Queen’s University Belfast
School of Medicine and Dentistry
Phase 3 Clinical Placement Student Selected Component
Generic Study Guide
Contents
Page
Introduction 3
Important Dates 4
Teaching Staff and Resources 5
Student Support and Guidance 6
University Regulations 7
Learning Outcomes 9
Assessment 10
Example of SSC Diary 13
SSC Diary 15
Resource material & suggested reading 18
Intimate examination guidelines for students 21
Marking schemes 25
Introduction to the Clinical SSC
In this SSC, you will have the opportunity to study in depth an area of clinical practice. You will take a full part in the life of the unit that you are attached to. SSCs should encourage the development of abilities in self study, critical thinking and problem solving.
This is a great opportunity for you to learn more about an area that you are interested in and you can develop your history taking skills as well as seeing lots of interesting procedures. We expect that you work all 15 days and either be present in the ward/outpatients clinics/day procedure units/operating theatres etc. or be involved in self-directed learning. The total study time for the SSC is 120 h. i.e. 40 hours per week should be spent on this work.
The assessment outcomes for this module will be a CASE, PROJECT and a completed signed DIARY. See pages 10-12 of this study guide for further information.
If you run into any problems during the SSC, you should first contact the module coordinator. If there is a problem in the hospital that you are in, then contact the pastoral tutor in that hospital (see http://www.qub.ac.uk/cm/guidance/ for details). For any other SSC related problems, contact the semester SSC coordinator, or the Programme SSC coordinator (p5). The details of other people to contact for student support and guidance are given on pages 5 and 6 of this Study Guide.
Important Dates
3rd September 2007 First day of SSC. Meet with module coordinator and discuss the clinics and other sessions you will need to attend, details of your project work, find out where to hand in work etc. Schedule dates into SSC diary.
14th September 2007 Hand in case report to designated person as discussed above and arrange time for feed back.
21st September 2007 Last day of SSC. Project work must be handed in by this date at the latest. Ensure Diary has been signed.
TEACHING STAFF
QUB Staff
SSC Programme Coordinator
Dr Vivienne Crawford,
Year 3 SSC Coordinators
Autumn – Prof Denis Johnston, /
Spring – Prof Sheena Lewis,
Information on Facilities in Hospitals and who to contact for help while on placement: http://www.qub.ac.uk/fmhs/sumde/Index.htm
Information about Student Support and Guidance
1. Head of Student Support
Miss G Silvestri, Head of Student Support and Guidance
Contact: 028 90 63 31 52 (answering machine available outside main office hours)
Please arrange an appointment using the above telephone number
2. Tutor
If you do not know who your Tutor is or how to contact them speak to Mrs Perpetua Lewis, Department of Ophthalmology
Contact: 028 9063 3152 or email
3. The Web
Student Support and Guidance Website: http://www.qub.ac.uk/cm/guidance/
Students News site: http://www.qub.ac.uk/cm/mednews/
Information on Facilities in Hospitals and who to contact for help while on attachment: http://www.qub.ac.uk/cm/guidance/
4. School Office
Curricula enquiries: Linda McGuinness
, Tel: 028 9097 1448
Exam Enquiries: Mrs Arlene Stockman
, Tel: 028 9097 5963
Student Support: Mrs Nicola Swenarton
, 028 9097 1451
5. Female Medical Student Counsellor
Dr Ann Harper: 028 9026 3009 or 028 9024 0503 Ext 2506
University Regulations 2007-2008
Plagiarism
Blatant cheating, i.e presenting work done completely by someone else and representing it as your own, is an academic offence and may result in you receiving no marks for the module (see Para 7.17 -7.29 of the General Regulations, University Calendar 2006/2007). It is also a fitness to practice issue and may result in you being expelled from Medical School.
If you quote another person’s work, you must acknowledge this fully by means of a reference in the text (source to be given in the reference list) and putting the quotation in quotation marks i.e. “ “. This also applies if you use verbatim short sections from a source.
Paraphrasing statements/text of factual knowledge or ideas from published works, lectures or WEB sources is not plagiarism if you reference the original source and the paraphrasing is not too extensive. If in doubt – don’t!! You will lose marks for excessive paraphrasing.
Any diagrams, tables, graphs etc which have been taken directly from a source or modified from a source must include appropriate details of the author and source, as well as being acknowledged: e.g. from Bloggs et al. 1998 or adapted from Bloggs et al. 1998.
Attendance
Full attendance is expected, as is submission of course work and contribution to group work. In keeping with University Regulations students must inform their School of any absences from examinations or compulsory components of their courses and to submit medical certificates or other evidence of extenuating circumstances within 3 days of returning to their studies.
University Calendar General Regulations – http://www.qub.ac.uk/info/calendar/
Late submission of work
Students who submit work late will be penalised. Coursework signed in after the published submission deadline will be automatically penalised at the rate of 5% marks for each day late, up to a maximum of 5 working days late, after which a mark of zero will be awarded.
NOTE: exemption from late penalties will be the exception rather than the rule (please refer to the Notes for Undergraduate Medical Students Booklet for guidance regarding extenuating circumstances). Application for late submission of coursework should be made using the approved form available from the School Office and submitted to the member(s) of staff designated by the School within 3 days after the deadline for submission of the work.
Mobile phones
Mobile telephones and electronic messaging devices must be switched off during all lectures, tutorials, practical classes, clinical teaching sessions and class tests.
For further information on regulations, please read the Pathway Specific Regulations for Medicine issued to all students at the start of each academic year.
1
LEARNING OUTCOMES
SKILLS
By the end of the SSC the student should be able to demonstrate:
1. Competence in clinical skills
2. Appropriate decision making skills, clinical reasoning and judgment
3. Competence in retrieval, handling and presentation of information
4. Competence in communication
5. Ability to weigh up and balance ethical arguments
ATTITUDE
By the end of the SSC the student should demonstrate:
1 Reflection on learning
2 Ability for self-directed learning
3 Responsibility for own learning
4 Appropriate approach to patient care
5 Team working
UNDERSTANDING
By the end of the SSC the student should have an understanding of:
1. The doctor’s role within the health service
2. An understanding of basic and clinical sciences and their underlying principles
3. Health promotion and disease prevention
4. Research methods and limitations
ASSESSMENT
The final assessment mark is made up of:
Individual case presentation
Group or individual project
+ submission of signed diary record
+ elements of interest & motivation and reliability
Marking schemes can be found on p25-26.
The Diary should be handed in at the end of the course while the case should be handed in no later than the Friday of week 2. Adequate time must be allowed for case marking and feedback. During the attachment the student should interact with all levels within the medical team. They should also develop an awareness of the roles of the nurses and the other professions allied to medicine (ie. Physiotherapists, Social Services, Pharmacists, Occupational therapists etc.).
(see page 13 for weightings assigned to each constituent)
1 Written Case (40%)
During the clinical attachment you will write up a case in detail and a commentary. See below for details of how to approach this work. This will be discussed with you by the consultant in your unit and you will be given feedback on these.
Within the first two days select a patient who you have come across in any of the clinical areas and work up their case for presentation. This should be handed in by the end of week 2. You must hand in 2 hard copies to the module coordinator and also email a copy to the SSC Semester coordinator (see p5). One marked copy will be returned to you and the other marked copy will be retained for future GMC and Subject Review inspections. The written case will not be word limited but its length and content should be appropriate for the subject matter being covered. Students may lose marks if it is felt the case is incomplete or too lengthy (see marking scheme p25-26). Care should therefore be taken when deciding what is appropriate to include. If the student is uncertain regarding appropriateness of subject matter they should consult with a member of the clinical team they are attached to.
In writing up this case you should.
· Take a full history. This should include a history of the presenting complaint, the past history, medications, an occupational history, a family history and an assessment of personal and family circumstances.
· Examine all systems focusing particularly on the system, which is most likely to provide information of help in diagnosis and record the findings of your examination. You should perform a mental state examination where appropriate. At the end of the clerkship you should be able to examine each system in a competent and practiced manner and be confident in the accuracy of your findings.
· Formulate a problem list and make a differential diagnosis.
· List the investigations, which you would consider appropriate and be able to justify your choice. The investigations should help support the final diagnosis. You should be able to describe the purpose of an investigation and give an outline of the procedure in language, which can be understood by patients.
· Describe all forms of therapy appropriate. If drug therapy you should list drugs (using Generic names) written in block capitals and stating dose and route of administration. You will be expected to know the mode of action of commonly used drugs and their side effects and interactions.
· Make an assessment of the disability likely to result from this illness and decide on appropriate measures for rehabilitation.
· Detail the advice you would give to the patient.
Before commencing your case project ensure you familiarise yourself with the regulations for performing an intimate examination. NO STUDENT SHOULD EXAMINE A PATIENT WHO DOES NOT HAVE THE CAPACITY TO GIVE CONSENT.
2 Project (40%)
This can be an individual or group project. The preparation, content, timeliness and delivery of the project contribute another 40% of the marks. Information about the project and your group members (if any) will be given at the introductory session. Each group member should contribute to the project presentation and its preparation.
This should be handed in at the end of the course (2 hard copies to the module coordinator and also email a copy to the SSC Semester coordinator (see p5). For presentations, you should provide your PowerPoint presentation. One marked copy will be returned to you and the other marked copy will be retained for future GMC and Subject Review inspections. The project can take different formats: a patient information sheet; an audit study or a literature search and presentation. Either way you will have an opportunity to discuss which type of project you will be doing with your SSC coordinator on the first day of the SSC. The length of the project will not be limited but should be appropriate to the subject matter being covered (see comments on same in written case). An audit is a method of assessing compliance with a given standard. It should include the guidelines to be audited, a presentation of your data, how this data compares with the guidelines and any recommendations you would make depending on your results. Examples of patient information sheets can be found in most outpatient departments. Students should liaise with an appropriate specialist nurse (ie. COPD, diabetes, stroke, incontinence etc.) as their assistance may be invaluable.
CLINICAL Assessment TASKS
3 DIARY
There is a blank diary contained within this study guide. A completed diary is also provided as an example of how it should be completed. Following a discussion at the initial meeting with your consultant you should make a list of the activities and procedures that you are to take part in or watch and schedule these into the diary.
The diary must be signed by a consultant in the unit to which you are attached to indicate that you have attended and have satisfactorily completed the tasks. Students must complete their clinical attachment satisfactorily.
e.g. See example (below)
Example for diary for the Respiratory Unit at the BCH
Respiratory Unit at BCH – the actual specialist clinics will depend on the consultant who you have been assigned to. You are very welcome to attend any other sessions of interest but only 2 students can attend most of the sessions at one time. All students should aim to attend at least 2 multi-disciplinary team meetings and 3 specialist clinics.
Example list
Bronchoscopy session (all students)
Pulmonary function testing (all students)
Exercise testing (all students)
Pulmonary rehabilitation in the gym (all students)
Tutorials as scheduled (all students)
MDT Cancer (all students)
For those in the CF group: CF Research Meeting; CF Clinic;
CF Multi-disciplinary team meeting
For those in the asthma group: Difficult asthma clinic, Ward follow-up asthma
Example of a completed SSC Diary
Student Name: AN Example Semester
Title of SSC: Respiratory Medicine
Hospital: Belfast City Hospital
Supervisor: Professor JS Elborn
Morning / Lunch / Afternoon / SignatureW E E K 1
3.9.2007 / 8.00 Introduced to Department and found out about clinics and other opportunities. Discussed project
9.15 – 10.30 Bronchiectasis MDT and
Ward Round (JSE)
10.30 CF MDT Presentation (JSE)
11.00 – 1.00 CFMDT/Ward Round (JSE) / Select patient for case study / Attended Chest Clinic with LGH
4.9.2007 / Bronchoscopy session / Read up about case / Pulmonary rehabilitation in gym
5.9.2007 / Difficult Asthma Clinic with LGH / Discussed case with JSE / CF Clinic (JSE)
6.9.2007 / Lung cancer clinic (RS) / Read up about case / Private study for case report
7.9.2007 / 8.30 – 10.00 Bronchiectasis Clinic (JSE)
10.00 – 11.30 General Respiratory Clinic (JSE) / 13.00-15.00 MDT Cancer (all) / Worked on case report
W E E K 2
10.9.2007 / 8.30-9.00
Discussed project work with JSE
9.15 – 10.30 Bronchiectasis MDT and
Ward Round (JSE)
10.30 CF MDT Presentation (JSE)
11.00 – 1.00 CFMDT/Ward Round (JSE) / Worked on project/case / Worked on project/case
Morning / Lunch / Afternoon / Signature
11.9.2007 / Pulmonary function testing / Worked on project/case / Worked on project
16.00 Attended Respiratory Research Meeting
12.9.2007 / Scleroderma/primary pulmonary hypertension (MR) / Worked on project/case / CF Clinic (JSE)
13.9.2007 / TB Clinic (RS) / Worked on project/case / Chest clinic (JMcM)
14.9.2007 / 8.30 – 10.00
Bronchiectasis Clinic (JSE)
10.00 – 11.30 General Respiratory Clinic (JSE)
11.30 – 14.00 Cystic Fibrosis Clinic (JSE) / Worked on project/case / Handed in case report
Worked on project
W E E K 3
17.9.2007 / 8.00 Discussed progress with JSE
9.15 – 10.30 Bronchiectasis MDT and
Ward Round (JSE)
10.30 CF MDT Presentation (JSE)
11.00 – 1.00 CFMDT/Ward Round (JSE) / Worked on project / Chest Clinic (LGH)
18.9.2007 / Bronchoscopy / Worked on project / Worked on project
16.00 Attended Respiratory Research Meeting
19.9.2007 / Difficult Asthma Clinic (LGH) / Worked on project / Sleep disorders clinic
20.9.2007 / Exercise testing / Worked on project / Worked on project
21.9.2007 / 8.30 – 10.00 Bronchiectasis Clinic (JSE)
10.00 – 11.30 General Respiratory Clinic (JSE)
11.30 – 14.00 Cystic Fibrosis Clinic (JSE) / Worked on project / 15.00 Gave oral presentation
Handed in project
Handed in completed diary
SSC Diary