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DRPS : Course Catalogue : Edinburgh Medical School : MBChB

Undergraduate Course: Year 4 - Process of Care 1 (MBCH10020)

Course Outline
SchoolEdinburgh Medical School CollegeCollege of Medicine and Veterinary Medicine
Credit level (Normal year taken)SCQF Level 10 (Year 4 Undergraduate)
Course typePlacement AvailabilityNot available to visiting students
SCQF Credits180 ECTS Credits90
SummaryThe 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 and short answer questions). 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.
Course description 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. clinical observations) with students and provide additional written and verbal narrative comments on general progress, with suggestions for developments.

There are many other opportunities for feedback. 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)
Pre-requisites Co-requisites
Prohibited Combinations Other requirements None
Course Delivery Information
Academic year 2018/19, Not available to visiting students (SS1) Quota:  None
Course Start Full Year
Timetable Timetable
Learning and Teaching activities (Further Info) Total Hours: 1800 ( Lecture Hours 85, Seminar/Tutorial Hours 65.5, Supervised Practical/Workshop/Studio Hours 28, Online Activities 28, Feedback/Feedforward Hours 7, Summative Assessment Hours 10, Programme Level Learning and Teaching Hours 36, Placement Study Abroad Hours 746, Directed Learning and Independent Learning Hours 794 )
Assessment (Further Info) Written Exam 80 %, Coursework 0 %, Practical Exam 20 %
Additional Information (Assessment) IN-COURSE ASSESSMENT
Portfolio: Students are required to submit clinical portfolio reports as they rotate through modules. These are marked as Pass/Fail so Weighting = 0%.

Professionalism: For each module and theme teaching delivered across the year, this includes measures of:

Attendance; Engagement; and Professional Conduct.
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.

Portfolio: Students must pass all case reports to progress.

Professionalism: Students must complete all attachments, modules and theme teaching without Professionalism Issues being raised. This requires students to
- 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
- 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
- demonstrate professional conduct as defined in the course information

Portfolio: Students who achieve fail in a portfolio item will be advised by the Board of Examiners to resubmit and will be offered specific feedback beforehand. Students must pass all case reports

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

WRITTEN EXAMS at the end of each semester after 19 weeks of learning
Students experience the Course in a carousel so half the class take each block.
The exam is a year long assessment, students will undertake paper 1 in January, paper 2 and 3 in June. Paper 1 and paper 2 are subject specific to carousel which has been taken in that semester. Paper 3 combines knowledge from all specialities. Student must achieve an overall pass over the 3 papers.

CLINICAL EXAM at the end of the year usually in OSCE format

Students can progress to Year 5 if have passed written, clinical exams, all written reports and professionalism requirements.
Students must achieve at least a pass for the Clinical Exam.

Students will have one opportunity to resit written Exams and the Clinical Exam
Students will resit combined paper for written exam

4 Portfolio reports = 0%
Written exams - 80%
Clinical exam - 20%
There are formative online Knowledge Tests before each diet of summative exams. Students are sent a performance report, see their own answers, the correct answers and explanations.

There is a MOCK OSCE in Spring before the summative clinical exam. Students will receive a written feedback report.

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.

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.
Knowledge Tests: Students will receive a performance report.
Clinical exam: Students will receive a performance report.

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.
Exam Information
Exam Diet Paper Name Hours & Minutes
Main Exam Diet S1 (December)Examination Paper 1 Ortho et al2:00
Main Exam Diet S1 (December)Examination Paper 1 Cardio et al2:00
Main Exam Diet S2 (April/May)Examination Paper 2 Ortho et al2:00
Main Exam Diet S2 (April/May)Examination Paper 2 Cardio et al2:00
Outwith Standard Exam Diets MayExamination Paper 35:00
Outwith Standard Exam Diets JulyResit Examination Paper2:00
Learning Outcomes
On completion of this course, the student will be able to:
  1. 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.
  2. 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.
  3. 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.
Learning Resources
Information is given on the virtual learning environment, Learn, 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.
Additional Information
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:

Biomedical Sciences
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
Medical Informatics
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:

The Consultation
Clinical Communication
Medical Informatics

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:

The Consultation
Emergency Care, Clinical and Resuscitation Skills
Clinical Pharmacology
Medical Informatics
Course organiserDr Karen Fairhurst
Tel: (0131 6)50 9495
Course secretaryMiss Gemma MacLellan
Tel: (0131) 242 6477
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