2020/21 Undergraduate Module Catalogue

MEDI1221 Clinical Assessment, Reasoning, Ethics and Patient Safety

Module manager: Dr Alison Brown
Email: A.L.Brown@leeds.ac.uk

Taught: Semesters 1 & 2 (Sep to Jun) View Timetable

Year running 2020/21

Pre-requisite qualifications

Compulsory strand of MBChB programme - runs over year 1-3. For students entering via alternative routes, evidence of satisfactory teaching and academic attainment is mandatory.

Co-requisites

MEDI1204	Individuals and Populations
MEDI1213	Research, Evaluation and Special Studies 1
MEDI1214	Innovation, Development, Enterprise, Leadership and Safety 1
MEDI1216	Introduction to Medical Sciences
MEDI1218	RESS 1 Special Studies Project
MEDI1220	Body Systems

Module replaces

PPD (Personal and Professional Development) & Patient Evaluation. CtoC has been designed to meet the needs of the new MBChB 2010 curriculum, and builds on the strength of the current model.

This module is not approved as a discovery module

Module summary

The CtoC course aims to give a thorough grounding in history taking, physical examination and basic clinical assessment of patients. The module will emphasise the central importance of the patient perspective, through development of excellent communication skills and a respectful and caring approach to clinical evaluation of patients from all backgrounds. Other key components of this course include understanding and application of ethical practice in clinical care, inter-professional and team working and CtoC integrates closely with other ICUs in years 1-3, with particular linkage with IDEALS.

Objectives

The CtoC programme is a core strand of the MBChB programme, aimed at providing medical students with the opportunity to acquire and develop those skills that map directly onto the Tomorrow's Doctors 2009 themes 'Doctor as a practitioner' and 'Doctor as a professional'. The outcomes for this component of the course span three years. These outcomes will spiral through the three year course with a focus on increasing integration at a patient level, and the wider interface with health providers. The 3 year CtoC course prepares students for the latter two years of senior studentship in years 4 and 5 of the course.

Year 1 specific objectives
- Observation of multi-professional healthcare teams in practice.
- Identify good practice in clinical history taking which is thorough yet succinct and integrates the patient's perspective.
- Demonstrate the measurement of basic physiological parameters.
- Explore basic ethical principles, consent and dignity through campus sessions, and as applied in practice as part of clinical placements.
- Communicate effectively with their patients and their carers, using easily understood language, and be able to pick up on non-verbal cues from them. Students should also be able to communicate in situations that present further challenges, including those patients where English is not their first language, those who are hearing-impaired or those with speech or learning difficulties.
- Develop fluency in medical language, to be able to communicate effectively and efficiently (both written and verbally) to other health professionals. They should be able to write out a full history and examination and present this verbally in a clinical scenario.
- Recognise own communication limitations and be prepared to ask for assistance in order to improve this where appropriate. Communication skills teaching will be delivered through the Leeds model.
- Undertake basic skills in an (initially) non-clinical environment such as hand hygiene, moving and handling and basic First Aid training. Attainment will be recorded in an (electronic) skills portfolio that will map across the whole MBChB course.

The Year 1 CtoC course maps directly to following Tomorrow's Doctors outcomes:
- Biomedical science in medical practice (8)
- Psychological + Social Science principles, method and knowledge in medical practice (9 &10)
- Consultations with patients (13)
- Diagnosis and management (14)
- Communication with patients and colleagues (including effective multi-disciplinary team working) (15)
- Emergency Care (16)
- Safe, effective drug prescription (17)
- Safe practical procedures (18)
- Use of information in a medical context (19)
- Behaviour in keeping with ethical and legal principles (20)
- Reflection, learning and teaching (21)
- Protect patients and improve care (22)

The overall aims, philosophy and objectives of the course are listed below, and have been subdivided to reflect the new themes of the GMC's Tomorrow's Doctors 2009. Further detail is contained in 'Subject specific skills'. A supplementary paper details the year level outcomes for each of the course level outcomes below:

Clinical Science, prescribing and informatics:
- Recognises how conditions present in hospital and primary care, with learning facilitated by a series of clinical cases.
- Demonstrates understanding of the pathophysiology underlying these conditions and how this translates into symptoms and signs.
- Demonstrates an appreciation of the cause and effect of these conditions in the context of a patient's life.
- Maintains confidentiality, understanding the legal and ethical implications of verbal, written and electronically communicated/stored information.
- Demonstrates an understanding of the role of the basic principles of prescribing, recognising the contribution of the patient.
- With regards to prescribing, students will:
> become familiar with the use of a standard drug chart
> show the factors involved in safe prescribing
> show t he different routes used when prescribing
> use this knowledge in context with a range of common drugs
(See Basic Formulary 'A')

Consultation, ethical/medico-legal practice and management
- Understands patients' strengths, resources and problems in the context of illness.
- Forms a hypothesis regarding diagnosis and how to apply and correctly interpret simple investigations.
- Formulates a shared management plan, including the basic principles of prescribing, recognising the contribution of the patient.
- Demonstrates awareness of the different organisational settings in which medicine is practised.
- Demonstration of understanding and application of key ethical and legal principles in relation to clinical care.
- Elicit a clinical history which is thorough yet succinct and integrates the patient's perspectives.
- Competence in clinical examination, taking into account patient dignity, privacy, wishes and concerns.
- Share mutual understanding clearly and effectively, with patients/carers, medical colleagues and other health professionals.
- Communicate clinical information via written format (case histories, management plans etc).
- Proficiency in a range of basic practical procedures as detailed in the pan year 3-5 skills portfolio.

Professionalism & key attributes
- Clearly demonstrate professionalism and appropriate behaviour in a clinical setting.
- Recognition of the importance of patient safety and demonstrate this in practice.
- Shows respect towards patients and carers, appreciating the part they play in care.
- Demonstrates empathy and an understanding of patient and carer perspectives.
- Shows self-awareness and the ability to reflect.
- Work in clinical teams, showing respect for professional colleagues.

Learning outcomes
See module objectives and subject specific skills - knowledge, skills, and attributes have been conflated above as part of the integrated nature of this strand of the MBChB course.

Skills outcomes
The ability to elicit a clinical history which is thorough yet succinct and integrates the patient's perspective:

In the first year, students will predominantly observe these skills in practice, building on a theoretical framework taught on campus. Students will learn to communicate with patients and colleagues (see below), and practise these skills in clinical placements in terms 2 and 3.

Competence in clinical examination, taking into account patient dignity, privacy, wishes and concerns.

In the first year, students will learn skills of the measurement of basic physiological parameters.

Teaching around basic ethical principles, consent and dignity will be explored in campus sessions, and applied in practice as part of clinical placements.

The ability to share mutual understanding clearly and effectively, with patients/carers, medical colleagues and other health professionals.

In addition to history-taking skills, students need to be able to communicate effectively with their patients and their carers, using easily understood language, and be able to pick up on non-verbal cues from them. They should be able to give patients information in a way they can understand and be able to explain when there are areas of uncertainty. They should recognise opportunities for health promotion.

Students should also be able to communicate in situations that present further challenges, including those patients where English is not their first language, those who are hearing-impaired or those with speech or learning difficulties.

Students need to become fluent in medical language, to be able to communicate effectively and efficiently (both written and verbally) to other health professionals. They should be able to write out a full history and examination and present this verbally in a clinical scenario.

Students must be aware of their own communication limitations and be prepared to ask for assistance in order to improve this where appropriate.

Communication skills teaching will be delivered through the Leeds model.

Proficiency in a range of basic practical procedures.

In Clinical Skills sessions, first year students will undertake basic skills in an (initially) non-clinical environment such as hand hygiene, moving and handling and basic First Aid training. Attainment will be recorded in an (electronic) skills portfolio that will map across the whole MBChB course.

Syllabus

Year 1:
Term 1: Preparing for patients, introduction to ethical practice (lecture/small group sessions, community and patient visits, clinical practice visits).
Terms 2+3: Working in Healthcare teams, engaging with people & patients (lecture/small group, ½ day per week of clinical placement).
Placements rotate between primary and secondary care (students will stay with the same primary care supervisor for both year 1 and 2).

Teaching methods

Delivery type	Number	Length hours	Student hours
Placement	19	4.00	76.00
Lecture	20	1.00	20.00
Tutorial	18	2.00	36.00
Private study hours			0.00
Total Contact hours			132.00
Total hours (100hr per 10 credits)			132.00

Private study

Please note that the above hours will vary between clinical placement and teaching content. Some of the clinical placements will contain small group (often bedside) teaching. Due to the variability in clinical timetables, the proposal can only illustrate fixed teaching for all students within the Medical School.

*Private study is incorporated within programme, and in placements.

Opportunities for Formative Feedback

Students will be required to document progress through an electronic portfolio throughout the entire CtoC strand, with a range of clinical activities, work place learning (and assessment) and feedback. The portfolio will incorporate access to monitoring and tracking of students' progress towards the intended learning outcomes as well as a personal developmental progress log (shared with other ICUs and strands in the MBChB programme. Monitoring of progress in this strand will follow the student support model (with local monitoring and feedback from (clinical) teachers and regular meetings with tutors and groups to look at overall progress periodically within IDEALS) and a review of student progression via examination boards and the Student Progress committee, incorporating academic and personal tutoring mechanisms.

Methods of assessment

Coursework

Assessment type	Notes	% of formal assessment
Portfolio	e-Portfolio with clinical competencies	100.00
Total percentage (Assessment Coursework)		100.00

Please note that the majority of in-course assessment is assessment for learning, and will vary according to year, and clinical placement. For each year of the CtoC programme, students will achieve a non-graded pass for in-course assessment, based on demonstration of satisfactory professional attributes, attendance and submission of an adequate number of project and/or clinical case reports.

Reading list

The reading list is available from the Library website

Last updated: 09/09/2020 15:31:39

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