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2023/2024

Phoniatrics

Code: 102898 ECTS Credits: 3
Degree Type Year Semester
2502442 Medicine OT 4 0

Contact

Name:
Miquel Quer Agusti
Email:
miquel.quer@uab.cat

Teaching groups languages

You can check it through this link. To consult the language you will need to enter the CODE of the subject. Please note that this information is provisional until 30 November 2023.


Prerequisites

General knowledge of anatomy, physiology, histology and pathological anatomy related to the field of the phoniatrics.

The student will acquire the commitment to preserve the confidentiality and professional secret of the data that he can have access due to the learning of health care services. The student has to maintain an ethical attitude.


Objectives and Contextualisation

Give the student the learning of knowledge and skills in the field of phonetics. In other words that is, provide theoretical, scientific and practical training to understand the diagnostic and therapeutic bases of the disorders of human verbal communication (listening and language).


Competences

  • 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.
  • Demonstrate an understanding of the fundamentals of action, indications, efficacy and benefit-risk ratio of therapeutic interventions based on the available scientific evidence.
  • 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.
  • Demonstrate understanding of the causal agents and the risk factors that determine states of health and the progression of illnesses.
  • Demonstrate understanding of the importance and the limitations of scientific thought to the study, prevention and management of diseases.
  • Demonstrate understanding of the manifestations of the illness in the structure and function of the human body.
  • Establish a diagnostic approach and a well thought-out strategy for action, taking account of the results of the anamnesis and the physical examination, and the results of the appropriate complementary tests carried out subsequently.
  • Establish the diagnosis, prognosis and treatment, basing decisions on the best possible evidence and a multidisciplinary approach focusing on the patient's needs and involving all members of the healthcare team, as well as the family and social environment.
  • Indicate the most suitable treatment for the most prevalent acute and chronic processes, and for the terminally ill.
  • Listen carefully, obtain and synthesise relevant information on patients' problems, and understand this information.
  • Obtain and prepare a patient record that contains all important information and is structured and patient-centred, taking into account all age and gender groups and cultural, social and ethnic factors.
  • Put forward suitable preventive measures for each clinical situation.
  • Recognise the role of complexity, uncertainty and probability in decision-making in medical practice.
  • Write patient records and other medical documents that can be understood by third parties.

Learning Outcomes

  1. Adapt the therapy procedure and the surgical technique, if appropriate, in accordance with the available data.
  2. Build diagnostic and therapeutic algorithms based on the best scientific evidence, taking into account the facilities available.
  3. Calculate the surgical risk indices, both general and by apparatus, and adjust the indications accordingly.
  4. Choose a therapy option in accordance with available information and patient preference.
  5. Critique original or review scientific papers.
  6. Describe the mechanisms of action of physical and chemical agents on the organism.
  7. Distinguish the bases of the different surgical specialisations to integrate and lead the treatment in acute and chronic patients with multiple conditions.
  8. Distinguish the implications of different interventions regarding functional and morphological changes.
  9. Encourage the search for answers to the questions that arise during surgery.
  10. Establish rapport as the first important step in all medical procedures, both in elective and emergent situations and leave a written record of the information transmitted and the wishes of the patient.
  11. Estimate the risks and benefits of the various therapy options.
  12. Evaluate the appropriate scientific methodology for a biomedical paper.
  13. Further investigate the risk factors of morbidity and mortality in operations.
  14. Gather information and select the most important facts about the patient, both in normal visits and emergencies.
  15. Identify all prophylactic measures to reduce indices of morbidity and mortality to the minimum.
  16. Integrate all pre-operative information for decision-making.
  17. Make a critical analysis of the objectives to be achieved with surgery, contrasting this with the adverse effects that may be involved.
  18. Obtain the most important data, both on the illness being treated and on factors influencing morbidity and mortality.
  19. Provide clear, comprehensible information on the therapy options to patients and their families.
  20. Provide the bases for preparing clinical guides and constructing diagnostic and therapeutic algorithms.
  21. Transmit information clearly and accurately, leaving no room for possible misunderstandings.
  22. Use the specific bibliographic sources that will help to develop further one's knowledge.

Content

  1. Adapt the therapeutic procedure and the surgical technique, if applicable, according to the available data.

  2. To learn more about the risk factors for operative morbidity and mortality.

  3. Evaluate the scientific methodology appropriate for a biomedical work.

  4. Calculate the surgical, general and device risk indexes, and adapt the indications.

  5. Construct diagnostic and therapeutic algorithms according to the best scientific evidence, taking in count the available means.

  6. Criticize original scientific articles or review.

  7. Describe the mechanisms of action of the physical and chemical agents about the organism.

  8. Distinguish the bases of the different surgical specialties to integrate and lead the treatment in acute and chronic patients with pluripathology.

  9. Distinguish the implications of different interventions regarding functional and morphological changes.

  10. Carry out a critical analysis of the objectives that are intended to be achieved through surgical intervention by constraining it with the adverse effects it may entail.

  11. Choose, according to the available information and the preferences of the patient, a therapeutic option.

  12. Establish a good relationship as an important first step in any medical act, both in emerging situations as in the electives, and leave written record of the transmitted information and of the wills of the patient

  13. Estimate the risks and benefits of the various therapeutic options.

  14. Identify all measures of prophylaxis to minimize morbidity and mortality rates.

  15. Encourage the search for answers to the questions that arise during the surgery.

  16. Integrate all preoperative information for decision making.

  17. Obtain the most relevant data both with regard to the disease that is involved, as well as those that they can mark the morbidity and mortality.

  18. Provide information on the therapeutic options clearly and comprehensively to the patient and his family.

  19. Provide the bases for the elaboration of clinical guides and guides and the construction of algorithms diagnoses and therapeutics.

  20. Compile the information and select the most relevant facts presented by the patient, both in situations electives of specialized consultation as emergencies.

  21. Transmit the information clearly, accurately, without elements that lead to confusion or bad interpretation

  22. Use the specific bibliographic sources that allow to develop and extend the knowledge acquired

 

Contents

Theoretical classes (8 hours)

  1. Introduction to phoniatrics. Oral communication: voice, words and language.

  2. Exploration of dysphonia: stroboscope and acoustic analysis of the voice.

  3. Dysphonia: physiopathological bases and classification.

  4. Disorders due to structural and inflammatory pathologies of the larynx.

  5. Disorders due to neurological and neuromuscular pathologies.

  6. Dysglossies, dysarthria and aphasias.

  7. Hearing aids: hearing aids and cochlear implants.

  8. Oropharyngeal dysphagia: type, diagnosis and treatment.

Clinical cases in classroom practices (4 hours)

  1. Clinical cases of structural dysfunction: diagnostic and therapeutic guidance.

  2. Clinical cases of neurological and neuromuscular dysfunction: diagnostic and therapeutic orientation

  3. Cases of deafness: diagnosis and rehabilitation.

  4. Cases of oropharyngeal dysphagia: diagnostic and therapeutic guidance.

Clinical healthcare practices (3 hours)

Each student will go to a different activity every day, where accompanied by a doctor of the service they will see different aspects of phoniatrics. The activities that are carried out are: visit laryngology with special emphasis on exploration of the voice and dysphagia and visits otology with special emphasis on hearing and rehabilitation exploration of severe deafness.

Day 1

Visit the laryngeal clinic with special interest for stroboscope, voice analysis and evaluation of the dysphagia.

Day 2

Visit to the otology clinic with special interest for audiology, with study of tonal audiometry, verbal audiometry and objective audiometry.


Methodology

This guide describes the framework, contents, methodology and general norms of the subject, in accordance with the Studying current studies. The final organization of the subject with regard to the number and size of groups, distribution in the Schedule and dates of examinations, specific criteria for evaluation and review of examinations, will be specified in each one of the Hospital Teaching Units (UDH), who will explain it through their web pages and on the first day Class of each subject, through the teachers responsible for the subject at UDH.

For the present year, the professors appointed by the Departments as responsible for the subject at the level of Faculty and UDH are:

UDHSP

Miquel Quer

mquer@santpau.cat

(25 students)

UDHVH

 Juan Lorente

jlorente@vhebron.net

(25 students)

UDPT

Anton Francesc Aguilà Artal

AFAguila@tauli.cat

(15 students)

A minimum of 11 students has to be enrolled in order to offer this optional study. Orientative time can be consulted on the website of the corresponding UD.

 

In the current exceptional circumstances, at the discretion of the teachers and also depending on the resources available and the public health situation, some of the theoretical classes, practicals and seminars organized by the Teaching Units may be taught either in person or virtually.

 

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) 4 0.16 1, 13, 3, 2, 5, 6, 8, 17, 11, 15, 9, 16, 18, 22
Clinical care practices (PCAh) 3 0.12 1, 13, 3, 2, 6, 8, 17, 15, 9, 16, 18, 20, 14
Contents given as oral lectures (Theory) 8 0.32 1, 13, 3, 2, 6, 8, 4, 9, 16, 18, 20, 14, 22
Type: Autonomous      
Self-study and reading articles/reports of interest 56 2.24 1, 12, 3, 2, 5, 6, 7, 8, 17, 4, 10, 11, 15, 9, 16, 18, 19, 20, 14, 21, 22

Assessment

The assessment activities will last 4 hours and will consist of three evaluations:

- First theoretical evaluation with clinical cases: 35% of the mark.

There will be 3 clinical cases with short answer questions.

- Second theoretical evaluation with multiple choice questions: 35% of the mark.

Objective test of 40 multiple choice questions.

- Practical module: 30% of the note

Assessment of practical knowledge once the practices have been completed: A 2 page report on two cases in relation to the cases seen in the two days of the practices. In each case the student will have to consider the clinic, the diagnosis approach and possible therapeutic approach and the one used.

Final grade

Weighted sum of the two theoretical tests (35% each) and the clinical-practical evaluation (30%). A minimum score of 4/10 on both tests are requested.

Expression: Numeric note with a decimal, from 0 to 10.

Qualification: insufficient, approved, remarkable, excellent, MH

There will be a recovery test for students who do not pass all or part of the content.

Students who do not perform both theoretical and practical evaluation tests will be considered as non-evaluated exhausting the rights to the matriculation of the subject.

 

The single assessment system is not provided in this case. 


Assessment Activities

Title Weighting Hours ECTS Learning Outcomes
Evaluation through case studies and problem solving 35% 1 0.04 1, 13, 12, 3, 2, 5, 6, 7, 8, 17, 4, 10, 11, 15, 9, 16, 18, 19, 20, 14, 21, 22
Narrative records 30% 2 0.08 1, 13, 12, 3, 2, 5, 6, 7, 8, 17, 4, 10, 11, 15, 9, 16, 18, 19, 20, 14, 21, 22
Second theoretical evaluation; Multiple choice questions 35% 1 0.04 1, 3, 6, 7, 8, 11, 15, 16, 20

Bibliography

1.  Tratado de Otorrinolaringología y Cirugía de Cabeza y Cuello (2ª Edición). Editado por C. Suárez, LM. Gil-Carcedo, J. Marco, J.E. Medina, P. Ortega, y J. Trinidad. Editorial Médica Panamericana. Madrid, 2009. (ISBN 978-84-9835-079-1).

2. Surgery of larynx and trachea. M. Remacle and H.H. Eckel, editors. Springer-Verlag Berlin Heidelberg 2010

(ISBN 978-3-540-79135-5) pags 229-243.

3. There is a wide variety of useful Internet sites for learning aspects of Phoniatrics, such as

http://www.voiceproblem.org/

http://www.seorl.net/

http://www.scorl.org/

http://www.orlevidencia.org/

http://www.library.nhs.uk/ENT/


Software

no cal programari específi