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2019/20 Undergraduate Module Catalogue

MEDI2219 Campus to Clinic 2

Module manager: Dr Dermot Burke (Overall Manager; Secondary Care)
Email: d.burke@leeds.ac.uk

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

Year running 2019/20

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

MEDI2201	Control and Movement
MEDI2202	Individuals and Populations 2
MEDI2217	Research, Evaluation and Special Studies 2
MEDI2218	Innovation, Development, Enterprise, Leadership and Safety 2
MEDI2219	Campus to Clinic 2
MEDI2220	RESS 2 Special Studies Project
MEDI2221	Essential Medical Science
MEDI2222	Clinical Pathology

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

Year 2 specific objectives
- Demonstrate the skills of routine history-taking, including that of mental state examination, initially under supervision.
- Develop communication skills to effectively gather information from the patient, taking their ideas, concerns and expectations into account, in a timely manner.
- Develop routine examination skills, although students at this stage would not be expected to reliably identify abnormal physical signs.
- Recognise the importance of patient comfort, privacy and dignity and when the use of chaperones is appropriate.
- Develop specific systems of examination using the Leeds unified teaching model for Physical Examination.
- Demonstrate shared mutual understanding through communicating effectively with patients/carers, medical colleagues and other health professionals.
- 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.
- 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.
- Identify own communication limitations and be prepared to ask for assistance in order to improve this where appropriate.
- Perform a range of basic practical skills in a non-clinical environment. Attainment will be recorded in an (electronic) skills portfolio that will map across the whole MBChB course.

The Year 2 CtoC course maps directly to following Tomorrow's Doctors (2009)
- 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)

Learning outcomes
Students will be able to demonstrate the following as appropriate to the stage of the course:

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 the different routes used when prescribing;
- Use this knowledge in context with a range of common drugs.
(See Basic Formulary 'A')

Skills outcomes
The ability to elicit a clinical history which is thorough yet succinct and integrates the patient's perspective:
From the second year onwards, students will be taught the skills of history-taking, including that of mental state examination, initially supervised, and becoming able to do this independently by the end of the third year.

Students will develop communication skills that enable them to effectively gather information from the patient, taking their ideas, concerns and expectations into account, in a timely manner.

Competence in clinical examination, taking into account patient dignity, privacy, wishes and concerns:
Students will start to learn examination skills in the second year, and should be competent in the process by the end of the third year, although would not be expected to reliably identify abnormal physical signs.

Students should understand the importance of patient comfort, privacy and dignity and when the use of chaperones is appropriate.

Students will be taught specific systems of examination using the Leeds unified teaching model for Physical Examination.

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, which is broadly based on the existing Calgary Cambridge framework.

Proficiency in a range of basic practical procedures:
Second year students will learn a range of basic practical skills in a non-clinical environment. Attainment will be recorded in an (electronic) skills portfolio that will map across the whole MBChB course.

Syllabus

Year 2
Terms 1-3: Working in Healthcare Teams, clinical methods and ethical practice: 1 day per week (½ day per week of clinical placement, lecture/small group sessions). Placements rotate between primary and secondary care (students will stay with the same primary care supervisor for both year 1 and 2)

Students will be able to demonstrate the following as appropriate to the stage of the course:

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

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

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 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	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.

Exams

Exam type	Exam duration	% of formal assessment
Practical Exam / OSCE	1 hr 20 mins	0.00
Total percentage (Assessment Exams)		0.00

There is no separate written exam for this module; Material will be integrated into an end of year common single best answer paper. OSCE - Students will participate in an Objective Structured Clinical Examination (OSCE) during term 3 in year 2. The OSCE will not be graded, but attendance is obligatory. Students will receive feedback on their performance which should assist them in year 3 where the OSCE is a major assessment and must be passed for progression. The School wishes the option of failing students who do not engage hence the pass criteria is attendance. There is no August resit, but there is a a mop-up OSCE will be run each year in September instead to ensure that Malaysian students and dentists joining in year 3 have the opportunity to experience an OSCE. Fail students will also sit this OSCE. Non-attendance at the September OSCE will be dealt with on an ad hoc basis depending on circumstances but the School would reserve the right to exit a student or make them resit the year.

Reading list

The reading list is available from the Library website

Last updated: 04/08/2016

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