Essentially, your final submitted CPA will comprise of the following three parts:
1. the flow diagram/other graphical representation of decision making process;
2. 2000 word justification
3. the reference list (UWE Harvard).
(full details are up loaded below due to limited space )
Part 1 – The flow chart (or similar) should include:
| 1. A clear and unambiguous definition of the Clinical Condition being treated |
| 2. Identification of patient group to be treated. What are the inclusion and exclusion criteria would you apply? Would you not treat certain patient groups (in the interest of staying safely within an area of competence)? Common exclusion criteria include – specified extremes of age, a defined level of severity or stability of a disease, excluded co-morbidities that may complicate management…. in other words – who are you going to treat and who are you not and why? This must not be generic – I would expect to see differences depending on place of work and profession. |
| 3. Diagnostic process. How are you diagnosing the condition? What information do you need? This may include: Symptoms from history taking, symptoms from physical examination, information from blood tests, information from imaging, information from other diagnostic tests or interventions. However, your CPA should not merely list the diagnostic indicators, it should also demonstrate how these are used in order to make a positive diagnosis (or indeed rule out a diagnosis). This may include existing validate diagnostic processes – E.g. the “Two level Wells score” for PE and VTE…. in other words – how do you know what’s wrong with them? What does it all mean? |
| 4. Differential diagnoses. As well as demonstrating how diagnostic indicators inform making a working diagnosis, the CPA should clearly demonstrate your understanding of how the differential diagnostic process safely identifies and/or rules out common and SERIOUS differential diagnoses. This must include key RED FLAG indicators that would require urgent management/referral to another healthcare professional for management…. in other words – please don’t let me miss anything….what’s the worse it could be and work backwards? (always works for me)…remember the “full review of systems” that might help you here – as well as a quick red flag “google search” before doing a full literature review (from more reputable research sources J ) |
| 5. Severity rating/classification/staging. You may need to also include a section setting out how you use diagnostic indicators to inform the classification of severity of the condition that you are managing. Again, this should not just be a list of indicators, but should set out a clearly usable process for turning this information into a classification/rating of severity/staging of disease. E.g. Use of the CURB65 tool for assessing the severity and prognosis of cases of community acquired pneumonia….. In other words – is there anything out there that could help me manage the patient – has someone else already done all the hard work putting together a recognised tool that I should be using…. (I hope so …!) What does research / local policy say? |
| 6. Therapeutic options. Your CPA should set out all key therapeutic options available to you (including both pharmacological and non-pharmacological treatment options), and indicate how you would select between these, especially taking into account any severity rating/staging from point 5 above, patient factors (including age, pharmacokinetics, co- morbidities, preferences and patient beliefs), and common drug interactions…. in other words – what are my options now that I have done 1 – 5 above. And are they applicable to my patients / my competence / my profession etc. – make those links. |
| 7. Monitoring and Follow Up. For each therapeutic option you must include details of how this will be monitored to determine effectiveness and identify adverse effects. This will include: WHAT will be monitored, HOW it will be monitored, FREQUENCY of monitoring, WHO will review the monitoring. This may include information relating to the handing-over of this process to other members of the healthcare team…. in other words – don’t just hand the prescription and say goodbye….give the patients / clients control and information and check they know what you are talking about J |
| 8. You can have more steps or amalgamate steps if your chosen are necessitates this. |
Part 2 – The Critique of Your Flow Chart
You need to critically review each of the steps of your clinical practice algorithm and present that information to us within 2000 words. There is no set “format” for doing this as will be led by your chosen subject and your own clinical practice area.
- You could present the evidence, step by step, in a table
- Or perhaps you decide to undertake a more extensive annotated
- Or perhaps you decide to present the information asa written literature review related to the steps within your algorithm
…..In other words – the choice is yours but it must be a 2000 worded fully referenced critique of the decision making within your flow chart.
Part 3 – The Reference List
You should finish with full reference list utilising the UWE Harvard reference system. This is not included in the word count.
