ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 65
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Building a diagnostic picture of asthma in primary care:
Development of a novel ‘jigsaw puzzle’ approach
Prof Amanda Barnard1,2
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International Primary Care Respiratory Group, 2Australian National University
Introduction
Asthma remains both under- and over-diagnosed globally. There is an identified educational need for
simple tools to diagnose asthma in the absence of a single objective test. New teaching and learning
tools are required.
Aims
To describe the process of defining the format and content of teaching and learning tools to facilitate
and improve the quality of asthma diagnosis by students, early stage clinicians and other primary care
practitioners using a jigsaw puzzle metaphor.
Methods
A half-day ‘jigsaw’ workshop of primary care academics and clinicians in low-, middle- and highincome countries with an asthma diagnosis interest was convened. Four working groups in two
rounds negotiated and prioritised jigsaw pieces describing: reason for presentation, symptoms,
predisposing factors and tests/investigations most relevant when building a clinical picture of asthma.
In the third round a single comprehensive jigsaw puzzle was formed through debate about the relative
importance of jigsaw pieces over time (https://youtu.be/jguPHc8XHDE).
Resource content
Building the puzzle begins with establishing the reason/s the person has presented in primary care,
followed by an exploration of their respiratory symptoms. A personal and family history is important
and continuity of care is crucial as more than one encounter is often needed to build the diagnostic
puzzle. Objective tests should be considered where available (eg a simple test of airway reversibility
using peak flow pre- and postadministration of a short-acting bronchodilator, serial peak flow
monitoring, microspirometry or spirometry). Other tests, such as blood eosinophil levels or FeNO,
may be considered.
Conclusions
This project identified a new teaching and learning strategy, the asthma jigsaw puzzle, applicable to
many teaching situations. The creation of context-specific development process and a tool enables
learners to visualise the clinical picture and decide on the likelihood of an asthma diagnosis before
taking action.
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