CASE BASED LIFE COURSE MEDICINE 4 - 2021/2

Module code: PASM004

Module Overview

Students will be working through Cases 14 - 18 of the 18 Case sequence that makes up Year 1, covering mental health, dermatology, hearing and visual loss, and cancer presentations of illness (Abnormal PV bleeding, depression, psoriasis and cancer of the colon). In addition there is a slightly more complex case of CVA in an elderly patient with multiple morbidity. The module finishes with a consolidation section, which looks back across all four modules’ cases and prepares students for the OSCE at the end of the year.

Module provider

School of Health Sciences

Module Leader

DOULTON Jia (Health Sci.)

Number of Credits: 15

ECTS Credits: 7.5

Framework: FHEQ Level 7

Module cap (Maximum number of students): N/A

Overall student workload

Lecture Hours: 400

Module Availability

Semester 2

Prerequisites / Co-requisites

A student has to complete module 4 before being able to sit the relevant section of the SBA and the OSCE examinations at the end of the year.

Module content

Indicative content includes:

Cases 14 - 18 of the sequence of 18 cases in Year 1.

A consolidation period that ‘brings together’ all that has been learnt in Year 1 and places this learning with the patient firmly in the centre.

Students will learn:

Professional Values

Public Health and Epidemiology Ethical and legal issues

Basic sciences relating to the cases in the module.

Communication and development of interpersonal skills

The Clinical Method – taking focussed histories and performing clinical examinations in the systems identified by the cases in the module.

The Life-course Case-Based learning

Pharmacology and Therapeutics

The core procedural skills listed above

Assessment pattern

Assessment type	Unit of assessment	Weighting
Examination	SBA Examination	100
Examination	OSCE Examination	Pass/Fail
Coursework	PBCP Portfolio	Pass/Fail

Alternative Assessment

N/A

Assessment Strategy

The assessment strategy is designed to provide students with the opportunity to demonstrate progression in their learning in three domains of learning:

Knowledge and Applied Knowledge of Clinical Medicine and the Basic Biosciences that underpin Clinical Medicine

Clinical Skills, in both core procedural skills, and consulting with patients

Professional Behaviour

Because this is an integrated course, many of the learning outcomes listed above are tested by more than one type of assessment method.

Knowledge and applied knowledge will be tested mainly by the SBA paper, Clinical skills by the Clinical Skills log, the portfolio and Module 4 OSCE examination, and Professional Behaviour by the SBA paper, the portfolio and the OSCE examination.

The OSCE examination tests across the clinical learning for Year 1, and the assessment strategy has been designed in this way (rather than testing a few stations at the end of each module in Year 1) because students need to be prepared to take the 14 station OSCE that is part of the national licensing examination following their graduation with a Diploma in Physician Associate Studies. A similar OSCE examination will take place at the end of Year 2.

Students will receive frequent formative assessment, with rapid feedback and remediation as needed. This will take place at the end of each section of the module, ie induction, and the end of each Case.

At the end of the module, students will need to show that they have attained the learning outcomes for Module 4.

Thus, the summative assessment for this module consists of:

50 questions from a 100 question Single Best Answer (SBA4) paper at the end of Year 1 (2 hour paper, 120 minutes). In order to pass Module 4, students will need to show a mark of 50% or more in the 50 questions relating to Module 4 content.

Pass in Professional Behaviour and Clinical Practice (PBCP) eportfolio work to from beginning of Case 14 – end of Case 18 (to include Tutor Report, Clinical Skills log, Team Assessment of Behaviour, Coursework). (This is a Pass/ Fail assessment and needs to be passed in order to pass the module, but does not contribute to the module mark).

Pass in the 10 station OSCE examination at the end of Module 4. This blueprinted exam will test across the Introduction and 18 cases in Year 1, using a blueprint to ensure sampling across the cases. Students will need to pass 7 stations or more in this examination.

Formative assessment

Quizzes at the end of each Virtual Case

Coursework as determined by module content (case studies, short essays on topical related issues in health etc)

Clinical Skills log (formative section with feedback)

Reflective diaries and short essays based on clinical placements Patient feedback (simulated and real patients)

Feedback

Students will receive rapid feedback from their frequent formative tests, and from the eportfolio marking.

Module aims

Give students a basic introduction to clinical medicine as applied to the learning of common mental health, skin, ENT and visual, and cancer presentations. Towards the end of the module, a multiple morbidity case allows students to consider the more realistic presentation of patients, who normally present with more than one medical problem.
Common patient presentations in these systems will be learnt, with students learning how to perform focussed histories and focussed clinical examinations (in particular a mental health consultation).
Basic investigations, differential diagnoses and initial clinical management (including therapeutics) of patients presenting with symptoms in these systems will be taught.
Core clinical procedures allied to these systems will be taught and practised
Students will be able to meet real patients with conditions related to these clinical systems and reflect on what they have learnt.
The final section of the module will focus on a review of all the systems covered so far in Year 1, allowing students the opportunity to see them as part of the presenting patient, rather than the system in isolation.

Learning outcomes

		Attributes Developed
1	Describe the functional anatomy and physiology of the nervous, ENT and visual systems, and the skin, and the pathophysiology and risk factors of common conditions affecting these systems.	K
2	Outline the physiology and mechanisms of stroke (CVA).	K
3	Show how lesions in different parts of the brain can relate to different losses of function in CVA.	C
4	Describe how normal cells become cancerous on a molecular and cellular basis, the epidemiology and risk factors for the common cancers in the UK (breast, bowel,	K
5	Prostate, skin, liver) and how they are screened for, diagnosed and managed.
6	Describe the principles of epidemiology as applied to diabetes, carcinomas of the colon and breast, and cerebro-vascular disease, and the evidence base behind population screening for some of these conditions.	K
7	Demonstrate basic ability to use clinical information to put together a likely differential diagnosis. This will be primarily in the ‘virtual cases' but increasingly with real patients seen in Primary Care.	C
8	Describe how to perform intimate examinations sensitively – in particular the per rectum, breast and per vaginal examination, including explanation, informed consent and use of a chaperone.	K
9	Demonstrate in simulation how to discuss intimate and personal medical details in a professional manner with patients, showing empathy and concern and ability to listen	P
10	Describe common imaging techniques and their appropriate use in diagnosing disease.	K
11	Describe and demonstrate ability to take a patient-centred, focussed mental health history from a patient, including use of a depression screening tool such as the HAD (Hospital Anxiety and Depression) scale.	P
12	Demonstrate ability to take a patient-centred focussed history from patients with multiple problems, summarise and prioritise the medical and social problems, and deal with the case in a holistic, family/ carer and community-aware manner.
13	Describe the principles of epidemiology as applied to mental health disorders and their risk factors	K
14	Understand why good clinician-patient relationships foster informed patient choice and help negotiating care decisions	C
15	Identify and understand ethical and legal issues, in particular maintaining patient confidentiality, and obtaining informed consent	P
16	Show an understanding of the issues in the treatment of patients with mental health disorders, in particular the application of the Mental Health Act (2007).	P
17	Identify relevant psychological and social factors, integrating these perspectives with the biomedical evidence to elucidate current problems	T
18	Perform a focussed skin examinations, tailored to the needs of the patient.	P
19	Describe common skin and nail infections and how they are treated.	K
20	Demonstrate appropriate use of initial and follow- up investigations	K
21	Communicate effectively and appropriately with patients and carers	T
22	Discuss drugs used in common mental health, skin, ENT and eye conditions, their mechanisms of action and their side-effects/ interactions.	K
23	Discuss the principles of palliative care, for both cancer and non-cancer related illnesses.	K
24	Demonstrate how to perform a repeat prescription review with a patient with multi- morbidity	T
25	Discuss how the physician-patient relationship and good communication can influence compliance with medication and lifestyle changes.	T
26	Discuss principles promoting health and preventing disease, in particular healthy lifestyle issues such as drug and alcohol use and abuse.	K
27	Show knowledge of the British National Formulary and how to use it when deciding how to treat the above clinical systems.	K
28	Maintain an awareness of national and local guidelines	K
29	Describe techniques that assess community needs in relation to how services are provided	K
30	Discuss public health issues related to the cases studied in Module 4.	K
31	Show ability to use reflective thinking and writing to critically evaluate own practice to identify learning/ developmental needs and identify and utilise learning opportunities	C
32	Understand and value roles of other members of the health and social care team, with particular reference to the professional teams contributing to mental health in the community and in hospital, stroke management and rehabilitation, and Palliative Care.	P
33	Show knowledge of other presentations from Section A1 of the matrix specification, allied to the cases in this module, and their investigation and management (Appendix 1).	K
34	Undertake a nutritional assessment
35	Perform fluorescein dye examination of the cornea
36	Remove loose foreign bodies from under eye-lids
37	Undertake simple skin suturing using models
38	Learn how to use local anaesthetics, using models

Attributes Developed

C - Cognitive/analytical

K - Subject knowledge

T - Transferable skills

P - Professional/Practical skills

Methods of Teaching / Learning

The learning and teaching strategy:

The building of knowledge and understanding will be achieved by an integrated learning strategy in Year 1, centred around small group Case Based Learning, following a sequence of 18 virtual cases, that between them deliver the ‘life course’ from cradle to grave. Concurrently, they will spend one day/ week on clinical placement in a carefully selected GP surgery, learning in the workplace and meeting patients who illustrate and add to their learning from the virtual cases.

In Year 2 a spiral curriculum design will ensure that learning from the cases and 1 day clinical placements in Year 1 is consolidated through a range of longer clinical placements in both Primary and Secondary Care, to include: Paediatrics, Obstetrics and Gynaecology, Acute Medicine, Surgery, Care of the Elderly, Psychiatry and General Practice.

The learning and teaching methods include:

Small group case based learning in Year 1 – each case lasts for 2 weeks. (4.5 hours/ week x 7 week)

Lectures (3-4 hours/ week x 10 weeks)

Practicals in Year 1, to revise and refresh biosciences learning in physiology (1.5 hours/ week x 10 weeks)

Clinical Anatomy teaching based on models, clinical demonstrations, imaging and e learning. (1.5 hours/ week x 10 weeks)

Clinical Skills sessions in the Simulations Suite, to learn consultation skills as well as core procedural skills (3 hours/ week x 36 weeks)

Clinical Placements – in Year 1, these will be 1 day/ week in GP surgeries selected by HEKSS following GMC guidelines, where students will meet a variety of patients, including patients similar to their ‘virtual’ cases. (8 hours/ week x 7 weeks)

Independent study, guided by the small group case based learning (9 hours/ week x 10 weeks)

Indicated Lecture Hours (which may also include seminars, tutorials, workshops and other contact time) are approximate and may include in-class tests where one or more of these are an assessment on the module. In-class tests are scheduled/organised separately to taught content and will be published on to student personal timetables, where they apply to taken modules, as soon as they are finalised by central administration. This will usually be after the initial publication of the teaching timetable for the relevant semester.

Reading list

https://readinglists.surrey.ac.uk
Upon accessing the reading list, please search for the module using the module code: PASM004

Other information

This module is only available to students undertaking the Physician Associate programme.

Please note that the information detailed within this record is accurate at the time of publishing and may be subject to change. This record contains information for the most up to date version of the programme / module for the 2021/2 academic year.