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Lymphoedema Education Benchmark Statements (LEBS)

Lymphoedema Education Benchmark Statements (LEBS) for Undergraduate Programmes leading to Professional Healthcare Qualifications

These Lymphoedema Education Benchmark Statements have been developed as a teaching resource under the auspices of the International Lymphoedema Framework, a global umbrella organization, and registered UK charitable body. They have been developed through a process of expert panel consensus. In recognition of the demands on any health professional curriculum guidance and resources are being developed to facilitate their integration without the need for additional teaching sessions.

What are educational benchmark statements?

Subject benchmark statements provide an important external source of reference and guidance for the development and enhancement of courses and programmes enabling learning outcomes to be evaluated against agreed expectations and standards. They are designed to be used flexibly, in conjunction with the requirements set by professional, statutory and regulatory bodies.

Who are they for?

  • Leaders of undergraduate programmes of education leading to professional healthcare qualifications in medicine, nursing, physiotherapy, occupational therapy, podiatry and in some countries, remedial massage therapy.
  • Educators involved in provision of undergraduate professional education or continuing professional development in relation to lymphoedema or chronic oedema.

Why are Lymphoedema Education Benchmarks important for health professional education?

The justification for incorporating basic knowledge of lymphoedema into undergraduate curricula is the evidence of:

  • Increasing prevalence of lymphedema and chronic oedema, in which lymphatic impairment is a feature;
  • Growing ‘at risk’ population – elderly, obese, those with limited mobility and various co-morbidities, such as chronic venous disease, some cancers and heart failure;
  • Early identification and intervention improving patient outcomes, quality of life and reducing costs to the health service
  • The role of the lymphatic system and lymphedema being poorly addressed in health professional education curricula.

The LEBS reflect what international consensus indicates that any person with, or at risk of lymphoedema, might reasonably expect from newly qualified health professionals. Their implementation will foster global consistency and governance in relation to lymphoedema education.

What do Lymphoedema Education Benchmark Statements cover?

LEBS represent the expectations of health professionals at the point of completion of their undergraduate degree and/or registration in their profession. They are intended to reflect basic levels of the following and provide a sound foundation for subsequent learning:

Professional knowledge and understanding

  1. Anatomy and physiology
  2. Pathophysiology of lymphoedema
  3. Recognition of various causes of oedema
  4. Recognition of lymphoedema
  5. Patient education and support needs
  6. Components of treatment

Professional skills and abilities: The newly qualified health care professionals will have generic skills that may be applied to good effect for individuals with, or at risk of, lymphoedema, provided they have a basic understanding of the principles, e.g. in skin care or exercise. No additional treatment or specialist skills are expected at the point of registration. However, any health care professional working with particular high risk groups would be encouraged to develop the appropriate skills for their client group, e.g. specific assessment skills, exploration of information needs and supporting appropriate lifestyle changes.

*Assessment – would be online with multiple attempts possible until correct response and simple feedback to direct when errors made. There would be automatic issue of certificate for correct completion.

How do I use the LEBS resource?

Learning outcomes: Specific learning outcomes are associated with each of the LEBS, identifying what would be relevant expectations of students.

Curriculum Area: These are points in most existing curricula to which resources could be linked to enable students to achieve the learning outcomes. A brief rationale/explanation is provided for each on a hyperlink.

Resources/Assessment:

Benchmark 1

Benchmark 2

Benchmark 3

Benchmark 4

Benchmark 5

Benchmark 6

Benchmark Expected Learning Outcome Curriculum Area Resources/Assessment*
Explore the anatomy and physiology of the lymphatic system Explain the basic anatomy and function of the lymphatic system in simple terms
  1. Basic anatomy of the lymphatic system
  2. Basic physiology of the lymphatic system
  3. Physiology of the cardiovascular system and the return of fluid from the interstitium to the circulatory system
  4. Physiology of the digestive system in relation to absorption of fat from the small intestine
Explanation

Most curricula address the lymphatic system as a basis for understanding its role in immunity, so the focus is on the nodes. To appreciate the significant role that the lymphatic system plays in regulating fluid balance and flow within and between the various compartments of the body it is important to be aware of the structure of the lymphatic capillaries and superficial capillaries in addition to the deeper vessels, nodes and organs. Recent research into the function of the lymphatic system has highlighted that it is the main route for return of fluid and by-products of cellular metabolism to the circulatory system, rather than the venous system, as a result of its unique anatomy.

Slides for integration with existing anatomy teaching

Background reference

YouTube videos

On-line assessment with feedback

Explain in simple terms the role of the lymphatic system in removing excess fluid and particles from interstitial spaces and composition of lymph
Benchmark Expected Learning Outcome Curriculum Area Resources/Assessment*
Discuss the pathophysiology of lymphoedema Identify primary and secondary forms of lymphoedema, including those relayed to cancer, filiariasis and venous disease Google search
Identify groups at risk of lymphoedema, including those with:

  • Cancer
  • Venous insufficiency
  • Obesity
  • Immobility
  • High exposure to mosquito bites
Google search
List the consequences of lymphostasis in terms of skin and tissue changes, cellulitis YouTube video- Assessment – on-line quiz
Benchmark Expected Learning Outcome Curriculum Area Resources/Assessment*
Recognise that there are various causes of oedema which may co-exist with lymphoedema Recognise local and systemic causes of oedema, including:

  • Cellulitis
  • Deep vein thrombosis
  • Other vascular disorders
  • Lymphoedema
  • Systemic disorders, e.g. cardiac, liver or renal impairment
  • Advancing and metastatic cancer
  • Collection of clinical photos and descriptions of clinical features / symptoms to differentiate various causes
  • Assessment – online quiz – matching photos and causes
Benchmark Expected Learning Outcome Curriculum Area Resources/Assessment*
Identify the features of lymphoedema Describe the clinical features of early and late presentations of lymphoedema
  • Collection of clinical photos and descriptions of clinical features / symptoms to differentiate various causes
  • Video clips of people with lymphoedema

Assessment – online quiz – matching photos and causes

Identify symptoms associated with lymphoedema
Identify features of cellulitis as a cause or complication of lymphoedema
Identify symptoms that may be experienced by a person with lymphoedema
Benchmark Expected Learning Outcome Curriculum Area Resources/Assessment*
Explore the education needs of individuals who have, or at risk of developing lymphoedema and how these might be met List the basic advice required by those with established lymphoedema to minimise worsening of the condition, including information on:

  • Skin hygiene and hydration
  • Fungal infection
  • Trauma prevention
  • Lymphoedema
  • Regular activity and exercise to maintain a healthy weight
  • How to put on and take off garments
Identify suitable sources of information on reducing the risk of lymphoedema/exacerbation and how to access treatment
Benchmark Expected Learning Outcome Curriculum Area Resources/Assessment*
Explore the basics of lymphoedema management Identify the core components of lymphoedema management as:

  • Education
  • Skin care
  • Exercise – gradual progression and warm down to enhance lymph flow, general well being, strengthening and fitness
  • Breathing exercises
  • Compression therapy
  • Lymphatic drainage
Recognise the psychosocial and financial impact of lymphoedema
Recognise the need for long term monitoring and maintenance for lymphoedema
Identify the urgency for treatment of cellulitis, and the treatment options
Identify limitations of own role and when and where to refer on to a qualified lymphoedema practitioner

Sample Assessment

Why not try out one of our online assessments? This is a simplified 5-question example which will give you an idea of the final format. At the end of the test, you will be presented with a score and feedback on your performance.

Click on the button below to begin.

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