10
10.3 Extending skills
Situation: description of a current situation, outlining the background and the key issues
Problem(s): the issues arising from the current situation and the negative eff ects that these are causing
Solution(s): solutions to the problems (i) which have been suggested or are currently underway (ii) which will, may or could be tried in the future; suggestions for further solutions
Evaluation of solution(s): comparison of solutions; opinions on how successful the solutions are or could be + justifi cation; an opinion on which is the best option + justifi cation
B
Set for individual work and pairwork checking. Tell students to read the case study, make notes and then fi ll in the table. Give students time to check their tables in pairs, and then elicit and feed back using the following table.
Model answers
Situation University Hospital Swendon has developed a strategic plan for the revision and full implementation of clinical guidance for all procedures.
Problem Solutions
An audit of clinical procedures in the hospital showed that less than 30% of the staff were using them eff ectively.
1. new guidelines using systematic reviews and material from BMJ Best Practice
2. detailed discussions following a journal club model to ensure the new guidelines are eff ective in meeting local conditions
3. guidelines to be integrated into the hospital’s computerized decision support system (CDSS)
C
Set for individual work and pairwork checking. Tell students to read the extract, make brief notes and then fi ll in the table. Give students time to check their tables in pairs, and then elicit answers and feed back using the following table.
Model answers Situation
Argument for Argument against 206
get doctors to modify and update clinical guidelines
the guidelines are more likely to be implemented in practice
doctors would take far too long to create the guidelines
E
1. Set for pairwork discussion. Remind students to refer back to Lesson 10.2 for ideas and information, as well as the texts they have discussed in this lesson. Remind students about the basic structure of an essay (introduction – main body – conclusion).
10.3_E
Depending on the class, you may want to give students the table in the PDF, which has the third column blank for them to write their own ideas.
Elicit and feed back visually with the class, using the table opposite. Tell students that they will need their essay plans again in Lesson 10.4.
Model answer See table opposite.
description
description (cause and eff ect)
description (+ possibly suggestion)
comparison and argument
D 10.3_D
Set for pairwork discussion. Encourage students to use their own ideas, as well as those in the text. Elicit and feed back visually with the class, using the table below or the PDF. Accept any reasonable suggestions.
Suggested answers Advantages Disadvantages
New guidelines to be based on best available evidence/ Clinical Evidence site
Detailed discussions with relevant staff to ensure that the new guidelines are eff ective in meeting local conditions
Integration into new computerized clinical support system
up to date, refl ects best practice
provide opportunity to amend guidelines to local conditions
journal club format shown to work elsewhere
easy access to guidelines
quick to update guidelines and share new guidelines
integrated into other processes
not always relevant to local conditions on the ground
staff may not want to take ownership
it may be diffi cult to identify all relevant staff , resulting in only partial coverage
computer system still in development
doctors can still ignore evidence
computer bugs/ security issues
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