Unit of competency details

Descriptor 

This unit of competency describes the skills and knowledge required to observe the condition of the client and gather information relevant to the case, according to an ayurvedic framework

Application 

This unit may be applied in a range of health settings

Employability Skills 

This unit contains Employability Skills

Elements define the essential outcomes of a unit of competency.

The Performance Criteria specify the level of performance required to demonstrate achievement of the Element. Terms in italics are elaborated in the Range Statement.

ELEMENT 

PERFORMANCE CRITERIA 

1. Determine the scope of the assessment and the client's needs

1.1 Establish the client's purpose for consultation and identify the symptoms

1.2 Determine the client's eligibility for service using clinic/practitioner policies

1.3 Clearly explain services able to be provided and limits of available services

1.4 Explore and clarify the client's expectation of the service/clinic

1.5 Identify factors likely to have a negative impact on assessment  in consultation with the client and wherever possible implement strategies to minimise the effects of these factors

1.6 Explain personal abilities, level of professional competence and parameters of role to the client and practise within these at all times

1.7 Refer client to other health care providers  where the needs of the client are identified as beyond the scope of the services able to be provided, or if in the opinion of the practitioner the needs of the client are best met by doing so

1.8 Identify and promote the rights of care of the client

2. Obtain and record an accurate history  of the client

2.1 Seek information from the client for the client's history with all enquiries asked in a respectful, purposeful, systematic and diplomatic manner

2.2 Collect accurate and relevant in a well-organised form which can be interpreted readily by other professionals

2.3 Treat information as confidential and store securely at all times

3. Manage the health assessment

3.1 Obtain informed client consent prior to conducting tests in accordance with legislative requirements

3.2 Pursue abnormal findings and investigate these in a deliberate, logical and appropriate manner

3.3 Assess the reliability of data obtained and where possible clinical correlation with the client's complaints is established

3.4 Use questions to clarify results and gain further information in a manner relevant to the client's needs and test results

3.5 Base decisions to carry out laboratory tests on the integration of previously obtained clinical data and history

3.6 Adhere to the protocol required by the agency in ordering tests

3.7 Allow adequate time during consultation to gather critical information

3.8 Identify and minimise factors that may interfere with the information gathering process

3.9 Identify, establish and observe essential requirements for the maintenance of clinical and practitioner hygiene

3.10 Anticipate potential sensitivities  of the client are and adapt approach accordingly to take these into account.

3.11 Take steps to ensure the client's sense of dignity is maintained at all times

4. Make a comprehensive assessment of the client

4.1 Apply trividha pariksha  (threefold examination method)

4.2 Apply the eightfold examination method  if further assessment if necessary

4.3 Determine causative factors of diseases

4.4 Determine different stages of disease 

4.5 Determine the samprapti (pathogenesis in ayurveda)

4.6 Determine the different stages of progression of disease  and state and location of ama

4.7 Perform ayurvedic differential diagnosis

4.8 Accurately record all information in a systematic manner in accordance with clinic guidelines.

REQUIRED SKILLS AND KNOWLEDGE 

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge :

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

• Anatomical terminology and levels of organisation
• Ayurvedic pathophysiology and ayurvedic disease processes
• Ayurvedic physical signs and symptoms of disease
• Anatomy and physiology according to various stages of life
• Ayurvedic anatomy and physiology including:

• basic physiology - including physiology of musculoskeletal system - muscles, posture and movement
• ENT and other senses - hearing and equilibration, vision, smell, taste
• gastrointestinal - motility, secretions, movement of food, digestion and absorption
• general physiology - including cell structure and function, metabolism, levels of organisation in the body
• nervous system - central, peripheral and automatic nervous systems
• respiratory system - pulmonary function; cardiovascular system - heart, circulation; lymphatic system - lymph, immunity and allergy
• urogenital and endocrine - renal function, micturition, extracellular fluid, metabolism, thyroid gland, hormones, and reproduction

• Ayurvedic diagnosis according to ayurvedic classification of disease
• Ayurvedic Rog Vigyan and Chikitsa Sootra including disease of all the channels with their specific Samprapti, Pooravroopa, nidan, Upashya and chikitsa, along with western correlation
• Ayurvedic anatomical systems including

• musculoskeletal - including; muscles, bones, cartilage, joints, head, upper trunk, upper limb, pelvis, lower limb
• nervous - including peripheral, autonomic and central nervous systems
• cardiovascular (including haemopoetic) - including vascular system, spleen, heart and pericardium, systemic arteries, systemic veins, portal veins, foetal circulation
• lymphatic - including thoracic viscera, abdominal and pelvic viscera, alimentary tract, urinary and genital systems, trunk and limbs, deep and superficial lymph nodes
• gastrointestinal - including mouth, salivary glands, tongue, pharynx, oesophagus, abdomen and peritoneum, stomach, small intestine, large intestine, liver, biliary system, pancreas
• respiratory - including larynx, trachea, lungs and mediastinum, pleura
• urogenital (reproductive and urinary) and endocrine - including kidneys, ureter and bladder, male genital organs, female genital organs, thyroid, parathyroid glands, pituitary gland, adrenal gland, thymus gland
• ENT and Special Senses - including hearing and equilibration, vision, smell, taste

continued  ...

Essential knowledge  (contd ):

• Basic knowledge of biochemistry
• Basic knowledge of the physical relationship of the position on the tongue of the Doshas and organs.
• Clinical features and pathophysiology of common bacterial and viral diseases to assess the client, stage, severity and likely prognosis
• Critical information required for diagnosis and treatment according to ayurvedic framework
• Dietary impact on health and symptoms
• Ethical and legal implications of enquiry
• Factors affecting transmission of disease and choice of treatments of common infectious diseases
• Identification of infectious organism, indications, complications, epidemiology, occurrence, mode of transmission, vectors, incubation period, period of communicability, presentation, diagnosis, treatment, management and prevention
• Location of each Dosha or organ on the pulse
• Pathophysiology and disease processes of common clinical diseases and interactivity between them, to the level necessary to support the making of a screening assessment and assessment of the client's condition to support the practice of ayurvedic medicine
• Pathophysiology and disease processes affecting the nervous system - central and peripheral nervous tissue, brain, spinal cord and associated nerves, sensory, motor and integrative systems, autonomic nervous system and:

• cardiovascular system - blood, clotting, erythropoietin, cardiac cycle
• endocrine system - thyroid, parathyroid and adrenal glands, pancreas, calcium and bone metabolism, pituitary gland, pineal gland
• ENT and special senses - vision, hearing, smell, taste
• lymphatic system - immunity, allergy
• respiratory system - pulmonary function, gas transport, regulation of respiration, respiratory adjustments
• urogenital system - renal function, fluid balance, male and female reproductive systems

• Philosophical approach to diagnosis and treatment
• Philosophy of ayurvedic diagnoses
• Prostaglandins, development, inheritance, DNA, RNA, introduction to genetics
• Pulse diagnosis (Nadi Pariksha)
• Symptomology and pathology according to ayurvedic practice
• The state and quality of the tridoshas
• The state of each individual organ found at the appropriate pulse position.

continued  ...

Essential knowledge  (contd ):

• Terminology correct to discipline
• The cost benefit ratio of special tests or studies
• The causes of disease according to Ayurveda
• The legal and ethical requirements for confidentiality
• The physical relationship of the position on the pulse to the Doshas and organs.
• Time management requirements during consultation

Essential skills :

It is critical that the candidate demonstrate the ability to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

• Access and interpret up-to-date information
• Apply methods of keeping medical records
• Communicate effectively to gain required information
• Conduct external physical examination
• Demonstrate communication skills
• Demonstrate observation skills
• Demonstrate record-keeping skills
• Demonstrate respect for practitioner / client boundaries
• Detect and record symptoms and signs present including precipitating factors, relieving factors and associated manifestations
• Identify location, stage and characteristics of disease
• Perform basic points diagnosis (Marma Pariksha)
• Perform basic tongue diagnosis (Jihva Pariksha)
• Perform nail diagnosis
• Perform observation (Darshana)
• Perform palpation (Sparshana)
• Perform questioning (Prashna).
• Request high precision laboratory and/or radiology tests when required
• Require the minimum number of additional tests
• Understand and discuss medical reports
• Use a range of ayurvedic medical equipment used in external physical examinations
• Use equipment and technology competently and safely
• Use terminology correct to discipline
• Use the threefold and eightfold examination techniques

EVIDENCE GUIDE 

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit :

• The individual being assessed must provide evidence of specified essential knowledge as well as skills
• Observation of performance in the workplace or a simulated workplace (defined as a supervised clinic) is essential for assessment of this unit
• Consistency of performance should be demonstrated over a range of workplace situations
• Assessment may contain both theoretical and practical components and examples covering a range of clinical situations
• Evidence is required of both knowledge and skills application
• Assessment of sole practitioners must include a range of clinical situations and different client groups covering at minimum, age, culture and gender
• Assessment of sole practitioners must consider their unique workplace context, including:

• interaction with others in the broader professional community as part of the sole practitioner's workplace
• scope of practice as detailed in the qualification and component competency units
• holistic/integrated assessment including:
• working within the practice framework
• performing a health assessment
• assessing the client
• planning treatment
• providing treatment

All procedures must be conducted according to legislative and regulatory requirements 

Access and equity considerations :

• All workers in the health industry should be aware of access and equity issues in relation to their own area of work
• All workers should develop their ability to work in a culturally diverse environment
• In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people
• Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

Context of and specific resources for assessment :

• Assessment should replicate workplace conditions as far as possible
• Simulations may be used to represent workplace conditions as closely as possible
• Where, for reasons of safety, access to equipment and resources and space, assessment takes place away from the workplace, simulations should be used to represent workplace conditions as closely as possible
• Resources essential for assessment include:

• an appropriately stocked and equipped clinic or simulated clinic environment
• skilled assessors
• relevant assessment instruments
• appropriate assessment environment

Method of assessment 

• Observation of performance in the work place
• Written assignments/projects
• Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice.
• Questioning
• Role play simulation
• Examples of assessment notes
• Research work or written reports of observations in a practical setting
• Oral questioning on technique or assessment strategy
• Case studies and scenarios as a basis for discussion of issues and strategies to contribute to best practice in the work environment

Related units :

This unit should be assessed in conjunction with the following related units:

• HLTAYV615C Apply ayurvedic diagnostic framework
• HLTCOM404C Communicate effectively with clients
• HLTIN301C Comply with infection control policies and procedures

RANGE STATEMENT 

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Factors likely to have a negative impact on assessment may include :

• Cultural or gender factors
• Disabilities
• Emotional trauma
• Lack of privacy or focus due to additional parties being present
• Language difficulties

Other health care professional may include :

• Allied health workers
• Alternative health practitioners
• Counsellors
• Doctors
• Social workers

Client history may include :

• Accidents, injuries, operations
• Childhood and adulthood illness
• Date of presentation
• Family history
• General state of health

• physical
• emotional
• allergies
• dietary picture
• sleep pattern
• exercise
• leisure activities

• Hospitalisations
• Identifying personal details
• Main presenting complaint or reason for consultation
• Medication, supplements and natural remedies - current and previous
• Occupational history and environment
• Other current medical treatment
• Presenting symptom picture
• Social lifestyle including social drug usage
• Source of referral (if applicable)

Potential sensitivities may include :

• Ability
• Cultural heritage
• Ethnicity
• Gender
• Language
• Presenting disease state and personal history
• Religious beliefs
• Sexuality

Trividha Pariksha  (Threefold examination method ) includes :

• Darshana (Observation)
• Prashna (Questioning)
• Sparshana (Touch)

The eightfold examination method includes :

• Akriti pariksha ( general physical features, ie height, weight, deformation of limbs, nails, skin etc)
• Druka pariksha ((eye diagnosis)
• Jivha pariksha (tongue diagnosis)
• Mala pariksha (stool examination)
• Mutra pariksha (urine examination)
• Nadi pariksha (pulse diagnosis)
• Shabda pariksha (voice examination)
• Sparshana (palpation)

The different stages of disease includes :

• Aama stage
• Niraama stage
• Pacyaama stage

The different stages of progression of disease includes :

• Bheda (differentiation or complication)
• Prakopa (excitation or provocation)
• Prasara (spreading)
• Sanchaya (accumulation)
• Sthana samsraya (relocation)
• Vyakta (manifestation)