Download DERMATOLOGY CARE 7KNIP034

DERMATOLOGY CARE
7KNIP034
Level: 7
Credits: 15
Module leader: Shelley Peacock
Tel: 020 7848 3603
Email: [email protected]
Clinical Lead: Lucy Moorhead
Tel: 020 7188 7188 x 87847
Email: [email protected]
Academic support is offered by the module leader and the clinical lead.
This handbook must be read in conjunction with module information provided on KEATS, the King’s ELearning And Teaching Service. You will be given access to KEATS on enrolment. Important information
relating to assessment and related regulations can be found in the Undergraduate Programme Handbook,
available on KEATS and via the Student Services Centre.
This handbook can also be provided in alternative formats (such as large print) upon request to
[email protected].
1
Contents
Module overview ............................................................................................................... 3
Module aim .................................................................................................................... 3
Learning outcomes ......................................................................................................... 3
Teaching arrangements .................................................................................................. 3
Support in Practice ......................................................................................................... 3
Timetable ....................................................................................................................... 4
Submitting coursework ...................................................................................................... 7
Assessment criteria ......................................................................................................... 7
Formative assessment ..................................................................................................... 7
Summative assessment.................................................................................................... 7
Submission date for course work: ................................................................................... 7
Results and re-submissions for course work .................................................................... 8
Practical Exam ............................................................................................................... 9
Results and re-sits for examinations ................................................................................ 9
Re-submission date for coursework ................................................................................ 9
Resubmitted coursework available for download............................................................ 9
Learning Outcomes ............................................................................................................ 10
Session 1 – Learning outcomes ....................................................................................... 10
Session 2 – Learning outcomes ....................................................................................... 10
Session 3 – Learning outcomes ....................................................................................... 11
Session 4 – Learning outcomes ....................................................................................... 12
Session 5 – Learning outcomes ....................................................................................... 12
Session 6 – Learning outcomes ....................................................................................... 13
Indicative reading ........................................................................................................... 14
Module evaluation.............................................................................................................. 16
Action from previous evaluations.................................................................................... 16
2
Module overview
This module can form part of the MSc Advanced Practice. The module can also be taken as a freestanding
module.
Module aim
This module will offer primary and secondary care practitioners an opportunity to further develop their
knowledge and skills in the assessment, therapeutic interventions and care required for individuals with skin
disease. The module will enable practitioners to synthesise and implement knowledge into practice.
Learning outcomes
At the end of the course the student should be able to:

Critically analyse and synthesise national and local policy in relation to skin services and patient
care.

Critically utilize knowledge of dermatological or health sciences research to develop approaches
to evaluation and evidence based practice.

Demonstrate consolidation and further development of clinical assessment skills.

Critically demonstrate an understanding of the presentation of common dermatological
conditions and their management in practice.

Critically analyse and discuss the risk factors in relation to certain dermatological conditions and
related therapies.

Critically analyse and synthesise knowledge and skills in the use of a range of topical therapies
and medicines management for dermatological conditions.
Teaching arrangements
A variety of teaching methods will be used throughout the course, including: lectures, group work,
discussions, interactive learning, e learning and practical sessions. We hope to encourage your active
participation throughout the course and look forward to a time of discussion, questions and challenges.
A number of lecturers and practitioners contribute to the course both in terms of teaching and course
development. The range of speakers is deliberate; it is intended to offer as wide a breadth as possible of
teaching styles as well as appropriate knowledge.
Support in Practice
In order to successfully meet the learning outcomes of this course, it is advisable to gain supervised practice
in your clinical area. You may like to identify someone to support your practice e.g. GP, nurse practitioner,
tissue viability nurse or registrar. In developing new clinical skills it is essential to continue to learn outside of
the classroom, as it is only with continued practice, seeing a wide range of patients, that proficiency and
expertise will be developed.
If you do not currently work in a dermatological department, we suggest you arrange a visit to specialist
clinic so that you can apply classroom knowledge to the clinical environment, as appropriate to your learning
needs. In order to prepare for the practical assessment, you will need to have gained competence in using
common topical dermatological therapies. Please discuss this further with the course leaders.
3
Timetable
Teaching
mode
University
based
Study
Date
05/05/2016
Time
Room
Lecturer
Lecture
Introduction, course outline, enrolment issues and access to
online material
10:00-10:30
FWB2.47
Shelley Peacock
Lucy Moorhead
Lecture
Systematic history taking
10:30-11:30
FWB2.47
Shelley Peacock
Coffee break
Lecture
Skin assessment
12:00-13:00
11:30-12:00
FWB2.47
Lucy Moorhead
Lecture
Clinical Practice
Lunch
Psychological Assessment
Acquiring clinical skills
14:00-15:30
15:30-16:00
13:00-14:00
FWB 2.47
Dr Mark Turner
FWB 2.47
Lucy Moorhead
Lecture
University
based
Study
Dermatology Timetable – Term 3
Title
Type of session
How topical therapy works and prescribing safely and
effectively
12/05/2016
Lecture
Coffee break
Corticosteroids and high risk drugs used in dermatology
Lunch
10:00-10:45
11:15-12:15
12:15-13:00
13.00-14.00
Lecture
Woundcare
Lecture
Clinical work stations
Station 1 Corticosteroids and emollients, Station 2 Paste
bandages
Station 3 Scalp and Occlusions.
4
14:00-16:30
Shepherd’s
House,
Guy’s Campus Arlene McGuire
Room 2.3
10:45-11:15
Shepherd’s
Karina Jackson
House,
Guy’s Campus
Room 2.3
Shepherd’s
Debbie Brown
House,
Guy’s Campus Tracy Clarke
Gemma Minifie
Room 2.3
Kim Green
Lecture
University
based
Study
19/05/2016
Lecture
Lecture
Child Assessment Issues
Coffee break
Childhood eczema
10:00-11:00
11:30-12:30
Lunch
Recognition and management of common paediatric
dermatological conditions.
13:30-14:15
Coffee break
Lecture
University
based
Study
26/05/2016
FWB 2.41
Kathy Radley
11:00-11:30
FWB 2.41
Kathy Radley
12:15-13:00
FWB 2.41
St Johns Institute of
Dermatology Team
15:15-15:30
Case study review – challenges
15:30-16:30
FWB 2.41
Kathy Radley and
Charlotte Walker
Lecture
Aetiology, risk factors and diagnosis of pre-cancerous lesions and
non- melanoma and melanoma skin cancer
09.30- 10:30
FWB1.21
Dr Satveer Mahill
Assessment
Assignment and clinical stations
10:30-11:00
FWB 1.21
Lucy Moorhead
Lecture
Coffee break
Screening and skin cancer prevention
11:20-12:15
Treatment options for primary skin cancers
Lunch
Melanoma staging and treatment pathways
12:15-13:15
13:15-14:15
14:15-15:00
11:00-11:20
Zhang Hui
FWB1.21
Serhiy Aleksysyenko
Coffee
Cutaneous Lymphoma (CTCL) and sezary – diagnosis, staging
and treatment
15:00-15:30
15:30-16:30
Lecture
Lecture
Lecture
5
FWB1.21
Cath Morgan
FWB1.21
Ian Gosling
Lecture
University
based
Study
University
based
Study
09/06/2016
Lecture
Skin infections and infestations
Coffee break
Acute cutaneous allergy - urticaria and angioedema
11:30-12:30
Dr Andrew Pink
FWB 2.47
11:30-12:00
FWB 2.47
Dr Shien-Ning Chee
12:45-13:30
Debbie Brown
10:00-11:30
Lecture
Lunch
Dermatological emergencies and medical and nursing
management of a patient with severe skin failure management
13:30-15:00
Lecture
Obtaining skin samples
15:30-16:30
Lecture
Ezcema
FWB 2.47
10:00-11:30
16/06/2016
Dr Sue Howell
FWB 2.47
Hydradenitis
Debbie Brown
Coffee break/lunch
Lecture
Lecture
St Johns Institute of
Dermatology Team
11:30-12:30
Alopecia
12:30-13:30
Acne and Rosacea
13:30-14:00
Coffee break
Dr Fenton
FWB 2.47
Clarence Moore
15:30-16:00
Lecture
Psoriasis
14:00-16:00
Lecture
Evaluation
16:00-16:30
Lucy Moorhead
FWB 2.47
Shelley Peacock/Lucy
Moorhead
Key to classroom locations:
FWB – Franklin-Wilkins Building;
JCMB - James Clerk Maxwell Building
Shepherd’s House – Guy’s campus, London Bridge
Student Computer Rooms in Waterloo campus are located at the library (FWB); FWB Rooms 2.49, 2.84 and 2.87; JCMB B20 and Waterloo Bridge
Wing 3/6.
It is possible to book library meeting rooms in advance for group study work.
6
Submitting coursework
For this module you are assessed by an assignment and a practical examination.
Assessment criteria
1 - Assignment. Must not exceed 2,500 words excluding appendices and references.
A critical account of the care delivered to a patient with a skin condition.
The account should include;
 A brief description of the patient including an indication of the severity of their skin disease, any
other co-morbidity and relevant social data that would be likely to impact on the management of
their disease

The pathophysiology of the skin condition and critically discuss the risk factors in relation to certain
dermatological conditions.

A critical analysis of the care delivered. The care delivered should be discussed in relation to the
local and national guidelines and current healthcare policy and research. Include a discussion
relating to the psychological impact on the patient and the ‘tools’ used to assess the patient’s mental
health.
2 - Practical examination
Two practical skills will be examined relating to the skills demonstrated on day 2.
Formative assessment
Students will have the opportunity to discuss with their peers and module leader(s) the case studies that are
being considered for the assignment, one to one appointments with the module leader Shelley Peacock are
also available on request.
Students are also encouraged to attend the mock physical skills exam on the THURSDAY 30 June
10.00-14.00 at FWB 2.45. These exercises will provide formative feedback to enable self-assessment
and the development of competence.
Summative assessment
Course work submission are provided on the KEATS module page.
It is essential that you use your candidate number on all assignments/examinations. Your candidate number,
which will begin with W for the academic year 2017/18, will be available via Student Records on the
King’s Intranet approximately one month after you enrol.
If you are unable to submit your work by the deadline please refer to the information in your programme
handbook on “mitigating circumstances”.
Submission date for course work:
1. Assignment Tuesday 19 July
Late submissions will be accepted for 24 hours following the submission date. All work submitted late will
be marked as normal but will be capped at the pass mark for the module. If your assignment is hard copy
please ensure you date stamp it and submit it to the submission room G15 JCMB. If your assignment is
7
submitted electronically through TurnItIn, information about how to submit late will be provided on
KEATS module sites under assessment information.
The external examiner for this module is Catherine Monaghan. Students are not to make direct contact with
external examiners, in particular regarding their individual performance in assessments
Results and re-submissions for course work
Students will receive a provisional (unratified) mark for their coursework 4 weeks following submission.
According to the method of submission as detailed on your KEATS site, if your work was submitted online
you will be able to download marked coursework from KEATS; alternatively, if you completed a hard-copy
submission you can collect your coursework and feedback from the Student Services Centre.
To collect a hard copy assignment, you must provide your candidate number. Alternatively, you may send a
stamped addressed envelope to the Student Services Centre ensuring that this is large enough to
accommodate your assignments and that you have applied sufficient postage. Hard copy assignments will be
retained for four weeks; if you have not collected your assignment by then, it will be destroyed.
Feedback will include the award of a numerical grade which remains provisional until ratified by the
examination boards. The dates for the examination boards are available on KEATS. Ratified marks can be
viewed via Student Records on the King’s Intranet, the Monday following the relevant examination board.
The marking criteria by which your work is judged are provided in full in your programme handbook.
Please also refer to the section in your programme handbook on plagiarism and how to avoid it. If you have a
query about how to refer to a specific piece of work please ask your module leader, your group leader or a
member of library staff for guidance.
The feedback you receive on your assignment will guide you towards how to do better next time or how to
maintain your existing high standard!
If you do not understand your mark or the feedback you receive please contact Shelley Peacock.
If you are unsuccessful, it is recommended that you contact the module leader before submitting your
second attempt. This will enable the module leader to provide you with an appropriate level of support as
you prepare to re-submit your work.
8
Practical Exam
21 July 2016; Guy’s Campus Shepherd’s House
Results and re-sits for examinations
Unratified results from exams will be available on your KEATS module site 4 weeks from the date of the
examination.
Faculties are required from this academic year (2015/16) to make examination scripts available to any
student who makes a request, free of charge. Any requests for examination scripts should still be managed in
accordance with the Data Protection Act 1998. Students may request access to their exam paper at any time
(after the Assessment Sub Board meeting) during their programme of study. This policy applies to all
summative, unseen, written examinations. MCQs and OSCEs are exempt from this process.
Re-sit dates will available on your KEATS module site. If you are unsuccessful, it is recommended that you
contact the module leader before submitting your second attempt or re-sitting your examination.
Re-submission date for coursework
18 October 2016
Resubmitted coursework available for download
15 November 2016
9
Learning Outcomes
Session 1 – Learning outcomes
5 May 2016
Systematic history taking
By the end of this session, students should be able to:
 Demonstrate the skills required to undertake systematic and structured patient histories.
 Be aware of the knowledge and skills required for the consideration of differential diagnoses.
 Explain the range of patient/client data required from both primary and secondary sources in order
to make informed nursing decisions.
 Critically analyse the process of using interpersonal skills for data collection.
 Demonstrate the importance of the inclusion of social/psychological assessment aspects for people
with skin disease and utilize in practice.
Skin assessment
By the end of this session, students should be able to:
 Undertake a skin assessment maintaining dignity.
 Understand the importance of appropriately describing and documenting the location, type,
distribution and characteristics of cutaneous lesions and rashes.
 Be familiar with correct specialist terminology used to describe clinical findings.
 Appreciate the dynamic relationship between the clinical examination and history taking.
Psychological Care
By the end of this session, students should be able to:
 Be familiar with assessment tools for mental health, when and where to refer.
 Demonstrate basic counselling skills.
 Analyse referral criteria for psychological.
Session 2 – Learning outcomes
12 May 2016
How topical therapy works, how to prescribe safely and effectively
By the end of this session, students should be able to:
 Describe the mechanism of action of common topical therapies.
 Understand and critically explore the key considerations when prescribing topical therapies.
 Identify the key elements of a well written prescription for topical therapy.
Corticosteroids and high risk drugs used in dermatology
By the end of this session, students should be able to:
 Understand the role of systemic corticosteroids and other frequently used systemic therapies in
dermatological disease.
 Identify the risks and potential side effects of these treatments.
 Describe the monitoring requirements for safe use of these treatments in dermatological care.
10
Wound Care
By the end of this session, students should be able to:

Critically discuss the pharmacological properties of different wound dressings and Identify
appropriate dressing according to wound type.
Clinical Workstations
Station 1
By the end of this session, students should be able to:

Demonstrate the clinical skills required in order to safely and effectively apply topical emollients
and steroids and occlusions.
Station 2
By the end of this session, students should be able to:

Demonstrate the safe and effective practical application of paste bandages.
Station 3
By the end of this session, students should be able to:

Demonstrate the clinical skills required in order to safely and effectively apply scalp treatments.
Session 3 – Learning outcomes
19 May 2016
Child assessment issues
By the end of the session, students should be able to:


Critically describe assessment principles in relation to paediatric dermatology.
Critically reflect upon the role of the nurse in differentiating between child abuse and dermatological
conditions.
Recognition and management of common childhood skin rashes
By the end of the session, students should be able to:



Identify common childhood skin rashes.
Describe best practice management of childhood rashes.
Critically discuss the role of the nurse in managing treatment options.
Childhood eczema
By the end of the session, students should be able to:




Describe the presentation of childhood eczema.
Critically analyse the evidence on the management of atopic eczema.
Critically evaluate the role of the nurse in managing childhood eczema.
Understand the indications for use of wet wraps in childhood eczema and important
contraindications.
11
Session 4 – Learning outcomes
26 May 2016
Aetiology and presentation of precancerous lesions, non-melanoma and melanoma skin cancer
By the end of this session, students should be able to:
 Critically describe the aetiology and presentation of precancerous lesions and non-melanoma skin
cancer.
 Analyse the aetiology and presentation of melanoma skin cancer.
 Critically discuss the diagnostic process and care pathways for patients with precancerous cancerous
and cancerous lesions.
Screening and skin cancer prevention
By the end of this session, students should be able to: provided by speakers
 Have an understanding of the legislation which underpins the skin cancer screening service and
know how to manage patients effectively when they have a suspected skin cancer.
 Understand the importance and relevance of taking an accurate patient history to include risk
factors, together with clinical examination in screening patients for skin cancer.
 Be able to give appropriate advice on sun protection and other preventative measures.
Treatment options for primary skin cancers: (1) precancerous (2) non-melanoma (3) melanoma
By the end of this session, students should be able to:
 Critically debate treatment options for skin disease as above and analyse the factors which may
affect treatment choice.
 Critically discuss the role of the nurse in delivering treatment.
Melanoma staging and treatment pathways
By the end of this session, students should be able to:
 Discuss the staging system for malignant melanoma (MM).
 Relate this to treatment options appropriate for different stages.
 Understand the importance of clinical trials in the adjuvant and palliative setting.
 Evaluate the role of the CNS supporting patients with MM.
Cutaneous Lymphoma (CTCL) and sezary – diagnosis, staging and treatment
By the end of the session, students should be able to: IG reviewed and agreed
 Discuss the process of diagnoses of CTCL.
 Critically evaluate the role of the nurse in managing CTCL.
 Understand ‘staging’ in relation to the range of treatment options including safety and effectiveness.
 Evaluate the nursing role in supporting the psychosocial impact of T-cell lymphoma.
 Critically explore the patient pathway and role of specialist services in relation to people with
cutaneous lymphoma.
Session 5 – Learning outcomes
9 June 2016
Skin infections and infestations
By the end of the session, students should be able to:
 Critically analyse treatment options for common skin infestations and infections.
12
Acute cutaneous allergy (urticaria, angioedema, contact dermatitis)
By the end of the session, students should be able to:



Describe the presentation of common acute cutaneous allergic conditions.
Critically discuss the nursing role in diagnostic methods.
Critically evaluate the role of the nurse in managing treatment options.
Dermatological emergencies and medical and nursing management of a patient with severe skin failure
By the end of the session, students should be able to:
 Critically evaluate the nature of a dermatological emergency.
 Critically discuss the causes of severe skin failure and nursing role in the management of a
dermatological emergency.
 Evaluate the risks associated with severe skin loss or compromised skin integrity.
 Critically evaluate the nursing role in the reduction of the risk of sepsis and interventions for a
patient with severe skin failure.
Obtaining skin samples
By the end of this session, students should be able to:


Critically discuss the indications for mycology and bacteriology sampling in dermatological practice.
Demonstrate how to obtain good quality skin and hair samples for bacteriological or mycological
analysis
Session 6 – Learning outcomes
16 June 2016
Acne and Rosacea
By the end of this session, students should be able to



Recognize and explore the common and differentiating clinical features of acne and rosacea
Critically analyse the treatment options available in primary and secondary care
Critically discuss the evidence for the suicidal risk profile of isotretinoin
Alopecia
By the end of this session, students should be able to:
 Recognize and explore the common clinical features of different forms of alopecia in adults
 Critically analyse treatment options and indicators for specialist care
Eczema
By the end of this session, students should be able to:


Recognize and explore the common clinical features of different forms of eczemas in adults.
Critically analyse treatment options and indicators for specialist care.
Hydradenitis
By the end of this session, students should be able to:
 Recognize and explore the common clinical features.
 Critically analyse treatment options.
13
Psoriasis
By the end of this session, students should be able to:
 Recognize and explore the common clinical features of psoriasis
 Critically analyse treatment options and indicators for specialist care
Indicative reading
Key Journals
American Journal of Clinical Dermatology
British Journal of Dermatology
British Journal of Dermatology Nursing
Journal of the American Academy of Dermatology
Paediatric Dermatology
Wounds
Websites
British Association of Dermatologists: www.bad.org.uk
British Dermatological Nursing Group: www.bdng.org.uk
Worldwide wounds: www.worldwidewounds.com
American Academy of Dermatology: www.aad.org
New Zealand Dermatological Society: www.dermnetnz.org
DermWeb: www.dermweb.com
Key Textbooks
Burns T. (2010) Rook’s Textbook of Dermatology. London: Wiley Blackwell.
Benton E., Morris-Jones R., Powell A.M. (2011) 100 Cases in Dermatology. London:Hoddar Arnold.
Flanagan M. (ed) (2013) Wound Healing and Skin Integrity:principles and practice. UK Wiley-Blackwell
Gawkrodger D. (2012) Dermatology:An illustrated colour text. London: Churchill Livingstone
Penzer R., & Ersser S.J. (2010) Principles of Skin Care: A guide for nurses and other health care professionals.
London: Wiley Blackwell.
Schofield J., Grindlay D., & Williams H.C. (2009) Skin Conditions in the UK; a Health Care Needs
Assessment. University of Nottingham, Centre for Evidence Based Dermatology.
http://onlinelibrary.wiley.com/doi/10.1111/j.13652133.2011.10464.x/abstract;jsessionid=D25A1961C059FDC450AF9005AE6DD3C6.f04t03?deniedAcces
sCustomisedMessage=&userIsAuthenticated=false
14
Quality Standards for Dermatology: Providing the right care for people with skin conditions. Department of
Health (2011) http://www.bad.org.uk/shared/get-file.ashx?itemtype=document&id=795
Watkins J. (2010) Dermatology Differentials. London: Mark Allen publishing Ltd.
15
Module evaluation
At the end of the module you are requested to complete the short online evaluation which will be available
on your module KEATS site. Student evaluations are very important to us and are required by Health
Education England and the regional London Local Education and Training Boards.
Action from previous evaluations
Students previously said:
‘The course was very well organised’.’
‘Very useful to consolidate practice’.
‘Very informative’
‘Everything covered was great’.
‘More time for workshops’.
‘LTC day is very busy and psoriasis session was not long enough- we had so many questions’.
‘Psychological session was great but brief’.
We changed this for your course:



Increased the workshop time by 30mins
Reviewed the LTC sessions – cut out any repetition between sessions and allocated more time to
the psoriasis session.
Reviewed day and extended the introduction and psychological session.
16