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Domain 2 : Diagnosis: Assessment, Investigation, Monitoring and Data Interpretation
It is very easy to acquire large amounts of data in modern medical practice. The challenge is to acquire appropriate data and convert it into information, essential steps on the pathway to diagnosis and treatment. Monitoring devices combine the functions of clinical investigation with surveillance. Clinical investigations are forms of hypothesis testing; they bring burdens and occasional risks for patients, as well as additional costs and work for the investigating clinician and laboratory staff. Their utility, safety and accuracy must be balanced against these factors.

By the end of specialist training, the trainee...

2.1 Obtains a history and performs an accurate clinical examination
2.2 Undertakes timely and appropriate investigations
2.3 Describes indications for echocardiography (transthoracic / transoesophageal)
2.4 Performs electrocardiography (ECG / EKG) and interprets the results
2.5 Obtains appropriate microbiological samples and interprets results
2.6 Obtains and interprets the results from blood gas samples
2.7 Interprets chest x-rays
2.8 Liaises with radiologists to organise and interpret clinical imaging
2.9 Monitors and responds to trends in physiological variables
2.10 Integrates clinical findings with laboratory investigations to form a differential diagnosis

Features of competent performance

  • Recognition of clinical signs and symptoms
  • Plan and prioritise investigations / monitoring - appropriate; timely
  • Safe use of equipment / devices
  • Obtain accurate data effectively
  • Interpret data in the clinical context
  • Accurate differential diagnosis on basis of information available
  • Effective team-working: planning & interpretation of investigations
  • Appropriate referral / consultation / further investigation
  • Recognition of limitations (self and others)
  • Attention to patient safety


All competencies
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Note that the "Resources" that are included in this page, have not been updated in the recent years. An updated collection of useful resources will be available soon as part of the ESICM Academy (for more details, see www.esicm.org).

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