Clinical Medicine V

Learning outcomes

KNOWLEDGE AND UNDERSTANDING

On completion of the course the student:

• Be familiar with the most important diseases within the three subject areas and their approximate prevalence, prognosis, long-term consequences and impact in a public health perspective
• Be able to carry out diagnostics, clinical investigation and treatment concerning the above disorders
• Be able to apply basic preclinical scientific knowledge and relate this to patho­physiology, psychopathology, clinical manifestations, treatment and prognosis of the above diseases.
• Be able to identify risk factors and be familiar with preventive strategies within the three subject areas.
• Be able to evaluate the ethical, social, demographic and psychological aspects of the above diseases and risk factors.
• Have a general knowledge regarding the global distribution and transmission of the above diseases and risk factors.
• Have knowledge of the impact of human rights on, and the influence of, diseases and health factors in the three subject areas. For example, within the pediatric field, this means a knowledge of the UN Convention on the Rights of the Child
• Be familiar with different professions and their role around the patient, within and outside the healthcare setting

SKILLS AND ABILITIES

On completion of the course the student should be able to:

• apply interview and examination techniques within the relevant medical specialties.
• without assistance take proper case histories and make physical examinations of patients within paediatrics, obstetrics/gynaecology and infectious disease medicine. This includes children in all ages as well as collaboration with the patients' relatives or guardians.
• evaluate the case history and status findings and based on this suggest investigations, apply diagnostic methods, suggest diagnosis and make decisions regarding proper treatment within the relevant medical specialty.
• make decisions regarding level of care, prioritise and carry out necessary diagnostic or therapeutic interventions
• summarise the medical history, clinical findings and overall evaluation orally or in writing in a brief yet comprehensive way.
• actively and independently lead the clinical round, with an emphasis on adequate preparations based on a checklist and in interplay with other health­care professionals as well as the patient, resulting in prescriptions and decisions that are well supported.
• in an emphatic, confidential and tolerant way obtain relevant information from the patient and/or relatives.
• create a therapeutic environment through a professional and empathic attitude vis-à-vis the patient and his/her relatives.
• identify and evaluate psychological phenomena and explain the importance of psychosocial factors in parallel with the purely medical and biological mechanisms.
• in a way that is adjusted to the patient and his/her relatives explain diseases, diagnostic procedures and therapy.
• explain and consult regarding management and evaluation with patients/rela­tives and coworkers such as other physicians, nurses and other healthcare professionals.
• communicate and explain the knowledge that has been acquired for the general public

JUDGEMENT AND ATTITUDES

On completion of the course the student:

• demonstrate an ethical, tolerant and empathetic attitude vis-à-vis patients, their relatives, coworkers of various professions as well as the general public.
• adopt a scientific approach with respect for knowledge, and have the ability to tell the difference between evidence based knowledge, common experience and opinions - founded or unfounded.
• show respect to patients, relatives and coworkers irrespective of gender, sexual orientation, age, disability, ethnicity or religious belief.

Content

Clinical medicine V consists of three sub-courses or modules of equal duration: paediatrics, obstetrics/gynaecology and infectious diseases/microbiology. These modules rotate in such a way that every student follows all three of them during six weeks each, but in individual order. At the end of the semester the students will have two weeks set aside for preparation for the exam, whereupon they complete the written exam of all three modules in the last week.

The paediatric and obstetric/gynaecological modules both start with an introductory week during which basic knowledge is acquired, whereupon follows five weeks of clinical practice according to a rotating, individualised schedule. During these five weeks one week devoted to seminars and clinical exercises may be included and usually all students have joint seminars and lectures for one day each week irrespective of their clinical practice.

Instruction

The teaching is given in several forms and methods:

• Lectures
• Practical group exercises (such as physical examination technique practice and cardiopulmonary resuscitation
• Seminars with or without pre-seminar assignments, including or excluding other professionals (among the healthcare professions or not)
• Seminars according to problem-based learning (PBL) or other case-based methodologies
• Clinical practice and auscultation at in- and/or out-patient wards
• "Round school" - practical, structured training in the skill of leading ward rounds in collaboration with other health-care professionals
• Student-led out-patient wards

The modules will also, on a recurring basis, be given in English

Assessment

For rules regarding absence from obligatory teaching activities and rules regarding participation in examinations, please consult the programme syllabus in the Students' guide.

Passing the course requires:

• Active participation in all compulsory teaching activities (these are clearly marked on the course schedule and include activities such as seminars, group exercises and the "round school"). Complementary assignments can some­times be offered as compensation for activities that are missed.
• Passed clinical practice, both as regards attendance, attitude and activity
• Passed practical examination (see below) in modules where this is included
• Passed final examination

PRACTICAL EXAMINATION

Towards the end of the paediatric and obstetric/gynaecological modules the student will be required to show, in front of a colleague, that he/she can independently assess (medical history and status) a sick child and a gynaecological patient and set up a realistic clinical management plan. During this examination not only knowledge but also skills, communication, attitudes and judgement is evaluated.

FINAL EXAMINATION

The course ends with a written exam containing questions of the MCQ (multiple choice question) and MEQ (modified essay questions). The course leader may choose to exchange the MEQ questions for oral examination.

If there are special reasons for doing so, an examiner may make an exception from the method of assessment indicated and allow a student to be assessed by another method. An example of special reasons might be a certificate regarding special pedagogical support from the University's disability coordinator.

REPEATED EXAMINATION ATTEMPTS

Students who have not passed the examination have the right to make four extra examination attempts (i.e. five attempts in total). If special circumstances apply, the Programme Committee of the Medical Study Program may admit additional examination opportunities. Each occasion when the student participates in the examination counts as an examination attempts; this inculdes submission of a blank written exam. The student has the right to request a change of examiner after two failed examinations.

PREMATURELY INTERRUPTION OF CLINICAL PRACTICE

A student may fail clinical practice and have to interrupt this education activity prematurely if there is a risk that he/she due to insufficient skills or poor attitudes may cause injury to persons or valuable property should the clinical practice be prolonged. An individual study plan should then be decided for the student and be communi­cated in writing. In this plan, which is to be established by the Programme Committee of the Medical Study Program, it should be stated which shortcomings the student has shown, which support can be given from the university department as well as how and when it can be ascertained if the student has successfully compensated for the shortcomings. The student has the right to at most two separate evaluation occasions - although only once per year. The student who has thus interrupted clinical practice may not take part of the clinical part of the course until the Program­me Committee has checked and accepted that the student has attained the required knowledge, skills and attitudes. Decisions regarding the individual study plan may be delegated by the Programme Committee to a student wellfare committee or other group with student representation. Students who have not passed their cilinical training have the right to undergo this course activity once more. The Programme Committee may, if special circumstances apply, admit additional occasions for the student to undergo clinical training.