Download Ophthalmic and Vision Science Draft Trainee

Healthcare Scientist Training Programme
(Neurosensory Sciences)
Specialism: Ophthalmic and Vision Science
Draft Trainee Learning Guide
With
Workplace-based Learning Outcomes
2010/11
CONTENTS
Page No
1. Introduction
1.1 Good Scientific Practice
1.2 The Scope of Practice for a Healthcare Scientist
1.3 The Role of a Healthcare Scientist (HSC) in
Ophthalmic and Vision Sciences
2. Aim and Content of the Healthcare Scientist Training Programme
2.1 Induction
2.2 Workplace-based Training Programme – Rotations in Neurosensory
2.2.1 A-1:
Introduction to Audiology
2.2.2 N-2:
Introduction to Neurophysiology
2.2.3 O&V-3:
Introduction to Ophthalmic & Vision Science
2.2.4 CA&I-4:
Clinical Assessment and Investigation
2.3 Workplace-based Training Programme
– 18 month specialist placement for Ophthalmic and Vision Sciences
2.3.1 PA-5:
Patient Assessment
2.3.2 PAV-6:
Psychophysical Assessment of Vision
2.3.3 OILL-7:
Ophthalmic Imaging with Light and Lasers
2.3.4 UEO-8
Ultrasonography of Eye and Orbit
2.3.5 OMRB-9:
Ocular Measurement, Refraction and Biometry
2.3.6 OMBF-10: Ocular Movement and Binocular Function
2.3.7 VE-11:
Visual Electrophysiology
2.3.8 O&V-Res-12: Research Project in Ophthalmic
and Vision Sciences
2.4 Professional Practice Curriculum
3. Assessment and Trainee Portfolio
3.1 The Assessment Programme
3.2 Competency Log Book
3.3 Online Assessment and Personal Development Management System
4. Workplace-based Competencies
4.1 Competencies
4.2 Rotational work placements
4.2.1 A-1:
Introduction to Audiology
4.2.2 N-2:
Introduction to Neurophysiology
4.2.3 O&V-3:
Introduction to Ophthalmic & Vision Science
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4.2.4 CA&I-4:
Clinical Assessment and Investigation
4.3 18 month specialist placement for Ophthalmic and Vision Science
4.3.1 PA-5:
Patient Assessment
4.3.2 PAV- 6:
Psychophysical Assessment of Vision
4.3.3 OILL-7:
Ophthalmic Imaging with Light and Lasers
4.3.4 OEA- 8:
Ultrasonography of Eye and Orbit
4.3.5 OMRB-9:
Ocular Measurement, Refraction and Biometry
4.3.6 OMBF-10: Ocular Movement and Binocular Function
4.3.7 VE-11:
Visual Electrophysiology
4.3.8 O&V-Res-12: Research Project in Ophthalmic & Vision Science
4.4 Professional Practice
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Appendix 1
Good Scientific Practice
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Appendix 2
Scope of Practice of a Healthcare Scientist
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Appendix 3 Assessment Tools:
 Direct Observation of Practical/Procedural Skills (DOPS)
 Case Based Discussion (CBD)
 Observation of Clinical Events based upon Mini CEX
Appendix 4 Professional Practice Curriculum
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Healthcare Scientist Training Programme (STP) in
Ophthalmic and Vision Science
Trainee identification details
Name:
Training Centre:
Healthcare Scientist Training Programme (STP) in
Ophthalmic and Vision Science
1. Introduction
This learning guide describes the workplace-based element of the Healthcare
Scientist Training Programme (STP) in Ophthalmic and Vision Science. This takes
place over the three years of the Programme. The workplace-based training element
of STP will begin in the first part of the programme when you will undertake 4
rotations in different aspects of Neurosensory Sciences. In the second 18 months of
training you will specialise in one area. This trainee learning guide describes the
Workplace-based training for the 4 rotations and the 18 month specialist programme.
It describes the content of your training programme, the assessment strategies and
your portfolio structure.
This trainee learning guide should be read in conjunction with the accompanying
2010/2011 STP curriculum which can be downloaded from the NHS Networks
website.
The diagram below summarises the Scientist Training Programme for specialisms
within the Neurosensory Sciences and shows the relationship between the academic
and
workplace-based
elements
of
the
training.
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1.1 Good Scientific Practice
Good Scientific Practice sets out the principles and values on which good practice
undertaken by Healthcare Scientists is founded.
Good Scientific Practice sets out for the Profession and the public the standards of
behaviour and practice that must be achieved and maintained in the delivery of work
activities and care provided.
Good Scientific Practice aims to contextualise and make more explicit the standards of
practice and proficiency set down by the Health Professions Council (HPC) in a way
that is accessible to the profession and the public. It uses as its basis the HPC
Standards of Proficiency and HPC Standards of Conduct, Performance and Ethics, but
elaborates these within the context of the modalities within the sphere of Healthcare
Science.
The Domains of Good Scientific Practice are;
1. Professional
2. Scientific
3. Clinical
4. Technical
5. Investigation and Reporting
6. Quality
7. Working with colleagues
8. Research and development
9. Probity
10. Leadership
11. Training and Developing Others
Appendix 1 sets out the details of Good Scientific Practice.
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1.2
The Scope of Practice of a Healthcare Scientist (HCS)
Healthcare Scientists have clinical and specialist expertise underpinned by theoretical
knowledge and experience in a specific clinical specialism, underpinned by broader
knowledge and experience within a healthcare science theme. They will undertake
complex scientific and clinical roles, defining and choosing investigative and clinical
options, making key judgements about complex facts and clinical situations. Many will
work directly with patients. They will be involved, often in lead roles, in innovation and
improvement, research and development and education and training. Some will
pursue explicit academic career pathways which combine clinical practice and activity
in research, innovation and education.
The scope of practice of a Healthcare Scientist is given in Appendix 2
1.3 The Role of a Healthcare Scientist (HCS) in Ophthalmic and Vision Science
Healthcare Scientists Ophthalmic and Vision Science fulfil all elements of the generic
Scope of Practice outlined in section 1.2 and given full in Appendix 2. They use
knowledge and experience across a wide range of Ophthalmic and Vision Science
services including:



Electrophysiology of vision
Ophthalmic imaging
Diagnostic ultrasonography of eye and orbit
Healthcare Scientists in Ophthalmic and Vision Science function in the
multidisciplinary clinical team to:







Assure the quality of the Ophthalmic and Vision Science services
Provide an appropriate, modern range of services in a patient focussed
operation
Advise on patient investigation
Interpret results and offer clinical advice on follow up and management
Conduct clinical audit
Contribute to evidence based good practice guidelines
Participate in relevant collaborative research
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2. Aim and Content of the Healthcare Scientist Training Programme
in Ophthalmic and Vision Science
The Scientist Training Programme (STP) is designed to provide the Healthcare
Scientist (HCS) with strong science-based training across all aspects of Ophthalmic
and Vision Science with an appropriate level of underpinning knowledge to enable
them to perform in a range of healthcare settings.
The workplace-based training is organised into two sections which will complement
and require you to utilise the academic element of your training. A generic module
“Professional Development” is included in the work-based training element of STP for
all specialisms.
In the first part of the programme you will undertake four, 3 month rotations in 3
specialisms and a fourth rotation split into smaller placements. The learning outcomes
you are required to achieve in those rotations can be found in section 2.2. The
competences you will need to achieve to demonstrate these outcomes have been
met are described in section 4.2.
In the second 18 months of training you will undertake a work placement in an
Ophthalmic and Vision Science department. The learning outcomes you are required
to achieve in Ophthalmic and Vision Science can be found in section 2.3. The
competences you will need to achieve to demonstrate these outcomes have been
met are described in section 4.3.
2.1
Induction
Each time you begin workplace-based training in a new environment, you should be
given an induction which is likely to include: Assure the quality of the Ophthalmic and Vision Science services
 Provide an appropriate, modern range of services in a patient focussed operation
 Local hospital induction – local policies
 Review of local service and functioning of Ophthalmic departments
 Review of clinical users of the Ophthalmic and Vision Science
 Review and more detailed description of health and safety, pertinent to the
modules and to the local department
 Detailed knowledge of policies relating to health and safety
 Basic knowledge of risks and hazards used within the department including
awareness of Control of Substances Hazardous to Health (COSHH), safe
handling and risk assessments
 Basic knowledge about the function, operation, and routine and corrective
maintenance requirements of equipment appropriate to the section(s) of the
department in which you are working
 Departmental protocols for testing and patient management
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

2.2
Local referral pathways
Information materials for patients; patient support services available and
how to access them.
Workplace-based Training Programme - Rotations
This section presents the learning outcomes, practical skills and clinical experience
that you should gain for the modules listed, during the rotational element of your
Workplace-based training. The modules for the four specialisms are listed together to
help you gain a feel for the structure of this phase of the training. Each learning
outcome is linked to the demonstration of specific competencies. These are detailed
in Section 4.2
The four Modules are:
Module A-1:
Module N-2:
Module O&V-3:
Module CA&I-4:
Introduction to Audiology
Introduction to Neurophysiology
Introduction to Ophthalmic and Vision Science
Clinical Assessment and Investigation
There will be continuous assessment across the Programme using a series of
validated tools. Assessment is detailed in Section 3.
Section 2.2.1
Division:
Theme:
Year 1
Module A-1:
Physiological Sciences
Neurosensory Sciences
Introduction to Audiology
Aim
This module will provide the trainee with the knowledge, understanding and
awareness into the diversity of patients attending audiology services. Trainees will
undertake a range of investigations and assist with the assessment and
management of a wide range of patients experiencing hearing, tinnitus or balance
difficulties.
Learning Outcomes in the Workplace
On successful completion of this module the trainee within the audiological clinical
environment, will:
1. Identify a range of routine audiological equipment and their use in the assessment
of case management.
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2. Describe the fundamental principles of aural rehabilitation.
3. Summarise the investigations and treatment of routine otological and audiological
disorders.
4. Explain the role and function of a multi-professional approach to the assessment
and management of patients attending an audiology service.
5. Describe the diversity of patients attending audiology services and some of their
special needs; this should include people with learning difficulties, cognitive and
sensory impairment, physical disabilities, older people, paediatrics, intensive care.
6. Apply the non NHS or external statutory, voluntary, charitable agency services
that offer support to patients in the Community following discharge from hospital
following receiving treatment from an audiology service e.g. Social Services.
Section 2.2.2
Division:
Theme:
Year 1
Module N-2:
Physiological Sciences
Neurosensory Sciences
Introduction to Neurophysiology
Aim
This module will provide the trainee with the knowledge, understanding and
awareness into the diversity of patients attending neurophysiology services.
Trainees will undertake a range of investigations and assist with the assessment
and management of a wide range of patients experiencing central or peripheral
neurophysiological difficulties.
Learning Outcomes in the Workplace
On successful completion of this module the trainee will:
1. Explain the internal and external calibration on neurophysiological equipment
describing the effects of the recording characteristic of the equipment
components.
2. Evaluate the type of patient recording derivations and stimulus and recording
parameters used in the recording of all modalities of evoked potentials (Visual,
Auditory and Somatosensory).
3. Recognise measure and label using the correct nomenclature the major
components of all modalities of patient evoked potential (Visual, Auditory and
Somatosensory).
4. Critically evaluate the causes of error encountered and the non-pathological effect
in the recording of evoked potentials and their elimination.
5. Describe the diversity of patients attending neurophysiology services and some of
their special needs; this should include people with learning difficulties, cognitive
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and sensory impairment, physical disabilities, older people, paediatrics, intensive
care.
6. Apply non NHS or external statutory, voluntary, charitable agencies or services
that offer support to patients in the Community following discharge from hospital
following receiving treatment from a neurophysiology service e.g. Social Services.
Section 2.2.3
Division:
Theme:
Year 1
Module O&V-3:
Physiological Sciences
Neurosensory Sciences
Introduction to Ophthalmic and Vision Science
Aim
This module will provide the trainee with the knowledge, understanding and
awareness into the diversity of patients attending ophthalmic and vision science
services. Trainees will undertake a range of investigations and assist with the
assessment and management of a wide range of patients experiencing ophthalmic
or vision difficulties.
Learning Outcomes in the Workplace
On successful completion of this module the trainee will:
1. Describe a range of methods and ophthalmic equipment used for the routine
psychophysical assessment of patients‟ vision.
2. Describe the principles and equipment used for imaging and measurement of eye
and ocular adnexae.
3. Describe the principles and methods used for the electrophysiological assessment
of patients‟ vision.
4. Describe patient special needs and circumstances as applied to ophthalmic and
vision services, such as; people with learning difficulties, cognitive and sensory
impairment, physical disabilities, older people, paediatrics, and intensive care.
5. Describes the ways that non NHS or external statutory, voluntary, charitable
agency services in the Community can assist with patient care in ophthalmic and
vision services i.e. Social Services.
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Section 2.2.4
Division:
Theme:
Year 1
Module CI&I4:
Physiological Sciences
Neurosensory Sciences
Clinical Assessment and Investigation
Aim
This workplace-based module will provide the trainee with the opportunity to apply
their knowledge and some basic skills of clinical assessment and investigation used in
the diagnosis, care and treatment of patients of all ages in a range of clinical settings
and care.
Learning Outcomes in the Workplace
On successful completion of this module the trainee will:
Clinical Assessment and Investigations
1. Appraise the different auditory, visual, central and peripheral neurological
imaging related assessments and investigations that contribute to the holistic
patient approach in the diagnosis, management, prognosis and care.
2. Review how different assessments and investigations are used in primary or
secondary care services who undertake auditory, or visual, or central and
peripheral neurological disorders e.g. healthcare for older people; neonatal
care, (NICU) (SCBU), integrated care, critical care, primary care, independent
sector.
3. Characterize how different auditory, or visual, or central and peripheral
neurological disease or disorders can influence the differential diagnosis of a
„neurosensory‟ disease, or disability.
4. Identify the range of auditory, or visual, or central and peripheral neurological
assessments and investigations and the implications of the results on patient
care in a variety of different environments e.g.:
• Healthcare for older people
o Sensory, cognitive function and well-being
• Primary Care
o Role of Health Visitors and District nurses
o Post-natal clinics and assessments
o Healthcare in the Community
o Screening
•
Independent Sector
o Hearing acuity; Vision acuity; Colour acuity
•
Neonatal Care Units
•
ICT / Operating Theatres.
o Neurological signs
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Imaging and Pathology Diagnostics (assessments and investigations)
5. Assist experienced imaging staff with the preparation, as appropriate, using
screening or diagnostic ionizing and non-ionizing imaging equipment, observing
current safety and legislative requirements.
6. Assist in the processing and analysis of samples in the pathology laboratory
observing current safety and legislative requirements.
7. View and identify key anatomical landmarks of either auditory, or visual, or
central and peripheral neurological systems obtained using ionising and nonionising imaging media.
8. View and identify common pathology test results compared to standard
reference ranges and possible effect on either auditory or visual, or central and
peripheral neurological disease or disorder.
9. Recognise the errors or potential risks of using defective imaging and pathology
equipment in clinical practice.
Clinical Assessment and Investigations within Patient Pathways
10. Discuss the needs of people with disabilities within neurosensory patient
pathways
11. Describe the role different healthcare services play in the care of patients
following neurosensory patient pathways e.g. healthcare for older people;
neonatal care, (NICU) (SCBU), integrated care, critical care, primary care,
independent sector.
12. Undertake a range of procedures and understand the implications of the results
on patient care in a range of clinical environments;
 Medical Assessment Unit of hearing, sight and neurological function in
the community, primary care, healthcare for older people, independent
sector
 ICU /CCU e.g. life sign measures, neurological monitoring, cognitive
function
 Neonatal Units
13. Work in partnership with colleagues, other professionals, patients and their
carers to maximise patient care.
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2.3 Workplace-based Training Programme – 18 month specialist placement for
Ophthalmic and Vision Science
This section presents the learning outcomes, practical skills and clinical experience
that you should gain for the modules listed, during the 18 month specialist placement
in Ophthalmic and Vision Science. The modules are listed together to help you gain a
feel for the structure of this phase of the training. Each learning outcome is linked to
the demonstration of specific competencies. These are detailed in Section 4.2
The 8 modules are:
Module PA-5:
Module PAV-6:
Module OILL-7:
Module UEO-8:
Module OMRB-9:
Module OMBF-10:
Module VE-11:
Module O&V-Res-12:
Patient Assessment
Psychophysical Assessment of Vision
Ophthalmic Imaging with Light and Lasers
Ultrasonography of Eye and Orbit
Ocular Measurement, Refraction and Biometry
Ocular Movement and Binocular Function
Visual Electrophysiology
Research Project in Ophthalmic and Vision Science
There will be continuous assessment across the programme using a series of
validated tools. Assessment is detailed in Section 3.
Although the titles of the modules for the academic curriculum and the Workplacebased curriculum are identical the timing of the delivery of the modules will be flexible
across the STP. Learning outcomes from different modules may be delivered
together.
Section 2.3.1
Division:
Theme:
Specialism:
Year 2 and 3
Module PA-5:
Physiological Sciences
Neurosensory Sciences
Ophthalmic and Vision Science
Patient Assessment
Aim
This module will provide the trainee with detailed knowledge and understanding of
the impact of visual impairment and its clinical assessment, diagnosis and
management. They will understand the aetiology, progression and management,
gaining experience of assisting in performing and interpreting patient results in a
range of ophthalmic and vision disorders.
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Learning Outcomes in the Workplace
On successful completion of this module the trainee will be able to:
1. Demonstrate ability to interpret referral letters in conjunction with medical,
optical, ophthalmic, and imaging findings where available to formulate the
appropriate testing strategy.
2. Demonstrate an understanding of the impact of visual impairment and treat
visually impaired individuals and their families appropriately.
3. Demonstrate the ability to build a professional relationship with patients,
identifying and addressing any special needs and maintaining patient
confidentially.
4. Demonstrate ability to communicate effectively with patients and carers, to
explain the test procedures in a manner relevant to the patient or their carer,
and to answer their questions appropriately.
5. Demonstrate safe and effective instillation eye medication required for
undertaking investigation.
6. Demonstrate ability to obtain a comprehensive ophthalmic patient history.
7. Demonstrate ability to undertake a comprehensive ophthalmic examination,
including external examination of ocular adnexae, assessment of pupil size
and reactions, examination of anterior segment with a slit lamp, fundus
examination, and tonometry.
8. Demonstrate ability to construct a differential diagnosis and identify further
investigations that will facilitate reaching of a diagnostic conclusion.
9. Demonstrate accurate, relevant and legible recording of information in patient
record.
10. Demonstrate ability to prepare reports which address the identified clinical
question.
Section 2.3.2
Division:
Theme:
Specialism:
Year 2 and 3
Module PAV-6:
Physiological Sciences
Neurosensory Sciences
Ophthalmic and Vision Science
Psychophysical Assessment of Vision
Aim
This module will provide the trainee with detailed knowledge and understanding of
the measurement of visual acuity, colour assessment and contrast sensitivity. They
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will gain experience of assisting in performing and interpreting patient results using a
range of ophthalmic equipment.
Learning Outcomes in the Workplace
On successful completion of this module the trainee will be able to:
1. Demonstrate ability to perform assessment of visual acuity in children and
adults including adults who are illiterate, have learning difficulties, or who are
non-English speaking, with Snellen, logMAR and contrast sensitivity.
2. Demonstrate ability to assess colour vision with Ishihara charts and at least one
other form of colour vision assessment.
3. Demonstrate ability to assess visual field with standard automated perimetry
and other methods that may include kinetic perimetry, microperimetry,
automated Amsler grid testing, frequency doubling perimetry.
Section 2.3.3
Division:
Theme:
Specialism:
Year 2 and 3
Module OILL- 7:
Physiological Sciences
Neurosensory Sciences
Ophthalmic and Vision Science
Ophthalmic Imaging with Light and Lasers
Aim
This module will provide the trainee with detailed knowledge and understanding of
Ophthalmic Imaging with light and lasers and their clinical use and how they help in
the ophthalmic assessment, diagnosis and management. They will understand the
aetiology, progression and management, gaining experience of assisting in
performing and interpreting patient results in a range of ocular disorders.
Learning Outcomes in the Workplace
On successful completion of this module the trainee will be able to:
1. Demonstrate ability to take colour photographs and image with OCT or other
scanning laser modality of the anterior segment and fundus of the eye, assess
quality of image, identify artefacts and interpret findings in clinical context.
2. Demonstrate understanding of the procedures and ability to perform ocular
angiography, identifying contraindications, the appropriateness of procedure
for investigation of ocular condition, the quality of the results, and to interpret
the findings in clinical context.
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3. Appreciate the differences in procedures and techniques for retinal disease
imaging and screening for retinal disease.
4. Understand the principles of contact lens imaging of the eye including
gonioscopy.
5. Understand the technique and indications for recording autofluorescence.
Section 2.3.4
Division:
Theme:
Specialism:
Year 2 and 3
Module UEO- 8:
Physiological Sciences
Neurosensory Sciences
Ophthalmic and Vision Science
Ultrasonography of Eye and Orbit
Aim
This module will provide the trainee with detailed knowledge and understanding of
ultrasonography of eye and orbit and its clinical applications in ophthalmic
assessment, diagnosis and management. The trainee will understand the aetiology,
progression and management, gaining experience of assisting in performing and
interpreting patient results using a range of ultrasound equipment.
Learning Outcomes in the Workplace
On successful completion of this module the trainee will be able to:
1. Demonstrate ability to screen the globe with A- and B-scan, understanding
normal features and artefacts, and distinguishing features of dense cataract,
vitreous haemorrhage, retinal detachment and ocular tumours.
2. Demonstrate ability to measure with ultrasound the dimensions of ocular
masses and other lesions in the eye and orbit.
3. Demonstrate familiarity of the principle of ophthalmic “Standardized
Echography” including the unique features of Standardized A-scan, and the
principle of “Echographic tissue diagnosis”.
4. Demonstrate understanding of the application of “Special Examination
Techniques” that include topographic, kinetic and quantitative echography.
5. Demonstrate ability to screen the orbits and image and measure the optic
nerve and extra-ocular muscles.
6. Demonstrate understanding of the principle of high frequency ultrasound and
its application in ophthalmic diagnosis.
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Section 2.3.5
Division:
Theme:
Specialism:
Year 2 and 3
Module OMRB-9:
Physiological Sciences
Neurosensory Sciences
Ophthalmic and Vision Science
Ocular Measurement, Refraction and Biometry
Aim
This module will provide the trainee with detailed knowledge and understanding of a
range of methods for measuring ocular structures and experience of performing,
interpreting and applying results for a range of ocular disorders including cataract,
glaucoma and corneal pathologies. The trainee will also learn how to measure
refractive error and optical aids.
Learning Outcomes in the Workplace
On successful completion of this module the trainee will be able to:
1. Demonstrate ability to measure axial length of eye with low coherence
interferometry A- and A- and B-scan modalities, including in patients with
significant ocular pathology or previous corneal refractive surgery, and make
appropriate calculations of intraocular lens power.
2. Demonstrate ability to perform corneal pachymetry with ultrasound and at
least one other imaging modality, and interpret and utilise results in clinical
context.
3. Demonstrate ability to perform corneal topography, distinguishing abnormal
results and interpreting these in the clinical context.
4. Demonstrate ability to perform focimetry and autorefraction and interpret
results in context of patient‟s current optical prescription and ocular disease or
condition.
Section 2.3.6
Division:
Theme:
Specialism:
Year 2 and 3
Module OMBF-10:
Physiological Sciences
Neurosensory Sciences
Ophthalmic and Vision Science
Ocular Movement and Binocular Function
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Aim
This module will provide the trainee with knowledge and understanding of ocular
movement and binocular vision, methods of assessment and their clinical
applications in ophthalmic assessment, diagnosis and management.
Learning Outcomes in the Workplace
On successful completion of this module the trainee will be able to:
1. Demonstrate ability to distinguish and assess different forms of ocular
movement (saccades, smooth pursuit, OKN etc.) and demonstrate familiarity
with recording methods including video-oculography and electro-oculography.
2. Demonstrate familiarity with methods of assessment of binocular vision and
stereopsis, and demonstrate ability to perform at least one method of
assessment of stereopsis.
Section 2.3.7
Division:
Theme:
Specialism:
Year 2 and 3
Module VE-11:
Physiological Sciences
Neurosensory Sciences
Ophthalmic and Vision Science
Visual Electrophysiology
Aim
This module will provide the trainee with detailed knowledge and understanding of
electrophysiological testing of the eye and its clinical use in the ophthalmic
assessment, diagnosis and management. They will understand the aetiology,
progression and management, gaining experience of assisting in performing and
interpreting patient visual recordings.
Learning Outcomes in the Workplace
On successful completion of this module the trainee will be able to:
1. Demonstrate correct procedures for preparing for and recording all visual
electrophysiology tests (ERGs, EOG, VEPs).
2. Know the international standard tests and their relevant clinical applications.
3. Understand specific modifications or adaptations required for preparing for
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4.
5.
6.
7.
8.
and recording all international standard tests in neonates and paediatrics.
Critically evaluate the effects and merits of altering: recording conditions;
electrode types and positions; acquisition parameters; stimulation parameters.
Demonstrate ability to recognise, identify and remove sources of artefact.
Understand the challenges and restrictions associated with recording in
environments such as theatre or ICU.
Know the normal waveforms and understand the effect of patient age, sex and
race: understand the nature and limitation of normative data.
Demonstrate ability to analyse recordings correctly with appropriate use of a
wide range of analysis techniques.
Section 2.3.8
Division:
Physiological Sciences
Theme:
Neurosensory Sciences
Specialism:
Ophthalmic and Vision Science
Year 2 and 3
Module O&V-Res-12: Research Project in Ophthalmic and Vision Science
Aim
The overall aim of this module, building on the Research Methods module is for
the trainee to undertake research that shows originality in the application of
knowledge, together with a practical understanding of how established techniques
of research and enquiry are used to create and interpret new information in a
specialism of healthcare science.
During Years 2 and 3 the trainee will undertake an original piece of research
involving the application of scientific investigation to one or more clinical situations.
The trainee will also be expected to complete either one [single] large research
project or three shorter health services research projects to gain an understanding
of the health services contexts within which clinical research is undertaken.
Whichever is chosen the y should include:
 Evidence-based practice
 Clinical audit
 Supporting professional service users
Learning Outcomes in the Workplace
On successful completion of this module the trainee will:
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1. Establish the core skills necessary for scientific research.
2. Develop and propose a hypothesis.
3. Undertake a research project to test the hypothesis from conception to
completion.
4. Confirm the necessary ethical, audit and/or Research and Development (R
and D) approval.
5. Assemble a body of data and analyse the data using appropriate statistical
techniques.
6. Prepare a written project report and analyses the findings and identifies
strengths and weaknesses of the research/audit project.
7. Critically evaluate and draw conclusions about the quality of published
research.
8. Communicate knowledge or arguments from the research project both orally
and in writing including presentation at a workplace based meeting.
9. Contribute to a clinical audit.
Section 2.4
Professional Practice
Integrated theme running from Year 1 to Year 3
This integrated theme will apply progressively across all three years of study. The
overall aim of the professional practice curriculum is to ensure that the trainee applies
the underpinning knowledge to gain the accompanying skills and attitudes to work as a
Healthcare Scientist. This module crosses the academic Masters programme and the
workplace learning.
Learning Outcomes in the Workplace
On successful completion of this module the trainee will:
1. Be able to demonstrate professional practice that places the patient at the centre of
care dealing with patients in an empathic and sensitive manner that promotes
patient well-being and self-care
2. Be able to demonstrate the knowledge, skills, attitudes and behaviours to
communicate effectively with patients, relatives, service users, other healthcare
professionals and colleagues
3. Be able to demonstrate the knowledge, skills, attitudes and behaviours to respond
to ethical and legal issues and challenges arising from the practice of healthcare
science
4. Be able to demonstrate the knowledge, attitudes, behaviours, skills and
competences required of an emerging leader within healthcare science
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5. Be able to demonstrate understanding of NHS policy and practice as it affects
healthcare science and the role of screening in reduce the burden of disease
6. Be able to demonstrate professional practice that maintains good quality patient
care and ensures and promotes patient safety.
7. Be able to demonstrate the knowledge, skills, attitudes and behaviours to promote
the importance of health and safety in the workplace, identify actions that will
improve health and safety and reduce the risk of infection, critical incidents and
accidents
8. Be able to demonstrate the knowledge, skills, attitudes, behaviours and
competencies to undertake innovation, research and development during STP
training and in future practice as a Healthcare Scientist
9. Be able to demonstrate the knowledge, skills, attitudes, behaviours and
competencies to use information and communication technology effectively to
support and enhance patient centred care.
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3. Assessment and Trainee portfolio
3.1 The Assessment Programme
There will be continuous assessment during the workplace-based training using a
series of validated tools.
The assessment programme is an integral part of curricula. The curricula are
based on Good Scientific practice. This linkage is crucial to standard setting and to
support review of the progression of individuals. The assessment tools taken
together therefore provide evidence/information about the trainee‟s ability in
relation to all aspects of the curriculum.
The purpose of the assessment programme is to be able to consider the trainees
progression at any time within the programme and to provide feedback around
areas of development.
The overall assessment programme makes use of a number of assessment tools.
The tools are:

Case based discussion (CbD)
o This tool is designed to demonstrate the trainee‟s knowledge and
understanding of any aspect of an „output‟ for which they have been
wholly or partially responsible. This can range from discussion of the
science behind the „output‟ to ethical and communication issues
arising in context.
 Direct observation of practical skills (DOPS)
o This tool records an observation of a skill or procedure. Feedback is
given and learning needs identified. Each specialism will have a core
list of skills with documentation of what is expected at the relevant
stage of training
 Multi-source feedback (MSF)
o The tool enables feedback to be given to trainees by different
colleagues who work with them. The trainee and trainer nominate a
range of colleagues who will be invited in accordance with agreed
guidelines for who is eligible.
o Research has shown that 8-10 raters are necessary to achieve
reliability.
o The trainee also rates him/herself.
o This tool is also entirely on-line and there is no local paperwork. A
report is generated which should be discussed with the trainee by a
trainer who has been trained in giving feedback. The report is placed
in the electronic-training portfolio.
 Observation of clinical events (based on Mini-Cex)
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o A clinical event is defined as any occasion when the trainee is
present with a patient as part of the clinical team. This is true for all
patient-facing occasions whether the trainee only observes, or
speaks to, touches, positions or examines a patient.
o This tool records aspects of the trainee‟s communication and clinical
skills as relevant. It also records professionalism
The assessment tools taken together can provide evidence and information about
the trainee‟s about the trainee‟s ability, demonstrated in the workplace, in relation
to all aspects of the curriculum.
The table below gives a summary of the purpose and process of each of the
different assessments.
DOPS
Mini Cex
CbD
MSF
Purpose Observation Observation Conversation/discussion Review by
others/colleagues
Observe and Observe and Discuss an outcome/
assess the
assess a
output from workplace
Professionalism
conduct of a clinical
activity using a record,
Interpersonal
practical
encounter
result,
skills/Team
procedure
working
Communication
Takes
Process
Process
Outcome/output
Reflecting on
place
Reviewed
Reviewed
Discussing, explaining,
comments of
and
and
justifying aspects of the
others within the
documented documented report/record/result.
framework of
with
with
Including aspects of
constructive
feedback in
feedback in professionalism
feedback
the moment/ the moment/
as it is
as it is
happening
happening
There is a requirement for each trainee to engage with the assessment process
and to complete minimum numbers of the different types of assessments within
each module.
A number of Operational Guides, relating to the use of the assessment tools and
the online-system are available in the document section within the online tool.
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3.2 Competency Log Book
The competencies form the foundation of the workplace-based training
programme and are an important part of the online portfolio and the trainee‟s
record of competence. Competencies are transferable across learning outcomes
and do not need to be undertaken twice where they are repeated in the
programme. Where they are repeated reference should be made to the point at
which this competency has been previously completed.
Competencies are cumulative and as such not all competencies have to be
completed within the relevant module. All competencies should be completed by
the end of the programme.
This learning guide contains a summary list of the required competencies within
the training programme linked directly to learning outcomes. It also provides
examples of areas of application or evidence required to demonstrate
competence.
Each trainee maintains a log whereby as the competency is achieved, the trainer
will sign off successful completion. The expectation is that as the trainee
progresses the competency log reflects this and builds the evidence. The
competency log is maintained within the online portfolio. Trainees are expected to
utilise different tools, resource and media within the local practice area to
demonstrate each area of competence.
3.3 Online Assessment and Personal Development Management System
(online portfolio)
An online assessment and personal development management system provides
an electronic mechanism for completion and logging of all of the personal
assessments required to be completed in the workplace throughout the STP
programme. Trainees will be expected to keep a record of all workplace based
assessments and competencies in their online portfolio.
The electronic portfolio provides support to the trainees with their continuous
professional development throughout the training programme and provides a
mechanism through which their development and progress can be monitored and
managed. Trainees will be expected to keep a record of all assessments and
competencies in their online portfolio. Maintenance by the trainees of this portfolio
is essential for their progression.
The portfolio will contain a number of formal assessments and space for the
trainees to add other elements such as reflective learning, which they believe
supports their progression through the STP programme.
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4.
Workplace-based Competencies
4.1
Competencies
These tables must be completed by the trainee and the trainer together throughout
the period of training and will form an important part of the e-portfolio and the
trainee‟s record of competence.
Section 4.2 details the competences to be obtained in four rotational elements of
training.
Section 4.3 details the 18 month work placement in Ophthalmic and Vision Science.
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4.2
Rotational Work Placements
Section 4.2.1
Division:
Theme:
Year 1
Module A-1:
Physiological Sciences
Neurosensory Sciences
Introduction to Audiology
Learning Outcome 1
Describe the range and diversity of patients attending an audiological service.
Competency
Reviewer
Date
Evidence/Comment
Recognise
how
different
communication strategies
are
used with patients.
Describe the different referral
routes and the range of diagnostic,
assessment and management
pathways.
Identify the proportion of new to
follow up patients, and any
differences in age range or in
different diagnostic groups.
Identify source of referral and
whether this was part of formal or
opportunistic screening.
Identify the most common reason
for attendance and at least one
other diagnostic category in the
outpatient population.
Identify and describe the roles of
the multi-professionals in the
service.
Learning Outcome 2
Identify a range of routine audiological equipment and their use in the assessment of
case management.
Competency
Participate
Reviewer
in
different
Date
Evidence/Comment
clinical
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approaches and strategies used in
• clinical reasoning
• innovative approaches
in complex situations
• responding to differing
priorities of a given
situation
Undertake the daily checks of
equipment
used
in
adult
rehabilitation
and
first
line
diagnostic
assessment,
e.g.
audiometers, tympanometers.
Perform the normal room set up for
the different hearing diagnostic
appointment sessions.
Obtain a full and relevant adult
medical and audiological patient
history.
Undertake the examination, selects
the appropriate test procedures and
techniques including; otoscopy,
Pure
tone
audiometry,
tympanometry,
acoustic
reflex
testing, uncomfortable loudness
level testing, transient otoacoustic
emission testing.
Integrate relevant information to
make an informed decision on
management of individual cases.
Write-up your methods, results and
discuss and evaluate any changes.
Learning Outcome 3
Describe the fundamental principles of aural rehabilitation.
Competency
Reviewer
Date
Evidence/
Comments
Perform the normal room set up for
the different diagnostic appointment
sessions.
Summarise a patient‟s history and
suggest
a
suitable
aural
rehabilitation
strategy
and
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recommend an initial management
plan.
Identify and use the basic
counselling skills used in noncomplex hearing aid provision.
Integrate relevant information to
make an informed decision on
management of individual cases.
Write-up your methods, results and
discuss and evaluate any changes.
Learning Outcome 4
Summarise the investigations and treatment of routine otological and audiological
disorders.
Competency
Reviewer
Date
Evidence/Comment
Differentiate between tests of
middle ear and cochlear function
and apply the knowledge to
everyday clinical practice.
Perform a listening test and
comment on the performance of a
hearing aid, identify common errors
or malfunctions. Initiate the repair.
Identify EAM normal landscapes via
otoscopy.
Summarise a patient‟s history,
suggest a suitable assessment
strategy and recommend an initial
treatment plan.
Identify and describe the different
roles of other professionals in the
investigation and treatment of
ontological
and
audiological
disorders.
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Learning Outcome 5
Explain the role and function of a multi-professional approach to the assessment and
management of patients attending an audiology service.
Competency
Reviewer
Date
Evidence/Comment
Integrate relevant information in
making an informed decision
concerning the diagnosis and
management of individual cases.
Produce a written report, including
test results and recommendations
suitable for the intended audience,
to include a range of professionals
and parents.
Identify
the
boundaries
of
audiologist role and need for
onward referral.
Learning Outcome 6
Describe the diversity of patients attending audiology services and some of their special
needs; this should include people with learning difficulties, cognitive and sensory
impairment, physical disabilities, older people, paediatrics, intensive care.
Competency
Reviewer
Date
Evidence/Comment
Describe the diversity of patients
attending the service.
Understand the special needs and
services available for people with
learning difficulties, cognitive and
sensory
impairment,
physical
disabilities,
older
people,
paediatrics, intensive care.
Describe common causes of
hearing impairment, the populations
disproportionately affected (e.g. by
age, ethnicity).
Outline basic methods for hearing
impairment rehabilitation, including
electronic aids and daily living skills.
Describe adaptations to the clinical
environment that can improve
accessibility for patients with
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hearing
impairment,
including
environmental design, furnishings,
decoration, signage and forms of
communication.
Interview and hold a conversation
with a hearing impaired person.
Learning Outcome 7
Apply the non NHS or external statutory, voluntary, charitable agency services that offer
support to patients in the Community following discharge from hospital following
receiving treatment from an audiology service i.e. Social Services.
Competency
Reviewer
Date
Evidence/Comment
Identify and describe the range of
hospital based services or support
available to patients following
discharge.
Identify and describe the range of
community based services or
support, advocacy and rehabilitation
available to patients following
discharge.
Differentiate between hospital based
and community statuary, voluntary
and charitable services and apply
the
knowledge
in
clinical
management.
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Section 4.2.2
Division:
Theme:
Year 1
Module N-2:
Physiological Sciences
Neurosensory Sciences
Introduction to Neurophysiology
Learning Outcome 1
Describe the range and diversity of patients attending a neurophysiology service.
Competency
Reviewer
Date
Evidence/Comment
Describe the range of conditions of
patients
referred
for
clinical
neurophysiological testing.
Differentiate
how
different
communication strategies are used
with patients.
Understand the referral system and
the range of tests performed in a
clinical neurophysiology department
Note the proportion of new to follow
up patients, and any differences in
age range, or in different diagnostic
groups.
Identify the most common reason
for attendance and at least one
other diagnostic category in the
outpatient population.
Understanding and describes the
roles of the multi-professionals in
the service.
Learning Outcome 2
Explain the internal and external calibration on neurophysiological equipment describing
the effects of the recording characteristic of the equipment components.
Competency
Reviewer
Date
Evidence/Comment
Explore the effect that changing the
high frequency filters has on an
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internally generated
calibration
pulse.
Explore the effect that changing the
low frequency filters has on an
internally generated
calibration
pulse.
Document and explain the effect
that the filter has on an internally
generated square wave calibration
pulse.
Correct external devices are
selected and connected to the
neurophysiological
recorder
correctly for the measurement of
Common Mode Rejection Ratio
(CMRR).
Correct
input
signal
voltage,
frequency/frequencies and type of
wave (square/sine) are selected on
the signal generator for the
measurement of Common Mode
Rejection Ratio (CMRR).
Correct display parameters are
selected on the neurophysiological
recorder for the measurement of
Common Mode Rejection Ratio
(CMRR).
The common mode rejection ratios
for a number of the recorder
channels are calculated.
Show the calculation of the common
mode rejection ratio in decibels (dB)
for each channel.
Document and critically appraise
the results obtained.
Write-up methods, results and
discuss and evaluate any changes
in the response, citing references.
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Learning Outcome 3
Evaluate the type of patient recording derivations and stimulus and recording
parameters used in the recording of all modalities of evoked potentials (Visual, Auditory
and Somatosensory).
Competency
Reviewer
Date
Evidence/Comment
Measure and apply the electrodes
for the recording of a visual evoked
potential using a midline to
reference derivation on a normal
subject.
Use four channels of the evoked
potential recorder design a montage
so that each channel records a
midline to reference derivation.
On channel one set the upper and
lower filter settings to the values
usually used to record a visual
evoked potential.
On the last three channels set the
low frequency filters to different
values.
Record a visual evoked using the
stimulus rate usually used to record
a visual evoked potential.
Measure
and
document
the
latencies and amplitude of the major
components for each filter setting.
For the last three channels reset the
low frequency filter to the value
usually used to record a visual
evoked potential.
On the last three channels set the
high frequency filters to different
values.
Record a visual evoked using the
stimulus rate usually used to record
a visual evoked potential.
Measure
and
document
the
latencies and amplitude of the major
components for each filter setting.
Write-up your methods, results and
discuss and evaluate any changes
in the responses citing references.
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Learning Outcome 4
Recognise measure and label using the correct nomenclature the major components of
all modalities of patient evoked potential (Visual, Auditory and Somatosensory).
Competency
Reviewer
Date
Evidence/Comment
Measure and apply the electrodes
for the recording of a visual evoked
potential on a normal subject.
Use
the
standard
recording
parameter and stimulus parameters
record a full field visual evoked
potential from each eye, in each
case checking for reproducibility and
ensuring the subject maintains a
constant
vigilance
level
and
maintains fixation.
Use
the
standard
recording
parameter and stimulus parameters
record a right and left half field
visual evoked potential from each
eye, in each case checking for
reproducibility and ensuring the
subject maintains a constant
vigilance level and maintains
fixation.
Use
the
standard
recording
parameter and stimulus parameters
record a central field visual evoked
potential from each eye, in each
case checking for reproducibility and
ensuring the subject maintains a
constant
vigilance
level
and
maintains fixation.
Measure
and
document
the
latencies and amplitude of the major
components for each of the full, right
and left half field and central field
responses.
Write up you method, result and
findings and critical evaluate the
changes in the visual evoked
potential for full, half field and
central field citing references.
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Learning Outcome 5
Critically evaluate the causes of error encountered and the non-pathological effect in
the recording of evoked potentials and their elimination.
Competency
Reviewer
Date
Evidence/Comment
Collect a number of different types
of biological and non-biological
artefacts over a period of time.
Collate the type of artefact how they
can be eliminated.
Show examples of artefacts.
Write up you findings and critical
evaluate the different types of
artefacts.
Learning Outcome 6
Describe the diversity of patients attending neurophysiology services and some of their
special needs; this should include people with learning difficulties, cognitive and
sensory impairment, physical disabilities, older people, paediatrics, intensive care.
Competency
Reviewer
Date
Evidence/Comment
Can map the diversity of patients
attending the service.
Understand the special needs and
services available for people with
learning difficulties, cognitive and
sensory
impairment,
physical
disabilities,
older
people,
paediatrics, intensive care.
Describe common causes of
referrals and the populations
disproportionately affected (e.g. by
age, ethnicity).
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Learning Outcome 7
Apply non NHS or external statutory, voluntary, charitable agencies or services that
offer support to patients in the Community following discharge from hospital following
receiving treatment from a neurophysiology service e.g. Social Services
Competency
Reviewer
Date
Evidence/Comment
Understand and can describe the
range of hospital based services or
support
available
to
patients
following discharge.
Understand and can describe the
range of community based services
or
support,
advocacy
and
rehabilitation available to patients
following discharge.
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Section 4.2.3
Division:
Theme:
Year 1
Module O&V-3:
Physiological Sciences
Neurosensory Sciences
Introduction to Ophthalmic and Vision Science
Learning Outcome 1
Describe the range and diversity of patients attending an ophthalmic service.
Competency
Reviewer
Date
Evidence
Identify the reason for attendance
by diagnosis of patients in adult
ophthalmic outpatient clinics, and
the most common diagnostic
categories.
Note the proportion of new to follow
up
patients,
and
also
any
differences in age range, in different
diagnostic groups.
Note source of referral and whether
this was part of formal or
opportunistic screening.
Identify the most common reason
for attendance and at least one
other diagnostic category in the
paediatric outpatient population.
Differentiate
how
different
communication strategies are used
when working with patients.
Understand and describes the roles
of the multi-professionals in the
service
Learning Outcome 2
Perform basic assessments of visual acuity, colour vision, field of vision, refractive
error and pupil responses.
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Competency
Reviewer
Date
Evidence/Comment
Perform visual acuity assessment
with Snellen chart in an adult, under
supervision.
Perform assessment of colour vision
with
Ishihara
chart,
under
supervision.
Perform
assessment
of
confrontation visual field and
standard
automated
perimetry,
under supervision.
Perform
auto-refraction
under
supervision.
Assess pupil responses under
supervision.
Write-up your methods, results and
discuss and evaluate any changes
in the responses citing references.
Learning Outcome 3
Describe the processes of ophthalmic history taking and examination
Competency
Reviewer
Date
Evidence/Comment
Describe
the
processes
of
ophthalmic history taking in adults to
include
presenting
complaint,
current and past ophthalmic history,
current and past general medical
history, and social and occupational
history.
Describe
common
presenting
symptoms or absence of symptoms
in patients with glaucoma, cataract,
diabetic retinopathy and age-related
macular degeneration.
Observe
the
processes
of
ophthalmic history taking in children
and describe differences in history
taking between adults and children.
Describe the steps and methods of
routine
clinical
ophthalmic
examination in adults to include
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visual acuity, colour vision, pupil
assessment,
visual
field
by
confrontation
and
standard
automated perimetry, slit lamp
examination and tonometry.
Observe assessment of visual acuity
in preliterate children and describe
how it differs from testing visual
acuity in adults.
Learning Outcome 4
Describe basic methods for assessment of binocular vision.
Competency
Reviewer
Date
Evidence/Comment
Observe and describe methods
used to assess disorders of
development of binocular vision in
children.
Observe and describe methods
used to assess acquired disorders
of binocular vision in adults.
Describe
the
differences
in
presenting symptoms and signs
between
children
with
developmental
disorders
of
binocular vision and adults with
acquired disorders of binocular
vision.
Learning Outcome 5
Outline the principles and methods of imaging and measurement of eye and ocular
adnexae.
Competency
Reviewer
Date
Evidence/Comment
Describe a range of imaging and
measurement modalities used to
assess ophthalmic diseases to
include retinal photography, OCT
imaging, biometry (low coherence
interferometry and ultrasound).
Apply practical experience under
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supervision
of
different
imaging/measurement modalities.
Observe and describe fundus
fluorescein angiography, and apply
an understanding of how blood
flows through the eye.
Describe indications for fundus
fluorescein angiography, and how
the procedure can aid the diagnosis
of ocular disease.
Learning Outcome 6
Describe fundamental principles and methods of electrophysiological assessment of
vision.
Competency
Reviewer
Date
Evidence/Comment
Observe and describe a range of
electrophysiological test modalities
used to assess diseases of the eye
and visual system (EOG, ERG and
VEP).
Gain
practical
experience
of
different test procedures.
Effectively apply electrodes and
position patient for testing.
Learning Outcome 7
Summarise the investigations and treatment of routine ophthalmic disorders.
Competency
Reviewer
Date
Evidence/Comment
Summarise the investigations and
treatment of common ophthalmic
disorders,
including
cataract,
glaucoma, diabetic retinopathy and
age-related macular degeneration.
Learning Outcome 8
Describe the diversity of patients attending ophthalmic and vision science services and
some of their special needs; this should include people with learning difficulties,
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cognitive and sensory impairment, physical disabilities, older people, paediatrics, and
intensive care.
Competency
Reviewer
Date
Evidence/Comment
Describe common causes of vision
impairment and severe vision
impairment,
the
populations
disproportionately affected (e.g. by
age, ethnicity), and the criteria and
process for registration as vision
impaired.
Outline basic methods for vision
rehabilitation, including optical and
electronic aids, mobility training and
daily living skills.
Describe adaptations to the clinical
environment that can improve
accessibility for patients with vision
impairment, including environmental
design, furnishings, decoration,
signage
and
forms
of
communication.
Show how to guide and assist
patients with vision impairment.
Learning Outcome 9
Apply non NHS or external statutory, voluntary, charitable agencies or services that
offer support to patients in the Community after receiving treatment from and
ophthalmic and vision service e.g. Social Services.
Competency
Reviewer
Date
Evidence/Comment
Describe statutory provisions for
patients with vision impairment.
Describe the role of voluntary
agencies in provision of advice,
support,
advocacy
and
rehabilitation.
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Section 4.2.4
Division:
Theme:
Year 1
Module CA&I-4:
Physiological Sciences
Neurosensory Sciences
Clinical Assessment and Investigation
This workplace-based module will provide the trainee with the opportunity to apply
their knowledge and some basic skills of clinical assessment and investigation used in
the diagnosis, care and treatment of patients of all ages in a range of clinical settings
and care.
Throughout this document, where the term ‘Neurosensory’ is used, this should be understood to
mean the individual disciplines of Audiology, Neurophysiology, Ophthalmic and Vision Science
Learning Outcomes
Clinical Assessment and Investigations
1. Appraise the different auditory, visual, central and peripheral neurological
imaging related assessments and investigations that contribute to the holistic
patient approach in the diagnosis, management, prognosis and care.
2. Review how different assessments and investigations are used in primary or
secondary care services on patients who have auditory, or visual, or central and
peripheral neurological disorders e.g. healthcare for older people; neonatal care,
(NICU) (SCBU), integrated care, critical care, primary care, independent sector.
3. Characterize how different auditory, visual, central and peripheral neurological
assessments and investigations can be combined in differential diagnosis of
disease, or disability.
4. Identify the range of auditory, or visual, or central and peripheral neurological
assessments and investigations and the implications of the results on patient
care in a variety of different environments e.g.:
• Healthcare for older people
o Sensory, cognitive function and well-being
• Primary Care
o Role of Health Visitors and District nurses
o Post-natal clinics and assessments
o Healthcare in the Community
o Screening
•
Independent Sector
o Hearing acuity; Vision acuity; Colour acuity
•
Neonatal Care Units
•
ICT / Operating Theatres.
o Neurological signs
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Competency
Reviewer
Date
Evidence/Comment
Understand the local Health and
Safety policies and works safely
within the clinical environment.
Understand how different imaging
tests and requests contribute to the
holistic approach in the diagnosis,
management of patients with
neurological, auditory or visual
disorders
Observe and discuss how different
assessments and investigations are
used in healthcare for older people;
neonatal care, (NICU) (SCBU),
integrated care, critical care, primary
care, independent sector and can
contribute to the holistic patient
approach.
Describe how different auditory, or
visual, or neurological assessments
can be combined in the differential
diagnosis of disease, or disability.
Describe how different auditory, or
visual, or neurological outcomes can
impact on patient care.
Discuss the role of community
optometrists and audiologists in the
detection of ophthalmic and auditory
disease.
Imaging and Pathology Diagnostics (assessments and investigations)
1. Assist experienced imaging staff with the preparation, as appropriate, using
screening or diagnostic ionizing and non-ionizing imaging equipment, observing
current safety and legislative requirements.
2. Assist in the processing and analysis of samples in the pathology laboratory
observing current safety and legislative requirements.
3. View and identify key anatomical landmarks of either auditory, or visual, or
central and peripheral neurological systems obtained using ionising and nonionising imaging media.
4. View and identify common pathology test results compared to standard reference
ranges and possible effect on either auditory or visual, or central and peripheral
neurological disease or disorder.
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5. Recognise the errors or potential risks of using defective imaging and pathology
equipment in clinical practice.
Competency
Reviewer
Date
Evidence/Comment
Discuss the relevant Health and
Safety Policies for the Imaging
department.
Discuss the
choice
of
test
equipment, measurements
and
image quality used in diagnostic
radiology departments.
Assist experienced imaging staff in
the routine maintenance and
checks on imaging equipment
using local, or national or
international standards.
View and identify key anatomical
landmarks of auditory, or visual, or
neurological systems obtained
using ionising and non-ionising
imaging media.
Discuss the relevant Health and
Safety Policies for the Pathology
service.
Assist experienced pathology staff
in the routine maintenance and
checks
on
pathology
test
instrumentation using local, or
national or international standards.
Assist
in
performing:
basic
haematological pathology tests with
relevance to physiological science,
e.g. D-dimer blood test in the
diagnosis of Deep Vein Thrombosis.
Assist
in
performing:
basic
biochemistry pathology tests with
relevance to physiological science,
e.g. Brain Natriuretic Peptide (BNP)
or Troponin tests used in the
diagnosis of heart damage and
myocardial infarction.
Recognise the errors or potential
risks of using defective imaging
and pathology equipment in clinical
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practice.
Clinical Assessment and Investigations within Patient Pathways
1. Discuss the needs of people with disabilities within neurosensory* patient
pathways
2. Describe the role different healthcare services play in the care of patients
following neurosensory* patient pathways e.g. healthcare for older people;
neonatal care, (NICU) (SCBU), integrated care, critical care, primary care,
independent sector.
3. Undertake a range of procedures and understand the implications of the results
on patient care in a range of clinical environments;
 Medical Assessment Unit of hearing, sight and neurological function in the
community, primary care, healthcare for older people, independent sector
 ICU /CCU e.g. life sign measures, neurological monitoring, cognitive
function
 Neonatal Units
4. Work in partnership with colleagues, other professionals, patients and their
carers to maximise patient care.
Competency
Reviewer
Date
Evidence/ Comment
Discuss the patient demographic
structure
of
audiology,
or
neurophysiology or ophthalmology
services, referral patterns and
appropriate
onward
referrals
pathways.
Discuss the needs of people with
disabilities within audiology, or
neurophysiology or ophthalmology
patient pathway.
Describe the role that different
healthcare services play in the care
of patients following an audiology, or
neurophysiology or ophthalmology
patient pathway e.g. healthcare for
older people; neonatal care, (NICU)
(SCBU), integrated care, critical
care, primary care, independent
sector.
Visit a range of healthcare
environments / services to identify
the key components in providing a
holistic approach to patient care.
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e.g.
•
•
Medical Assessment Unit
Healthcare for older people
services
• Primary Care
• Healthcare in the Community
• Independent Sector
• Neonatal Care Units
• ICT / Operating Theatres.
During visits undertake or assist in a
range of procedures perform by
associated healthcare professionals
and understand the implications of
the results on patient care e.g.
• Hearing acuity
• Vision acuity
• Colour acuity
• Neurological signs
• Neurological monitoring and
function
• Life sign measures,
• Cognitive function and wellbeing
• Role of Health Visitors and
District nurses
• Post-natal
clinics
and
assessments
• Screening
Work in partnership with colleagues,
other professionals, patients and
their carers to maximise patient
care.
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4.3 Specialist Work Placements in Ophthalmic and Vision Science
Section 4.3.1
Division:
Theme:
Specialism:
Year 2 and 3
Module PA-5:
Physiological Sciences
Neurosensory Sciences
Ophthalmic and Vision Science
Patient Assessment
This module provides comprehensive training in patient assessment, from
interpreting referral letters, patient history and examination, ensuring a safe clinical
environment, and understanding and dealing appropriately with patients with vision
impairment. The trainee will gain insight into the aetiology, progression and
management in a range of ophthalmic disorders and will learn how to interpret and
analyse clinical findings and understand how they contribute to the development of a
differential diagnosis and the preparation of a diagnostic report.
• Demonstrate ability to interpret referral letters in conjunction with medical,
•
•
•
•
•
•
•
•
•
optical, ophthalmic, and imaging findings where available to formulate the
appropriate testing strategy.
Demonstrate an understanding of the impact of visual impairment and treat
visually impaired individuals and their families appropriately.
Demonstrate the ability to build a professional relationship with patients,
identifying and addressing any special needs and maintaining patient
confidentially.
Demonstrate ability to communicate effectively with patients and carers, to
explain the test procedures in a manner relevant to the patient or their carer,
and to answer their questions appropriately.
Demonstrate safe and effective instillation of eye medication required for
undertaking investigation.
Demonstrate ability to obtain a comprehensive ophthalmic patient history.
Demonstrate ability to undertake a comprehensive ophthalmic examination,
including external examination of ocular adnexae, assessment of pupil size and
reactions, examination of anterior segment with a slit lamp, fundus examination,
and tonometry.
Demonstrate ability to construct a differential diagnosis and identify further
investigations that will facilitate reaching of a diagnostic conclusion.
Demonstrate accurate, relevant and legible recording of information in patient
record.
Demonstrate ability to prepare reports which address the identified clinical
question.
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Learning Outcome 1
Ensure health, safety and security of the clinical environment.
Competency
Reviewer
Date
Evidence/Comment
Know and understand the major
issues of health and safety in a
clinical environment and ensure a
safe environment is maintained for
staff and patients.
Ensure equipment is maintained
and calibrated to relevant local,
national or international standards.
Know and understand the principles
of infection control and ensure they
are implemented in clinical practice.
Assess the requirements of visually
impaired patients and their carers
and ensure that the clinical
environment is suitable for patients
with vision impairment.
Ensure the clinical environment is
appropriate for patients with special
needs e.g. sensory impairment,
physical
disability,
learning
disability, cognitive dysfunction,
paediatric patients.
Ensure security and confidentiality
of patient information, including
verbal, written, electronic and
imaging data.
Learning Outcome 2
Perform the assessment, documentation, interpretation and analysis of clinical
findings.
Competency
Reviewer
Date
Evidence/Comment
Review and interpret referral letters
in conjunction with medical, optical,
ophthalmic, and imaging findings
where available to formulate the
appropriate examination and testing
strategy.
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Determine sources of referral and
ensure sufficient, accurate and
appropriate information is provided
to referral source.
Know the purposes and procedures
of screening programmes for ocular
disease and note if a referral is a
result of formal or opportunistic
screening.
Show understanding of the impact
of visual loss on a patient, and, as
needed, refer patient for advice,
support,
rehabilitation
and
certification of vision impairment.
Document all findings legibly,
accurately and appropriately in
patient record, with date and
signature.
Prepare data in suitable form for
clinical reporting and provide factual
assessment of results.
Recognise when additional tests or
expertise from other clinical staff
may
be
needed
and
take
appropriate action.
Plan and implement a differential
diagnosis based on available
evidence.
Identify further investigations that
may contribute to understanding of
pathology and facilitate reaching of
diagnostic conclusion.
Prepare reports which address the
identified clinical question.
Learning Outcome 3
Instillation of eye medication for the purpose of examination.
Competency
Reviewer
Date
Evidence/Comment
Confirm patient identity.
Confirm prescription for substance
to be instilled including strength,
timing and frequency.
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Confirm that medication to be
instilled has not exceeded expiry
date.
Identify possible precautions which
need to be taken or contraindications
to
instillation
of
medication by obtaining relevant
history from patient and patient‟s
records.
Where precautions or contradictions
have been identified, take action or
seek
advice
from
relevant
personnel.
Explain to the patient the purpose,
effects and duration of the
medication.
Instil the correct medication in the
correct strength, with the correct
method and at prescribed frequency
to the correct eye.
Record instillation in accordance
with relevant protocol or procedure,
including signature, time and date of
administration.
Limit risks of infection by using
appropriate
infection
control
procedures.
Identify a range of drugs used in
ophthalmic practice, their indication
and mode of action, adverse effects
and contraindications to their use.
Assess current knowledge of ocular
adverse effects of drugs used to
treat non-ophthalmic disease.
Learning Outcome 4
Take a comprehensive patient history.
Competency
Reviewer
Date
Evidence/Comment
Confirm patient identification and
demographic details.
Introduce self and explain to patient
own role and responsibility in taking
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patient history.
Obtain a history of patient
presenting ocular and/or visual
symptoms.
Obtain a history of patient past
ocular diseases, conditions and
surgery to eye or ocular adnexae.
Obtain and record a family history of
diseases,
in
particular
those
affecting eye or vision.
Record occupation of patient and
any relevant details of patient‟s
social circumstances and special
needs.
Obtain a history of any current and
past problems relating to general
health
including any surgical
procedures.
Obtain details of birth history where
appropriate.
Obtain
details
of
current
medications (prescribed and selfpurchased) for any ocular and other
medical conditions.
Record any known allergies or other
adverse reactions.
Accurately record all information
gathered including relevant dates.
Record signature and date verifying
all information obtained.
Notify the appropriate member of
the multidisciplinary team in all
instances of unexpected or clinically
significant information.
Record any further actions taken as
a consequence of the information in
the notes stating the date and the
time.
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Learning Outcome 5
Ophthalmic Examination – ocular adnexae, pupil assessment, anterior segment,
fundus examination, and tonometry.
Competency
Reviewer
Date
Evidence/Comment
Ensure all equipment is maintained
and calibrated.
Identify the component parts of the
slit lamp and perform slit lamp
examination techniques.
Confirm patient identity.
Confirm patient understands of the
procedure and consent prior to
commencing examination.
Instill
topical
medications
as
required
for
purposes
of
examination.
Note any abnormalities of head
posture or facial appearance
relevant to ocular examination.
Position and align patient correctly
for examination, avoiding patient
discomfort.
Examine ocular adnexae and
anterior segment of eye with slit
lamp to confirm normal appearance
or for evidence of disease or
disorder.
Determine or otherwise full range of
ocular movement and note any
abnormalities of eye movement.
Examine pupil responses and
recognise
abnormal
responses
including afferent pupil defect.
Evaluate tear production and
patency of naso-lacrimal passage.
Identify components of Goldmann
tonometer and demonstrate use of
tonometer to accurately measure
intraocular pressure.
Describe sources of error when
performing
tonometry
and
demonstrate how to minimise them.
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indications to procedure and the
relevant personnel to contact for
further advice.
Recognise significance of abnormal
findings and measurements and
take appropriate action.
Record all findings accurately in
case notes according to relevant
protocols.
Limit risks of infection by using
appropriate
infection
control
procedures.
Section 4.3.2
Division:
Theme:
Specialism:
Year 2 and 3
Module PAV-6:
Physiological Sciences
Neurosensory Sciences
Ophthalmic and Vision Science
Psychophysical Assessment of Vision
During this module the trainee will gain practical experience in the performance of a
range of psychophysical tests in adults and children, including visual acuity, contrast
sensitivity, visual field assessment and assessment of colour vision.



Demonstrate ability to perform assessment of visual acuity in children and
adults including adults who are illiterate, have learning difficulties, or who are
non-English speaking, with Snellen, logMAR and contrast sensitivity.
Demonstrate ability to assess colour vision with Ishihara charts and at least one
other form of colour vision assessment.
Demonstrate ability to assess visual field with standard automated perimetry
and other methods that may include kinetic perimetry, microperimetry,
automated Amsler grid testing, frequency doubling perimetry.
Learning Outcome 1
Assessment of visual acuity (Snellen, logMAR, contrast sensitivity).
Competency
Reviewer
Date
Evidence/Comment
Ensure visual acuity chart is
correctly
illuminated
for
test
purpose.
Perform tests for visual acuity
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consistent with personal role,
responsibilities
and
level
of
competence.
Select appropriate visual acuity test
according to any instruction in
patient‟s notes, patient‟s age, cooperation, ability and any special
needs.
Position and align patient at the
correct distance from the test chart.
Change distance from test chart if
appropriate.
Instruct patient clearly, including
wearing of current optical correction
appropriate to the test distance.
Ensure the occluder is correctly
positioned over the non-tested eye
and the position is monitored
throughout the test.
Asses the visual acuity with the
pinhole if normal vision is not
achieved or has reduced from the
previous visit.
Assess the vision to the smallest
print / letter size possible for the test
used.
Accurately record results and any
patient responses or difficulties at a
place appropriate for the test.
Use the appropriate form of notation
for recording visual acuity.
Explain
and
describe
the
significance of the test results to the
patient with regard to their level of
comprehension and ophthalmic
history.
Record any further actions taken as
a consequence of the test results in
the notes, stating the time and date,
who they communicated with, any
further instructions received or given
to the patient and then sign .
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Learning Outcome 2
Assess psychophysical measures of visual function (Colour Vision).
Competency
Reviewer
Date
Evidence/Comment
Date
Evidence/Comment
Ensure that the area is clean and
safe by preparing the area and
equipment appropriately.
Greet patient and ensure that this is
the correct patient with correct
details.
Ensure patient has no present
infection or reason for not being
able to carry out procedure.
Ensure that the patient is wearing
the appropriate optical correction.
Give clear and precise instructions
to the patient.
Monitor the patient and evaluate
responses.
Complete the required series of
tests.
Accurately document results in
patient records.
Return the patient records to the
appropriate person.
Inform the appropriate person if any
further action needs to be taken
differing to the local protocol.
Learning Outcome 3
Assessment of visual field (Static & Kinetic).
Competency
Reviewer
Ensure that the area is clean and
safe by preparing the area and
equipment appropriately.
Confirm patient‟s identity.
Ensure patient has no current
infection or reason for not being
able to carry out procedure.
Carry out visual acuity and set up
appropriate optical correction.
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Enter correct data for patient age
and optical correction.
Give clear and precise instructions
to the patient ensuring that he/she
understands.
Reassure and monitor the patient
throughout the examination.
Adjust testing strategies during the
test according to patient cooperation
and reliability indices.
Analyse results and carry out
additional testing if required.
Document results in patient records
Accurately record patient responses
and any difficulties with compliance.
Return the patient records to the
appropriate person.
Inform the appropriate person if any
further action needs to be taken
differing to the local protocol.
Section 4.3.3
Division:
Theme:
Specialism:
Year 2 and 3
Module OILL-7:
Physiological Sciences
Neurosensory Sciences
Ophthalmic and Vision Science
Ophthalmic Imaging with Light and Lasers
In this module the trainee will gain practical experience in imaging the eye with a
range of equipment using light and lasers, including photography and OCT of the
anterior and posterior segments of the eye, and ocular angiography. The trainee will
understand the clinical indications for performing the different investigations and the
interpretation of results for a range of ocular disorders.
• Demonstrate ability to take colour photographs and image with OCT or other
•
scanning laser modality the anterior segment and fundus of the eye, assess
quality of image, identify artefacts and interpret findings in clinical context.
Demonstrate understanding of the procedures and ability to perform ocular
angiography, identifying contraindications, the appropriateness of procedure for
investigation of ocular condition, the quality of the results, and to interpret the
findings in clinical context.
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• Appreciate the differences in procedures and techniques for retinal disease
•
•
imaging and screening for retinal disease.
Understand the principles of contact lens imaging of the eye including
gonioscopy.
Understand the technique and indications for recording autofluorescence
Learning Outcome 1
Imaging the eye with light or laser (Fundus Photography, Optical Coherence
Tomography OCT, Scanning Laser Polarimetry GDx, Scanning Laser Tomography
HRT, Fundus Autofluorescence).
Competency
Reviewer
Date
Evidence/Comment
Know and understand the various
imaging
modalities
used
to
investigate and diagnose ophthalmic
diseases, their capabilities and
clinical indications.
Select the appropriate imaging
modality to be used in different
common ophthalmic diseases.
Ensure that the area is clean and
safe by preparing the area and
equipment appropriately.
Greet patient and ensure that this is
the correct patient with correct
details.
Ensure patient has no current
infection or reason for not being
able to carry out procedure.
Explain possible side effects and
consequences of procedure to the
patient.
Ensure sufficient topical medication
is instilled to create the appropriate
mydriasis.
Determine patient‟s refractive error
with autorefraction, keratometry and
focimetry as required.
Adjust the equipment appropriately
to accommodate patient‟s refractive
error.
Select the appropriate image
modality.
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Position and align patient correctly
for each image capture, avoiding
patient discomfort.
Review and change image modality
as necessary throughout the
procedure.
Ensure consistent and reproducible
image measurements are obtained.
Obtain clear and appropriate images
to meet the clinical demand.
Evaluate, interpret and annotate
images as required to obtain
appropriate result.
Record and store images in
accordance with relevant protocols
and procedures.
Annotate records as necessary.
Understand the results produced
including the ability to detect
artefacts.
Describe significant findings through
a broad spectrum of imaging
investigation in common chorioretinal pathologies including age
related
macular
degeneration,
diabetic retinopathy, retino-vascular
disease, ocular tumours and genetic
and acquired maculopathies and
vitreo macular disease.
Learning Outcome 2
Ocular Angiography (Fluorescein Sodium & Indocycanine Green).
Competency
Reviewer
Date
Evidence/Comment
Describe
personal
role,
responsibilities
and
level
of
competence
for
performing
investigations.
Describe
requirements
and
protocols for maintenance and
calibration of
equipment
and
relevant international and national
recommendations for performance
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of investigation in addition to local
protocols.
Show
an
understanding
of
requirements for authorisation of
request and patient consent.
Show
an
understanding
of
precautions and contra-indications
to procedure and the relevant
personnel to contact.
Identify the relevant safety issues
including
safety
implications
associated with the use of contrast
medium.
Ensure adequate mydriasis or instil
topical medications as required in
accordance with protocols.
Explain possible side effects and
consequences of procedure to the
patient.
Select imaging modality appropriate
to clinical question and review and
change.
Position and align patient correctly
for each image capture, avoiding
patient discomfort.
Adjust
equipment
or
use
supplementary lenses to correct for
patient‟s refractive error to enable
consistent and reproducible image
measurements.
Obtain images of suitable clarity and
type and in sufficient quantity to
respond to clinical question.
Acquire stereo images where
appropriate, in the correct sequence
for display method chosen and from
the image sequence identify and tag
stereo pairs for review.
Determine additional tests or
expertise
needed
and
take
appropriate action.
Respond appropriately to any
adverse reactions to contrast
medium
and
deterioration
in
patient‟s condition.
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Evaluate, interpret and annotate
images as required.
Record and store images in
accordance with relevant protocols
and procedures.
Limit risks of infection through use
of appropriate infection control
procedures.
Appraise a detailed understanding
of ocular anatomy and physiology
shown by angiography and the
clinico-pathological correlation of the
angiographic image.
Show
a
comprehensive
understanding of the technical
aspects of angiography, contrast
medium used, indications for the
test, and an understanding of
limitations of the investigation.
Section 4.3.4
Division:
Theme:
Specialism:
Year 2 and 3
Module UEO-8:
Physiological Sciences
Neurosensory Sciences
Ophthalmic and Vision Science
Ultrasonography of Eye and Orbit
During this module the trainee will learn the clinical applications and techniques of
ultrasonography of the eye and orbit, including topographic examination of the globe
and kinetic echography. The trainee will also gain knowledge and understanding of
methods of quantitative echography and ultrasound biomicroscopy.
• Demonstrate ability to screen and perform topographic examination of the globe
•
and kinetic echography for tissue mobility, understanding normal features and
artefacts, and distinguishing features of dense cataract, vitreous haemorrhage,
retinal detachment and ocular tumours.
Know how to perform quantitative echography of globe and orbit and ultrasound
biomicroscopy of the anterior segment of the eye
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Learning Outcome 1
Perform an examination of the eye using echography and ultrasound.
Competency
Reviewer
Date
Evidence/Comment
Understand
personal
role,
responsibilities
and
level
of
competence
for
performing
ultrasound investigation of the eye
and orbit.
Understand
requirements
and
protocols for maintenance and
calibration of equipment.
Confirm authorised request and
patient consent prior to commencing
procedures.
Obtain relevant history from patient
and patient‟s records.
Identify possible precautions which
need to be taken or contraindications to planned procedures
by obtaining relevant history from
patient and patient‟s records.
Where precautions or contraindications to procedure have been
identified, take action or seek advice
as
appropriate
from
relevant
personnel.
Explain possible side effects and
consequences of procedure to the
patient.
Where topical medications are
instilled, confirm correct dosage,
strength and frequency of use
against relevant protocol.
Select appropriate imaging modality
with clinical/ systemic status, age,
ability and co-operation.
Position and align patient correctly
for image capture, avoiding patient
discomfort.
Obtain images of suitable clarity and
in sufficient quantity to answer
clinical question, demonstrating
understanding
of
A
and
B
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ultrasound, instrumentation and
probe orientation.
Record and store images in
accordance with relevant protocols
and procedures.
Obtain images of suitable clarity and
in sufficient quantity to answer
clinical question.
Limit risks of infection by using
appropriate
infection
control
procedures.
Evaluate, interpret and annotate
images as required to obtain
appropriate result.
Show a clear knowledge of the
clinical-pathological correlation of
the ultrasound A and B scan image
and its significance in diagnosis.
Section 4.3.5
Division:
Theme:
Specialism:
Year 2 and 3
Module OMRB-9:
Physiological Sciences
Neurosensory Sciences
Ophthalmic and Vision Science
Ocular Measurement, Refraction and Biometry
During this module the trainee will learn how to measure refraction and the optical
prescription in glasses and contact lenses, and the dimensions of the eye with low
coherence interferometry, ultrasound, and at least one method of corneal topography.
The trainee will learn how to use these measurements to determine intraocular lens
power, including for patients who have had corneal refractive surgery, and to assist
with the diagnosis of different forms of corneal pathology and glaucoma.
• Demonstrate ability to measure and transpose the optical prescription in
•
•
glasses and contact lenses.
Know and understand methods for determining the refractive error of an eye
and demonstrate ability to determine refractive error with autorefractor.
Demonstrate ability to measure axial length of eye with low coherence
interferometry, and A-scan, including patients with significant ocular pathology
or previous corneal refractive surgery, and make appropriate calculations of
intraocular lens power.
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• Demonstrate ability to perform corneal pachymetry with ultrasound and at least
•
one other imaging modality, and interpret and utilise results in clinical context.
Demonstrate ability to perform corneal topography, distinguishing abnormal
results and interpreting these in the clinical context.
Learning Outcome 1
Determine prescription of optical aids (focimetry).
Competency
Reviewer
Date
Evidence/Comment
Demonstrate
knowledge
and
understanding of different methods
for correcting refractive error.
Confirm patient‟s existing use of
optical correction including any
contact lens wear.
Set up and check calibration of
focimeter, including adjusting for
examiner‟s own refractive error
where required.
Identify type of optical prescription in
lenses by inspection.
Ensure glasses are correctly and
securely placed on equipment.
Measure optical prescription of
spectacles, including distance, near
and prismatic corrections of lenses
with
manual
and
automatic
focimeters.
Measure optical prescription of
lenses by neutralisation.
Determine optical centre of lenses.
Transpose optical prescription as
needed.
Document
optical
prescription
accurately, with correct notation in
patient record.
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Learning Outcome 2
Determine refractive error.
Competency
Reviewer
Date
Evidence/Comment
Demonstrate
knowledge
and
understanding of types of refractive
error, any correlations with ocular
anatomy and measurements, and
methods for determining refractive
error.
Confirm patient‟s existing use of
optical correction.
Confirm patient‟s understanding of
procedure and requirements for
compliance.
Instil mydriatic or cycloplegic drops
as indicated, according to personal
role and responsibilities and local
protocols.
Position and align patient correctly.
Measure refractive error for distance
with an autorefractor
Transpose the optical prescription
as needed.
Perform additional measurements of
refractive error consistent with
personal role, responsibilities and
level of competence.
Document refraction accurately, with
correct notation in patient record.
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Learning Outcome 3
Perform and obtain structural measurements of the eye (axial length measurement,
Biometry, Corneal Topography & Pachymetry).
Competency
Reviewer
Date
Evidence/Comment
Show knowledge of modalities
including
corneal
topography,
pachymetry, A-Scan biometry and
low coherence interferometry.
Differentiate which test modality
should be used to produce an
accurate measurement.
Ensure that the area is clean and
safe by preparing the area and
equipment appropriately.
Greet patient and ensure that this is
the correct patient with correct
details.
Ensure patient has no current
infection or reason for not being
able to carry out procedure.
Provide
clear
and
precise
instructions.
Select
the
appropriate
test
parameters according to patient
age, co-operation, ability and/or eye
condition.
Carry out the measurements in the
correct sequence.
Obtain sufficient number of accurate
readings to provide reliable results.
Document results and record any
difficulties encountered.
Select appropriate formulae to
calculate results where applicable.
Interpret results and identify and
alert team members to patients
whose eye condition or other factors
may give rise to unreliable results of
measurements or calculations.
Seek further information and advice
as appropriate according to local
protocol.
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Section 4.3.6
Division:
Theme:
Specialism:
Year 2 and 3
Module OMBF-10:
Physiological Sciences
Neurosensory Sciences
Ophthalmic and Vision Science
Ocular Movement and Binocular Function
During this module the trainee will gain understanding of the clinical presentations of
disorders of eye movement and binocular function and how they can be assessed and
documented.
• Demonstrate ability to distinguish and assess different forms of ocular
•
movement (saccades, smooth pursuit, OKN etc.) and demonstrate familiarity
with recording methods including video-oculography and electro-oculography.
Demonstrate familiarity with methods of assessment of binocular vision and
stereopsis, and demonstrate ability to perform at least one method of
assessment of stereopsis
Learning Outcome 1
Observe eye movement and assist with binocular vision and stereopsis
measurements.
Competency
Reviewer
Date
Evidence/Comment
Show an understanding of the basis
for binocular vision and ocular
movement including anatomical and
functional concepts.
Show an understanding of normal
and abnormal visual development
and
the differences between
developmental
and
acquired
disorders of binocular vision.
Show an understanding of methods
of assessment of binocular vision
and stereopsis.
Assess
stereopsis
with
one
commonly used method and explain
the underlying principles of the
method used.
Show understanding of reflex
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systems
that
control
ocular
movement and clinical manifestation
of disorders of these reflex systems.
Justify the clinical evaluation of
ocular
movement
including
saccades, smooth pursuit and
optokinetic
nystagmus,
and
methods used to record ocular
movement
including
videooculography
and
electrooculography.
Section 4.3.7
Division:
Theme:
Specialism:
Year 2 and 3
Module VE-11:
Physiological Sciences
Neurosensory Sciences
Ophthalmic and Vision Science
Visual Electrophysiology
During this module the trainee will gain experience of clinical indications for, methods
and techniques, and interpretation of results of investigations of the electrophysiology
of the visual system.
• Demonstrate correct procedures for preparing for and recording all visual
•
•
•
•
•
•
•
electrophysiology tests (ERGs, EOG, VEPs).
Know the international standard tests and their relevant clinical applications.
Understand specific modifications or adaptations required for preparing for and
recording all international standard tests in neonates and paediatrics.
Critically evaluate the effects and merits of altering: recording conditions;
electrode types and positions; acquisition parameters; stimulation parameters.
Demonstrate ability to recognise, identify and remove sources of artefact.
Understand the challenges and restrictions associated with recording in
environments such as theatre or ICU.
Know the normal waveforms and understand the effect of patient age, sex and
race: understand the nature and limitation of normative data.
Demonstrate ability to analyse recordings correctly with appropriate use of a
wide range of analysis techniques.
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Learning Outcome 1
Electrophysiology of the eye and visual system (EOG, ERG, VEP, & Multifocal ERG).
Competency
Reviewer
Date
Evidence/Comment
Understand
personal
role,
responsibilities
and
level
of
competence
for
performing
investigations.
Understand relevant equipment and
electrical safety issues.
Understand requirements for and be
able to perform protocols for
maintenance and calibration of
equipment.
Know relevant international and
national
recommendations
for
performance of electrophysiological
investigations in addition to local
protocols.
Understand
the
likely
electrophysiological consequences
of
clinical
condition
being
investigated.
Understand effect of: type of
electrodes (actives, references and
„ground‟); absolute and relative
impedances;
polarization/bias;
amplification; bandpass; sampling
rate; time period; artefact rejection;
signal processing.
Understand effect of stimulus type;
pattern;
presentation
mode;
adaptation state.
Select appropriate investigations
and protocols in consideration of the
clinical question, patient‟s age, cooperation and ability.
Prepare,
position
and
apply
electrodes appropriately and safely
for the test(s) being performed.
Provide patient with the necessary
level of
information,
support,
instructions
and
reassurance
throughout the investigation.
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Review and change plan of
investigation as necessary during
the course of the procedures.
Adjust stimulus and acquisition
parameters according to the test
being performed.
Ensure that stimulus modalities
and characteristics are appropriate
to the purpose of the investigation
and adjusted to avoid unnecessary
patient discomfort or harm.
Evaluate presence of noise or
artefact in signal, determine cause,
take relevant corrective action and
annotate accordingly.
Know normal waveforms, and
effect of age (neonates to
geriatrics), gender and race on the
normal waveform.
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Section 4.3.8
Division:
Physiological Sciences
Theme:
Neurosensory
Specialism:
Ophthalmic and Vision Sciences
Year 2 and 3
Module O&V-Res-12:
Research Project in Ophthalmic and Vision Sciences
Learning Outcomes
On successful completion of this module the trainee will:
• Establish the core skills necessary for scientific research in a clinical
environment
• Develop and propose a hypothesis.
• Undertake a research project to test the hypothesis from conception to
•
•
•
•
•
•
•
completion.
Confirm the necessary ethical, audit and/or Research and Development
(R and D) approval.
Assemble a body of data and analyse the data using appropriate
statistical techniques.
Prepare a written project report that analyses the findings and identifies
strengths and weaknesses of the research project.
Communicate knowledge or arguments from the research project both
orally and in writing including presentation at a workplace based
meeting.
Critically evaluate and draw conclusions about the quality of relevant
research publications.
Contribute to and take an active part in the performance of a clinical
audit that involves completion of the audit cycle.
Demonstrate the importance of multidisciplinary working in the design,
delivery and optimisation of improved laboratory medicine services.
To be performed on the initiative of the trainee with support as required
Competency
Reviewer
Date
Evidence/Comment
Plan, perform, evaluate and report a
project using evidence from the
scientific literature that aims to
optimise or improve one aspect of
current service provision or delivery.
Plan, perform, evaluate and report a
clinical audit project to examine the
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clinical
effectiveness
or
appropriateness of one aspect of
current service provision.
In conjunction with service user
group(s) assess and report on how
the organisation, quality or delivery
of one or more aspects of current
service may be improved.
Plan, perform, evaluate and report
an original scientific and/or clinical
research project aimed at gathering
new information of value to patient
diagnosis and/or management.
Prepare and present to peers a
critical analysis of a publication from
the scientific literature.
Prepare and deliver an oral scientific
communication to peers at a local,
national or international meeting.
Contribute to the preparation and
submission of a research paper for
publication in the scientific literature.
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Section 4.4
Professional Practice
Integrated theme running from Year 1 to Year 3
Learning Outcome PP1
Be able to demonstrate professional practice that places the patient at the centre of
care dealing with patients in an empathic and sensitive manner that promotes patient
well-being and self-care.
Competency
Reviewer
Date
Evidence/Comment
Explain patient centred care and
how it ensures that the wishes,
beliefs, concerns, expectations and
needs of patients are respected.
Describe the patient and carer
perspective with respect to:
• Illness
• Disability
• Health inequalities
• Diversity
of
patient
experience
Describe the process of patient
centred
interviewing
and
the
features of a good consultation.
Describe how information from a
history and examination is used to
develop clinical management plans.
Demonstrate the ability to take a
history and present the findings to a
peer or colleague
Perform a range of clinical
examination skills relevant to the
healthcare science specialism.
Explain
the
importance
of
developing
and
maintaining
appropriate
patient-professional
relationships. Demonstrate this in
your practice.
In the context of patient centred
care give and receive feedback
sensitively to or from a peer or
colleague.
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Learning Outcome PP2
Be able to demonstrate the knowledge, skills, attitudes and behaviours to communicate
effectively with patients, relatives, service users, other healthcare professionals and
colleagues.
Competency
Reviewer
Date
Evidence/Comment
Explain the principles of effective
communication including:
• Written and electronic,
• Verbal and non-verbal
• Feedback.
Demonstrate
the
ability
to
communicate
effectively
and
sensitively with patients, relatives
and carers across the age
spectrum.
Demonstrate
the
ability
to
communicate
succinctly
and
effectively with the public.
Demonstrate
the
ability
to
communicate
succinctly
and
effectively with service users, other
healthcare
professionals
and
colleagues as appropriate.
Describe
local
guidelines
for
responding
to
unacceptable
behaviour by patients, carers,
relatives, peers and colleagues
including harassment, bullying and
violent behaviour.
Describe the importance of public
engagement in science and its role
in health and society.
Demonstrate the ability to explain
science to specialist and nonspecialist audiences.
Demonstrate the ability to give
effective feedback to colleagues and
patients.
Demonstrate effective negotiation
skills,
including
influencing
colleagues.
Explain
how
information
is
communicated within:
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•
•
•
The
trainee‟s
employing
institution.
The trainee‟s profession and
professional body.
The
wider
Healthcare
Science community.
Learning Outcome PP3
Be able to demonstrate the knowledge, skills, attitudes and behaviours to respond to
the ethical and legal issues and challenges arising from the practice of healthcare
science.
Competency
Reviewer
Date
Evidence/Comment
Describe the principles, guidance
and law with respect to:
• Medical ethics
• Confidentiality
• Informed consent
• Equality and diversity
• Child protection
• Use of chaperones
Within the scope of your practice be
able to demonstrate compliance
with this guidance and law.
Describe
and
demonstrate
compliance with guidance and laws
relating to research ethics.
Describe
and
demonstrate
compliance with the legal framework
for practice including probity and
fitness to practise.
Learning Outcome PP4
Be able to demonstrate the knowledge, attitudes, behaviours, skills and competences
required of an emerging leader within healthcare science.
Competency
Reviewer
Date
Evidence/Comment
Describe the core theories of
learning, particularly adult learning
and
reflective
practice,
and
demonstrate how these are relevant
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to your practice as a healthcare
scientist.
Explain how effective leadership can
underpin the delivery of high quality
services, and the aspiration and
strategy to service development.
Describe how planning can actively
contribute to the achievement of
service goals.
Describe the importance of shared
leadership and the associated
personal qualities and behaviours
that promote shared leadership.
Discuss personal values, principles
and assumptions, understanding
how these may differ from those of
other individuals and groups and
learn from experience.
Identify personal strengths and
limitations and the impact of
personal behaviour on others.
Identify personal emotions and
prejudices and understand how
these can affect personal judgement
and behaviour.
Develop and demonstrate selfawareness, self-management and
self-development
acting
with
integrity at all times.
Identify and use evidence, both
positive and negative, to identify
options in addressing challenges.
Obtain, analyse and act on
feedback from a variety of sources.
Demonstrate
self-direction
and
originality in tackling and solving
problems including dealing with
complex issues, making sound
judgements in the absence of
complete data.
Prioritise and organise academic
and work based tasks in order to
optimise own performance
Demonstrate autonomous action in
planning and implementing tasks at
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a professional level.
Develop skills of an independent
learner
and
demonstrate
a
commitment
to
continuing
professional development.
Demonstrate
how
continuing
advancement of knowledge, skills,
understanding and feedback has
improved
your
personal
performance.
Explain
the
need
for
and
demonstrate the ability to accept
change, working across different
provider landscapes as required.
Describe and give examples from
your experience of the role of the
healthcare scientist in practical
aspects of personnel management
including:
• Team building
• Staff training
• Motivation
• Continuing professional
development
• Appraisal
• Industrial relations
• Problem resolution
Describe and give examples from
your experience of leadership by a
healthcare scientist in areas of
practice including:
• Strategic planning
• Policy implementation
• Health and safety
• Personnel recruitment and
training
• Equipment procurement
• Purchasing
• Business planning
• Contracting
• Financial control
Describe and give examples from
your experience of the leadership
role of the healthcare scientist in the
multidisciplinary clinical team.
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Learning Outcome PP5
Be able to demonstrate understanding of NHS policy and practice as it affects
healthcare science and the role of screening in reduce the burden of disease.
Competency
Reviewer
Date
Evidence/Comment
Describe the current structure and
organisation of the NHS and explain
the central role of healthcare
science.
Describe current major NHS policy
documents and identify key areas
where healthcare scientists can
contribute.
Describe
the
current
quality
improvement
structures
and
processes within the NHS and give
examples of the implications for
healthcare science.
Describe the importance of self-care
and shared care as part of NHS
function and explain the impact for
life
threatening
and
critical
conditions.
Explain the principles and practice
of
screening
programmes
in
healthcare as a means of reducing
disease burden.
Describe and gain experience of
current screening programmes in
your area of practice.
Learning Outcome PP6
Be able to demonstrate professional practice that maintains good quality patient care
and ensures and promotes patient safety.
Competency
Reviewer
Date
Evidence/Comment
Describe and demonstrate the
importance of correctly identifying
patients referred to healthcare
science settings and/or samples
sent for analysis.
Demonstrate the importance of the
correct use of clinical coding and
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medical terminology in contributing
to
good
healthcare
science
practice.
Describe and demonstrate best
practice for record keeping and
data security.
Define and demonstrate from your
practice use of:
• Standard
operating
procedures
• Protocols
• Clinical guidelines
Describe and give examples of
national and local communications
relating to service quality.
Describe and demonstrate from
your practice:
• Common sources of error
• Identification of risk
• Critical incident reporting
Explain
the
desirability
of
monitoring performance, learning
from mistakes and adopting a no
blame culture in order to ensure
high standards of care and
optimise patient safety.
Explain the importance of honesty
and
effective
apology
in
responding to errors of practice.
Describe the principles and
practice of:
• Internal quality control (IQC)
• External quality assessment
(EQA)
Critically appraise both IQC and
EQA performance in your area of
practice.
Describe the principles and
practice of quality management
and its link to service accreditation.
Participate in the implementation of
a quality management system.
Contribute to service and quality
improvement and productivity in
the workplace.
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Learning Outcome PP7
Be able to demonstrate the knowledge, skills, attitudes and behaviours to promote the
importance of health and safety in the workplace, identify actions that will improve
health and safety and reduce the risk of infection, critical incidents and accidents.
Competency
Reviewer
Date
Evidence/Comment
Explain and demonstrate the
importance of health and safety
with the workplace.
Describe
and
apply current
regulations with respect to patient
safety and safe systems within the
workplace.
To
include
as
appropriate to scope of practice:
• Biological
specimen
handling
• COSHH
• RIDDOR
• Radioactivity
• Fire safety
• Electrical safety
• Moving and handling
• Display screen equipment
• Incident reporting
Explain
and
demonstrate
adherence to the regulations and
current procedures for equipment
safety.
Identify
and
demonstrate
compliance with the requirements
of relevant local health and safety
manuals and other documents.
Describe the basic principles of
infection control and explain the
importance of current infection
control measures within the
workplace.
Demonstrate adherence to current
infection control regulations at all
times.
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Learning Outcome PP8
Be able to demonstrate the knowledge, skills, attitudes, behaviours and competencies
to undertake innovation, research and development during STP training and in future
practice as a Healthcare Scientist.
Competency
Reviewer
Date
Evidence/Comment
Describe and give examples from
your practice of the application of
the current research framework and
research methods.
Explain and give examples of the
importance of innovation across
healthcare science.
Explain and give examples of the
role of innovation in improving
quality and patient care.
Identify and give examples of
emerging trends that will have an
impact on future health outcomes in
your area of practice.
Describe and give examples of the
role of the healthcare scientist and
the potential impact of scientific
research in your area of practice.
Describe and give examples of the
role of the healthcare scientist in
service developments in your area
of practice.
Learning Outcome PP9
Be able to demonstrate the knowledge, skills, attitudes, behaviours and competencies
to use information and communication technology effectively to support and enhance
patient centred care.
Competency
Reviewer
Date
Evidence/Comment
Demonstrate competence in the use
personal computers, including:
• Word processing,
• Databases,
• Statistics packages
• PowerPoint
• Internet
• Email
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Demonstrate competence in the use
of computers to source, sort and
store relevant articles from the
scientific literature.
Describe the range and application
of clinical information systems used
in the workplace.
Demonstrate knowledge of and
proficiency in the use of:
• Hospital information system
• Linked information systems
(e.g. laboratory information
management system)
• Middleware linking equipment
to information systems
Demonstrate knowledge of and
proficiency in:
• Data filing and archiving
• Data security and protection
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Appendix 1
The Domains of Good Scientific Practice (May 2010, draft)
1.1 Professional Practice
1.1.1 Make the patient your first concern
1.1.2 Exercise professional duty of care
1.1.3 Work within the agreed scope of practice for lawful, safe and effective
healthcare science
1.1.4 Keep your professional, scientific, technical knowledge and skills up to date
1.1.5 Engage fully in evidence based practice
1.1.6 Draw on appropriate skills and knowledge in order to make professional
judgements
1.1.7 Work within the limits of your personal competence
1.1.8 Be open and honest and act with integrity
1.1.9 Act without delay if you have good reason to believe that you or a colleague
may be putting people at risk
1.1.10 Never discriminate unfairly against patients or colleagues
1.1.11 Maintain your fitness to practice
1.1.12 Treat patients as individuals, respect their dignity and confidentiality and
uphold the rights, values and autonomy of every service user, including their
role in the diagnostic and therapeutic process and in maintaining health and
well-being.
1.1.13 Respond constructively to the outcome of audit, appraisals and performance
reviews, undertaking further training where necessary
1.2 Scientific
1.2.1 Develop investigative strategies/procedures/processes that take account of
relevant clinical and other sources of information
1.2.2 Provide scientific advice to ensure the safe and effective delivery of services
1.2.3 Undertake scientific investigations using qualitative and quantitative methods
to aid the screening, diagnosis, prognosis, monitoring and/or treatment of
health and disorders appropriate to the discipline
1.2.4 Investigate and monitor disease processes and normal states
1.2.5 Use and display outcomes from statistical packages that are appropriate to
scope of practice
1.2.6 Critically evaluate data, draw conclusions from it , formulate actions and
recommend further investigations where appropriate
1.3 Clinical
1.3.1 Ensure that you and the staff you supervise understand the need for and
obtain relevant consent before undertaking any investigation, examination,
provision of treatment, or involvement of patients in teaching or research
1.3.2 Ensure that you and the staff you supervise maintain confidentiality of patient
information and records in line with published guidance
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1.3.3 Ensure that you and your staff understand the wider clinical consequences of
decisions made on your actions or advice
1.3.4 Demonstrate expertise in the wider clinical situation that applies to patients
who present in your discipline
1.3.5 Maintain up to date knowledge of the clinical evidence base that underpins the
services that your provide and/or supervise and ensure that these services are
in line with the best clinical evidence
1.3.6 Plan and determine the range of clinical/scientific investigations or products
required to meet diagnostic, therapeutic, rehabilitative or treatment needs of
patients, taking account of the complete clinical picture
1.3.7 Plan and agree investigative strategies and clinical protocols for the optimal
diagnosis, monitoring and therapy of patients with a range of disorders
1.3.8 Ensure that detailed clinical assessments are undertaken and recorded using
appropriate techniques and equipment and that the outcomes of these
investigations are reviewed regularly with users of the service
1.3.9 Ensure the provision of expert interpretation of complex and or specialist data
across your discipline in the context of clinical questions posed
1.3.10 Undertake and record a detailed clinical assessment using appropriate
techniques and equipment
1.3.11 Provide specialised clinical investigation and/or analysis appropriate to your
discipline
1.3.12 Provide interpretation of complex and/or specialist date in the context of the
clinical question posed
1.3.13 Provide clinical advice based on results obtained, including a diagnostic or
therapeutic opinion for further action to be taken by the individual directly
responsible for the care of the patient
1.3.14 Provide expert clinical advice to stakeholders in order to optimise the
efficiency and effectiveness of clinical investigation of individuals and groups
of patients
1.3.15 Prioritise the delivery of investigations, services or treatment based on clinical
need of patients
1.3.16 Represent your discipline in multidisciplinary clinical meetings to discuss
patient outcomes and the appropriateness of services provided
1.3.17 Ensure that regular and systematic clinical audit is undertaken and be
responsible for modifying services based on audit findings.
1.4 Technical
1.4.1 Provide technical advice to ensure the safe and effective delivery of services
1.4.2 Plan, take part in and act on the outcome of regular and systematic audit
1.4.3 Work within the principles and practice of instruments, equipment and
methodology used in the relevant scope of practice
1.4.4 Demonstrate practical skills in the essentials of measurement, data generation
and analysis
1.4.5 Assess and evaluate new technologies prior to routine use
1.4.6 Use tables and graphs in order to analyse experimental data
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1.4.7 Identify and manage sources of risk in the workplace, including specimens,
raw materials, clinical and special waste, equipment, radiation risks and
electrical risks
1.4.8 Apply principles of good practice in health and safety to all aspects of the
workplace
1.4.9 Apply correct principles and applications of disinfectants, methods for
sterilisation, decontamination and for dealing with waste and spillages
correctly.
1.4.10 Demonstrate appropriate level of skill is the use of information technology
appropriate to practice
1.5 Investigation and reporting
1.5.1 Plan and conduct scientific, technical, diagnostic, monitoring, treatment and
therapeutic procedures with professional skill and ensuring the safety of
patients, the public and staff
1.5.2 Perform investigations and procedures/design products to assist with the
management, diagnosis, treatment, rehabilitation or planning in relation to the
range of patient conditions/equipment within a specialist scope of practice
1.5.3 Monitor and report on progress of patient conditions/use of technology and the
need for further interventions.
1.5.4 Interpret and report on a range of investigations or procedures associated with
the management, of patient conditions/equipment
1.6 Quality
1.6.1 Set, apply and maintain and apply quality standards, control and assurance
techniques for interventions across all clinical, scientific and technological
activities
1.6.2 Make judgements on the effectiveness of procedures, processes
1.6.3 Participate in quality assurance programmes
1.6.4 Maintain an effective audit trail and work towards continuous improvement
1.7 Working with colleagues
1.7.1 Work with other professionals, support staff, service users, carers and
relatives in the ways that best serve patients‟ interests
1.7.2 Work effectively as a member of a multi-disciplinary team
1.7.3 Consult and take advice from colleagues where appropriate
1.7.4 Be readily accessible when you are on duty
1.7.5 Respect the skills and contributions of your colleagues
1.7.6 Participate in regular reviews of team performance and take steps to remedy
any deficiencies
1.8 Research and development
1.8.1 Search and critically appraise scientific literature and other sources of
information
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1.8.2 Engage in evidence-based practice and participate in audit procedures
1.8.3 Apply a range of research methodologies and initiate and participate in
collaborative research
1.8.4 Manage research and development according within a governance framework
1.8.5 Evaluate, validate and verify new scientific, technical, diagnostic, monitoring,
treatment and therapeutic procedures
1.8.6 Evaluate research and other evidence to inform own practice
1.8.7 Interpret data in the prevailing clinical context
1.8.8 Perform experimental work, produce and present results
1.8.9 Present data and research findings to peers in appropriate forms
1.9 Probity
1.9.1 Make sure that your conduct at all times justifies the trust of patients and
colleagues and maintains the public‟s trust in the scientific profession
1.9.2 Inform your statutory authority without delay if, at any time, you have accepted
a caution, been charged with or found guilty of a criminal offence, or if any
finding has been made against you as a result of fitness to practice
procedures, or if you are suspended from a scientific post, or if you have any
restrictions placed on your scientific, clinical or technical practice
1.9.3 Be honest and trustworthy when writing reports or signing documents
1.9.4 Be honest about your qualifications, experience, and position in the scientific
community
1.9.5 Take all reasonable steps to verify information in reports and documents,
including research
1.9.6 Be honest in written and verbal information provided to any formal enquiry or
litigation, including that relating to the limits of your scientific knowledge and
experience.
1.9.7 Work within the HPC Standards of Conduct, Performance and Ethics
1.10 Leadership
1.10.1 Maintain responsibility when delegating healthcare activities and provide
support as needed
1.10.2 Respect the skills and contributions of your colleagues
1.10.3 Protect patients from risk or harm presented by a colleague‟s conduct,
performance or health
1.10.4 Treat your colleagues fairly and with respect
1.10.5 Make suitable arrangements to ensure that roles and responsibilities are
covered when you are absent, including handover at sufficient level of detail to
competent colleagues
1.10.6 Ensure that patients and colleagues understand the role and responsibilities of
each member of the team
1.10.7 Ensure that systems are in place through which colleagues can raise concerns
1.10.8 Ensure regular reviews of team performance and take steps to remedy any
deficiencies
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1.10.9 Refer patients only to professional staff who can be accountable to a statutory
body
1.11 Training and developing others
1.11.1 Support colleagues who have difficulties with performance, conduct or health
1.11.2 Share information with colleagues to protect patient safety
1.11.3 Provide work-based development for colleagues to enhance/improve skills
and knowledge
1.11.4 Identify and take appropriate action to meet the development needs of those
for whom you have management, supervision or training responsibilities
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Appendix 2
Healthcare Scientist Scope of Practice (May 2010, draft)
A registered HCS will:
 Work within a range of healthcare settings including NHS hospitals, the
community, private healthcare, academic institutions or medical device
industry
 Undertake complex scientific and clinical roles
 Apply clinical and specialist expertise in a range of healthcare settings
 Apply generalized scientific knowledge and experience to patient care, the
management of equipment, healthcare science processes and service
development
 Make judgments involving complex data that impacts on patient care,
equipment and processes
 Identify, develop and undertake activities with respect to innovation, service
re-design and improvement and Research and Development and audit
 Develop, plan and deliver education and training to other healthcare science
professionals and the wider NHS community
Scientific and Technical
 Conduct scientific interpretation of a wide range of healthcare science tests
and investigations that support the diagnosis and treatment of patient
conditions
 Conduct detailed data analysis
 Develop, innovate and validate novel technologies
 Contribute to setting service standards
 Develop, evaluate and implement new methodologies, technologies,
equipment and working practices
 Determine and recommend clinical, risk and equipment strategies and
processes
 Initiate and conduct audits, including clinical audit where appropriate
 Provide scientific and clinical advice to a wide range of healthcare
professionals and service users
 Contribute to innovation through analytical and translational research
activities
Patient contact and care
 Manage risks associated with direct patient care
 Confirm patient consent for appropriate procedures
 Support specialist clinics and advisory groups for patient care
 Plan and investigate processes and procedures to support patient care
 Perform, report and clinically interpret complex investigations undertaken
directly with patients
 Plan and prospectively review/investigate patient diagnostics, treatment or
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





therapy
Monitor and report on progress of patient conditions
Advise on prescription of medical support devices and equipment
Design, develop, validate and introduce novel devices into patient care
Provide clinical and scientific advice to assist with patient care
Participate in multidisciplinary team activities to support patient care
Apply and promote evidence based practice in healthcare
Leadership
 Demonstrate self awareness: be aware of personal values, principles and
assumptions and learn from experience
 Work with others in teams and networks to deliver and improve services,
working in partnerships with patients, carers, service users and colleagues
 Ensure patient safety by assessing and managing the risk to patients
associated with service developments
 Plan, prioritise and organize own work and actions
 Lead specialist teams in the development and delivery of healthcare
services within area of expertise
 Actively contribute to planning to achieve service goals
 Lead service improvement and innovation projects
 Manage performance of designated areas of responsibility
Communication
 Work in partnership with other healthcare professionals regarding clinical
and scientific issues affecting patient care
 Respect the privacy, dignity and values of patients and staff
 Advise and inform service users on procedures and processes
 Explain complex matters in using appropriate forms of verbal and non-verbal
communication
 Maintain accurate and complete records of clinical and scientific activities
 Inform others of complex clinical and scientific interpretation with clarity and
in terms appropriate to audience
 Communicate results of R and D in a range of formats
 Contribute to innovation and service development through specialist forums
and events
 Advise and inform others on patient care and management
Education and Training
 Plan, develop, provide and assess clinical, scientific and technical training to
a wide range of healthcare professionals
 Support the learning of others in the application of scientific and technical
skills, knowledge, practices and procedures
 Advise on use of relevant methodologies, technologies, processes,
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procedures and protocols
Research and Development
 Identify opportunities to improve healthcare service delivery and patient care
 Design and implement R and D projects including translational research
 Lead on implementation and application of new technologies and working
practices
 Undertake medium term service development and enhancement activities
 Assimilate current R and D data into healthcare provision
 Evaluate and publish R and D results
Clinical Governance
 Maintain standards and procedures within relevant healthcare setting
 Comply with quality and governance procedures
 Maintain confidentiality
 Maintain high standards of professional and personal conduct
 Report incidents associated with work activity
 Manage risks associate with work activities within defined area of
responsibility
 Ensure patient safety and effectiveness of patient care
 Perform clinical audits
 Advise healthcare organizations on the actions required to establish safe
environments for practice
 Interpret UK legislation, British, European and international standards that
govern and affect healthcare science
 Design and develop systems and processes for external accreditation
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Appendix 3
Assessment Tools
Direct Observation of Practical/Procedural Skills for STP in Ophthalmic & Vision
Science
Trainee identification data
Procedure:
Insert Module
Title
Assessor’s Name:
Assessor’s
position:
Insert Module Title
Insert
Difficulty of the procedure:
Number of times procedure
performed by trainee:
Insert
Low
Average
High
1-4
5-9
>10
Please grade the following areas using the
scale below
Meets
expectation
s
Above
expectation
s
Insert Module
Title
Below
expectation
s
Borderline
Clinical
context:
1. Understands scientific principles of
procedure including basic science
underpinning it
2. Has read, understands and follows the
appropriate SOP‟s, risk and COSHH
assessments, and any other relevant H
and S documentation
3. Understands and applies the appropriate
internal and external quality control
associated with the procedure
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U
C1
4. Understands the risks associated with
items of equipment and uses them
appropriately
5. Accurately completes associated
documentation
6. Output meets accepted
laboratory/professional standards
7. Carries out the procedure within
appropriate time frame
8. Is aware of the limitations of the test
9. Demonstrates awareness of the limits of
responsibility and when to seek advice
10. Professionalism
1
Unable to comment - Please mark this if you have not observed the behaviour
FEEDBACK AND
DOCUMENTATION OF
LEARNING NEEDS
Outcome
Satisfactory
AGREED ACTION
Date of
assessment
Unsatisfactory
Signature
of
Assessor
Signature
of
Trainee
Time taken
for
assessment:
Time taken
for
feedback:
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Case Based Discussion Template for STP in Ophthalmic & Vision Science
Trainee identification data
Brief description
of output and
focus of scenario
discussed:
Module:
Insert Title
Complexity of
Low
the scenario:
Insert Title
Insert Title
Average
High
Assessor’s Name:
Above
expectations
Meets
expectations
Borderline
Please grade the following areas using
the scale below
Below
expectations
Assessor’s position:
1. Understands clinical and/or scientific
principles relevant to scenario
2. Can discuss relevant health and
safety issues
3. Can discuss the procedures used to
obtain the results
4. Can discuss the quality control
procedures to ensure the result is
accurate
5. Demonstrates a knowledge of
relevant „Best Practice‟ guidelines
and other policies relevant to the
scenario
6. Can discuss the significance of
routine patient results with reference
to the reason for referral
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C1
7. Is aware of, and can use as required,
appropriate resources to aid in the
interpretation of results
8. Is aware of importance of audit trail
and can complete audit trail
accurately
9. Demonstrates awareness of the
limits of responsibility and when to
seek advice
10. Professionalism
1
Unable to comment - Please mark this if you have not observed the behaviour
FEEDBACK AND
DOCUMENTATION OF
LEARNING NEEDS
Outcome
Satisfactory
AGREED ACTION
Date of
assessment
Unsatisfactory
Signature
of
Assessor
Signature
of
Trainee
Time taken
for
assessment:
Time taken
for
feedback:
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Observation of Clinical events based on Mini CEX Template
Brief Description of
clinical scenario
Clinical setting
Outpatients
Hospital
Community
GP
Module
Assessors position
4
5-9
9+
Above
expectations
Please grade the following areas using
the scale below
2
Meets
expectations
1
Borderline
0
Requires
Development
Numbers of times the
trainee seen patient
before?
1. History taking
2. Physical/Clinical examination
skills
3. Communication skills
4. Clinical judgement
5. Organisation and efficiency
6. Professionalism
7. Overall clinical care
1
Unable to comment. Please mark this if you have not observed the behaviour
Anything especially Good?
Suggested areas of development
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U
1
C
FEEDBACK AND DOCUMENTATION OF
LEARNING NEEDS
AGREED ACTION
Outcome
Date of
assessment
Signature
of
Assessor
Satisfactory
Unsatisfactory
Signature
of Trainee
Time taken
for
assessment:
Time taken
for
feedback:
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Appendix 4
Professional Practice Curriculum
Within the Scientist Training Programme (STP) the generic curriculum contains two
modules namely Healthcare Science and Research Methods. Professional Practice is
also generic across the 3-year STP programme and it is intended that the learning
outcomes with respect to Professional Practice will be delivered within the workplace
and MSc.
Generic Outcomes: Professional Practice
Integrated theme running from Year 1 to Year 3
The overall aim of this part of the curriculum is to ensure that the trainee has the
underpinning knowledge and gains the accompanying skills and attitudes to work as a
Healthcare Scientist.
Learning Outcomes: Knowledge and Understanding
On successful completion of this module the trainee will:
1. Know the current structure, management, legal framework and quality improvement
structures and processes within the NHS.
2. Discuss patient centred care to ensure that the wishes, beliefs, concerns,
expectations and needs of patients are respected.
3. Recognise the patient and carer perspective with respect to illness, the diversity of
the patient experience, disability, potential health inequalities, the importance of selfcare and the impact of life threatening and critical conditions.
4. Discuss the importance of developing and maintaining appropriate patientprofessional relationships.
5. Explain the principles of effective communication including written, verbal and nonverbal communication and feedback.
6. Discuss the principles, guidance and law with respect to medical ethics,
confidentiality, informed consent, equality and diversity, child protection and the use
of chaperones.
7. Describe local guidelines for responding to unacceptable behaviour by patients,
carers, relatives, peers and colleagues including harassment, bullying and violent
behaviour.
8. Discuss best practice requirements for record keeping and data security
emphasising accurate recording within patient records.
9. Explain the basic principles of infection control and the importance of current
infection control measures within the work-base.
10. Explain the principles of screening programmes in healthcare and is aware of a
current screening programmes in a relevant division.
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11. Explain the importance of health and safety with the work-base, the regulations and
current procedures with respect to equipment safety.
12. Define Standard Operating Procedure, Protocol and Guideline and understand the
purpose of and difference between each document.
13. Explain the processes for document distribution for example Medical Device Alerts
(MDA).
14. Explain the common causes of error, the critical incident reporting process and the
importance of a no blame culture.
15. Recognise the importance of correctly identifying patients referred to healthcare
science settings and/or samples sent for analysis.
16. Explain the importance of innovation across healthcare science and the role of
innovation in improving quality and patient care.
17. Recognise the role of the healthcare scientist and the potential impact of scientific
developments for example health prevention, genomic medicine, diagnostics and
rehabilitation.
18. Understand the importance of public engagement in science and its role in health
and society.
19. Know and understand the underpinning principles of effective team work and
working within and across professional boundaries.
20. Explain the core theories of learning particularly adult learning and reflective
practice.
Clinical Examination Skills
21. Describe the process of patient centred interviewing and the features of a good
consultation.
22. Know how information from a history and examination is used to develop clinical
management plans.
Leadership
23. Explain how effective leadership can underpin the delivery of high quality services,
an organisation‟s aspiration and strategy and in developing improvements to
services.
24. Discuss personal values, principles and assumptions, understanding how these may
differ from those of other individuals and groups and learn from experience.
25. Explain the importance of the concept of shared leadership and the associated
personal qualities and behaviours that promote shared leadership.
26. Know how planning can actively contribute to the achievement of service goals.
Learning Outcomes: Associated Personal Qualities and Behaviours
(Professionalism)
On successful completion of this module the trainee will:
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1. Demonstrate practice that places the patient at the centre of care dealing with
patients in an empathic and sensitive manner that promotes patient well-being and
self-care.
2. Establish and maintain appropriate patient-professional partnership.
3. Communicate effectively and sensitively with patients, relatives and carers across
the age spectrum utilising clear explanations/descriptions.
4. Communicate succinctly and effectively with other professionals as appropriate and
the public including the ability to explain science to both specialist and non-specialist
audiences.
5. Demonstrate the ability to give effective feedback to colleagues and patients.
6. Contribute to service and quality improvement and productivity in the work-base.
7. Recognises the need for, and accepts change working across different provider
landscapes as required.
8. Develop and demonstrate self awareness, self management and self development
acting with integrity at all times.
9. Demonstrate accurate record keeping and the ability to adhere to current data
security regulations.
10. Apply appropriately the principles, guidance and laws regarding equality and
diversity, medical ethics, confidentiality and informed consent.
11. Apply current regulations with respect to patient safety and safe systems within the
work-base including child protection and the use of chaperones.
12. Work within teams encouraging and valuing contributions from all members whilst
ensuring the team are aware of and work together to minimise risk including the
multi-disciplinary team.
13. Develop and maintain professional relationships and networks
14. Demonstrate adherence to current infection control regulations at all times.
15. Demonstrate adherence to the regulations and current procedures in place with
respect to equipment safety.
16. Recognise the causes of error and learn from them, realising the importance of
honesty and effective apology.
17. Recognise the desirability of monitoring performance, learning from mistakes and
adopting no blame culture in order to ensure high standards of care and optimise
patient safety.
18. Prioritise and organise academic and work based tasks in order to optimise own
work and the work of the department and act autonomously in planning and
implementing tasks at a professional level.
19. Develop skills of an independent learner and demonstrates a commitment to
continuing professional development.
20. Demonstrate self-direction and originality in tackling and solving problems including
dealing with complex issues, making sound judgements in the absence of complete
data.
21. Identify best practice and emerging trends and innovation that will have an impact on
health outcomes
22. Continue to advance personal knowledge and understanding applying skills of
reflection to continually improve performance, acknowledging and acting on
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feedback.
Clinical Examination Skills
23. Demonstrate the ability to take a history and present the findings to a peer or
colleague including initiation of a consultation, eliciting information, clarifying where
necessary, summarising and empathising.
24. Give and receive feedback sensitively to or from a peer or colleague.
25. Perform a range of clinical examination skills relevant to the healthcare science
specialism.
Leadership
26. Identify personal strengths and limitations and the impact of personal behaviour on
others.
27. Identify personal emotions and prejudices and understand how these can affect
personal judgement and behaviour.
28. Obtain, analyse and act on feedback from a variety of sources.
29. Use evidence, both positive and negative, to identify options.
Indicative Content
• Structure and management of health and social care services
• Management of local healthcare systems in the United Kingdom
• Legal framework within which healthcare is provided across the UK including its
devolved administrations
• Local healthcare systems
• Patient centred care
o Response to illness
o Patient and carer perspective
o Health belief models
o Diversity of the patient experience
o Disability including learning disabilities
o Potential health inequalities
o Self-care
 Impact of life threatening and critical conditions
 Patient-professional partnership.
 Effective Communication Skills
Principles and underpinning models for:
 Written
 Verbal
 Non-verbal communication
 Giving and receiving feedback from patients and colleagues
 Breaking bad news
 Negotiation
 Communication within patients across the age spectrum
• Principles, guidance and law with respect to:
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

•
•
•
•
•
•
•
•
•
•
o Medical ethics
o Confidentiality
o Informed consent
o Equality and diversity
o Child protection
o Use of chaperones
o Elder Abuse.
Local guidelines for responding to unacceptable behaviour
Record Keeping and Data Security
Best practice requirements for record keeping
Data security
Accurate recording within patient records
Data protection Act
Caldicott Standards
Clinical Information Systems
o Clinical coding/terminology
o Clinical information systems and applications
Infection Control
o Basic principles
o Current infection control measures within the work-base
o Hand washing
Screening
o What is screening?
o When is a Screening Programme justified?
o How is Screening organised?
o Which Screening Programmes currently exist and which may be developed?
Health and safety within the work-base
o Regulations and current procedures with respect to equipment safety
 Safety Testing
o Importance of regulations with respect to patient safety, safety of 3 rd parties
and safe systems
o Standard Operating Procedures
o Protocol and Guidelines
o Department of Health (DH) Central Alerting System (CAS)
o Common causes of error
Critical incident reporting
Processes for document distribution
o Department of Health (DH) Central Alerting System (CAS),
o Medical Device Alerts (MDA)
Public engagement in science and its role in health and society
Effective team work
Time management and decision making
Core theories of learning
o Adult learning
o Active Learning
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o Reflective practice.
• Recognise and accept the responsibilities and roles of the Healthcare Scientist
o In relation to other healthcare professionals
o Working within and across professional boundaries
o Health and well being.
Clinical Examination Skills
• Typical structures used in patient-centred history taking and clinical examination
• Listening skills
• Commonly used questioning techniques.
• Clinical management plans
Leadership:
• Demonstrating personal qualities
o Self Awareness
o Managing Yourself
o Continuing Professional Development
o Acting With Integrity
• Working with others
o Developing Networks
o Building & Maintaining Relationships
o Encouraging Contribution
o Working within Teams
• Managing Services
• Improving Services
• Setting Direction
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