2024/25 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 2024/25

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 CARES 1 course aims to give you a grounding in the Clinical Assessment of patients, diagnostic Reasoning, Ethical and legal aspects of patient care and patient Safety 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. CARES integrates closely with other ICUs in years 1-2, with particular linkage with IDEALS.

Objectives

By integrating teaching in the classroom with time spent in the clinical environment, Year 1 of the course has a number of aims, to enable students to:

- Experience the different environments in which medicine is practised

- Be aware of the importance of patient safety and the part that you play in this as a medical student

- Develop the communication skills you need to interact with patients, carers and other healthcare workers and understand the impact of your own behaviour and communication

- Understand how ethical and legal principles underpin patient encounters

- To develop year 1 clinical skills so that you can carry these out safely and efficiently in clinical practice

- Learn about the important elements of safe prescribing and drug administration

- To understand how the clinical skills you are learning are used in practice to aid diagnosis or clinical management decisions

- Recognise the role of the doctor as part of a team of health professionals and as part of the wider community in which they practise

- Learning from patients and working in partnership with patients

- Understand what constitutes professional behaviour in the clinical setting

- Recognise how interactions with others may affect you personally, and develop coping mechanisms for this

- Develop the skills of lifelong, reflective learning

- Safeguarding: To develop an understanding of what abuse is and how it relates to health, what your safeguarding roles and responsibilities are as a developing clinician which includes seeking support for yourself if needed.


The Year 1 CARES course maps directly to following Outcomes for Graduates (2018):

1. Newly qualified doctors must behave according to ethical and professional principles.
2. Newly qualified doctors must demonstrate knowledge of the principles of the legal framework in which medicine is practised in the jurisdiction in which they are practising, and have awareness of where further information on relevant legislation can be found.

3. Newly qualified doctors must demonstrate that they can practise safely. They must participate in and promote activity to improve the quality and safety of patient care and clinical outcomes.

4. Newly qualified doctors must be able to recognise and identify factors that suggest patient vulnerability and take action in response.

5. They must be able to: a identify signs and symptoms of abuse or neglect and be able to safeguard children, young people, adults and older people, using appropriate systems for sharing information, recording and raising concerns, obtaining advice, making referrals and taking action

6. Newly qualified doctors must learn and work effectively within a multi-professional and multi-disciplinary team and across multiple care settings. This includes working face to face and through written and electronic means, and in a range of settings where patients receive care, including community, primary, secondary, mental health, specialist tertiary and social care settings and in patients’ homes.

7. Newly qualified doctors must be able to communicate effectively, openly and honestly with patients, their relatives, carers or other advocates, and with colleagues, applying patient confidentiality appropriately.

8. Newly qualified doctors must work collaboratively with patients and colleagues to diagnose and manage clinical presentations safely in community, primary and secondary care settings and in patients’ homes.

9. Newly qualified doctors must, wherever possible, support and facilitate patients to make decisions about their care and management.

10. Newly qualified doctors must be able to perform the core set of practical skills and procedures safely and effectively, and identify, according to their level of skill and experience, the procedures for which they need supervision to ensure patient safety.

11. Newly qualified doctors must demonstrate how patient care is delivered in the health service.

Learning outcomes
By the end of year 1 students will be able to:

- Demonstrate the communication skills needed to interact with patients, carers and other healthcare workers and understand the impact of their own behaviour and communication
- Demonstrate the ability 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.
- Demonstrate understanding of the importance of patient comfort, privacy and dignity and when the use of chaperones is appropriate.
- Demonstrate knowledge about the important elements of safe prescribing and drug administration of the following over-the-counter medicines: paracetamol, co-codamol, ibuprofen, gaviscon and chlorphenamine
- Demonstrate proficiency in a range of basic practical procedures: Handwashing, Basic Life Support, Manual Handling, Vital Signs, Urinalysis, PEFR and BMI measurement.
- Demonstrate an understanding of what constitutes professional behaviour in the clinical setting
- Demonstrate an understanding of how ethical and legal principles underpin patient encounters
- Demonstrate an understanding of what abuse is and how it relates to health, what your safeguarding roles and responsibilities are as a medical student, including seeking support for yourself if needed.
- Demonstrate the ability to reflect on patient encounters to inform personal and professional development.

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

Syllabus
There are many aspects to CARES and there are therefore multiple strands of teaching:

- Ethics & Law
- Communication skills
- Clinical skills
- Community visits
- Clinical Placements


Communication Skills is taught in a series of face-to-face facilitated small group-work sessions. Communication skills teaching will be delivered through the Leeds model, which is broadly based on the existing Calgary Cambridge framework.

Students will develop an understanding of:

a. Self and learning from both personal and professional experiences
b. Effective communication for shared understanding
c. The GMC’s framework for communicating effectively with patients and others

Students will have had the opportunity to:
- Increase understanding of how good communication is a requirement of Good Medical Practice (GMC, 2013), form part of the Generic Professional Capabilities Framework (GMC, 2017) and how these are assessed on placement 
- Gain an understanding of the impact of good and bad communication patients and their carers 
- Develop good verbal and non-verbal communication skills 
- Explore communication skills challenges that they will encounter throughout their careers and develop strategies to cope with these


Medical ethics is taught via small group interactive sessions. By the end of the course you will be able to:

- Demonstrate awareness of the role of ethical guidelines in good clinical practice
- Understand the basic ethical concepts of best interests, autonomy and competence, trust and honesty
- Understand how these are linked to the requirements for, and appropriate limits, to
o Informed consent for treatment
o Truthfulness in patient encounters
o Respect for the patient’s views, values and preferences
o Respect for the views of the patient’s carers or family
o Confidentiality
- Demonstrate an ability to apply this understanding to clinical cases to reach ethically justifiable decisions
- Demonstrate an ability to respond appropriately to ethical uncertainty


Clinical skills in year 1 are: Handwashing, Basic Life Support, Manual Handling, Vital Signs, Urinalysis, PEFR and BMI measurement.

Clinical placements will bring all of these aspects together as you begin to communicate with patients, work with team members and use your clinical skills in the community and hospital environment. Students will spend time in both Primary and Secondary care environments, working with clinicians and the wider team.

Community visits to voluntary sector organisations aim to help students recognise the role of the doctor as part of a team of health professionals and as part of the wider community in which they practise. Though visiting or interviewing a chosen organisation, students will develop an understanding of the role and operating environment of the voluntary, community and faith sector [the Third Sector] in promoting inclusion, community health and well-being.

Teaching methods

Delivery type	Number	Length hours	Student hours
Placement	30	4.00	120.00
Lecture	20	1.00	20.00
Tutorial	20	2.00	40.00
Private study hours			0.00
Total Contact hours			180.00
Total hours (100hr per 10 credits)			180.00

Private study

Due to Covid-19, teaching and assessment activities are being kept under review - see module enrolment pages for information:https://students.leeds.ac.uk/info/10103/module_enrolment/1329/module_enrolment_and_covid-19_arrangements

Please note that the hours listed 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 CARES 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. In addition, communication training, clinical examination teaching and clinical skills training will allow for direct feedback and support to students. Monitoring of progress in this strand will follow the student support model (with local monitoring and feedback from (clinical) teachers and ICU management team and regular meetings with tutors to look at overall progress 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: 29/04/2024 16:18:11

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