Introduction to Clinical Practice
Code
11124
Academic unit
Faculdade de Ciências Médicas
Department
MC
Credits
11
Teacher in charge
Prof. Doutor Jaime Branco
Teaching language
Portuguese
Objectives
The Department of Introduction to Clinical Practice (3rd year of medical school ) represents the first formal contact of students with the reality of clinical activity, thus playing a key role in introducing the basics of communication with the patient in and skills development of gestures, and finally the creation of the elementary basis for the development of clinical reasoning, to occur in subsequent years.
Fundamental Objectives of Course:
- Develop techniques and skills for proper communication with the patient.
- Knowledge of the essential bases of individual relationships - and medical disease - disease (and patient)
- Identify and develop the basic principles of the formation of clinical thinking and methodology for the collection of signs and symptoms
- Identify the main manifestations of disease, and forms of recognition
- Create the foundations for the integration of symptoms and signs, and demonstrate competence in integration
- Identify the clinical issues relevant to each case, and organize plans for a methodological approach
- Recognize the need for rigor and precision necessary for the production of history
- Conduct an independent interrogation and observation of a patient.
- Establish the level of the provisional diagnoses Major Clinical Syndromes, and determine the methodology necessary for its clarification.
Prerequisites
Not applicable
Subject matter
THEORETICAL PROGRAM:
- Introduction
- Clinical medicine and the scientific method
- Communication techniques, collection of symptoms and signs
- Systematization of the clinical history
- General Purpose Examination; Registration signs
- Patients with systemic manifestations
- Patients with respiratory complaints
- Patients with acute dyspnoea
- Systematization of observation of the patient with respiratory
- Note cardio - vascular 1
- Note cardio - vascular 2
- Patients with heart failure
- Patients with generalized edema
- Patients with blood pressure changes
- The patient with chest pain
- Patients with gastrointestinal symptoms
- The patient with altered bowel habits
- The patient with pancreatic disease
- The patient with jaundice
- The patient with liver cirrhosis
- The patient with malabsorption
- The patient with gastrointestinal bleeding
- Patients with urinary complaints
- The patient with renal insufficiency
- Systematization of observation of the patient with abdominal manifestations
- Patients with articular manifestations
- Patients with bone disease
- Systematization of observation of the members and the patient with muscle disease osteoporosis
- The patient with anemia
- The patient with enlarged lymph nodes
- Patients with rashes and skin changes
- Systematization of observation of the patient with skin changes
- The patient with headache
- Patients with loss of consciousness. Comas
- Neurologic examination summary
- Systematization of febrile syndromes
- Alcoholism, HIV and oxicodependência
- The diabetic patient
- Patients with thyroid disorders
- Patients with adrenal disease - renal
- The critically ill patient
- The cancer patient
- Ethics, patient physician relationship
- Final Thoughts
Bibliography
Textbooks:
- Mosby's Guide to Physical Examination: Seidel HM et al, 7 th edition, 2010
- Bate's Guide to Physical Examination and History Taking, 10 th edition, 2008
- Duclos JL Smith: Medical Semiology. Principles, Methods, Interpretation. 1st edition, 2007
Resources available for teaching online:
Loyola Medical School:
http://www.meddean.luc.edu/lumen/medcurr.htm
Physical exam steps:
http://www.meddean.luc.edu/lumen/MedEd/MEDICINE/PULMONAR/pdself/menu_f.htm
Screening physical exam:
http://www.meddean.luc.edu/lumen/MedEd/MEDICINE/PULMONAR/PD/Contents.htm
University of California San Diego
Introduction to Clinical Medicine:
http://meded.ucsd.edu/clinicalimg/links.htm
Pulmonary and Cardiac Auscultation:
http://www.wilkes.med.ucla.edu/intro.html
http://www.blaufuss.org/
Teaching method
Theoretical Education:
Will be held at the Faculty of Medical Sciences, with two classes per week for 50 minutes, starting on September. It is anticipated the completion of 50 Lectures by addressing the areas of communication with the patient, principles of clinical examination, the ethical aspects of doctor-patient relationship, collection and recording of signs and symptoms, general physical examination, examination and evaluation of patients with manifestations systemic and the various organs and systems (syndrome perspective). It also includes notions about the evaluation of critically ill / in need of life support. In the penultimate week of the theoretical course will be distributed an anonymous survey, to be analyzed in the last class.
Practical Education:
Will be held from October to May 20, 2012 with a practice session each class weekly, totaling about 24 practical sessions lasting two hours. The practical classes lasting 120 minutes, with questioning, observation and discussion of patients appropriate to the knowledge and skills to be acquired by students, accompanied by their teachers. In the first weeks of school learning is focused on communication with the patient and developing interview skills (questioning oriented). Once acquired skills in this area will start teaching Exam Objective. At the end of the Practical Education students should be able to conduct autonomously, questioning and observation of a patient, and to identify major problems (Great Syndromes), and what form of clarification is required.
Each student has a Handbook, where they are registered to practice in each class attendance, activities, themes etc. And that must be signed by the respective Class Teacher.
The frequency of practical classes is mandatory, and the student must be present in 2 / 3 of them. Students with Student Workers Statute should attend the practical classes but are not required by law to attend a minimum number of practical classes. They are however not exempted from practical evaluation.
Evaluation method
At the end of school year Students will be assessed at the practical, and theoretical level, including a multiple choice test and optional oral examination. Assessments are both practical and theoretical rounds (less than 3.8 values for a practical assessment - scale of 0 to 8; values less than 5.7 - scale of 0 to 12 - for the theoretical evaluation).
The Oral Examination will be optional for students who have the final assessment (written theoretical + practical) equal to or greater than 9.5, provided they have not been eliminated in any of the previous assessments (practical and written). Attendance to the oral theory examination does not guarantee the maintenance of the classification obtained in multiple-choice written examination.
PRACTICE RATING:
Represents 40% of the final classification of the discipline.
1. Assiduity : Value from 0 to 1
2. Questioning the fitness of the Sick: Values from 0 to 1.5
3. Aptitude Exam Objective: Values from 0 to 1.5
4. Demonstrated knowledge: Values from 0 to 1.5
5. Clinical trial summary: Values from 0 to 2.5
Total: 0-8 values
A practical classification values below 3.8 requires the achievement of Practical Examination. This practical test feature is only accessible to those who have been subject to continuous assessment (parameters 2, 3 and 4). The classification obtained in this survey (scored 0 to 8 values) will be considered as representing the final practical classification, were excluded Students with scores below 5 (equivalent to 12.5 points on a scale of 0 to 20).
Rules for the practical evaluation:
The practical assessment includes an ongoing evaluation (they are evaluated demonstrated knowledge and skills acquired in the interrogation and physical examination throughout the year in the practical lessons), and a final summary assessment. In early May, the Faculty of each Class will indicate which students acquired minimal practical knowledge, and their classification, taking into account the continuous assessment including the presence and participation in practical classes, and who have demonstrated the capabilities gained from the respect to interrogation, observation, and the realization of a practical summary consisting of the preparation of a medical history including anamnesis, physical examination and provisional Discussion centered on the Great Syndromes. The whole of the Practice Assessment is scored with 8 points. Students with Student Worker Statute are subject to practical assessment by the same rules applied to other students, and must met the conditions throughout the school year to be accountable to continuous assessment. Students that are accountable to evaluation, but in Practical Education (rating less than or equal to 3.8 values in the range 0 to 8 points) will be required to perform a practical examination in the presence of the Regent and the faculty, consisting of questioning and observation summary of a patient, and subsequent discussion. Students not rated positive on pratical evaluation can not submit to Theoretical Examination.
THEORETICAL RATING:
The ranking of the theory test is 60% of final grade. A grade lower than 9.5 in written or oral test (scale of 0 to 20, equivalent to 5.7 values in the range of 0 to 12) is marked as fail, regardless of classification practice obtained.
The theory test consists of a compulsory written examination (multiple choice test with 100 questions and 90 minutes), and an oral examination optional for students who have the final assessment (written theoretical + practical) equal to or greater than 9.5 values. May not present the oral examination the students failed the written exam or practical assessment. The marks obtained by students who present the oral theory test will be the final classification theory, and is independent of marks obtained in written examination.
FINAL:
Will be obtained by the sum of ratings practical and theoretical. Students will be disapproved Final with less than 9.5 (scale of 0 to 20), or which do not use the Theoretical and practical part.