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Interview with Sam Brace-Mcdonnell

Sam Brace-McDonnell is the course director for our Masters in Advanced Clinical Practice (ACP). We met up with her to find out more about the course and what she most enjoys about teaching it.

What’s your background?

I’m a nurse – I qualified in 1995 and have worked in lots of areas including elderly care, acute nursing, cardiology and emergency nursing. At the moment I’m back in Cardiology. I’ve been an Advanced Clinical Practitioner for 14 years, having completed the ACP course at Warwick when it launched, and have been teaching here for seven years. I’m also currently completing a PhD in Health Sciences focusing on Out of Hospital Cardiac Arrest. Generally I spend 1.5 days in clinical practice per week, one day teaching and three days doing my PhD.


What do you teach here at Warwick?

On the ACP course I teach the cardiovascular, gynaecology and ECG parts of the programme. I also run the Pre-Hospital Special Incident Management module on the separate Advanced Critical Care Practice course.


What makes the ACP course at WMS unique?

We were one of the first universities in the region to offer the course and the Health Education England West Midlands curriculum was based on the Warwick course. There are a few reasons why I think it’s different from other courses out there.

Firstly, unlike a lot of the other ACP courses around, year one at Warwick is entirely clinically based. When training as an Advanced Clinical Practitioner, NHS employers are keen for you to have the clinical skills upfront because that’s what allows you to do the job, so we frontload the clinical skills in year 1 so the students can go back into practice and start working as trainee ACPs and develop their clinical skills straight away. The next two years are focused on the other pillars of ACP practice – management and leadership, research, and education.

Doing it this way is great because it means that people who purely want to learn clinical skills can come just for the first year if they want to and gain a PG certificate without committing to the full Masters. For example, pharmacists usually already have a Masters so have already covered a lot of the areas that we look at in years 2 and 3. Completing the first year of study provides them with the clinical skills they need.

Secondly, one of the two modules we study in the first year – ‘Clinical Investigations and Diagnostics for Healthcare Professionals’ – isn’t offered at many other universities and it’s a module our students seem to find particularly useful. It aims to develop the skills required to deliver safe autonomous practice when requesting and interpreting clinical investigations for a wide variety of conditions. We have quite a lot of students who come and join us just for this module and gain a Postgraduate Award.

Finally, the evidence collected in our students’ portfolios can be used for other portfolios when studying for different qualifications. Many of our students go on to gain accreditation from the Royal College of Emergency Medicine and the evidence they’ve collected with us can be used for their portfolio too.


What’s a typical activity students on the course might take part in?

All modules in year one are clinically focussed so in the Clinical Examinations Skills module students will have a short lecture on examination technique and the application of these skills to different patient groups in the morning and this is followed by facilitated practice in the afternoon with current ACPs. In our ‘Clinical Investigations and Diagnostics for Healthcare Professionals’ module we do a lot of case based learning. So there’ll be a short lecture introducing a topic, then we’ll give the students a scenario and they work in small groups to decide what should be done. For example the scenario could be a patient presenting with chest pains - we provide the heart tracing report and ask them to discuss what’s going on and how best to proceed. It’s about developing practical as well as academic skills.


Who does the course?

The course is open to all healthcare practitioners who have four years’ post-registration experience, but the majority of our students are nurses, paramedics, physios and pharmacists – qualified practitioners who have been working at a fairly senior level within their area and want to move on to more autonomous practice (becoming nurse practitioners, ACPs, advanced paramedics, for example).

A lot of the pharmacists who join us work in GP practices. Developing their clinical skills means they can go back into surgery and in addition to conducting medication reviews will now be able to perform clinical examinations and treat minor illnesses, supplementing the work of the GPs.


What do you most enjoy about teaching on the course?

I really enjoy seeing the amount of confidence our students gain while they’re doing the course. They come in at the start and are often quite nervous but leave as competent autonomous practitioners who will be in a great position to provide even better patient care. I love seeing those ‘lightbulb’ moments where they start to learn about things they’ve seen around them for years but never understood.


What do you think makes Warwick ACP students special?

Their motivation and persistence. The course is intense - getting the evidence and case studies for the portfolios requires a lot of work. And the way of working in the course can be a big change from what our students are used to. Many of the nurses who join us don’t have a degree and come to us after a long period away from education, so writing up critical analyses can be challenging. I’m always impressed by our students’ commitment and determination.


What advice would you offer someone thinking of doing the course?

To get the most from the course and be successful, students need to ensure that for the clinical aspect of the course they are either working in a trainee ACP role or have sufficient time in their existing job plan to be able to independently see and assess patients. It's also vital to have a clinical supervisor (medical or ACP) identified and willing to provide clinical supervision to ensure they are able to develop their clinical skills. After these two key aspects are in place my best advice would then be to plan, plan and plan some more. This is a demanding - but career changing - course and students need to be prepared for the intense workload required.

Sam Brace-McDonnell