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Family and Community Medicine

Code: 106706 ECTS Credits: 3
2024/2025
Degree Type Year
2502442 Medicine OB 3

Errata

In the teaching team of the subject, teacher Maria Asunción Wilke Trinxant (MariaAsuncion.Wilke@uab.cat) replaces teacher Xavier Mundet Tudurí as head of the subject.

Contact

Name:
Javier Mundet Tuduri
Email:
xavier.mundet@uab.cat

Teachers

Javier Flor Escriche
Ana Maria Altaba Barcelo
Joan Juvanteny Gorgals
Francisco Lopez Exposito
Maria Isabel Gonzalez Saavedra
Clara Alavedra Celada
Amada Aguyé Batista
Silvia Guell Parnau
Judit Llussa Arboix
Maria Asuncion Wilke Trinxant
Miguel Angel Sarlat Ribas
Maria Antonia Llauger Rossello
Maria de las Nieves Barragan Brun
Maria del Mar Gili Riu
Victor Miguel Lopez Lifante
Guillem Fluxa Terrasa
Jose Miguel Llovet Lombarte
Montserrat Bare Mañas
Miriam Mulero Collantes
Maria Luz Bravo Vicien
Raquel Gayarre Aguado
Mercedes Roura Olivan
Alba Martinez Escude
Nuria Martínez Sánchez
Pascual Roig Cabo
Immaculada Serra Morera
Esther Limon Ramirez
Jose Manuel Escudero Ibañez
Roser Ros Barnadas
Maria Josefa Perez Lucena
Miquel Cirera Perich
Carmen Exposito Martinez
Pablo Andres Hidalgo Valls
Marta Pallas Ellacuria
Jose Manuel Cruz Domenech
Elisabeth Navarro Fontanellas
Laura Diaz Gete
Monica Rebollar Gil
Arancha González Osuna
Anna Estafanell Celma
David Lacasta Tintorer
Yoseba Canovas Zaldua
Anna Besa Beringes
Cristina Lleal Barriga
Ana Domenech Borras
Francesc Xavier Cos Claramunt
Jordi Ingla Mas
Lluis Cuixart Costa
Nuria Piquer Farres
Albert Xicola Botifoll

Teaching groups languages

You can view this information at the end of this document.


Prerequisites

There are no official prerequisites, but the candidates have to meet the following prerequisites:
- Be enrolled in 3rd course
- It would be recommandable fer the subject once once if you start the clinical training
- Have passed the subjects of clinical care practice I and II
- He is enrolled (faces that he did not pass) in the course of Physiopathology and Clinical Semiology (3rd year)
Due to the nature of the practices that are carried out in a Primary Care Center, the student will acquire the commitment to preserve the confidentiality and professional secrecy of the data that may have access by the learners to the assistance services. Also in maintaining a professional ethical attitude in all his/her actions.


Objectives and Contextualisation

The context in which the Family Medicine course takes place involves the first contact of the student during the clinical training phase with the primary health care system. It is considered that aspects of clinical care practice are determined by the area of primary care, such as: home care, preventive and community approach to behaviors, lifestyles and health problems, continuity of care throughout the whole the life of the patients (including the end of life), the integral management of the multipathological and frail patient and the familiar approach of determinats problems.

More to more in primary care, the diagnostic process for various health problems is developing, it is defined in the criteria for interconsultation and referral, and this cure is to ensure the "continuous care", it is, the coordination with altres asistants levels and with the socio-sanitary and community resources.

Despite these characteristics and conditions, in this subject it is intended that the student be aware of the importance of the clinical interview with the patient, of the role of preventive activities, the prey of diagnostic and therapeutic decisions in an environment of uncertainty and complexity , and the dam of decisions centered on the patient. Tanmateix is laying the foundations of com fer recerca in l'atenció primary.

It is considered as objective formatius of this subject the following:
• Connect with the primary care team and its members
• Use of the clinical interview in the event of having to donate bad news
• Home care knowledge
• Preventive activities
• Multipathological and polymedicated patient
• Introduction to research in primary care

  • Deprescription amb quaternary prevention

This subject is complementary to other subjects such as AIMs and Physiopathology and clinical semiology


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 knowledge of the national and international health organisations and the factors and circumstances affecting other healthcare systems.
  • 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.
  • 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.
  • Recognise the role of complexity, uncertainty and probability in decision-making in medical practice.
  • Use information and communication technologies in professional practice.

Learning Outcomes

  1. Accept that professional decisions are taken within a framework of uncertainty.
  2. Be able to work in an international context.
  3. Communicate clearly, orally and in writing, with other professionals and the media.
  4. Describe the communication process and its effect on the professional caregiver–patient relationship.
  5. Describe the new health problems arising from migratory movements in Europe that are treated in primary healthcare.
  6. Describe the system for assessing health programmes and make a critical analysis of this system.
  7. Differentiate between risk to the population and individual risks.
  8. Explain the elements to be considered when assessing patients' role in decision-making on their health and on the medical attention they receive at their primary healthcare centres.
  9. Identify the basic elements of the face-to-face doctor–patient interview in a context of high accessibility and longitudinal care.
  10. Identify the presentation forms of the different pathological processes.
  11. Know the basic elements of the communication of clinical research results.
  12. Maintain and sharpen one's professional competence, in particular by independently learning new material and techniques and by focusing on quality.
  13. Observe the therapeutic approach, the clinical course and its prevention in cases where this is possible.
  14. Participate in discussions to solve the clinical problems being faced.
  15. Perform an anamnesis and a complete physical examination by systems on adults and children.
  16. Prepare a complete patient record systematically.
  17. Question a simple model to explain the state of health/illness of individuals.
  18. Use information and communication technologies in professional practice.

Content

• The appropriateness of the clinical interview in special situations such as giving bad news that allows: identify the demands and the reasons for consultation, identify the aspects and the diagnostic and therapeutic possibilities, connect with the techniques of narrative recovery, exploration of the guiding symptoms and evaluation of the psychosocial aspects.

• Coneixement de l'attenció domiciliària: the reasons for consultation, the papers of the different professionals, the appropriate diagnostic and therapeutic techniques to the malalt's head, role of the caregiver and of the family and community environment.

• Preventive activities: knowledge of adult preventive activities (vaccines, screening for cardiovascular risk factors, screening for neoplasms, health promotion (physical activity, healthy eating...), and mental health.

• Multipathological and polymedicated patient: identify the problems of the management of multipathological malady, the use of polypharmacy and pharmacological interactions and identification of comorbidities.

• Know the basic elements of the communication of clinical research results in primary care

• Introduction of quaternary prevention concepts and its approach

Distributive blocks

• A. Clinical interview
• B. Home care
• C. Multipathological and polymedicated patient
• D. Preventive activities
• E. Introduction to research in primary care
• F. Deprescription and quaternary prevention


Activities and Methodology

Title Hours ECTS Learning Outcomes
Type: Directed      
Clinical care practices (CCP) 21 0.84 1, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18
SEMINARS 12 0.48 1, 3, 4, 7, 8, 9, 10, 11, 12, 17, 18
Type: Autonomous      
PREPARATION OF ASSIGNMENTS / PERSONAL STUDY 39.9 1.6 2, 6, 8, 9, 11, 12, 13, 17, 18

This Guide describes the framework, contents, methodology and general rules of the subject, in accordance with the current study plan. The final organization of the subject in terms of the number and size of groups, distribution in the calendar and exam dates, specific evaluation criteria and examination review, will be specified in each of the Hospital Teaching Units ( UDH), which will explain this through their web pages and on the first day of class of each subject, through the professors responsible for the subject at the UDH.
For the current academic year, the professors designated by the Departments as responsible for the subject at Faculty and UDH level are:

Department(s) responsible: Medicine
Head of Faculty: Asunció Wilke Trixant (MariaAsuncion.wilke@uab.cat)
Responsible UD Vall d'Hebron: Joan Juvanteny (juvanteny@gmail.com)
UD Germans Trias i Pujol: Asunció Wilke (awilke.bnm.ics@gencat.cat)  and Judith Llussa (jllussa.bnm.ics@gencat.cat)
UD Sant Pau: Mª Antonia LLauger (mallauger@gencat.cat)
UD Parc Taulí: Montserrat Baré (mbare.mn.ics@gencat.cat) and Rafael Azagra (Rafael.Azagra@uab.cat)

and  Internships: Typology Clinical care practices (PCA), directed activity.

Clinical practice in CAP, for 5 school days (21 hours). Groups of 2 students.

Seminars: Typology of specialized seminars (SESP). Groups of up to 25 students, 6 sessions of 2 hours (10 minutes for the assessment). Programming site: UUDDHH.

Seminar 1: Clinical interview (How to give bad news)
Seminar 2: The bases of research in primary care
Seminar 3: Home care
Seminar 4: Preventive activities
Seminar 5: The multipathological and polymedicated patient
Seminar 6: Deprescription and quaternary prevention
Given the characteristics of the seminars (work with clinical cases) it is necessary that the student has previously studied the contents of the seminars and that they will have at their disposalin the Virtual Campus.

Exceptionally and according to the criteria of the responsible teaching staff, the available resources and the current health situation in the different Teaching Units, part of the content corresponding to the theoretical lessons, practicals and seminars may be taught face-to-face or virtually.

Note: 15 minutes of a class will be set aside, within the calendar established by the center/degree, for students to fill in the teacher performance and subject evaluation surveys /module.

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.


Assessment

Continous Assessment Activities

Title Weighting Hours ECTS Learning Outcomes
Assessment by objective tests: multiple choice items/restricted questions 50% 1 0.04 2, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 17, 18
Evaluation of clinical cases and/or skills in the seminars 15% 0.7 0.03 1, 3, 4, 5, 6, 7, 8, 9, 10, 11, 13, 14, 17, 18
Practical evaluation 35 0.4 0.02 1, 4, 6, 9, 11, 13, 15, 16

This subject does not provide the single assessment system

The evaluation of the subject is continued through the assistance and assessment of the different types of teachers.

 To pass the subject IT IS ESSENTIAL:

a) The attendance of the student at 100% of the Clinical Practices in the CAP (5 days)
b) The attendance of the student at 100% of the seminars (6 seminars)
c) Assolir a minimum grade in the final test of the seminars of 5 points (out of 10)
d) Assign a minimum mark in the final exam of the subject of 5 (out of 10)

The final evaluation will consist of 3 consecutive evaluations

1.- Evaluation of training in the Primary Healsth Center (CAP)

The assessment will be made by the clinical tutor of the practices in the CAP, and will consist of:

a) The assistance and punctuality to the practices (maximum 5 points)
b) The student's attitude (maximum 4 points)
c) Participation and integration in the clinical group (maximum 3 points)
d) The progression of connections (maximum 4 points)
e) The progression of the skills (maximum 4 points)

The weight of this evaluation in the final grade will be 35%.


2.- Evaluation of the Seminars

The knowledge and skills acquired in the seminars will be evaluated with a test of short questions (between 2 and 4) or the evaluation of a clinical case related to the subject matter of the seminar. Es farà at the end of the seminar (10 minutes)

The weight of this evaluation in the final grade will be 15%.

3.- Exam of the subject

1) It will be a test type test with multiple answers and/or short questions
2) In the tipus test hi hauran several answers. Only one will be correct. You do not answer will not subtract from the final grade. The incorrect answers will be subtracted from the final score
3) The Matricula d'Honor is donated among the best grades earned. The minimum score required to gain access to MH is 9.5.

The weight of this evaluation in the final grade will be 50%

NON-ASSESSABLE STUDENT
A student will not beassessed in any of the following situations:
a) Not having assisted in the 5 days of practices in the CAP (100%)
b) Not having attended the 6 seminars (100%)

FINAL PROOF OF RECOVERY
The students who do not pass the exam of the subject with a grade lower than 5 or who, for personal reasons, do not have to do so, may take a recovery test.

FAILURE OF THE SUBJECT

In the case that the student does not pass the subject, he will be able to enroll again in the next course (or later).

The student who fails the subject, if he has completed 100% of the practices in the CAP, will not be able to repeat the practices in the CAP but will be obligatory to attend the seminars in order to present himself from now on. the exam of the subject.


Bibliography

ENTREVISTA  CLÍNICA

1.- Borrell F, Bosch JM. Entrevista clínica y relación asistencial. La atención centrada en la persona. Dins: Martin Zurro A, Cano Pérez JF, Gené Badia J. Atención primaria: principios, organización y métodos en medicina de familia. 8ª ed. Barcelona: Elsevier; 2019. Disponible a: https://bibcercador.uab.cat/permalink/34CSUC_UAB/1eqfv2p/alma991010488765406709 

 2.-Buckman R. How to break bad news: a guide for health care professionals. Baltimore: Johns Hopkins University Press, 1992. 

 3.- Epstein Ronald M, Street Richard L. Shared Mind: Communication, Decision Making, and Autonomy in Serious Illness. Ann Fam Med. 2011; 9(5):454-461. Disponible a: https://bibcercador.uab.cat/permalink/34CSUC_UAB/1c3utr0/cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3185482 

 

ATENCIÓ DOMICILIARIA

1.-Cegri F, Limón E. Paciente en el domicilio. Dins: Martin Zurro A, Cano Pérez JF, Gené Badia J. Atención Primaria. 8ª ed. Barcelona: Elsevier; 2019. p. 486-509. 

 2.- Badia-Rafecas W, Bonilla-Ibern M, Buendia-Surroca C, Cegri-Lombardo F, Company-Fontané J, Contel-Segura JC, et al. Programa de millora de l’atenció al domicili des de l’atenció primària de salut. Barcelona: Institut Català de la Salut; 2010. Disponible a: https://bibcercador.uab.cat/permalink/34CSUC_UAB/1eqfv2p/alma991000932029706709 

 3.- Corrales Nevado A, Alonso Babarro A, Rodríguez Lozano MA.Continuidad de cuidados, innovación y redefinición de papeles profesionales en la atención a pacientes crónicos y terminales. Informe SESPAS. Gaceta sanitaria. 2012; 26(S1): 63-68. Disponible a: https://bibcercador.uab.cat/permalink/34CSUC_UAB/1c3utr0/cdi_crossref_primary_10_1016_j_gaceta_2011_09_032 

MALALT PLURIPATOLOGIC 

  • Martin C, Wilke MA, Lopez Grau M. Paciente anciano. Dins: Martin Zurro A, Cano Pérez JF, Gené Badia J. Atención Primaria. 8ª ed. Barcelona: Elsevier; 2019. P. 440-461. 
  • Contel Segura JC, Santaeugenia Gonzalez J,Gutierrez Jimenez N. Paciente crónico en situación de multimorbilidad y complejidad. Dins: Martin Zurro A, Cano Pérez JF, Gené Badia J. Atención Primaria. 8ª ed. Barcelona: Elsevier; 2019. p. 462-485. 

 

ACTIVITATS PREVENTIVES 

RECERCA EN ATENCIO PRIMÀRIA 

  • Ètica de la investigación AMF 2015;11(4):191-198 

 

DEPRESCRIPCIO I PREVENCIO QUATERNARIA 

 


Software

No specific software is necessary


Language list

Information on the teaching languages can be checked on the CONTENTS section of the guide.