k_11how to initiate emergency and ongoing treatment for transient ischaemic attack and vascular prevention5
e5k_12the timeframe for emergency and follow-on investigations, interventions, and treatments for transient ischaemic attack5
e5k_13management options for transient ischaemic attack, stroke, mimics, and other conditions4
e5k_14the future risk of stroke and transient ischaemic attack5
e5k_15the implications of transient ischaemic attack for lifestyle; driving; occupation, including voluntary work or education; and social participation3
Skills and ability to…
e5s_1perform a physiological assessment and assess vital signs5
e5s_2take and interpret a thorough medical history, including information from carers, family, and other agencies where possible, and carry out decision-specific mental capacity assessments as appropriate3
e5s_3identify risk factors and apply vascular risk assessment tools for transient ischaemic attack and screening tests for stroke4
e5s_4identify and, where appropriate, classify transient ischaemic attack (high risk/lower risk), stroke, and atypical stroke, and exclude stroke mimics5
e5s_5recognise patients who have had a stroke rather than a transient ischaemic attack and refer for appropriate investigation and management4
e5s_6identify emergency interventions and treatments for transient ischaemic attack available locally and refer patients efficiently and effectively4
e5s_7determine, plan, and initiate the appropriate screening, assessments and investigations, and interventions and treatments, and their level of urgency3
e5s_8recognise stroke-related communication difficulties and adapt methods of communication to discuss with the patient, carer, and family: current event; need for and timeframes of assessments and investigations; rationale for interventions and treatments, their timeframes, and possible side effects; and provide timely information, advice and support4
e5s_9apply radiological knowledge for recognised investigations5
e5s_10apply technical knowledge for recognised investigations and interventions5
e5s_11obtain and interpret the results of investigations, formulate an immediate and ongoing management plan, and initiate treatments within the relevant timelines5
e5s_12apply surgical knowledge for recognised vascular interventions4
e5s_13recognise and manage postoperative complications after surgical interventions2
e5s_14establish the cause of transient ischaemic attack5
e5s_15identify the service(s) to which the individual should be referred and liaise effectively with those services4
e5s_16identify local management and referral routes for transient ischaemic attack, stroke, mimics, and other conditions4
e5s_17communicate and discuss with the patient, carer, family, and health and social care professionals: diagnosis and results of investigations; risk of future vascular event and actions to be taken if a further vascular event occurs; methods of secondary prevention; subsequent needs and aspirations; and a management plan3
e5s_18communicate and discuss with the patient, carer, and family advice on: lifestyle; driving; occupation including voluntary work or education; and social participation3
E6Treatment (TIA)Course Level
Knowledge and understanding of…
e6k_1the signs and symptoms of transient ischaemic attack5
e6k_2atypical presentation of transient ischaemic attack (TIA), TIA mimics, and how to act when they are identified5
e6k_3how to distinguish between stroke and transient ischaemic attack5
e6k_4pharmacological and non-pharmacological interventions, including those for the prevention and management of risk for future vascular events, their level of urgency, and potential side effects5
e6k_5late complications of surgical procedures and the implications of the procedures on lifestyle2
e6k_6risk factors for further vascular events5
e6k_7likely persistent deficits or other ongoing effects of transient ischaemic attack4
e6k_8medication adherence: how to assess it; how it is affected by individual preference; how to motivate; and how to facilitate improved engagement0
e6k_9how community targets for risk factor management affect prevention strategies0
e6k_10the implications of transient ischaemic attack for lifestyle; driving; occupation, including voluntary work or education; and social participation5
e6k_11why transient ischaemic attack review is important5
Skills and ability to…
e6s_1recognise recurrent vascular events5
e6s_2perform a holistic overview, including assessment of pharmacological, non-pharmacological, and psychological interventions4
e6s_3perform and interpret blood pressure measurement and electrocardiogram (ECG)3
e6s_4use results of history and investigations to confirm a diagnosis and make an individual management plan for the patient5
e6s_5identify who provides interventions, treatments, and immediate or ongoing risk factor management for transient ischaemic attack locally, and refer efficiently and effectively3
e6s_6recognise individuals with persistent deficits or other ongoing effects of transient ischaemic attack and arrange rehabilitation, support, and management3
e6s_7recognise stroke-related communication difficulties and adapt methods of communication to discuss with the patient, carer, and family: diagnosis and results of investigations; risk of future vascular event and actions to be taken if a further vascular event occurs; methods of secondary prevention; subsequent needs and aspirations; and a management plan3
e6s_8encourage people to come for review and arrange follow-up appointment where possible5
e6s_9assess medication adherence and facilitate improved engagement2
e6s_10monitor progress and agree or change a maintenance or management plan in conjunction with those affected by stroke0
e6s_11identify where community targets for risk factor management may affect prevention strategies and take steps to overcome this0
E7Urgent responseCourse Level
Knowledge and understanding of…
e7k_1the signs and symptoms of stroke and transient ischaemic attack5
e7k_2the anatomy and physiology of the central nervous system5
e7k_3stroke mimics and how they present5
e7k_4features of less common (atypical) presentation of stroke5
e7k_5the need for emergency response to stroke and transient ischaemic attack5
e7k_6the investigations, interventions, and treatments for stroke and transient ischaemic attack and their timeframes5
e7k_7the physiological, neurological, and psychological effects of stroke, their timeframe during and after a stroke, and the need to monitor and act upon them5
e7k_8the communication effects of stroke including, but not limited to: aphasia; dysarthria; articulatory dyspraxia4
e7k_9complications after stroke and preventing and managing them4
Skills and ability to…
e7s_1take and interpret a thorough medical history, including information from carers, family and other agencies where possible, and carry out decision-specific mental capacity assessments as appropriate5
e7s_2perform basic neurological and physiological assessment (vital signs)5
e7s_3perform ABCDs (airways, breathing, circulation, disability), pulse oximetry and blood glucose assessment, and act on abnormal findings5
e7s_4identify suspected stroke, using recognised screening and assessment tools, and act on results5
e7s_5identify and appropriately treat stroke mimics4
e7s_6identify emergency investigations and interventions available locally for stroke and transient ischaemic attack patients5
e7s_7recognise stroke-related communication difficulties and use a range of resources and approaches to adapt methods of communication3
e7s_8identify and use safe methods of moving, handling, and positioning depending on the individual patient or staff needs2
e7s_9communicate and discuss with the patient, carer, and family: current event; risk of future vascular event; need for and timeframes of assessments and investigations; rationale for interventions and treatments, their timeframes, and possible side effects; and provide timely information, advice and support5
E8Assessment (stroke)Course Level
Knowledge and understanding of…
e8k_1the signs and symptoms of stroke5
e8k_2stroke sub-types and their aetiologies5
e8k_3features of atypical presentation of stroke and stroke mimics4
e8k_4the physiological, neurological, and psychological effects of stroke, their timeframe during and after a stroke, and how to monitor and act upon them5
e8k_5emergency investigations and interventions for stroke and the timeframe within which they should be given5
e8k_6the indications and contraindications for investigations, interventions, and treatments for stroke5
e8k_7any complications of investigations, interventions, and treatments for stroke and how to prevent and manage them4
e8k_8different modalities to facilitate diagnosis and treatment of stroke (e.g. telemedicine)5
Skills and ability to…
e8s_1take and interpret a thorough medical history, including information from carers, family and other agencies where possible, and carry out decision-specific mental capacity assessments as appropriate5
e8s_2determine, plan, and initiate the appropriate screening, assessments and investigations, and interventions and treatments, and their level of urgency4
e8s_3perform a physiological assessment and assess vital signs5
e8s_4perform a standardised neurological assessment using a recognised stroke scale or tool5
e8s_5obtain and interpret the results of investigations to: diagnose and distinguish between stroke and transient ischaemic attack; classify stroke and identify atypical strokes; and to identify and exclude stroke mimics4
e8s_6formulate and implement an immediate and ongoing management plan and initiate treatments within the relevant timescales5
e8s_7recognise stroke-related communication difficulties and adapt methods of communication to discuss with the patient, carer, and family: current event; risk of future vascular event; need for and timeframes of assessments and investigations; rationale for interventions and treatments, their timeframes, and possible side effects; and provide timely information, advice and support4
e8s_8monitor progress, identify complications or deteriorations, and deliver additional treatments as required4
e8s_9Identify the need for more specialist or differing treatments when necessary3
E9Treatment (stroke)Course Level
Knowledge and understanding of…
e9k_1the signs and symptoms of stroke5
e9k_2how to manage strokes that occur as a complication of another primary pathology3
e9k_3the physiological, neurological, and psychological effects of stroke, their timeframe during and after a stroke, and the need to monitor and act upon them5
e9k_4assessment and management options for physiological, neurological, and psychological effects of stroke3
e9k_5complications after stroke and how to prevent and manage them3
e9k_6any complications of investigations, interventions, and treatments for stroke and how to prevent and manage them3
e9k_7cognitive effects of stroke and their impact on the patient's ability to consent to treatment3
e9k_8when to refer for other specialist care3
e9k_9assessing swallowing and management of dysphagia3
e9k_10alternative methods for hydration and feeding; the interactions between enteral fluids, feeds and drug treatments; and the symptoms and effects of dehydration and malnutrition3
e9k_11alternative methods for drug administration and the effects of stopping ongoing drug treatment because of swallowing problems3
e9k_12the importance and methods of oral hygiene3
e9k_13the importance of avoiding catheters, as well as managing retention and promoting continence3
e9k_14the need for early mobilisation and positioning4
e9k_15the range of potential impacts of stroke on the patient, carer, and family3
e9k_16the roles, level, and number of health and social service professionals who should contribute to the care and support of individuals with stroke and those affected by stroke3
e9k_17when to explore palliative care options, the availability and appropriateness of these options, and how to sensitively engage in discussions with the patient, carer, and family
Skills and ability to…
e9s_1determine, plan, and initiate the appropriate screening, assessments and investigations, and interventions and treatments, and their level of urgency4
e9s_2perform a physiological assessment and assess vital signs5
e9s_3perform a standardised neurological assessment using a recognised stroke scale or tool5
e9s_4obtain and interpret the results of investigations to: diagnose and distinguish between stroke and transient ischaemic attack; classify stroke and identify atypical strokes; and to identify and exclude stroke mimics5
e9s_5formulate and implement an immediate and ongoing management plan accordingly and initiate treatments within the relevant timescales5
e9s_6recognise stroke-related communication difficulties and adapt methods of communication to discuss with the patient, carer, and family: current event; risk of future vascular event; need for and timeframes of assessments and investigations; rationale for interventions and treatments, their timeframes, and possible side effects; and provide timely information, advice and support4
e9s_7identify the need for more specialist or differing treatments when necessary and refer to those services4
e9s_8monitor progress, identify complications or deteriorations, and deliver additional treatments as required4
e9s_9identify and use safe methods of moving, handling, and positioning depending on the individual patient or staff needs4
e9s_10assess and manage physiological, neurological, and psychological effects of stroke in collaboration with the multidisciplinary team3
e9s_11deliver relevant methods of nutrition, hydration, and medication in patients identified as requiring alternative administration3
e9s_12assess and discuss realistic goals with those affected by stroke, plan discharge, and link to follow-up services for patients and carers3
e9s_13recognise impending death, begin sensitive discussions with the patient, carer, and family, and initiate palliative care where necessary3
E10Specialist rehabilitationCourse Level
Knowledge and understanding of…
e10k_1the range of potential impacts of stroke on the patient, carer, and family0
e10k_2the psychological and emotional effects of stroke including, but not limited to: depression; suicidality; emotionalism; anxiety; fear of falling; low self-esteem; confidence and well-being; traumatic stress; behaviours that challenge0
e10k_3the functional activity and social participation effects of stroke including, but not limited to: relationships, pets, support network, community groups; return to meaningful occupation (employment, volunteering, study); leisure; carers; respite; finances; community access; return to driving; transport; activities of daily living0
e10k_4the communication effects of stroke including, but not limited to: aphasia; dysarthria; articulatory dyspraxia0
e10k_5the physiological and motor effects of stroke including, but not limited to: feeding, nutrition and hydration; skin integrity; mobility; balance; incontinence; bladder and bowel management; swallowing; sexual dysfunction; motor control; spasticity0
e10k_6the sensory effects of stroke including, but not limited to: visual field deficits; hemianopia; pain, including shoulder pain, and central post-stroke pain; hyperacusis / noise sensitivity; reduced hearing0
e10k_7the medical and neurological effects of stroke including, but not limited to: medication; comorbidities; medical complications; seizures; sleep disorders; respiratory disorders0
e10k_8the neuropsychological (cognition and perception) effects of stroke including, but not limited to: anosognosia / lack of awareness; agnosia; reduced processing speed; spatial awareness neglect/inattention); attention; memory; praxis; dyscalculia; executive functions
e10k_9the causes of, and interplay between, the above-described effects of stroke, and how to assess, manage, and treat them using a range of evidence-based therapy interventions0
e10k_10the impact of the above-described effects of stroke on stroke rehabilitation interventions, rehabilitation outcomes, and activities of daily living0
e10k_11the principles and techniques of multidisciplinary stroke assessment and rehabilitation and how these are applied in practice0
e10k_12when and how to use relevant screening measures and assessments0
e10k_13safe moving, handling, and positioning0
e10k_14the range of methods, resources, and approaches available to facilitate communication with those affected by stroke0
e10k_15health promotion approaches and how to embed them in stroke rehabilitation to identify and manage risks for further vascular events0
e10k_16strategies to enable those affected by stroke to: take an active role in their recovery; support the adoption of healthy behaviours; and improve the degree of engagement with the rehabilitation process - including the application of personalised care principles for example: behaviour change, goal setting, coaching, supported self-management, personalised care and support planning, shared decision making0
e10k_17pharmacological and non-pharmacological interventions for secondary prevention and to promote recovery after stroke; and their potential adverse effects0
e10k_18medication adherence: how to assess it; how it is affected by individual preference; how to motivate; and how to facilitate improved engagement0
e10k_19the full range of local and national resources and services available for those affected by stroke - particularly those relating to rehabilitation, self-management, equipment, adaptations, and psychological care - including: health, social, voluntary, and independent; how to facilitate access and length of referral time0
e10k_20the equipment, adaptations, and assistive technology available to support rehabilitation0
e10k_21the implications of stroke for lifestyle; driving; occupation, including voluntary work or education; and social participation0
e10k_22the process of transfer to the community including discharge planning, long-term management, further rehabilitation, and supporting social participation0
Skills and ability to…
e10s_1take and interpret a thorough medical history to inform specialist stroke rehabilitation, including information from carers, family and other agencies where possible, and carry out decision-specific mental capacity assessments as appropriate0
e10s_2recognise the signs, symptoms and impact of the psychological and emotional effects of stroke including, but not limited to: depression; suicidality; emotionalism; anxiety; fear of falling; low self-esteem; confidence and well-being; traumatic stress; behaviours that challenge0
e10s_3recognise the signs, symptoms and impact of the functional activity and social participation effects of stroke including, but not limited to: relationships, pets, support network, community groups; return to meaningful occupation (employment, volunteering, study); leisure; carers; respite; finances; community access; return to driving; transport; activities of daily living0
e10s_4recognise the signs, symptoms and impact of the communication effects of stroke including, but not limited to: aphasia; dysarthria; articulatory dyspraxia0
e10s_5recognise the signs, symptoms and impact of the physiological and motor effects of stroke including, but not limited to: feeding, nutrition and hydration; skin integrity; mobility; balance; incontinence; bladder and bowel management; swallowing; sexual dysfunction; motor control; spasticity0
e10s_6recognise the signs, symptoms and impact of the sensory effects of stroke including, but not limited to: visual field deficits; hemianopia; pain, including shoulder pain, and central post-stroke pain; hyperacusis / noise sensitivity; reduced hearing0
e10s_7recognise the signs, symptoms and impact of the medical and neurological effects of stroke including, but not limited to: medication; comorbidities; medical complications; seizures; sleep disorders; respiratory disorders0
e10s_8recognise the signs, symptoms and impact of the neuropsychological (cognition and perception) effects of stroke including, but not limited to: anosognosia / lack of awareness; agnosia; reduced processing speed; spatial awareness neglect/inattention); attention; memory; praxis; dyscalculia; executive functions
e10s_9determine, plan, and initiate the appropriate assessments and investigations, and interventions and treatments0
e10s_10use a range of communication methods, resources, and approaches to ensure the patient, carer, and family are fully involved in the decision making process and their care0
e10s_11provide a psychologically-informed, patient-centred assessment, formulation and intervention for behaviours that challenge after stroke0
e10s_12recognise stroke-related communication difficulties and adapt methods of communication to discuss with the patient, carer, and family: current event; risk of future vascular event; need for and timeframes of assessments and investigations; rationale for interventions and treatments, their timeframes, and possible side effects; and provide timely information, advice and support0
e10s_13identify and use safe methods of moving, handling, and positioning depending on the individual patient or staff needs, and that will help with the optimum return of functional abilities0
e10s_14provide a range of stroke-specialist rehabilitation techniques and the clinical rationale for the selection and administration of a specific technique0
e10s_15assess readiness for behaviour change and, in conjunction with those affected by stroke, assist in the development of a management or maintenance plan using patient-centred goal-setting and outcomes; identify resources to facilitate and continue participation and inclusion0
e10s_16assess, discuss, and review rehabilitation progress with those affected by stroke0
e10s_17assess motivational issues (e.g. post-stroke apathy, low motivation to engage with rehabilitation, possible depression or anxiety); where appropriate, use techniques to enhance motivation (e.g. identifying patient's values and preferred activities; goal-setting; motivational interviewing; discussion of barriers); and agree, or change, a maintenance or management plan0
e10s_18assess medication adherence and facilitate improved engagement0
e10s_19assist, encourage, and facilitate post-stroke physical, social, and cultural reintegration, to help the patient, carer, and family to: cope and manage; build self-esteem and confidence; encourage recovery and maximise potential0
e10s_20provide advice and support on driving and refer to specialist centres as required0
e10s_21identify the full range of local and national resources and services available to support rehabilitation, in hospital and after discharge, for those affected by stroke; assess their relevance and suitability for the patient, carer, and family; liaise with services, working across agencies and sharing information where appropriate; communicate referral arrangements, availability and waiting times0
e10s_22Identify need and when to refer for more specialist or differing treatments where necessary: also agree referral (e.g. assistive technology, major adaptations to the home, disability employment adviser)0
E11End-of-life careCourse Level
Knowledge and understanding of…
e11k_1end-of-life care pathways, advanced directives, and palliative care tools in relation to stroke0
e11k_2the range of support groups and services for those affected by stroke with palliative care needs0
e11k_3ways to assess and meet the needs and aspirations of those affected by stroke during end-of-life care0
e11k_4the assessment and management of the physiological, neurological, and psychological effects of stroke at end of life and possible implications for prognosis0
e11k_5pharmacological and non-pharmacological interventions for end-of-life care after stroke, and their potential adverse effects0
Skills and ability to…
e11s_1communicate and discuss with the patient, carer, and family: the palliative care options, their timeframes, rationale, and potential adverse effects0
e11s_2carry out decision-specific capacity assessments and follow "best interests" decision making when appropriate, in accordance with mental capacity law0
e11s_3provide sufficient information to enable informed choice and decision making by those affected by stroke0
e11s_4identify need and when to refer for more specialist or differing treatments where necessary, and agree referral0
e11s_5recognise and manage symptoms taking account of individual needs and aspirations0
e11s_6use palliative care, or other relevant tools, and care pathways0
e11s_7identify local services and resources, including waiting times and implications for the provision of end-of-life care0
e11s_8use strategies to help with breaking bad news, managing emotions, and obtaining information on advanced directives0
e11s_9develop mechanisms to support the palliative care team and provide opportunities for debriefing sessions0
E12Seamless transfer of careCourse Level
Knowledge and understanding of…
e12k_1the assessment and management of the physiological, neurological, and psychological effects of stroke to identify care and ongoing rehabilitation needs0
e12k_2the implications of stroke for lifestyle; driving; occupation, including voluntary work or education; and social participation0
e12k_3the full range of local and national resources and services available for those affected by stroke - particularly those relating to transfer, short and long-term needs assessment, packages of care, continued rehabilitation and psychological care, finance and personal budgets, and respite care - including: health, social, voluntary, and independent; how to facilitate access and length of referral time0
e12k_4the principles of good discharge planning for transition between services, cessation of services, and for transfer of care to the community, including the education of those affected by stroke0
e12k_5all agencies that are potentially involved along the whole of the Stroke Pathway0
e12k_6the principles of multi-agency working0
Skills and ability to…
e12s_1determine, plan, and initiate appropriate assessments, including risk assessments, to determine care and support needs on discharge, and to ensure risk is minimised0
e12s_2assess, discuss, and review goal-setting, outcomes, and a discharge plan with those affected by stroke0
e12s_3Identify need and when to refer for more specialist or differing treatments where necessary0
e12s_4identify the full range of local and national resources and services available to overcome barriers and facilitate effective and efficient discharge for those affected by stroke; assess their relevance and suitability for the patient, carer, and family; liaise with services, working across agencies and sharing information where appropriate; communicate referral arrangements, availability and waiting times0
e12s_5reflect on processes and pathways of care including mechanisms for review and discharge planning0
e12s_6reflect on methods and effectiveness of information sharing within and between agencies involved in transfer of care and discharge planning0
E13Long-term careCourse Level
Knowledge and understanding of…
e13k_1the assessment and management of the physiological, neurological, and psychological effects of stroke to inform long-term care0
e13k_2the range of potential impacts of stroke on the patient, carer, and family, the need to assess these, and assessment methods0
e13k_3the implications of stroke for lifestyle; driving; occupation, including voluntary work or education; and social participation0
e13k_4risk factors for further vascular events0
e13k_5pharmacological and non-pharmacological interventions for secondary prevention and to promote recovery after stroke; and their potential adverse effects0
e13k_6the full range of local and national resources and services available for those affected by stroke - particularly those relating to long-term care, housing, transport, adjustments, supporting independent living where possible - including: health, social, voluntary, and independent; how to facilitate access and length of referral time0
e13k_7the range of methods, resources, and approaches available to facilitate communication with those affected by stroke0
e13k_8medication adherence: how to assess it; how it is affected by individual preference; how to motivate; and how to facilitate improved engagement0
Skills and ability to…
e13s_1recognise stroke-related communication difficulties and adapt methods of communication to discuss with the patient, carer, and family: current event; risk of future vascular event; need for and timeframes of assessments and investigations; rationale for interventions and treatments, their timeframes, and possible side effects; and provide timely information, advice and support0
e13s_2monitor progress and agree or change a maintenance or management plan in conjunction with those affected by stroke, identifying resources to facilitate participation and inclusion0
e13s_3assess, discuss, and review goal-setting and outcomes with those affected by stroke0
e13s_4identify need and when to refer for more specialist or differing interventions and treatments when necessary0
e13s_5identify the full range of local and national resources and services available to support long-term care for those affected by stroke; assess their relevance and suitability for the patient, carer, and family; liaise with services, working across agencies and sharing information where appropriate; communicate referral arrangements, availability and waiting times0
e13s_6assess post-stroke apathy and readiness for behaviour change, and use approaches to support behaviour change0
e13s_7deliver and evaluate self-management programmes for those affected by stroke0
e13s_8assess adherence to treatment and rehabilitation in long-term care after stroke and facilitate improved engagement0
E14ReviewCourse Level
Knowledge and understanding of…
e14k_1the assessment and management of the physiological, neurological, and psychological effects of stroke at review0
e14k_2ways to assess and meet the needs and aspirations of those affected by stroke during review0
e14k_3the full range of local and national resources and services available to address the physiological, neurological, and psychological needs of those affected by stroke, including: health, social, voluntary, and independent; how to facilitate access and length of referral time0
e14k_4the range of potential impacts of stroke on the patient, carer, and family, the need to assess these, and assessment methods0
e14k_5the implications of stroke for lifestyle; driving; occupation, including voluntary work or education; and social participation0
e14k_6risk factors for further vascular events0
e14k_7pharmacological and non-pharmacological interventions for secondary prevention and to promote recovery after stroke, and their potential adverse effects0
e14k_8the range of methods, resources, and approaches available to facilitate communication with those affected by stroke when conducting a review0
e14k_9medication adherence: how to assess it; how it is affected by individual preference; how to motivate; and how to facilitate improved engagement0
Skills and ability to…
e14s_1take and interpret a thorough medical history, including information from carers, family and other agencies where possible, and carry out decision-specific mental capacity assessments as appropriate0
e14s_2recognise stroke-related communication difficulties and adapt methods of communication to discuss with the patient, carer, and family: current event; risk of future vascular event; need for and timeframes of assessments and investigations; rationale for interventions and treatments, their timeframes, and possible side effects; and provide timely information, advice and support0
e14s_3monitor progress and agree or change a maintenance or management plan in conjunction with those affected by stroke, identifying resources to facilitate participation and inclusion0
e14s_4assess, discuss, and review goal-setting and outcomes with those affected by stroke0
e14s_5assess medication adherence and facilitate improved engagement0
e14s_6plan appropriate assessments and treatments based on outcome of review0
e14s_7identify need and when to refer for more specialist or differing interventions and treatments where necessary0
e14s_8evaluate the review process in your service and act on the results0
E15Participation in communityCourse Level
Knowledge and understanding of…
e15k_1the assessment and management of the physiological, neurological, and psychological effects of stroke and how they affect community participation0
e15k_2the full range of local and national resources and services available for those affected by stroke - particularly those relating to social participation, vocation, education, recreation, and peer support, to support sustained inclusion - including: health, social, voluntary, and independent; how to facilitate access and length of referral time0
e15k_3the range of potential impacts of stroke on the patient, carer, and family, the need to assess these, and assessment methods0
e15k_4the implications of stroke for lifestyle; driving; occupation, including voluntary work or education; and social participation0
e15k_5the range of methods, resources, and approaches available to facilitate communication with those affected by stroke0
Skills and ability to…
e15s_1assess, discuss, and review goal-setting and outcomes with those affected by stroke0
e15s_2monitor progress and agree or change a maintenance or management plan in conjunction with those affected by stroke0
e15s_3plan appropriate assessments and treatments in relation to community participation0
e15s_4Identify need and when to refer for more specialist or differing treatments where necessary0
e15s_5identify the full range of local and national resources and services available to facilitate participation and inclusion for those affected by stroke; assess their relevance and suitability for the patient, carer, and family; liaise with services, working across agencies and sharing information where appropriate; communicate referral arrangements, availability and waiting times0
e15s_6use individual commissioning0
E16Return to workCourse Level
Knowledge and understanding of…
e16k_1the range of physiological, neurological, and psychological effects of stroke and how they may affect a return to work and/or education0
e16k_2how to assess and manage the physiological, neurological, and psychological effects of stroke0
e16k_3relevant legislation on employment, discrimination, and health and safety at work0
e16k_4the roles of healthcare and other professionals in employment-related services, for example: occupational health; occupational psychologist; disability employment adviser0
e16k_5the role of healthcare and other professionals in vocational rehabilitation0
e16k_6the full range of local and national resources and services available to those affected by stroke - particularly those supporting return to occupation, voluntary work or education - including: health, social, voluntary, and independent; how to facilitate access and length of referral time0
e16k_7what is meant by "reasonable adjustment" in the workplace, how to adapt or instigate adaptation to the work environment, and the employer's responsibility0
e16k_8available helpful technology for overcoming functional and activity limitations in the workplace0
e16k_9ergonomic principles and how to overcome access issues0
e16k_10the relationship between meaningful engagement in occupation, including voluntary work and education, and health and wellbeing0
e16k_11the benefits system in relation to occupation, including voluntary work and education0
e16k_12workplace assessment including risk, job analysis, return to work planning, and job retention0
e16k_13models of vocational rehabilitation for stroke and vocational case management0
e16k_14vocational rehabilitation guidelines and standards for people with stroke0
Skills and ability to…
e16s_1refer to a vocational rehabilitation service0
e16s_2undertake, or refer for, assessment of the physiological, neurological, and psychological effects following stroke0
e16s_3identify the full range of local and national resources and services available to support return to occupation, voluntary work or education, for those affected by stroke; assess their relevance and suitability for the patient, carer, and family; liaise with services, working across agencies and sharing information where appropriate; communicate referral arrangements, availability and waiting times0
e16s_4assess for, advise on, and review the need for workplace adaptation, assistive technology and environmental adaptations to overcome work-related activity limitations0
e16s_5advise, prepare, and co-produce a personalised plan for return to occupation, including voluntary work and education, providing resources for support on the return to work pathway0
e16s_6advise employers, colleagues, and educators about the effects of stroke, and negotiate a plan for return to occupation, including voluntary work and education0
e16s_7recognise the need for benefits advice and provide, or refer onwards, if required0
e16s_8carry out, or refer onwards for, a workplace assessment and risk assessment0
e16s_9carry out, or refer onwards for, a job analysis0
e16s_10set goals for return to, or retention of, occupation, including voluntary work and education0
e16s_11case manage, or refer to a case management service, for a return to occupation, including voluntary work and education0
e16s_12implement national vocational rehabilitation guidelines where appropriate and consistent with the patient's needs and wishes0
e16s_13review those affected by stroke in their work or education environment, and make necessary referrals or adjustments0
E17Professional behaviour and valuesCourse Level
Knowledge and understanding of…
e17k_1own abilities and developmental needs to deliver evidence-based care
e17k_2career development opportunities and pathways, and sources of career support including annual appraisal, mentorship, and research support infrastructure
e17k_3common barriers to effective professional communication and the different communication strategies and tools to improve communications with colleagues, patients, and stakeholders
e17k_4the code(s) of professional conduct and duty of candour relevant to your profession and their application within practice
e17k_5wider policy and how it guides professional practice, service improvement, and research
e17k_6person-centred and values-based care based on the needs of the patient, and the guidelines to promote them, including the principles of equality and diversity
e17k_7the importance of behaviour change and methods of implementing behaviour change interventions
e17k_8clinical reasoning methods for undifferentiated and differentiated presentations, complex situations, and risk management - including the principles to be considered where required care deviates from standard practice guidelines
e17k_9the theory of evidence-based practice, the role of applied health and social care research, and the methods of translation to improve practice and population health
e17k_10the role of confidence as a crucial component in personal development and leadership skills at all levels
e17k_11the roles and interplay between members of the multi-disciplinary, and wider team involved in the delivery of safe and effective care, your role within the team, and the potential for flexible working across professional boundaries
e17k_12working in partnership with individuals, families, carers, and stakeholders
e17k_13factors contributing to workplace stress and local and national processes and strategies to promote optimum mental health and wellbeing, emotional intelligence, and improved resilience
e17k_14the principles of time-management, workload planning, and responsive personal prioritisation
e17k_15the application of Data Protection (legal), and Patient confidentiality (ethics) in practice
e17k_16a wide range of digital technologies to work collaboratively with others
Skills and ability to…
e17s_1demonstrate critical self-reflection and identify developmental needs to advance strengths and address weaknesses in delivering evidence-based care
e17s_2contribute to personal appraisal process, discussing career development with line manager, setting realistic and achievable goals and pursuing relevant development activities
e17s_3articulate own opinions in a clear, evidenced manner, and communicate complex information effectively to support people in making decisions, plan care, or seek to make positive changes in service provision
e17s_4practice in compliance with the code(s) of professional conduct and candour relevant to your profession, being responsible and accountable for your decisions, actions, and omissions
e17s_5identify, interpret, and apply wider policy documents that guide professional practice, service improvement, and research
e17s_6practice person-centred and values-based care to elicit the needs and aspirations of service users to support sensitive decision-making and care planning
e17s_7assess readiness for, and implement interventions to facilitate, behaviour change
e17s_8exercise professional expertise and judgement to inform ethical clinical decision making and complexity management within your scope of practice, ensuring the safety of patients, carers, and families
e17s_9translate evidence into practice to improve service user outcomes, patient experience, and organisation culture
e17s_10act as a role model making an identifiable contribution to service provision and improvement, encouraging, motivating, and influencing others with confidence
e17s_11demonstrate understanding of your level of responsibility and autonomy and acknowledge limitations of own competence and professional scope of practice
e17s_12build professional working relationships with colleagues to work effectively in the multi-disciplinary team, and work in partnership with individuals, families, carers, and stakeholders
e17s_13identify stress and or stressful situations and other mental health concerns for self and identify coping mechanisms
e17s_14be flexible in your approach to changing clinical situations, demonstrating skill in prioritising workload
e17s_15identify when there is a requirement to breach confidentiality, when legal advice is required, and when to escalate to a senior clinician
e17s_16demonstrate digital literacy, and act accordingly and appropriately within digital environments, for example in email and video conferencing
E18Leadership, management, and governanceCourse Level
Knowledge and understanding of…
e18k_1the principles of planning, goal setting, and reviewing progress and how they contribute to the development of higher levels of autonomy
e18k_2the differences between leadership and management
e18k_3the approaches to effective management, change management, and models of leadership
e18k_4networking and negotiation styles and skills, including co-operation, flexibility, and understanding, and their role in influencing others
e18k_5the approaches to organisational and resource management
e18k_6methods of measuring and assessing staff performance, and supporting continued professional development
e18k_7the local, regional, and national policy regarding workforce review and development
e18k_8factors contributing to workplace stress for individuals and teams, and the local and national processes and strategies to promote optimum mental health and wellbeing, emotional intelligence, and improve resilience
e18k_9procedures for patient and staff member satisfaction, concerns, and complaints
e18k_10the governance structures used to improve care quality and national quality indicators
e18k_11ethical, moral, and legal dilemmas that have the potential to arise in practice
e18k_12the legal and ethical guidelines in the country of practice such as confidentiality, consent and the Mental Capacity Act, and their implications for practice
e18k_13safeguarding policies including statutory requirements, accountability, codes of conduct, and actions to take
e18k_14methods to empower patients taking into account health inequalities and seldom heard groups, the implications of the Mental Capacity Act, and how to advocate for patients when there is a legal duty to instruct an Independent Mental Capacity Advocate (IMCA)
Skills and ability to…
e18s_1apply the principles of autonomous working to own practice and that of the wider team
e18s_2apply leadership skills to your role and responsibilities, identify opportunities for change and develop case for change, and lead or support colleagues to deliver and implement service developments
e18s_3utilise negotiation skills when engaging with colleagues and wider networks to achieve effective engagement and work towards shared goals
e18s_4contribute to the appraisal of others and provide meaningful feedback, identify development needs and set achievable goals, and signpost or commission opportunities for continued professional development
e18s_5review the skill-mix of the existing workforce and develop and/or commission education and training provision in line with policy to create a skilled workforce
e18s_6identify stress and/or stressful situations and other mental health and wellbeing concerns for others, and take appropriate action to support individuals and teams
e18s_7respond appropriately, in line with local policy and escalation procedures, to patient and staff member satisfaction, concerns, and complaints
e18s_8identify, reflect upon, and respond to ethical, moral, and legal dilemmas within practice
e18s_9ensure practice adheres to ethical and legal guidelines, and recognise situations where it is necessary to provide treatment without consent, ensure this is lawful, seeking appropriate support and advice for complex situations
e18s_10ensure safeguarding is in place for staff and patients, taking the necessary action(s) where appropriate
E19Education, training, and personal developmentCourse Level
Knowledge and understanding of…
e19k_1the importance of continued learning and development for self and wider workforce
e19k_2the role of critical self-reflection in personal development planning and the need to undertake regular assessments of personal learning-needs
e19k_3how to create an effective learning environment through peer support, teaching, facilitating learning, nurture talent, and promoting autonomy
e19k_4the theories that underpin clinical education and mentorship, including learning and teaching styles and techniques
e19k_5the theory of evidence-based practice and the role of research informed teaching for both clinical and research skill development
e19k_6the key components of an effective learning environment and how to amend the environment based on the needs of learners at all stages
e19k_7a range of assessment and evaluation methods to measure knowledge acquisition and professional development
e19k_8feedback theory and strategies to improve knowledge and skill acquisition and motivate learners
e19k_9knowledge mobilisation and capacity building
Skills and ability to…
e19s_1demonstrate a positive attitude to practice, learning, and the development of self and others
e19s_2undertake a personal learning needs assessment, demonstrating critical self-reflection, to produce a personal development plan with clear realistic goals
e19s_3contribute to and promote the professional development of peers, assisting others to undertake a learning-needs analysis and produce a development plan where appropriate
e19s_4teach others and modify approaches in response to learning style and group size, for example one to one, small, or large groups
e19s_5devise and/or deliver research informed learning and development programmes, drawing on discipline relevant research
e19s_6promote learning and create a supportive and engaging learning environment
e19s_7select and implement appropriate methods of assessment and evaluation to ensure effective learning
e19s_8provide constructive, informative, and factual feedback, with actionable guidance for improvement in an encouraging manner
e19s_9develop sustainable networks to inform local knowledge mobilisation and build capacity such as: communities of practice, in service training, and journal clubs
E20Research, innovation, and quality improvementCourse Level
Knowledge and understanding of…
e20k_1the principles, methods, and stages of audit, quality improvement, and applied health research processes
e20k_2research methods including qualitative, quantitative, and mixed methods
e20k_3the tools and systems available to inform searching for evidence from multiple sources
e20k_4critical appraisal, and associated tools, for evaluating the quality of evidence
e20k_5the existing evidence base in relation to own and related areas of work
e20k_6the value of stakeholder involvement (public, patient and clinical) in the generation of priorities, and throughout all quality improvement and research processes: and the governance and standards surrounding this
e20k_7theoretical concepts, study designs, and methodologies relevant to quality improvement and research activities in health and social care settings
e20k_8local, regional, and national ethics and governance policy and approval procedures
e20k_9local, regional, and national policies and structures available to support audit, quality improvement, and research activities
e20k_10funding sources for quality improvement and research activities in health and social care
e20k_11implementation theory and when to implement changes based on the outcomes of research and quality improvement initiatives
e20k_12the methods of meaningful evaluation of interventions/programmes, and their role in improving healthcare and sharing learning/good practice
e20k_13principles of writing for publication such as authorship, intellectual property, peer review, and research impact, and the importance of dissemination to meet the needs of the target audience(s)
Skills and ability to…
e20s_1define, differentiate between, and contribute to audit, quality improvement, and applied health research processes
e20s_2identify and access multiple sources to retrieve relevant evidence
e20s_3critically appraise literature from professional, and/or academic sources, and make judgements regarding their quality and applicability to the local setting
e20s_4critique and recognise gaps in the existing evidence to identify topics and generate questions relevant to policy, practice, and the 'real world' context
e20s_5utilise innovative ways of working with stakeholders to generate priorities for improvement and research, achieving meaningful engagement at all stages of the process to co-produce useful outputs
e20s_6design quality improvement initiatives and research studies, selecting the appropriate theory/research design to answer questions and generate innovations/improvements
e20s_7undertake quality improvement and research in an ethical manner consistent with the proposed aims, objectives and outcomes
e20s_8access and navigate local, regional, and national networks, building sustainable cross-boundary networks (e.g. health, social care and academia) to support and enhance quality improvement and research activities
e20s_9identify relevant funding sources and develop stakeholder informed applications to support quality improvement and research initiatives aligned to local and national priorities
e20s_10identify and utilise appropriate implementation theory/methods to promote the adoption of quality improvement and research findings to embed evidence-based practice and improve outcomes in health and social care
e20s_11design, and conduct, meaningful evaluations with measurable indicators to determine how, why, and whether interventions/programmes achieve their intended aims
e20s_12develop and disseminate findings to a broad range of audiences using multiple methods (such as open access peer reviewed journals, local advocacy groups, interactive technologies) to achieve impact, and benefit practice and/or health outcomes


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