Undergraduate Course: Year 4 - Process of Care 1 (MBCH10020)
|School||Edinburgh Medical School
||College||College of Medicine and Veterinary Medicine
|Credit level (Normal year taken)||SCQF Level 10 (Year 4 Undergraduate)
||Availability||Not available to visiting students
|Summary||The emphasis throughout Year 4 - Process of Care 1 is on achieving a solid foundation in the generalities of medical practice,
The year is organised into two semesters with vacations at the end and in the middle of each.
Students rotate through large mainly systems-based specialties but the emphasis throughout is on learning the fundamentals of how patients present, how the clinical team works and how clinical management is determined and implemented by teams in partnership with the patient and carers.
In a wide range of hospital and General Practice settings students will put into practice the foundational knowledge and skills developed in Years 1 and 2 of the MBChB (Principles for Practice 1 and 2). They will assess patients in the specialties of the Course, through history-taking and clinical examination, will propose and interpret investigations and learn to create clinical management plans. Throughout, there will be an emphasis on communication and consultation skills within a holistic and patient-centred approach that recognises and addresses the physical, social and psychological perspectives of wellbeing and ill health.
Hospital and systems-based attachments will be complemented by an attachment in primary care and by another focusing on inter-professional teamwork, the life of a ward and patient safety.
There are opportunities for formative feedback throughout the Course.
Assessments occur at the end of each semester in the form of written exams (mainly MCQ exams). There is an anatomy practical at the end of one semester, and a clinical exam (usually an Objective Structured Clinical Examination) at the end of the year. Students write portfolio case reports on the patients they meet in the modules and are expected to demonstrate a professional approach towards their studies and conduct.
Modules include Cardiovascular, Respiratory, GP with Psychiatry, Neurosciences, Diabetes & Endocrinology, Rheumatology, Orthopaedics & Surgical Principles, GI and Liver, Infection, Team.
The teaching and learning experiences are varied and include: lectures, large group interactive plenaries, small group tutorials, directed reading using a range of materials including online lectures and computer based learning packages, anatomy practicals, resuscitation, clinical skills and communication workshops, clinical teaching in GP surgeries, clinics, wards, operating theatres, imaging and investigative labs.
There is a 2-week attachment when students become embedded in the ward team to learn more about the life of a ward, patient safety and working in a multi-professional team.
The curriculum and its teaching and learning methods continue to guide the development of self-directed learning. This requires both challenge and support. Less of the required knowledge is provided in face to face or online lectures but there will be clear guidance to prioritise students' reading and these methods are complemented by interactive tutorials, often in the clinical setting. The portfolio case reports direct students to explore in depth the needs of individual patients, and to reflect on and critique current approaches to clinical management. The feedback postcards offer students another opportunity to take responsibility for their own learning and emulates the requirements of postgraduate medical training for new doctors. Students can challenge themselves to be observed in new tasks, capture the feedback and store it in their portfolio to help them recall it and use it to improve their performance. At the end of modules tutors review the evidence of performance (e.g. feedback postcards) with students and provide additional written and verbal narrative comments on general progress, with suggestions for developments.
There are many other opportunities for feedback, described below. Students are expected to reflect on this feedback, discuss it with their Personal Tutors and use it to further direct and regulate their own learning.
Entry Requirements (not applicable to Visiting Students)
||Other requirements|| None
Course Delivery Information
|Academic year 2016/17, Not available to visiting students (SS1)
|Learning and Teaching activities (Further Info)
Lecture Hours 60,
Seminar/Tutorial Hours 232,
Online Activities 144,
Feedback/Feedforward Hours 36,
Formative Assessment Hours 8,
Summative Assessment Hours 10,
Programme Level Learning and Teaching Hours 36,
Placement Study Abroad Hours 480,
Directed Learning and Independent Learning Hours
|Assessment (Further Info)
|Additional Information (Assessment)
||IN-COURSE ASSESSMENT«br /»
Portfolio: Students are required to submit clinical portfolio reports as they rotate through modules. These are marked as Pass/Fail so Weighting = 0%.«br /»
Professionalism: For each module and theme teaching delivered across the year, this includes measures of:«br /»
Attendance; Engagement; and Professional Conduct.«br /»
Short modules and theme teaching will not routinely assess Professionalism when it is impossible for staff to know each student well, but will flag Professionalism concerns, especially around attendance, on an ad hoc basis. «br /»
PROGRESSION CRITERIA for IN-COURSE ASSESSMENT«br /»
Portfolio: Students may progress with 1 item at borderline fail if all others have achieved a pass. «br /»
Professionalism: Students must complete all attachments, modules and theme teaching without Professionalism Issues being raised. This requires students to:«br /»
- attend all teaching and learning sessions in the clinical setting, all small-group sessions and those with patients or guest speakers, and all interactive sessions«br /»
- engage by submitting evidence of required learning and assessment activities on attachment, by submitting / resubmitting all required portfolio items and by submitting specified PPD portfolio components such as CV and Record of Generic Professional Skills«br /»
- demonstrate professional conduct as defined in the course information«br /»
RESUBMISSION /RESIT LOOP for IN-COURSE ASSESSMENTS«br /»
Portfolio: Students who achieve a borderline fail in ONE portfolio item will be advised by the Board of Examiners to resubmit and will be offered specific feedback beforehand, but they will be REQUIRED to resubmit ALL failed items if they achieve 2 or more borderline fails, and if they achieve any clear fails. Students may resubmit mid-course after the Board of Examiners, if they fail in Semester 1, but the normal resubmission period is during the summer (resit) diet of exams. «br /»
Professionalism: If a module or theme raises a Concern/Issue about a student's professionalism (including attendance, engagement and professional conduct), the Board of Examiners (advised by an adjudication panel for Years 4-6) will ratify or change the award and decide appropriate further attendance, remedial learning or another opportunity to demonstrate professional conduct, as appropriate. All Issues must have been satisfactorily addressed by the end of the course to progress to Process of Care 2.«br /»
WRITTEN EXAMS at the end of each semester after 19 weeks of learning «br /»
Students experience the Course in a carousel so half the class takes each block. «br /»
Block A exams: 2 x 120min examinations«br /»
Block B exams: 2 x 120min examinations (includes anatomy spot)«br /»
Short in-class assessments with up to 5% of the year's total written exam marks awarded for this performance.«br /»
CLINICAL EXAM at the end of the year«br /»
120 min usually in OSCE format«br /»
PROGRESSION CRITERIA for EXAMS«br /»
Students can progress to Year 5 if they have no more than 1 borderline fail exam paper and no papers with a clear fail. «br /»
The borderline fail cut score for each written exam paper will be agreed by the Board of Examiners, usually no lower than 3 Standard Errors of Estimate below the pass score, and will be reported as 58 on the Common Marking Scheme.«br /»
Students must achieve at least a pass for the Clinical Exam. «br /»
RESIT LOOP for EXAMS«br /»
Students will have one opportunity to resit the Written Exams and the Clinical Exam.«br /»
Students must resit ALL papers achieving borderline fail if more than 1 paper achieves less than a pass, and resit ALL papers achieving a clear fail.«br /»
WEIGHTING OF ASSESSMENT«br /»
4 Portfolio reports = 0%«br /»
Written exams - 20% for each of 4 'papers' (one of which includes an anatomy spot component). Up to 5% of the year's total written exam marks may be awarded for performance in in-class assessments.«br /»
Clinical exam - 20%
||FEEDBACK ON FORMATIVE TASKS.
There are formative online MCQ exams before each diet of summative exams. In feedback mode students can revisit every question, see their own answers, the correct answers and explanations.
There is a peer-led and staff assisted formative OSCE in Spring before the summative clinical exam. Verbal feedback is given at each station.
Students are required to undertake some (listed) clinical tasks such as practical skills or clerking patients, for practice and feedback. Tutors will directly observe students undertaking some of these tasks and will offer verbal and/or written feedback, some of which will be recorded on feedback postcards and uploaded to the students' electronic portfolios to support recall and direct further learning.
FEEDBACK ON SUMMATIVE ASSESSMENT
This will be provided when in-course work is returned or, in the case of exams, after the Board of Examiners ratifies marks, and includes:
Portfolio: Written narrative feedback on portfolio case reports and an opportunity to discuss them with the student's Clinical Tutor Associate.
Professionalism: Written narrative feedback and an opportunity to discuss this with the module tutors at the end of each attachment.
Written Exams: Where the technology permits, a breakdown of scores into Themes and Domains with a comparison against the class scores to demonstrate a student's relative strengths and weaknesses.
Clinical exam: Return of all item scores for each station along with a brief written narrative.
Personal Tutors: Provide feedback on CVs and Record of Generic Professional Skills and are happy to discuss other feedback further and help students use it to build on current performance.
||Hours & Minutes
|Main Exam Diet S1 (December)||Cardiovascular and Respiratory||2:00|
|Main Exam Diet S1 (December)||GP, Neurosciences and Psychiatry||2:00|
|Main Exam Diet S1 (December)||Surgery, Orthopaedics, Rheumatology and Diabetes||2:00|
|Main Exam Diet S1 (December)||Gastrointestinal & Liver, Team and Infection||2:00|
|Outwith Standard Exam Diets June||Cardiovascular and Respiratory||2:00|
|Outwith Standard Exam Diets June||GP, Neurosciences and Psychiatry||2:00|
|Outwith Standard Exam Diets June||Surgery, Orthopaedics, Rheumatology and Diabetes||2:00|
|Outwith Standard Exam Diets June||Gastrointestinal & Liver, Team and Infection||2:00|
|Outwith Standard Exam Diets July||RESIT Cardiovascular and Respiratory||2:00|
|Outwith Standard Exam Diets July||RESIT GP, Neurosciences and Psychiatry||2:00|
|Outwith Standard Exam Diets July||Surgery, Orthopaedics, Rheumatology and Diabetes||2:00|
|Outwith Standard Exam Diets July||RESIT Gastrointestinal & Liver, Team and Infection||2:00|
On completion of this course, the student will be able to:
- as a scholar and scientist, apply the principles, methods and knowledge of the relevant disciplines of academic study to selected specialities, and take a scholarly and scientific approach to questions in patient care and health service delivery. More specifically: 1. Biomedical Sciences (BMS) - students will be able to apply to a defined list of specialties, the biomedical scientific principles, method and knowledge relating to relevant sciences including anatomy, biochemistry, cell biology, genetics, immunology, microbiology, molecular biology, nutrition, pathology and physiology. 2. Psychological Aspects of Medicine (PAM) - students will be able to recognise and ask patients about important psychological and behavioural aspects of health, illness and disease; and respond appropriately to these aspects, using strategies such as explanation and advice to address them. 3. Social Sciences and Public Health (SSPH) - students will be able to implement, at a clinical level, knowledge of how to understand the experience of illness and illness behaviour for a defined list of specialties and describe how to prevent disease, prolong life and promote health through the organised efforts of society, analyse a population's health problems, establish the causes and effects of these problems and assist appropriately in implementing effective solutions. 4. Evidence-Based Medicine and Research (EBM&R) - students will be able to use the best available medical evidence, found through a systematic search and appraisal of the relevant information sources, to inform their clinical thinking, in a defined list of specialties; and develop new knowledge or personal understanding through the application of basic research methods and skills.
- as a practitioner under supervision, assess patients with presentations relating to selected specialities, propose clinical management, review and ongoing care, and seek help from colleagues appropriately. More specifically: 5. The Consultation (TC) - students will be able to undertake an effective and efficient consultation that is sensitive to the needs of the patient in defined list of specialties and contexts. 6. Presentation, Diagnosis and Management (PDM) - students will be able to describe the modes of presentation and natural history of diseases, recognise and interpret the signs and symptoms with which people present to doctors, construct a differential diagnosis, and suggest appropriate methods to investigate, treat and care for patients in a multi-professional setting for a defined list of specialties and contexts. 7. Clinical Communication (CC) - students will be able to communicate clearly, sensitively and effectively with patients and their relatives, and with colleagues from the medical and other professions in a defined list of specialties and contexts. 8. Emergency Care, Clinical And Resuscitation Skills (ECCARS) - students will be able to recognise and systematically assess acutely unwell patients, and institute immediate management, including first aid and resuscitation in a simulated setting, and perform a defined range of clinical skills and procedures safely and effectively in defined contexts. 9. Clinical Pharmacology And Therapeutics (CPT) - students will be able to describe how drugs act and apply this knowledge to clinical practice to match appropriate drugs to the clinical context, to review the appropriateness of medication and to evaluate the potential benefits and risks in a defined list of specialties and contexts; and to prescribe clearly and accurately in simulated situations. 10. Medical Informatics (MI) - students will be able to use computers, computing, information and information technology effectively in a medical context, for a defined list of specialties and contexts, within the legal and professional constraints that relate to person-identifiable information.
- as a professional, take a reflective and self-directed approach to the study of medicine, demonstrate understanding of the ethical, professional and legal responsibilities expected in clinical practice, participate in a multi-professional team, and contribute to enhancing patient care when opportunities arise, whilst paying attention to personal health, wellbeing and professional development. More specifically: 11. Medical Ethics, Legal And Professional Responsibilities (MELPR) - students will be able to demonstrate understanding of how to practise medicine, in a defined list of specialties and contexts, within an ethical framework, with insight and compassion, according to the legal requirements and professional expectations of medical practice in the UK. 12. Personal Professional Development (PPD) - students will be able to take a reflective and self-directed approach to the ongoing study of medicine in a defined list of specialties and contexts, work effectively in a team, and develop others' learning in order to enhance safe patient care, maximise effectiveness and enjoyment.
|Information is given on the virtual learning environment, EEMeC, to guide students to a range of learning resources that include online lectures, computer based learning packages, quizzes, reading, and videos (of clinical skills, practical procedures and other content). Increasingly tutors use the University Resource Lists to keep all recommended reading in one location.|
|Graduate Attributes and Skills
||GRADUATE ATTRIBUTES, PERSONAL AND PROFESSIONAL SKILLS
Throughout the MBChB programme, the curriculum offers challenging opportunities and support to ensure all successful students develop the University graduate attributes of Enquiry and Lifelong Learning, Aspiration and Personal Development, and Outlook and Engagement.
More specifically the list below describes how the Process of Care 1 Course Learning Outcomes map to the 4 sets of Graduate Attributes and Skills, Knowledge and Understanding and Technical/Practical Skills.
Knowledge and Understanding.
The successful student completing this Course will apply to clinical practice, research and teaching their extensive knowledge and understanding described within the following themes:
Psychological Aspects of Medicine
Social Sciences and Public Health
Presentation, Diagnosis and Management
Clinical Pharmacology and Therapeutics
Medical Ethics, Legal and Professional Responsibilities
Graduate attributes: Skills and abilities in Research and Enquiry.
The successful student completing this Course will apply to clinical practice, research and teaching, the skills and attributes described within the following themes:
Evidence-Based Medicine and Research
Personal Professional Development
Graduate attributes: Skills and abilities in Personal and Intellectual Autonomy.
The successful student completing this Course will demonstrate socially-responsible independent thinking and take responsibility for their own actions through the application of skills and attributes described within the following themes:
Medical Ethics, Legal And Professional Responsibilities
Personal Professional Development
Graduate attributes: Skills and abilities in Communication.
The successful student completing this Course will use a range of communication skills in common clinical settings described within the following themes:
Graduate attributes: Skills and abilities in Personal Effectiveness.
The successful student completing this Course will be reflective and self-regulating, preparing for high levels of professional achievement and able to work well with others as described within the following theme:
Personal Professional Development (PPD)
Technical / practical skills.
The successful student completing this Course will have the skills and technical abilities to permit them to function as a Foundation Doctor and postgraduate learner as described within the following themes:
Emergency Care, Clinical and Resuscitation Skills
|Course organiser||Dr Karen Fairhurst
Tel: (0131 6)50 9495
|Course secretary||Miss Linda Pollock
Tel: 0131 242 6617
© Copyright 2016 The University of Edinburgh - 3 February 2017 4:45 am