Unit information: Community Orientated Medical Practice 2 in 2015/16

Unit name	Community Orientated Medical Practice 2
Unit code	MEDI34120
Credit points	0
Level of study	H/6
Teaching block(s)	Academic Year (weeks 1 - 52)
Unit director	Dr. Narayan
Open unit status	Not open
Pre-requisites	Must be on the MB ChB Programme.
Co-requisites	None
School/department	Bristol Medical School
Faculty	Faculty of Health Sciences

Description including Unit Aims

This course prepares students for managing the range of patient-centred problems presenting in Primary Health Care, Dermatology and Medicine for Older People. The learning in this unit takes place in different locations giving students a range of experiences. The common learning threads running through this unit include:

• Acute and chronic disease management
• Patient self-management
• Disease prevention
• Primary and secondary care interface working
• Team work and inter-professional learning
• Record keeping

Intended Learning Outcomes

Dermatology

By the end of this unit students should be able to:

• Take a dermatological history and explore a patient’s concerns and expectations
• Examine the skin systemically (including palpation)
• Be able to take skin swabs for bacteriology, virology and skin scrapings for mycology
• Describe and record findings using accepted dermatological terms
• Recognise and appreciate the incidence and appropriate management of common skin disorders and skin cancers and be familiar with principles of topical therapy
• Have an understanding of dermatological emergencies and their treatments
• Interact sensitively with people with skin diseases
• Have an understanding of the impact of skin disease on patients’ quality of life

Medicine for Older People

By the end of this unit students should be able to:

• Describe common health problems in old age and their drug and non-drug management based on the core and important problems listed in the lecture notes
• In an older patient with complex physical and social problems who is hospitalised or residing in the community:
• Know the principals of Comprehensive Geriatric Assessment (CGA)
•  Carry out a clinical assessment, construct working diagnoses
•  Define appropriate investigations and management plans
•  Name team composition, roles, processes and services meeting the specific patient and family needs
• Perform and interpret the functional assessments commonly used in older people
• Describe the processes of assessment and rehabilitation
• List the services available in the community to support older people (with physical and/or cognitive disability) and carers in their homes and explain the range of residential options distinguishing between them in terms of the level of care provided and the broad criteria used in relation to patient needs.

Primary Care

By the end of the unit students should be able to:

• Describe the role of the GP, other members of the primary health care team and the other systems that provide open access health care in the UK
• Conduct a complete consultation on any of the 16 core clinical problems listed in the primary care lecture notes and study guide Including:
• Consulting effectively with a patient with a disability
• Identifying patients at risk of intimate partner violence and having strategies to help them
• Understanding how the delivery of bad news impacts on patients and carers
• Describe the risks and benefits of commonly prescribed medication used in the treatment of these 16 core problems and understand the rationale behind making treatment decisions.
• Help patient reduce their risk of developing chronic disease and use data interpretation e.g. blood pressure measurement and cardiovascular risk to inform management.
• Understand the impact of multi-morbidity on the individual, and on health care services
• Describe methods by which the impact of disability on patients can be minimised

Teaching Information

Lectures, tutorial, workshops, self-directed learning sessions, bedside teaching. Clinical and GP attachments.

Assessment Information

Summative Assessment – All Year 4 Units have:

1. An Objective Structured Clinical Examination (OSCE) with stations on neonatal health, child health, reproductive health, psychiatry, primary care, dermatology, medicine for older people, peri-operative medicine and critical care.

2. Two written papers, each consisting of 100 best-of-5 multiple choice questions:

• Paper 1 will cover the learning outcomes from COMP1 and RCHN (ie neonatal and child health, reproductive health, evidence-based medicine and public health).
• Paper 2 will cover the learning outcomes from COMP2 and PsPC (primary care, medicine for older people, dermatology, psychiatry, peri-operative medicine and critical care)

Formative Assessment - During the course of the year each student will be given feedback to assist their learning.

Key vehicles for collecting and giving this feedback will include:

1) Performing two OSCE stations in each unit, run by the academies

2) Three internal students selected components:

• A presentation in Reproductive Health & Care of the Newborn
• A presentation in Psychiatry
• A critical appraisal and application of evidence from three key papers relating to a clinical scenario (COMP1)

3) Review of the logbooks and portfolios in each unit.

Reading and References

Library link

https://www.ole.bris.ac.uk/webapps/cmsmain/webui/_xy-136348_5-t_hYyAB8mF