Professional Certificate of Clinical Procedures (Brisbane) - Medicine

The Professional Certificate of Clinical Procedures provides the clinician with intermediate level knowledge including the ability to understand and manage a variety of common problems that require office-based surgical intervention, such as foreign body removal, lacerations, sebaceous cysts and ingrown toenails. The program is suitable for Medical Doctors, overseas trained doctors, newly arrived doctors seeking to work in rural networks, nurse practitioners and VR doctors who wish to further develop their surgical office-based knowledge. The program is approved for the Rural Procedural grant program.

Upon successful completion of the course, participants will receive the Professional Certificate of Clinical Procedures (online course components + practical workshop) or the Professional Certificate of Clinical Procedures Planning (online course components only).

Course Content

This course is designed to assist Medical Doctors in developing confidence in various procedures and understanding their limitations without further practical experience.

The common surgical problems often encountered in primary care, such as ingrown toenails, foreign bodies, lacerations and sebaceous cysts, can be readily dealt within general practice. This program demonstrates and practises a range of surgical procedures, local anaesthetic approaches, post-operative care and more complex suturing with valuable tips on obtaining good cosmetic outcomes. All techniques are demonstrated in expertly filmed videos from A/Prof Brygel's extensive media collection and are practised on models and wet specimens in the optional practical workshop.

In the management of ingrown toenails, successful surgical treatment depends on obtaining satisfactory local anaesthesia. The program teaches digital blocks to enable surgical correction and addresses other nail conditions such as acute paronychia abscess and subungual haematoma. The surgery ranges from removal of the nail edge, avulsion of the whole nail in selected cases, and more complex wedge resection. The increase in the popular use of Phenol ablation is also demonstrated and informed consent, safety precautions and multiple attempts at post-operative care are covered in detail.

Hands and feet are common sites for splinters, nails and other objects to be embedded. Apart from local anaesthetic and surgical approaches to a diverse variety of problems, the course addresses the management of the wound and possible infections.

Lacerations can range from a simple clean cut to a dirty, potentially infected wound. The program offers an overview on the management of different lacerations with the aim to obtain primary closure. Debridement of the wound is also demonstrated and practiced in the optional workshop to give the practitioner the ability to cope with the most type of lacerations in a primary care setting.

Sebaceous and pilar cysts are ubiquitous and can occur anywhere on the body. They may present as an infection or abscess around a previous lump. The course demonstrates local anaesthetic techniques in both the non-infected and infected sebaceous cyst with abscess, and addresses several surgical methods depending on the sites on the body, the severity of the infection and the skill and experience of the practitioner. Particular care is taken to demonstrate the management of the resultant cavity following the removal of a cyst and instructions are given to avoid damage to underlying structures.

The experienced course presenters also show how to manage subcutaneous lipomata and share tips and tricks on doing this procedure simply and avoiding excessive bleeding.

The course also discusses the treatment of haemorrhoids and anorectal conditions. The anorectal program will use power point presentations and video to visualize the common or important anal-related conditions, including haemorrhoids, haematoma, abscess, fistula, fissure, and warts. In diagnosing these conditions, it is very important to differentiate them from more sinister problems. The anatomical and pathological basis are presented, in particular, the classification of haemorrhoids and the development of a fistula. The history with appropriate examination is usually sufficient to give a precise diagnosis.

• Lacerations, leg ulcers and lipomas
• Abscesses and sebaceous cysts
• Foreign bodies
• Ingrown toenails
• Warts, skin lesions and haematomas
• Haemorrhoids and anal-rectal conditions
• Local anaesthesia
• Simple and advanced suturing
• Post-operative care and dressing selection

All topics are covered online and during the web live tutorials. *These topics are also covered during the hands-on practical sessions in the optional skills workshop. Course graduates also receive ongoing post-course support through regular alumni webinars.

Choose Your Delivery Format

The course is delivered fully online with the option to attend an eight-hour practical workshop. The modules are set up in such a way that you are not required to be online at specific times but can view and replay video lectures at your convenience. There are no face-to-face requirements for exams which can be conveniently completed online.

Fully Online

• Commence your course anytime online, access all course content instantly and study at your own pace.
• Reinforce your learning, participate in case discussions, follow along procedure demonstrations, and ask any questions in webinars with presenters.
• Complete your assessment online and receive your CPD points and certificate.

Online + Workshop

• Complete your course fully online and receive all of the benefits of online study.
• Receive your CPD points and certificate.
• Cement your knowledge in the accompanying workshop with hands-on training, demonstrations and expert guidance in a small group setting on a date and location of your choice.

Entry Requirements and Course Requisites

The Professional Certificate of Clinical Procedures is ideal for Medical Doctors and International Medical Graduates, nurse practitioners and VR doctors who wish to further their surgical office-based knowledge by gaining an intermediate level understanding of a variety of common problems requiring surgical intervention. This course is open to degree-qualified medical practitioners.

The course assumes no prior knowledge or training in the field. Participants do not have to pass an IELTS test but, as the courses are delivered in English, proficiency in listening, reading and writing in English is assumed.

Modules & Topics

1. Principles of Wound Healing and Managing Small Procedures in General Practice

Unit 1: Introduction, Theoretical and Practical Concepts: This unit commences with a presenters’ introduction and then outlines the principles of wound healing and management. Overall and specific objectives are listed. Preparation of a patient for a clinical procedure is outlined at the end of this unit. Informed consent and post-operative care are covered.

Unit 2: Skin Anatomy, Tension Lines and Wound Healing: The unit commences with drawings of skin anatomy and relaxed skin tension lines. The principles of wound healing and the three stages of healing, types of wound healing (primary and secondary intention) as well as wound classification are described. The unit finishes with an overview of factors that affect/aid wound healing and potential sources of wound complications.

Unit 3: Aseptic Technique and Local Anaesthetics: Aseptic techniques which protect patients during invasive clinical procedures by employing infection control measures are shown, divided into four potential sources of contamination. The unit concludes with local anaesthetics techniques, preparation prior to surgery, mechanism, agent dosages and needle technique.

Unit 4: Safety, Equipment and Complications: The unit lists the use of various equipment used for clinical procedures, illustrated by photos. Potential complications and how to reduce these complications are listed.

2. Closing the Wound

Unit 1: Wound Closure - Knot Tying and Suture Theory: This unit focusses on the objectives of wound closure and outlines the steps for effective wound closure using staples, glues, tapes or sutures. Characteristics of suture materials are evaluated and classified into absorbable sutures and non-absorbable sutures, including recommended timing for suture removal. At the end of this unit, suture materials including needle components, types and their design are discussed together with a diagram of the square knot for tying sutures.

Unit 2: Suturing Techniques: The unit commences with demonstrating the use of simple interrupted sutures. The unit considers anatomy related to skin suturing and the use of buried dermal sutures and continuous subcuticular sutures. Drawings of vertical and horizontal mattress stitches are shown and in which cases the different suture methods are used. The unit concludes with a diagram of the continuous subcuticular suture.

3. Lacerations and wounds

Unit 1: Types of Lacerations, Debridement and Assessment: This unit commences with an overview of various types of lacerations and how to conduct a wound assessment. Clinical images of wound debridement are included.

Unit 2: Treating Wounds and Lacerations: This unit begins with the surgical technique for slicing injuries located on the dorsum finger. Images are shown of several pretibial lacerations. The unit continues with surgical techniques for foot lacerations and describes which types of dressings are appropriate to use.

Unit 3: Hand and Finger Lacerations

Unit 3 commences with surgical techniques for lacerations located on the finger and hand, including a drawing of the nerve supply to the digits. Clinical images for tendon injury testing and wound examination is included. The unit distinguishes four categories of people: babies, children, elderly and frail people. Attention is paid to wound diagnosis and bleeding control.

4. Foreign Bodies and Healing by Second Intention

Unit 1: Assessment, Investigation, Principles and Types of Foreign Bodies: The unit commences with using diagnostic and surgical skills for patient assessment. After investigation by X-ray and/or ultrasound, the procedure to be followed can be determined. Images of several types of foreign bodies are shown. Surgical technique and images for removing foreign bodies located on the finger, foot, ear and nose as well as removal of Implanon devices are discussed. The surgical technique for removal of glass located on the dorsum of the foot and hand are illustrated by step-by-step images of these procedures. The unit finishes with an overview of required equipment, the ‘mother’s kiss’ technique and reinforces the importance of informed consent.

Unit 2: Healing by Second Intention: The unit concludes with several images of the procedure to remove debris or infected/dead tissue from a wound and includes the healing process.

5. Ingrown Toenails

Unit 1: Anatomy and Aetiology: This unit focusses on how to treat a variety of nail related conditions. A photo of the anatomical sagittal section germinal matrix as well as the anatomy of nerves and vessels for fingers, toes including dorsal and plantar digital vessels and nerves is shown. Treatment of ingrown toenails in a simulated setting is supported by clinical images.

Unit 2: Surgery and Consent: Surgical indications and options for the treatment of ingrown toenails are listed and supported by numerous clinical images.

Unit 3: Assessment, Nerve Blocks/ Tourniquets and Operative Technique: This unit commences with the pre-operation assessment of the patient and patient advice. The digital nerve block and tourniquet procedures are explained. Step-by-step clinical images of operative techniques, post-operation care and possible complications complete this unit.

Unit 4: Nail Conditions: The final unit outlines several nail conditions including subungual haematoma and paronychia of fingers and thumbs.

6. Lumps and Bumps

Unit 1: Diagnoses and Sebaceous Cysts: This unit lists the of principles of surgical examinations, pathological processes and procedures in order to develop a clinical/surgical approach to common lumps and bumps. The management of infected and inflamed cysts including cyst surgery is outlined.

Unit 2: Granuloma, Suppurative Hidradenitis and Pilar cysts: The surgical excision of granulomas is the first topic of this unit. The operative technique is explained, with clinical images of the procedure. The next topic is Suppurativa Hidradenitis, showing removal of the lumps and the unit concludes with removing pilar cysts using local anaesthesia.

Unit 3: Lipomata and Abscesses: The unit commences with planning and approach to surgical excision of a lipomata including wound closure. It then discusses abscess treatment and removal and concludes with the drainage and dressing after abscess removal.

7. Diagnosis and Management of Anal Rectal Conditions

This module is for diagnosing and referring patients to specialist care. Most listed procedures are not performed in a general practice clinical setting.

Unit 1: Conditions and Anatomy: The unit outlines a list of possible anal rectal conditions to assist with diagnosis and referral. Clinical images demonstrate the anal canal transition and sensory nerves, and includes diagrams of venous drainage, arterial supply and lymph drainage of the anal canal.

Unit 2: Haemorrhoids and Haematoma: This unit describes the mechanism and symptoms of haemorrhoids, including the four stages of haemorrhoids, and outlines various treatment options. Clinical images are shown of prolapsing haemorrhoids and the unit concludes with a video of perianal haematoma removal.

Unit 3: Haemorrhoids? Polyps? Tags? Warts?: A description is given of possible diagnoses and treatment of anal rectal conditions including haemorrhoids, polyps, tags, warts and fissures. It outlines symptoms, illustrated by diagrams and clinical images to assist with diagnosis and management.

Unit 4: Complex Conditions and Other Procedures: The final unit of this module focusses on procedures including proctoscopy and sigmoidoscopy that are rarely performed in general practice. Surgical management options for haemorrhoids are listed including post-operation instructions and possible complications.

This module is for diagnosing and referring patients to specialist care. Most listed procedures are not performed in a general practice clinical setting.

8. Managing Infected Lesions

Unit 1: Venous Ulcers – Identification and Treatment: Leg, foot and venous ulcers are the focus of this first unit, describing diagnosis and outlining treatment options. Clinical images of appropriate dressing and bandaging techniques are provided to maximise healing of venous ulcers.

Unit 2: Venous Ulcers – Biopsy, Healing, Grafting: This unit builds on the previous unit and focusses on biopsies as a diagnostic tool and describes the various biopsy techniques including split skin grafts and how to exclude arterial disease including the use of a doppler or duplex ultrasound. Clinical images and diagrams assist with learning.

Unit 3: Pyoderma, Neurovascular Ulcers and Diabetes, Cellulitis and Lymphoedema: The unit describes two unusual disorders: Pyoderma gangrenosum and vasculitis disorders including neurovascular ulcers, neurovascular diabetes, cellulitis and lymphoedema. It describes the symptoms and patient information to assist with diagnosis. It outlines the various treatment options including pros and cons of each option.

Unit 4: Varicose Vein Treatments: The module concludes with practice based varicose vein treatments using (micro) sclerotherapy or puncture and avulsion under local anaesthetic. Images of step-by-step procedural instructions are included. Possible side effects and disadvantages of sclerotherapy are listed. The final section of this unit focusses on treatment options including laser ablation, radio-frequency or embolization.

Course Inclusions

For your one-off investment, you will receive unlimited access to all course content, additional learning materials, ongoing post-course support and more.

• Online pre-course activity to be completed in your own time.
• Eight online video modules to be viewed, replayed and completed at your convenience.
• All presentation slides and further learning materials available for permanent access and download.
• Instruments and consumables for practical sessions in the optional practical workshop.
• Post-course online assessment to be completed in your own time within six months of the course start date.
• Ongoing post-course support in monthly webinars with the opportunity to discuss cases with course presenters.
• Access to the HealthCert Community with additional free learning opportunities, special offers and other benefits.

Assessment

Online assessment

In order to meet the requirements of professional and academic learning, the course assessment includes two online examinations:

• 88 knowledge questions based on a scenario of a medical practitioner undertaking special interest training.
  • 11 per module, Example: The medical practitioner believes that 10% of the population … Is he correct? Yes/No
• 88 authentic scenario based questions based on cases of patient care at a clinic.
  • 11 per module, Example: A patient arrives at your clinic with this problem … What should you do? Multiple choice images based on patient cases.

The knowledge-based examination is worth 50 per cent and the application-based examination is worth 50 per cent. The overall pass mark is 80 per cent. It is therefore not possible to pass this course on knowledge alone. Knowledge must be successfully applied to patient cases in order to pass the course.

Certification and Accreditation

This certificate course meets the minimum 50 hours CPD annual requirement across all three mandatory CPD activity types.

Upon successful completion of the course requirements, course participants will receive the Professional Certificate of Clinical Procedures certificate.