Clinical Practice IV

Coordination

• Núria Roger Casals
• Domingo Ruiz Hidalgo

Sustainable Development Goals (SDG)

• 3. Good health and well-being

Objectives

The Clinical Practice IV subject is equivalent to 9 ECTS in which practical activities are developed that are adjusted to the student's training and curricular itinerary and maintain a direct link with the subjects taught during the sixth year.

These practices are developed in two periods:

General practices

They correspond to intensive periods of clinical stay of 6 consecutive weeks. They mean the continued stay in one or more services or equipment, medical or surgical.

Objective: The student must achieve the defined learning outcomes and at the same time integrate into the dynamics of the healthcare center.

As a general criterion, in general practices the knowledge and skills worked on throughout the clinical period of the degree (which have to do with general clinical practice) are deployed, with special emphasis on the critically ill.

Specific practices (extensive period)

They are linked to the subjects of the clinical cycle. In the case of Pediatrics, they are developed during and after the subject and have a specific duration. They are carried out in the hospital and outpatient setting ("the healthy child") and are complemented by basic life support sessions.

Specific itinerary

Students who in previous courses have gone through the 3 compulsory care areas (Hospital Care, Primary Care, Intermediate Care) can choose from the entire medical and surgical offer.

Therefore, the Clinical Practice IV subject allows the student to put into practice everything they have worked on during the previous courses and is the space in which they can check their level of competence as a "learner", since they are already able to feel how they progress and acquire confidence in the exercise of the applied part of the degree in Medicine at UVic-UCC.

In this process, he has the support of various professionals, both from the Faculty itself and from the healthcare centers where he does his practical stays.

Therefore, it is a process of verifying your vocation to be a doctor.

The competency objectives are:

• Take a clinical history and physical examination of quality adjusted to the reason for the consultation and the scope of care.
• Interpret any complementary examination appropriately.
• Make reasoned diagnostic and therapeutic decisions.
• Be comfortable communicating with patients, family members and healthcare professionals.
• Develop clinical judgment and perform critical analysis.
• Acquire professional values and ethical attitudes.

Learning outcomes

In supervised internships, the student:

• Acquire the necessary skills to carry out the tasks arising from the clinical stay.
• Demonstrates skills in communicating bad news.
• Writes histories, reports, instructions and other records in a way that is understandable to patients, family members and other professionals.
• Assumes different responsibilities in individual or collaborative work and evaluates the results obtained.
• Recognizes the care environment and the internal and external relationships that are established within it.
• Acquires and demonstrates advanced knowledge of theoretical and practical aspects and work methodology in the field of clinical practice.
• Correctly prepares a clinical history and anamnesis.
• Performs a complete and adequate physical examination.
• Develops differential diagnoses with accuracy and consistency.
• Define hypotheses that take into account several variables.
• Determine the necessary diagnostic tests according to each case.
• Correctly interprets results derived from the different tests carried out.
• Shows skills in determining and arguing intervention proposals.
• It moves with desymboltura in the general use of ICT and, in particular, in the technological environments specific to the professional field.

Specifically, Clinical Practice IV aims for the student to achieve the following learning outcomes:

• Demonstrate that you know how to determine vital signs (blood pressure, temperature, heart and respiratory rates and oxygen saturation).
• Conducts at least 5 complete clinical interviews (in a structured, orderly and reliable manner) with patients with any reason for consultation or reason for admission, preferably in the emergency department.
• Performs a physical examination in a structured, orderly and technically correct manner on at least 5 patients with any reason for emergency consultation.
• Takes a clinical history and writes it according to the main reasons for consultation, including those of patients with urgent consultations.
• Performs a complete physical examination tailored to any reason for consultation.
• He does a systematic examination of the patient in a coma.
• Provides syndromic guidance for any reason for consultation.
• Makes a reasoned and contextualized differential diagnosis.
• It indicates the initial complementary examinations adjusted to the syndromic orientation and interprets them appropriately.
• Develops a treatment plan that takes into account the patient's preferences and available resources.
• Adopt appropriate attitudes and skills for self-learning and critical reflection.
• Evaluates the contents of the practical stay and the portfolio in an argumentative way.

Competencies

General skills

• Develop professional practice with due respect for other health professionals and acquire teamwork skills.
• In professional activity, bring to bear a critical, creative, constructively skeptical and research-oriented outlook.

Specific skills

• Be able to make an initial diagnosis and establish a rational diagnostic strategy.
• Carry out professional tasks with due respect for patient autonomy, beliefs and culture.
• Indicate the most appropriate treatment for the most common acute and chronic conditions, and for the terminally ill.
• Obtain and make medical records that contain all relevant information.
• Perform a physical examination and a mental assessment.
• Understand the basic components of the medical profession, including ethical principles, legal responsibilities and patient-centered professional practice.
• Understand the principles of action, indications and efficacy of therapeutic interventions, based on the available scientific evidence.

Basic skills

• Students can communicate information, ideas, problems and solutions to both specialists and non-specialists.
• Students have demonstrated knowledge and understanding in a field of study that builds on general secondary education with the support of advanced textbooks and knowledge of the latest advances in this field of study.

Core skills

• Become the protagonist of one's own learning process in order to achieve personal and professional growth and acquire all-round training for living and learning in a context of respect for linguistic, social, cultural, gender and economic diversity.
• Display professional skills in complex multidisciplinary contexts, working in networked teams, whether face-to-face or online, through use of information and communication technology.
• Exercise active citizenship and individual responsibility with a commitment to the values of democracy, sustainability and universal design, through practice based on learning, service and social inclusion.
• Interact in international and worldwide contexts to identify needs and and new contexts for knowledge transfer to current and emerging fields of professional development, with the ability to adapt to and independently manage professional and research processes.
• Project the values of entrepreneurship and innovation in one's academic and professional career, through contact with a variety of practical contexts and motivation for professional development.
• Use oral, written and audiovisual forms of communication, in one's own language and in foreign languages, with a high standard of use, form and content.

Content

1. The clinical history: elements and their preparation
2. Development of physical exploration
3. The differential diagnosis
4. Determination of the diagnostic hypothesis
5. Diagnostic tests
6. Clinical intervention according to different cases and situations
7. Effective communication
8. Digital tools and ICT
9. Organization and operation of the unit
10. Interprofessional relationship

Evaluation

In the Clinical Practice IV subject, two assessment instruments are used:

• Specific evaluation tests
• Delivery of work and projects

The assessment of skills is done through:

• Portfolios of a case seen during the practices in the format of case report (50%)
• Objective and structured skills assessment (ACOE) carried out by the Department of Health of the Generalitat de Catalunya (50%)

Methodology

The methodology is determined according to the objectives of the practical.

Clinical practices are carried out through stays in different healthcare centers collaborating with the degree and linked to the territorial teaching units of Vic and Manresa.

During the stay, students have as their main references an academic tutor (subject teacher) and a teaching collaborator (doctor from the healthcare center where the internship is carried out), who ensures the achievement of learning outcomes.

Bibliography

Further reading

Teachers will provide complementary bibliography and compulsory reading throughout the course via the Virtual Campus.