BASIC SKILLS COURSE
7th September – 5th October
2001
Course Director: Carl Gwinnutt
Clinical Skills Facilitator: Lorna McInulty
CONTENTS
Welcome to the Basic Skills Course2
Programme for the Introductory Day3
Student Support and Guidance (SSG) at Hope Hospital6
The Assessments for Year 3 and 4 - Points to Remember8
The A - Z Guide to Hope Hospital - By Students for Students 9
Undergraduate IT Facilities16
The Integrated Student Timetable and SignUp System17
Ward Based Clinical Days - Aims and Objectives21
Lead Tutors for Skills Labs Teaching25
Lead Tutors for PBL 26
THE BASIC SKILLS COURSE TIMETABLE27
THE COMMUNICATIONS SKILLS COURSE HANDBOOK32
Staff email addresses42
Welcome to the 2001 Basic Skills Course
Last year’s Basic Skills Course was very successful and many elements remain unchanged. However, following student and Faculty evaluation of the course, we have adapted it and added to the content. On this course you will be introduced to life in a NHS Hospital and start to learn the rudiments of communication with patients as well as physical examination skills. There is also a problem-based learning (PBL) case.
Please bear in mind that this Introductory Course is only four weeks out of a three-year course and you should not expect to have mastered all aspects of clinical medicine in four weeks! However, we are very keen to establish some basic approaches and skills, which will form the basis for learning clinical practice over the next three years.
Staff involved in the teaching of this course will often have rescheduled their normal activities, cancelled outpatient clinics, operating lists or wards rounds in order to teach you. We therefore ask you not to cause offence by failing to attend sessions. Occasionally however, some activities may have to be cancelled or rescheduled because of the needs of the patients. In a hospital like Hope, where up to two thirds of the workload are emergency or urgent cases, this is inevitable. We can only apologise in advance and hope that you will understand. It’s all part of life in the Health service.
Course Objectives
The Basic Skills Course has the following objectives, which we hope you will achieve:
Orientation
Feel as though you belong in the hospital and know your way around it
Communication skills
Demonstrate and attitude of respect towards patients
Develop confidence in meeting and talking to patients
Appreciate the concept of confidentiality and patients’ rights to it
Be able to:
Examination
Understand:
The etiquette of physical examination
Basic principles of examination of the cardiovascular and respiratory systems and of the abdomen
N.B You will be expected to participate in these sessions, which will involve examining your peers, so please come prepared and dressed appropriately, in order to get maximum benefit from these sessions.
Be able to:
Use sight, hearing and touch in physical examination
Describe your findings
Observe and describe some abnormalities of the skin
Measure pulse, respirations, temperature and blood pressure
Patient care
Have:
Carried out nursing duties appropriate to the ward to which you are attached
Learned from other professionals about their contribution to patient care
Laboratory procedures
Be able to:
Complete laboratory and imaging requests
Handle safely and label blood, urine, sputum and stool samples
Perform urine dipstick testing
Procedural/therapeutic skills
Appreciate:
The importance of personal hygiene
Be able to perform:
Venepuncture
IM and SC injections
Venous cannulation and setting up intravenous infusions
Basic life support
Basic airway management
Basic sterile technique
Basic wound dressing
Although the above objectives may seem a little daunting and a lot to achieve in four weeks, please try to enjoy the experience. If you have any queries or problems whatsoever, don’t hesitate to contact a member of the undergraduate administrative support staff who will either be able to help you or know where to get help.
Lorna McInultyCarl Gwinnutt
Clinical Skills FacilitatorConsultant Anaesthetist
Course Director
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BASIC SKILLS COURSE - INTRODUCTORY DAY
FRIDAY 7th SEPTEMBER 2001
UNDERGRADUATE LECTURE THEATRE, PHASE 2, HOPE HOSPITAL
09.15- 09.30Welcome to Salford Royal Hospitals NHS Trust.
Mr Jim Potter.
Chairman of the Trust
09.30 – 09.45Introduction to Clinical experience.
Dr Jon Shaffer
Hospital Dean
09.45-10.15The Challenge of Becoming a Doctor
Professor Mike Horan
10.15 - 10.30CoffeeServed in Crush Hall.
10.30 – 11.00Introduction to the Curriculum
Dr Tim Dornan
11.00 - 11.30To be announced
11.30 - 12.00Your Third Year in Medicine4th and 5th years
12.00 - 12.30Working on the wardsSharon Christie, Staff Nurse
Sarah Hanbridge, Staff Nurse
12.30 – 13.15LUNCH
13.15 – 13.30Domestic arrangementsKaren Gwinnutt
13.30-13.45Student Support and GuidanceJon Shaffer
Karen Gwinnutt
13.45-14.15Introducing Basic Skills CourseCarl Gwinnutt
14.15Student PhotographsLorna McInulty
(All students in alphabetical order in groups of 20 per 20 minutes)
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STUDENT SUPPORT AND GUIDANCE (SSG) AT HOPE HOSPITAL
Many students find adjusting to the clinical years confusing and a bit daunting. Some deal better than others with the challenge of becoming a clinical learner but pressures can manifest themselves in many different ways. The teaching team here at Hope is experienced in dealing with all manner of student problems including personal, family, health or study problems. In short, we will try and help you with anything you feel is a problem.
Dr Jon Shaffer heads the student support team at Hope Hospital. A Consultant Physician, he is also a trained counsellor with a great deal of experience supporting students with personal and/or academic problems. A Student Surgery is held weekly with Dr Shaffer and supported by Karen Gwinnutt, who has also undertaken training in Counselling Skills. They work closely with a number of other professionals including counsellors, psychologists and psychiatrists to whom they are able to refer students.
How does the system work?
Curricular / Timetable Problems
In the first instance you should speak to any member of the Undergraduate Team. They have wide experience of such issues and are expert at problem solving. Contact with students is frequent, informal and usually very productive.
Exam failure or other educational difficulties.
An appropriate member of the Undergraduate team may be able to offer advice. Failing this you will be offered an appointment with Dr Shaffer who will be able to explore the problem with you in more depth and explain the various options open to you.
At the end of each third, fourth or fifth year attachment, tutors will be asked to report on your progress. They are encouraged to discuss what they write with you and you are entitled to see their comments, which are kept on file in Karen's office. If you have any concerns about these reports you can discuss them with either the Consultant concerned or with Dr Shaffer. If your report highlights a particular problem or an area in which you require improvement, you will be offered an appointment with Dr Shaffer to discuss the matter. This system is intended to help and support you and prevent failure later in the course.
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Non-Attendance
Students who are reported for non-attendance at PBL, ward teaching or Community will receive an appointment with Dr Shaffer for an informal discussion. A second report will result in formal advice with Dr Shaffer and a letter of referral to Progress Committee at the University. PBL attendance is compulsory and 75% attendance at all other teaching sessions is expected. Remember – students can be held back or asked to repeat attachments on attendance alone. Passing exams is not enough.
Personal Problems
If a problem crops up, no matter how trivial, you can discuss it with: -
A friend or another student.
Your GP.
Hazel Baguley, who runs counselling sessions for the MSRC in the Stopford Building.
A member of the Undergraduate Team
Dr Shaffer - who can refer you for more help if required.
Remember - no problem is too big or too small. We have an excellent system of support here at Hope which has been instituted to help you deal with problems and achieve your full potential. If you have problems, come and talk to us.
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Assessments for Year 3 and 4 – points to remember
The University of Manchester will issue you with a document entitled, ‘The Assessments for Year 3-5; Your essential Guide’. This will describe the examination process in great detail and you should read it carefully.
Examinations/Assessments
Examinations grades from:
Unsatisfactory – Low pass – Satisfactory – Honours – Distinction
Progress test
250 statements with True/False answers which are negatively marked
Two examinations per year
New questions each test with the exam paper being released shortly after the exam
The results of a progress test will be combined with the results of the previous progress test, weighted so that the most recent test has the greatest impact
Unsatisfactory result is automatic referral to Progress Committee
Objective Structured Clinical Examination (OSCE)
14 stations
Two examinations per year
Year 3January (formative)
June (summative)
Year 4 December (summative)
April (summative)
Unsatisfactory result is automatic referral to Progress Committee
Special Study Modules (SSMs) & Project Options
Two SSMs per year – one to include Community and one DGH
Project Option at end of year 4
Graded from Unsatisfactory – Satisfactory – Honours
Unsatisfactory report will be re-marked and if still unsatisfactory, referral to Progress Committee
Other assessments/attendance
PBL tutorials are compulsory. 75% at all other sessions expected
PBL Tutor report
PBL tutors complete a report on individual students and group work
One unsatisfactory report results in an appointment with Dr Shaffer. Two unsatisfactory reports means referral to Progress Committee
Firm Tutor reports
All firms complete a student record card
One unsatisfactory report results in an appointment with Dr Shaffer. Two unsatisfactory reports means referral to progress Committee
Community Tutor reports
All Community tutors complete a report which is sent directly to Professor Whitehouse
If attendance falls below 75% - referral to Progress Committee follows
THE A - Z GUIDE TO HOPE HOSPITAL
BY STUDENTS FOR STUDENTS
A: ACCIDENT and EMERGENCY.
This is where all the action is! The department provides plenty of opportunity for you to practise your venflons and taking blood. It is also the place where you will be allowed to practise your acute history taking skills. Everyone will have the opportunity to go to A&E at sometime during the HLB semester, but this should not stop you arranging a night on-call with your partner if you wish. All you have to do is ask permission from one of the A&E Consultants and they will usually say "yes!!"
B: B - WARDS
These are new surgical wards. You will be attached to some of these when you do the NME semester.
C: CLINICAL SKILLS BUILDING
This is the University Teaching Building housing the following staff and facilities:
a)Beverley Walters – Year 3 Administrator and first contact point
b)Karen Gwinnutt – Karen is Curriculum Development Officer and Year 5 Administrator.
c)Keshi Minett – Year 4 Administrator
d)Lorna McInulty - Lorna is in charge of the Skills Lab
e) David Horrocks – Undergraduate Technician
f)Phase 2 lecture theatre - the venue for many of your seminars and meetings.
g)IT area - this is where you access your E-mail etc.
h)Common Room - which as yet, does not have much in it. There is lots of potential and we hope to elect a common room committee to do something about it.
i)Skills Lab - this is always open to you and has the facilities to practise any procedure you are expected to know as an undergraduate. Please
respect the manikins and other equipment as they are very expensive and some were damaged last year.
j)Lockers - everyone should have access to lockers. You should keep
bags and coats in them. There are lockers on the first floor and in the common room.
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D: DEAN
Dr Jon Shaffer is the Hospital Dean. He is a busy clinician – a Consultant in Gastroenterology – but is very approachable and happy to talk to students.
E: EXAMS
You sit two exams:
Firstly, the progress test. This comprises 250 true/false questions that rival the ambiguity of the first two years! The questions are from all four semesters 950 questions each) and 50 questions are taken from years one and two. Third, fourth and fifth years will sit the same paper. The idea is that each time you sit the paper you will be able to answer more questions, so in theory you "progress" from semester to semester.
Secondly, the OSCE. This exam is similar in structure to the first and second year OSCE exam, but is obviously more clinically based. It involves history-taking, examining patients, interpreting x-rays, data analysis and practical procedures such as taking blood, managing an airway amongst others. It is a good exam - you will enjoy it if you know your stuff. It separates the people who go in regularly from those who don't and it is a better opportunity than the progress test to show how much (or how little) you know.
F: FIRMS
A "firm" is the collective term for the house officer, senior house officer, registrar and consultant in a particular speciality. You are attached to different firms during both semesters; they should be relevant to the module you are on. Each firm has a different teaching programme, usually prepared for you. It is up to you to attend regularly and show enthusiasm and you will find that this is reciprocated in the teaching that you get. Sometimes the doctors may be too busy to teach and so it is up to you to use your initiative and practice taking histories and writing them up ready for presenting when the doctors have more time. You should have access to patients on your ward at all times, though you must respect the privacy and dignity of patients who are seriously ill or who are too tired to speak to you. You can also attend outpatient clinics, ward rounds, special investigations, theatre list etc etc. These can be booked using the Sign-up database.
G: GRAND ROUNDS
These happen once a month in the Phase 2 lecture theatre. Each month two student volunteers present cases that have been chosen by a consultant "supervisor". The audience comprises mainly students and the presentation is usually followed by lively discussion. It is worth attending as it is a good opportunity to learn how to present a case, which you will inevitably have to do as a postgraduate. The cases are invariably interesting and there is usually an important lesson to be learned from each one.
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H: HARVEY – The Cardiac Patient Simulator (CPS)
“Harvey” is a Cardiology Patient Simulator (CPS), produced by the University of Miami for use in the bedside teaching of medical students. The system consists of a life-size mannekin capable of simulating a variety of cardiovascular conditions, and associated slide programs providing patient history, physical examination, laboratory data, medical and surgical treatment options, and information about the pathology and epidemiology of the patient’s disease state.
The British Heart Foundation has recently purchased Harvey for a number of UK medical schools, for use in undergraduate medical student teaching at a cost of £44k per mannekin. Hope was successful in bidding to have Harvey sited within its Clinical Skills Lab. You are welcome to use Harvey and his associated computer programs but you must book an introductory session with Lorna (Clinical Skills Facilitator) before using Harvey for the first time.
I: INN OF GOOD HOPE
Got a spare hour? Just had an exam? Then pop in here for a quick one. The Inn is a popular venue with hospital staff out of hours and is being refurbished this summer, 2001
You should remember that you must not drink alcohol if you are going to be having any kind of patient contact later in the day.
J: JACCL
Learning how to decipher a patient's notes can be like learning a different language, especially as doctors use so many abbreviations. An example is " J A C C L" which you may see written on history sheets. We wondered what on earth it meant! Well, just for you it means: Jaundice, Anaemia, Cyanosis, Clubbing, Lymphadenopathy. When you see a little sign like this oJ, this means no jaundice.
There are loads of little abbreviations to get used to and some doctors make up their own!
K: KUMAR & CLARK
This will be your "bible" for medicine, though some people prefer Davidson's. As for examination books there are loads to choose from. The most popular is Macleod's and Hutchinson's, though Epstein or Talley & O'Connor seem to be a favourite for St. Andrews students. The only surgery book you will need is "Signs and Symptoms of Surgical Disease" by Browse. Every student has his or her favourite - ask your "mummy's and daddy's" for their advice.
The journals ‘Medicine International’ and ‘Surgery International’ are a good source of information and provide up to date, relevant articles written by clinicians. You'll find them in the library or you can subscribe. Members of the MDU get a free subscription for a year.