Timeframe: from first patient contact until diagnosis of syncope and development of a management plan (then, in cases of arrhythmia or other CVD, continued in specific EPAs)

Setting: outpatient setting, inpatient setting, and emergency department

Including:

initial assessment based on the clinical history, physical examination, ECG

further investigation

risk stratification (incl. driving and high-risk occupations)

Excluding: performing actual therapy of rhythm disorders (see specific EPAs)

• Medical expert

• Communicator

• Collaborator

• Professional

• Define the terms transient loss of consciousness and syncope

• List the causes of transient loss of consciousness

• Outline the epidemiology and prevalence of syncope

• Describe the clinical features of syncope and how they differ from other causes of transient loss of consciousness

• Outline the diagnostic evaluation of a patient presenting with suspected syncope

• Discuss risk stratification for a patient with syncope

• Describe the management options including education and reassurance, physical countermeasures, drug therapy and device implantation for the different causes of syncope

• Outline the national regulations on driving and high-risk activities

• Take a relevant history and perform an appropriate physical examination

• Distinguish syncope from other causes of transient loss of consciousness

• Select appropriate investigations for a patient with suspected syncope

• Collaborate, where appropriate, with other specialists

• Identify patients with syncope at high risk of sudden cardiac death (SCD)

• Select an inpatient or outpatient management treatment strategy according to the clinical circumstances

• Advise a patient with syncope on driving and high-risk activities such as working with machinery or at heights

• Teach the patient with syncope how to recognize and avoid triggers and how to perform physical countermeasures

• Involve witnesses in obtaining the history

• Be aware of the lifestyle impact of recurrent syncope

• Recognize that syncope can be a transient symptom, and not necessarily a disease

• Collaborate with neurologists, elderly care specialists and other care providers

• Accept that the diagnosis of syncope is often presumptive

• Recognize that many patients do not need specific treatment

• Help patients to understand that therapies are often ineffective

• Direct observation/WBA (e.g. DOPS, Mini-CEX, fieldnotes)

• CbD (case-based discussion)/EbD (entrustment-based discussion)

• 5. Able to teach (no supervision)