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2022/2023

Clinical Care Practice V

Code: 104074 ECTS Credits: 15
Degree Type Year Semester
2502442 Medicine OB 6 0
The proposed teaching and assessment methodology that appear in the guide may be subject to changes as a result of the restrictions to face-to-face class attendance imposed by the health authorities.

Contact

Name:
Jorge Miguel Cuevas Esteban
Email:
jorgemiguel.cuevas@uab.cat

Use of Languages

Principal working language:
catalan (cat)
Some groups entirely in English:
No
Some groups entirely in Catalan:
Yes
Some groups entirely in Spanish:
No

Teachers

Isabel Badell Serra
Carlos Rodrigo Gonzalo de Liria
Maria Soledad Angeles Gallego Melcon
Judith Sanchez Manubens
Narcis Cardoner Alvarez
Josep Antoni Montiel Dacosta
José Antonio Soriano Pacheco
Miguel Angel Luna Tomás

Prerequisites

It is advisable that students do not have any non-approved subject from previous courses.

It is convenient to have achieved sufficient knowledge in:

Biostatistics

Bioethics and communication

Epidemiology

Pathophysiology and clinical semiology

Surgical pathology

Medical pathology

Clinical pharmacology

Pediatrics

Gynecology-Obstetrics

Mental health

Knowledge of a third language, preferably English.

It is recommended that the student has passed the following subjects: Medical Physiology I and II. Human Anatomy: Splecnology. Medical Psychology. Human Anatomy: Neuroanatomy. Structural and Molecular Pathology. General Pharmacology. Pathophysiology and Clinical Semiology. Epidemiology. Bases of Clinical Surgery. Pediatrics. Obstetrics and Gynecology. Psychiatry.

The student will acquire the commitment of preserving the confidentiality and professional secrecy of the data to which he / she may have access because of the learning in the assistance services. Also to maintain an attitude of professional ethics in all his / her actions.

Objectives and Contextualisation

The subject corresponds to the last year of the Degree in Medicine (6th year), once the student already knows the scientific foundations of Pediatrics, Gynecology / Obstetrics and Psychiatry.

The general objective is that the student consolidates the previous knowledge and achieves the clinical, communicative skills and of search and handling of the scientific information referring to Pediatrics, Gynecology-Obstetrics and Psychiatry:

We classify the general and specific objectives of each area:

Generals

  • Make a diagnosis through knowing how to make a clinical history and establish a differential diagnosis, under the supervision of teachers.
  • Make a diagnosis and establish the treatment of a particular pathology, under the supervision of teachers.
  • Establish good interpersonal communication that enables him / her to address patients, relatives, companions, medical team and other health professionals with efficiency and empathy.

Specific

a) Gynecology and Obstetrics

  • Know the clinical features and controls and protocols in the control of normal pregnancy.
  • Study the appropriate controls in pathological pregnancy: high-risk monographic consultations.
  • Understand the ultrasound study in normal and pathological pregnancy: be able to interpret an ultrasound in the 3 trimesters of pregnancy.
  • To know the normality as well as the most frequent pathologies in Fetal Medicine.
  • Know the mechanism of childbirth assistance: be able to attend a eutocic birth in an emergency situation.
  • To study the process of the normal puerperium and the detection of the pathology of the puerperium as well as the recommendations on breastfeeding.
  • Study the basic concepts of female and male sterility: be able to interpret the basic study of sterility.
  • Know the process of assisted reproduction: be able to understand the processes of artificial insemination and in vitro fertilization.
  • Know the appropriate controls to perform preventive medicine ingynecology: be able to perform a cervico-vaginal cytological taking, a gynecological examination and know the recommendations on breast cancer screening.
  • Know the basic ultrasound in Gynecology: be able to interpret a gynecological ultrasound.
  • Study and know the cervical pathology: be able to interpret a colposcopy, know the basic protocols of cervical pathology as well as the most frequent surgical treatments.
  • Know the mechanisms of action of the papillomavirus (HPV) vaccine as well as the nationally and internationally accepted recommendations on their indications according to age groups.
  • Study the basic control of menopause as well as the recommended controls and basic treatment guidelines: be able to interpret the controls that are asked of the menopausal woman.
  • Know the most common methods of contraception, their indications and contraindications. Be able to recommend appropriate treatment to a particular patient.
  • To study the most common benign gynecological pathologies in Gynecology: diagnostic and therapeutic protocols.
  • Know the pathology of the pelvic floor and urinary incontinence: the diagnosis, indications for rehabilitation as well as the most common surgical techniques including mesh placement techniques.
  • Know the most common sexually transmitted diseases: epidemiology, diagnosis and treatment and the prevention of each of them.
  • Know the most common gynecological neoplasms: diagnostic and therapeutic protocols as well as follow-up.
  • Study clinical features, imaging and clinical diagnosis, and surgical treatment guidelines including sentinel node study.
  • Know and understand surgical techniques: hysteroscopy, laparoscopy, pelvic floor surgery, benign gynecological surgery, gynecological and breast cancer surgery.

b) Pediatrics

  • Know the most common pathology of the child.
  • Know the peculiarities of each pediatric age range.
  • Acquire the necessary skills for communication with the pediatric patient and their families.
  • Acquire the necessary knowledge to discern the severity of patients and be able to prioritize those that require immediate care.
  • Acquire knowledge based on evidence-based medicine to act in the face of different pediatric pathologies.
  • Establish a diagnostic algorithm based on the most common symptoms and be able to propose a differential diagnosis of problems.
  • Be able to handle acute non-critical situations.
  • Be able to handle critical situations that require urgent intervention.
  • Know the indications and the profitability of the different complementary tests
  • Know the necessary materials and the most frequently used procedures in Pediatrics

c) Mental Health

  • Recognize, diagnose and guide the management of mental disorders.
  • To know the semiology and the technique of the psychopathological exploration that allows to recognize the main psychiatric syndromes.
  • Know the basics of the relationship between health and the environment.
  • Know the practical foundations of psychotherapy.
  • Know how to perform a complete psychiatric history, patient-centered and oriented to different psychopathologies, interpreting their meaning.
  • Know the practical use of the main groups of drugs.

Competences

  • Be able to work in an international context.
  • Communicate clearly and effectively, orally and in writing, with patients, family-members and accompanying persons, to facilitate decision-making, informed consent and compliance with instructions.
  • Communicate clearly, orally and in writing, with other professionals and the media.
  • Critically assess and use clinical and biomedical information sources to obtain, organise, interpret and present information on science and health.
  • Demonstrate sufficient supervised clinical experience in hospitals or other healthcare centres, and familiarity with patient-centred care management and the correct use of tests, medicines and other resources of the healthcare system.
  • Empathise and establish efficient interpersonal communication with patients, family-members, accompanying persons, doctors and other healthcare professionals.
  • Engage in professional practice with respect for patients' autonomy, beliefs and culture, and for other healthcare professionals, showing an aptitude for teamwork.
  • Listen carefully, obtain and synthesise relevant information on patients' problems, and understand this information.
  • Maintain and sharpen one's professional competence, in particular by independently learning new material and techniques and by focusing on quality.
  • Maintain and use patient records for further study, ensuring the confidentiality of the data.
  • Use information and communication technologies in professional practice.

Learning Outcomes

  1. Access the healthcare protocols for the different components of the pathology.
  2. Analyse patient records systematically.
  3. Analyse the limitations to the interpretation of behaviour from non-verbal comunication.
  4. Apply the basic elements of bioethics (patients' rights, doctors' obligations).
  5. Apply the theoretical knowledge of the pathology acquired during the bachelor's degree to clinical practice.
  6. Be able to work in an international context.
  7. Collaborate on simple clinical and surgical manoeuvres after supervised practice on simulators.
  8. Communicate appropriately with patients and their family-members.
  9. Communicate clearly, orally and in writing, with other professionals and the media.
  10. Consult patient records appropriately and keep them in order.
  11. Correctly describe the criteria for hospitalisation.
  12. Describe the communication process and its effect on the professional caregiver–patient relationship.
  13. Draft medical instructions, reports on consultations and treatment, official reports and certificates.
  14. Identify basic emotions in primary healthcare patients through the interaction between the different non-verbal components.
  15. Identify the basic elements of the face-to-face doctor–patient interview in a context of high accessibility and longitudinal care.
  16. Identify the basic rules of pharmacotherapy in adults and children.
  17. Identify the presentation forms of the different pathological processes.
  18. Indicate and use the specific diagnostic and therapeutic procedures for the pediatric age group (phototherapy, nebulisers and aerosol-holding chambers, genetic and metabolic studies).
  19. Involve patients in decisions on the health-illness process.
  20. Know the basic elements of the communication of clinical research results.
  21. Maintain and sharpen one's professional competence, in particular by independently learning new material and techniques and by focusing on quality.
  22. Observe the therapeutic approach, the clinical course and its prevention in cases where this is possible.
  23. Participate in discussions to solve the clinical problems being faced.
  24. Perform an anamnesis and a complete physical examination by systems on adults and children.
  25. Prepare a complete patient record systematically.
  26. Take an active part in care tasks: preparing patient records, requesting complementary studies (laboratory, imaging techniques) when needed and helping to focus the patient record.
  27. Use information and communication technologies in professional practice.

Content

1) Pediatrics:

A. Rotation by the different assistance devices of the Pediatric Services of the Teaching Units

B. Laboratory practices or skills / Classroom Practices

2) Gynecology / Obstetrics:

A. Rotation by the different assistance devices of the Gynecology and Obstetrics Services of the Teaching Units

B. Hospital guards

C. Laboratory or Skills Practices / Classroom Practices

3) Psychiatry:

A. Rotations by the different assistance devices of the Psychiatric Services of the Teaching Units.

B. Attendance and participation in the Meetings of the Emergency Teams / Participation in the Clinical Sessions of the Psychiatry Service / Assistance to the Psychiatric Guard: at the discretion of the Teaching Unit.

C. Laboratory or Skills Practices / Classroom Practices

Methodology

Typology

Paediatrics

(Hours)

Gynaecology & Obstetrics

(Hours)

Mental Health

(Hours)

CLINICAL CARE PRACTICES

75

75

105

LABORATORY PRACTICES

2.75

2.75

1

CLASSROOM PRACTICES

1

1

1

SELF-STUDY

20

13.125

30

PREPARATION OF WRITTEN WORKS

8.125

15

7.5

Annotation: Within the schedule set by the centre or degree programme, 15 minutes of one class will be reserved for students to evaluate their lecturers and their courses or modules through questionnaires.

Activities

Title Hours ECTS Learning Outcomes
Type: Directed      
CLASSROOM PRACTICES (PAUL) 3 0.12 5, 4, 20, 12, 24, 15, 17, 16, 18, 21, 23, 13, 25, 19
CLINICAL CARE PRACTICES (PCA) 245 9.8 1, 2, 3, 5, 4, 7, 8, 9, 10, 20, 11, 12, 14, 24, 15, 17, 16, 18, 21, 22, 26, 23, 13, 25, 19, 6, 27
LABORATORY PRACTICES (PLAB) 14.5 0.58 5, 4, 7, 8, 9, 24, 18, 21, 26, 25, 19
Type: Autonomous      
WORK PREPARATION / PERSONAL STUDY / READING OF ARTICLES / REPORTS OF INTEREST 93.75 3.75 1, 2, 5, 10, 15, 17, 16, 18, 21, 22, 13, 6, 27

Assessment

Assessment activity

Paediatrics

(Weight)

Gynaecology & Obstetrics

(Weight)

Mental Health

(Weight)

ACOES

(Weight)

On the job evaluations

60%

50%

75%

---

Evaluation through case studies and problem solving

40%

30%

---

---

On the job evaluations (emergency guards)

---

20%

---

---

Attendance and active participation in class and seminars

---

---

25%

---

Simulations

---

---

---

70%

Multiple choice questions

---

---

---

30%

Total

100%

100%

100%

100%

Attendance and active participation in classroom &

laboratory practices

compulsory attendance

---

FINAL NOTE

18.5%

18.5%

23%

40%

Assessment Activities

Title Weighting Hours ECTS Learning Outcomes
Practical type evaluation 60% of final note 15 0.6 1, 2, 3, 5, 4, 7, 8, 9, 10, 20, 11, 12, 14, 24, 15, 17, 16, 18, 21, 22, 26, 23, 13, 25, 19, 6, 27
Practical type evaluation: structured objective clinical evaluation (ACOEs) 40% of the final note 3.75 0.15 1, 2, 3, 5, 4, 7, 8, 10, 20, 11, 12, 14, 24, 15, 17, 23, 13, 25, 19, 27

Bibliography

Paediatrics:

- Robert M. Kliegman & Joseph St. Geme. Nelson Textbook of Pediatrics, 2-Volume Set, 21st Edition. Elsevier Science, 2019 (Nelson Tratado de Pediatría, 21 ed. Elsevier, 2020).

- Karen Marcdante & Robert Kliegman.  Nelson Essentials of Pediatrics, 8th Edition. Elsevier, 2018 (Nelson Pediatría Esencial, 2019).

- Asociación Española de Pediatría. Cruz. Tratado de Pediatria. 11ª edición. Editorial Médica Panamericana, 2018.

Internet

http://www.aeped.es/protocolos/index.htm

- OMIM (base de dades de malalties genètiques)  http://www.ncbi.nlm.nih.gov/omim/

 

Gynaecology /Obstetrics:

- http://www.cdc.gov/ 

- http://www.observatoriodelaincontinencia.es

- http://nuevo.sefertilidad.com

- http://www.aepcc.org/

- http://www.figo.org/

- http://www.endometriosis.com.es/

- http://nccam.nih.gov/

- http://www.guideline.gov/

- http://www.cancer.gov/cancertopics/pdq/treatment/ovarianepithelial/HealthProfessional/page6#Reference6.28

- http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#site

 

Mental Health:

- Stern, T.  Fava, M.  Wilens, T.  Rosenbaum, J. Massachusetts General Hospital. Tratado de Psiquiatría Clínica. 2ª Edición. Elsevier, 2017.

- Sadock, V. Ahmad, S. Sadock, B. Manual de Bolsillo de Psiquiatría Clínica. 6ª Edición. Editorial Wolters Kluwer, 2018

- Julio Vallejo Ruiloba. Introducción a la psicopatología y la psiquiatría, 8 edition. Elsevier, 2015

 

Software

None