Clinical Skills Module

4th year - 2015

Clinical Skills Module

Duration 14 weeks

From 4/10/2015-5/1/2016

Credit hours : 20hrs.

Coordinators: Dr. Sharafeldin & Dr. Sumia

Aims & Objectives

On completion of the module, the 4th year

students will be able to:

1. Take proper history from the patient.

2. Elicit all physical signs of organs in their normal

state and in their disease state (e.g. changes of vital

signs, organomegaly, etc.)

3. Interpret physical signs, order appropriate

investigations and suggest a diagnosis.

4. Have a minimal knowledge of management of

various diseases.

Overall outcome of the CSM1. Knowledge:

By the end of this module; we would expect the students

to able to:

1. Develop the ability to take and report a full history

together with acquiring skills in performing a complete

physical examination.

2. Discuss cases at bed side teaching/clinical rounds to

emphasize pathophysiology of symptoms & signs.

3. Be familiar with the usual instruments in clinical practice, x-rays, pathology jars, slides, etc.

4. Develop the ability to outline management.

Overall outcome of the CSM2. Skills:

Following completion of the course, students will be:

1.Able to present general and specific (system – related) examination skills.

2. Capable for assessing the vital signs (including pulse rate, respiratory rate,

blood pressure, body temperature, etc.).

3.Skillful to do various maneuvers including giving injections, conducting

basic suturing techniques, inserting cannulas and tubes (e.g. nasogastric

tube, Foley’s catheters, etc.), taking blood and fluids samples, get rid of sharp

disposable instruments, etc.

4.Administer routine care for the newborn together with some pediatric skills

such as measuring head circumference, taking body temperature, measuring

blood pressure, etc.

5.Accomplished to perform obstetrical and vaginal examination.

Overall outcome of the CSMIn summary, all the following skills are going to be included in

the module:

-General and systemic clinical examination skills.

-Anthropometric measures, BMI & body temperature

measurement.

- Basic life Support and CPR.

-Suturing and basic surgical knotting., Injections and

cannulation., collection of blood and dealing with sharp

instruments.

-Pulse assessment and blood pressure measurement., ECG

interpretation, arrhythmias ,defibrillator, & different signs

of valvular heart diseases (Murmurs).

Overall outcome of the CSM

In summary, all the following skills are going to be included in

the module:

•Abdominal Examination & digital rectal

examination., organomegaly , ascites, GIT

instruments ,& laparoscopy.

• Nasogastric tube administration, bowel

preparations & colostomy.

Overall outcome of the CSM

In summary, all the following skills are going to be included in the

module:

Neurological Examination & different neurological signs,

cranial nerves examination ,head & neck injuries

management.

Urinary catheter& suprapubic cystotomy. haematoruia

(Presentation & Managements.)

Thyroid gland examination., diabetic septic foot

(examination& management), breast examination.

Ophthalmoscope method of uses & fundus examination

Overall outcome of the CSM

In summary, all the following skills are going to be

included in the module:

Obstetrical examination & normal vaginal delivery

Examination of testicles and scrotum., hernia

examination.

Examination of the respiratory system & different Signs

of respiratory diseases.

Pneumothorax&Haemothorax -presentation and

management (needle decompression & chest tube)

Overall outcome of the CSM

In summary, all the following skills are going to be included in

the module

Airway Patency & Intubation, tracheostomy application

and care.

Hand examination, First Aid management of multiple

injured patient.

laboratory finding of anaemia, vascular injuries

assessment and control of external hemorrhage.

Paediatric Examination , neonatal resuscitation.

Approach to lumps and ulcers., wound care.

Overall outcome of the CSM3. Attitude:

Student should have the attitude and behavior of:

1.Respect for every human being, building confidentiality, and

abide by relevant Islamic ethics.

2.A desire to ease pain and suffering.

3.Willingness to work in a team with other health professionals.

4.Responsibility to remain life-long learner and maintain the

highest ethical and professional standards.

5.Referring patients to other health professional when needed.

6.A realization that it is not always in the interest of patients to

pursue every diagnostic or therapeutic possibility.

Anyone who stops learning is old, whether at twenty or eighty !!

Henry Ford

Course Learning Outcomes-a. Knowledge

-Describe normal structure and function of human body and its

major organ systems

-Define molecular, biochemical, cellular and immunological

mechanisms that are important in maintaining homeostasis.

- Discuss etiology, mechanisms, morphology and effects of

diseases and their clinical significance.

-Explain principles of various basic medical and surgical

modalities and measures in the management of diseases and

patient care.

-Outline the ethical considerations in medical practice and the

professional principles

Course Learning Outcomes

-b. Cognitive Skills

-Review the structure and functions of the human

body in health and disease.

-Demonstrate Integration of the basic science

concepts in real life clinical practice.

Course Learning Outcomes

c. Interpersonal Skills and Responsibility

- Work with honesty and integrity.

- Show professional attributes such as ethical

commitment, commitment to maintaining good

practice and interpersonal skills.

- Work with responsibility and accountability to

promote health in a health care system

Course Learning Outcomes d. Numerical and Communication Skills

- Communicate effectively, both orally and in writing,

with patients, colleagues, relatives, disabled people,

media and in breaking bad news

- Demonstrate basic skills and positive attitudes

towards teaching others, and negotiating and dealing

with complaints

- Listen and use other appropriate communication

techniques including an appreciation of non-verbal

communication/body language

Course Learning Outcomes e Psychomotor Skills (if applicable)

- Apply sensory cues in motor activities

- Show skillful performance of motor activities

- Coordinate the activities in internal

consistency

- Perform high levels of motor skills

- Practice general and system based physical

examination of patient and record observations

Teaching strategies during this course

1. Theoretical (lectures , PBL Case presentations)

2. Skills lab.

3. Bedside teaching.

Teaching Staff1. Lectures:

- Staff from medical, surgical, obstetrical and

pediatric departments is going to be involved.

- Lectures, due to the limitation of allocated

time, will put emphasis on certain parts of the

topic. However, students are urged to study on

their own to cover the whole subject. This will

be achieved through reading from the

reference books chosen by each department.

Teaching Staff2. Clinical Skills Lab.:

-The same faculty staff will cover the skills lab

activities.

-Demonstration by the teacher will be done first,

and handouts to be delivered to the students at

the start of each module describing the type(s) of

skills to be learned, theoretical background and

procedure description.

-Debriefing will be made at the end of the session.

Teaching Staff

3. Clinical Teaching Rounds:

Selected hospital staff in collaboration with the faculty staff is

going to arrange and teach the students in the clinical rounds.

- On the day of the clinical teaching session students should:

Prepare at least two fully clerked patients.

Participate in the discussion of one or more cases.

Be able to present a case of a clerked patient during any teaching round.

The clinical teaching sessions are run 2 days a week.

Attendance during all sessions is mandatory. Any missed session will result in one mark deduction.

Students who are absent more than 20 % of the sessions are not illegible to sit for end of posting exam.

Clinical Round Logbook

Clinical Round Logbook had been designed to

evaluate & assess the overall knowledge,

participation & attendance of the students..

It is mandatory for every student to bring with

him/her the logbook in each session, and for

the supervisor to sign in the concerned table at

the END of the session.

At the end of the module, logbook marks will be

counted to represent a sensible percentage

from the final marks.

Clinical Round Logbook

Date: Session Noc

Student Name: Section:

Clinical Round Topic(s):

No. of Cases Clerked: No. of Cases Presented:

No. of Cases Examined:

Supervisor: Signature:

Case (1)

HistoryExaminationInvestigationDifferential diagnosisDiagnosisTreatments

Teaching Staff

4. Problem Based Learning (Problem

Solving):

The faculty staff is going to arrange clinical

clubs.

This will present a clinical scenario related to

the covered module, with some key

information to explore the problem, assessing

what is needed, sharing knowledge, solving

the problem and giving feedback.

5.Cases Presentation Each group of students should

present one –two cases scenario which were prepared during their clinical l rounds

All students should be participated in the dissection.

Cases scenario should include history , clinical examination and differential diagnosis.

Who’s On First

The patient comes first

Listen to your patient

Difficult patients are people, too

AssessmentAssessment Tasks and Percentages:

Assessment Task Proportion of Final AssessmentAttitude& log book

5 %

Attendance 5 %

Mid-term Examination

MCQs 15%30%OSCE 15%

Final Examination

MCQs 15 %60%OSCE 25 %

Clinical Case Examination

20%

Assessment1.Mid-term Examination (30 %): (week 7)

The exam will consist of MCQs, and Objective

Structured Clinical Examination (OSCE).

1. Multiple Choice Questions -MCQs (15 %):

(Venue: Class, Duration: 2 hr.)

- Multiple choice items consist of a stem and a set of 5

options. Only one answer can be keyed as correct. The

exam consists of 60questions, with a total mark of 15,

and no penalties will be given for wrong answers.

Objective Structured Clinical Examination –

OSCE (15 %):

(Venue: Skills Lab. Centre. Duration: 2 hrs or more).

The OSCE assesses a range of clinical, data

interpretation and knowledge application skills. It is

made up of two exams :

A) The clinical OSCE

B) B)The data OSCE

A). Clinical OSCE: This comprises clinical stations. Each

station will have an examiner and/ or clear written instructions to tell the student what to do. It includes:

History taking Clinical examination Skills application The assessment by check list

B). Data OSCE:

This comprises 10 or more data questions.

Some of these questions will require the

student to interpret the data provided on

the question sheet and/ or on the screen.

Assessment2.Final Examination (60 %): (week 14)

The exam will consist of three parts; MCQs, Clinical Cases Examination

and OSCE.

Multiple Choice Questions -MCQs (15 %): (Venue: Class room. Duration:

2hrs.)

The exam contains 60 questions with a total mark of 15.

Clinical Cases Examination (20%): (Venue: Hospital. Duration: 1 hr.).

Short Cases Examination (20 %): Two short cases for each student and

each have an examination time of 10 minutes. 

Each case is assessed by check list

Objective Structured OSCE (25 %):

(Venue: Skills Lab. Centre. Duration: 100 minutes).

The OSCE assesses a range of clinical, data interpretation and knowledge application skills. It is made up of two exams – the clinical OSCE and the data OSCE.

Everyone looks good in a lab coat ..

Curriculum Map1. Course sections:Section Lecture

sClinical Skills Lab.

Clinical Teaching Rounds

PBL (Problem Solving)

Clinical Meetings

Case presentation

No. of Sessions

52 38 22 10 12 5

Session Duration (hrs.)

2 2 3 2 2 2

Teaching Hours

(300)

104 76 66 20 24 10

Curriculum Map2. Modules & Requirements:

No. Topic Lectures Skills Lab. Activities Clinical Rounds PBL (Problem Solving)

1 Introduction 4 8

2 Cardiovascular system 4 4 2 1

3 Respiratory system 4 4 2 1

4 Gastrointestinal system 4 4 2 1

5 Nervous system 4 3 2 1

6 Endocrine system 5 2 2 1

7 Reproductive system 3 4 1

8 Musculoskeletal system 4 2 1

9 Renal system 5 2 2 1

10 Infectious diseases& 4 2 1

11 Skin 2 2 1

12 Hematology 5 2

13 General 2 10

Total 52 38 22 10

Doctors become what they expect themselves to become !!

References (TEXT-BOOKS)o Required Textbooks

Macleod's Clinical examination 12th-13 editiono Essential References

1. Browse's Introduction to the Symptoms & Signs of Surgical Disease - 4th edition.

2. Schwartz's Principles of Surgery - 8th edition.

3. Harrison's Principles of Internal Medicine - 18th Edition.

4. Obstetrics by Ten Teachers - 19th edition.

o Electronic Materials www.studentconsult.com www.emedicine.com www.uptodate.com

Follow the three R’s :

Respect for self

Respect for others

Responsibility for all your work ..

Clinical Skills Module

4th year - 2015