clinical
Clinical 1: Suspected sepsis in adults
Recognising suspected sepsis, evaluating risk, escalating care and applying current NICE guidance in adults aged 16 or over.
Browse and learn
Learning library
Only reviewed and published learning is listed publicly.
clinical
Clinical 3: Delirium in adults
Recognition, assessment, prevention and management of delirium in hospital and long-term care, with particular attention to hypoactive delirium.
clinical
Clinical 10: Advance care planning and care towards the end of life
Identifying people approaching the end of life, planning ahead, communicating uncertainty and applying NICE guidance for the last days of life.
clinical
Clinical 2: Acute kidney injury
Practical recognition, risk assessment, investigation and early management of acute kidney injury using NICE NG148.
clinical
Clinical 4: Falls assessment and prevention
Applying NICE NG249 to falls assessment and prevention in older people and adults aged 50 to 64 at higher risk.
clinical
Clinical 5: Venous thromboembolism – prevention, diagnosis and early management
Practical VTE risk assessment, hospital prophylaxis principles, and NICE diagnostic pathways for suspected DVT and pulmonary embolism.
clinical
Clinical 6: Atrial fibrillation – diagnosis and stroke prevention
Detection of atrial fibrillation, stroke and bleeding risk assessment, anticoagulation principles and review using NICE NG196.
clinical
Clinical 7: Hypertension in adults
Accurate diagnosis, cardiovascular risk assessment, postural blood pressure, treatment principles and review using NICE NG136.
clinical
Clinical 8: Type 2 diabetes – practical management principles
Individualised goals, cardiovascular and renal risk, medicines review and the 2026 NICE NG28 framework for adults with type 2 diabetes.
clinical
Clinical 9: Multimorbidity and polypharmacy
Person-centred review of multimorbidity, treatment burden and polypharmacy using NICE NG56.
clinical
What CGA is - and is not
Define CGA as a multidimensional, multidisciplinary and iterative clinical process. Distinguish CGA from a clerking template, screening tool or one-off assessment.
clinical
Who needs CGA and when
Identify clinical patterns that should prompt consideration of CGA. Use frailty, multimorbidity, geriatric syndromes and functional change as triggers rather than rigid eligibility rules.
clinical
Medical and physical domain
Build a problem list that integrates acute illness, chronic disease and geriatric syndromes. Distinguish diagnosis from impact on function and goals.
clinical
Medicines and treatment burden
Perform a structured medicines review within CGA. Identify indication, benefit, harm, adherence, monitoring and treatment burden.
clinical
Cognition, delirium and psychological health
Differentiate delirium, dementia, depression and other cognitive/psychological problems. Use baseline cognition and collateral history appropriately.
clinical
Function, mobility, falls and rehabilitation
Assess ADLs, IADLs, mobility, gait, balance and rehabilitation potential. Use current falls guidance to structure multifactorial assessment.
clinical
Nutrition, continence, pain and sensory health
Identify undernutrition risk, swallowing issues, dehydration and oral-health contributors. Assess continence, pain, vision and hearing as functional determinants.
clinical
Social, environmental and carer domains
Assess social support, carer capacity, isolation, finance and safeguarding concerns. Assess the home environment, accessibility, equipment and community services.
clinical
Future wishes, goals and anticipatory care
Elicit what matters to the person and convert it into meaningful goals. Incorporate advance care planning, treatment preferences and future wishes appropriately.
clinical
From assessment to integrated care plan
Convert multidomain information into a prioritised problem list. Assign actions, ownership, timescales and review points.
clinical
Foundations of consent and shared decision-making
Consent is the patient's permission for a proposed examination, investigation, treatment or other intervention. In good practice it is reached through a decision-making process in which the clinician and patient exchange information, identify what matters to the patient and reach a shared understanding of the available choices. The GMC describes shared...
clinical
Meaningful dialogue: information, material risk and reasonable alternatives
Materiality cannot be reduced to a standard complication list. The clinician needs to understand the outcomes that matter to the individual, because a low-frequency harm may be decisive for one person and less important to another. This is the practical legacy of Montgomery and is mirrored in GMC guidance requiring clinicians to explore a patient's...
clinical
Communication, accessibility and supported decision-making
A patient cannot make a meaningful healthcare decision if information is inaccessible or if they cannot express their preferences. Communication support is therefore part of valid decision-making, not an optional courtesy. The clinician should actively identify barriers and adapt the process rather than interpreting difficulty as incapacity. Barriers may...
clinical
Capacity, voluntariness, influence and coercion
Consent requires a person who can make the relevant decision, but disagreement with clinicians is not evidence of incapacity. The consent clinician should notice when capacity is genuinely in doubt, support the person to decide, and then use the applicable decision-specific framework. The full methodology belongs in the ClinicalEdu Mental Capacity...
clinical
Consent in urgent, emergency and time-critical care
An emergency can compress the time available for discussion, but it does not abolish respect for autonomy. A conscious patient who can make the decision should still be involved. Focus the discussion on the immediate decision, the most important benefits and harms, realistic alternatives and what may happen without treatment. Royal College of...
clinical
Children and young people: assent, competence and parental responsibility
Children and young people should be involved in decisions about their care as much as they are able. The first clinical task is therefore not to ask only who can sign, but to explain the decision in a developmentally appropriate way, hear the young person's views and identify what they understand and want. Assent is a useful educational term for a...
clinical
Refusal of treatment, advance decisions and future wishes
An adult who can make the relevant decision can refuse recommended treatment, including treatment that clinicians believe is life-saving. The response is not to raise the capacity threshold because the consequences are serious. Instead, ensure the patient has the information they need, check understanding and voluntariness, address communication...
clinical
Consent in procedures and complex clinical contexts
A procedure may generate more paperwork, but the underlying standard is unchanged: the patient needs an opportunity to understand the proposed intervention, the material risks and benefits, reasonable alternatives and what may happen without it. The depth of the discussion should reflect complexity, uncertainty and the patient's priorities. The clinician...
clinical
Consent across teams, delegation, remote care, teaching and recording
Consent is often built across several contacts: a specialist recommends treatment, a nurse provides education, a pharmacist discusses medicines, and another clinician performs the procedure. This can be good care, but only if roles are clear and the patient receives a coherent decision process. A dangerous team assumption is 'someone else must have done...
clinical
Documentation, disagreement, complaints and governance
A useful consent record identifies the decision being made, the relevant options and material information discussed, patient-specific concerns or priorities, questions raised, the outcome and any need for review. Capacity, communication support, voluntariness or legal authority should be recorded when they are relevant to the decision. The note should be...
clinical
Foundations of palliative and end-of-life care
Palliative care should be understood as an active approach to improving quality of life and reducing suffering for people living with serious or life-shortening conditions. It is not a declaration that disease-directed treatment has ended. Scottish national strategy now explicitly describes palliative care as helping people live as well as possible with...
clinical
Recognising approaching end of life, deterioration and uncertainty
NICE NG142 recommends systems to identify adults who may be approaching the end of life so that planning, support and coordination can begin. Identification may be prompted by progressive functional decline, increasing frailty, recurrent unplanned admissions, escalating symptom burden, weight loss or reduced intake, disease-specific deterioration, or...
clinical
Communication, shared decisions and advance/future care planning
Advance or future care planning is a voluntary process of thinking and talking about what matters now and what may matter if health changes. NHS England Universal Principles, NHS Wales Future Care Planning and Northern Ireland's policy all emphasise person-centred reflection rather than form completion. The terminology differs, but the underlying aim is...
clinical
Capacity, advance decisions, proxies and decisions for people who cannot decide
Serious illness can impair decision-making temporarily through delirium, fatigue, breathlessness, pain, medication effects or communication difficulty. Before concluding that a person cannot decide, clinicians should take practicable steps to support participation where time allows: treat reversible distress, choose a better time, simplify information,...
clinical
Goals of care, treatment escalation, emergency planning and CPR
Goals-of-care discussions should connect the person's priorities with what medicine can realistically achieve. The conversation asks which outcomes matter, what burdens are acceptable, which treatments are clinically appropriate and what should happen in an emergency. The product should be a positive care plan, not only a list of interventions that will...
clinical
Symptom assessment, anticipatory care and medicines in the last phase of life
Anticipatory medicines are prescribed in advance so that symptoms can be treated promptly if they arise, particularly when access to prescribing may be difficult out of hours. NICE recommends an individualised approach, with clear indications and routes, and requires assessment before administration. The presence of a 'just in case' medicine does not...
clinical
Hydration, nutrition and clinically assisted nutrition/hydration
Reduced appetite and fluid intake are common as dying approaches. This does not remove the duty to offer assistance with eating and drinking where wanted and appropriate. NICE recommends supporting a dying person to drink if they wish and are able, checking swallowing safety, providing frequent mouth and lip care, and helping with sips where appropriate....
clinical
Individualised care in the last days and hours
The central lesson from NICE NG31 is individualisation. Once a person may be entering the last days of life, the team should communicate the uncertainty, identify what matters, assess symptoms and hydration, review medicines and interventions, and keep the plan under active review. A standard form can improve reliability, but it must not replace clinical...
clinical
Ethical complexity, conflict, requests to hasten death and escalation
Statements such as 'I cannot go on' or 'I want this to end' can mean many different things: uncontrolled pain, fear of future dependency, depression, existential distress, a wish to stop burdensome treatment, a capacitous refusal, or a request for help to end life. The first clinical duty is to listen and clarify rather than label the request...
clinical
Care after death, bereavement, continuity and quality improvement
The moment of death changes the clinical task but does not end professional responsibility. Immediate care includes dignity and privacy, respectful care of the body, support for family and others present, attention to religious or cultural wishes where possible, safe management of devices and property, and clear explanation of what will happen next....
clinical
Understanding frailty
Define frailty as a state of reduced reserve and increased vulnerability rather than as chronological age. Distinguish frailty from disability, multimorbidity, sarcopenia and ordinary ageing.
clinical
Recognising frailty in clinical practice
Recognise common frailty syndromes and atypical presentations. Use baseline function and trajectory to distinguish chronic vulnerability from acute deterioration.
clinical
Frailty identification tools: choosing the right instrument
Differentiate population case-finding, diagnostic confirmation, bedside judgement, physical performance and multidomain assessment. Explain the appropriate role and limitations of the eFI.
clinical
Clinical Frailty Scale: foundations, purpose and limits
Describe the intended role of the CFS as a judgement-based summary of overall fitness/frailty. Explain why the current official tool and training resources should control scoring practice.
clinical
CFS levels and clinical meaning: reasoning across the continuum
Understand that adjacent CFS levels reflect meaningful differences in usual function and dependence. Use change in instrumental and personal activities to structure a judgement.
clinical
Scoring the CFS correctly: baseline, collateral and acute illness
Anchor CFS scoring to the appropriate pre-acute baseline. Take a structured functional history that supports scoring.
clinical
CFS case laboratory: applying judgement under uncertainty
Apply CFS reasoning to realistic cases with incomplete or conflicting information. Identify what additional information is needed before scoring.
clinical
Managing frailty: from identification to intervention
Translate frailty recognition into an individualised management plan. Prioritise reversible contributors, function, medicines, nutrition, mobility and patient goals.
clinical
Frailty services and pathways: designing care around the person
Describe core principles of effective frailty pathways across acute, community and care-home settings. Distinguish evidence-based service principles from locally variable operating models.
clinical
Complex frailty and decision-making: proportionality, goals and uncertainty
Use frailty as one component of complex clinical decision-making rather than a deterministic rule. Integrate reversibility, treatment burden, patient goals, function and prognosis.
clinical
Foundations: capacity, autonomy and the presumption of ability
Build a rights-based, decision-specific approach to mental capacity and avoid assumptions based on age, diagnosis, disability or disagreement.
clinical
Supported decision-making in practice
Use practical communication, timing and environmental adjustments to maximise a person’s ability to participate before concluding that they cannot decide.
clinical
When should capacity be assessed?
Recognise when a formal capacity assessment is proportionate, and avoid using capacity assessment simply because a person refuses, disagrees or lives with a particular diagnosis.
clinical
How to assess the specific decision
Apply a structured, decision-specific assessment that identifies relevant information, tests the required functional abilities and records the reasoning rather than relying on a checklist or cognitive score.
clinical
Fluctuating and complex capacity
Recognise fluctuating or complex decision-making ability and adapt timing, reassessment and multidisciplinary support to the person’s clinical state and the urgency of the decision.
clinical
Decision-making when the person lacks capacity
Use the correct jurisdiction-specific substitute-decision framework, involve the person as far as possible and distinguish consultation from legal authority.
clinical
Attorneys, deputies, guardians and other proxies
Verify whether another person has lawful decision-making authority, understand its scope and limits, and avoid the unsafe assumption that “next of kin” can consent for an adult.
clinical
Advance and future decision-making
Distinguish legally binding advance refusals from broader statements and clinical plans, and check validity, applicability and jurisdiction before relying on a future decision-making document.
clinical
Restraint, restriction and deprivation of liberty
Understand the distinction between restriction, restraint and deprivation of liberty, and apply the current post-June-2026 multifactorial Article 5 approach rather than outdated shorthand.
clinical
Documentation, disagreement and escalation
Create records that show the decision-making pathway, transfer essential information safely and escalate unresolved disagreement through proportionate clinical, safeguarding, ethics or legal routes.
