Bed side approach and clinical Methodology

A.Y. 2021/2022
6
Max ECTS
72
Overall hours
SSD
M-PSI/01 MED/09 MED/18
Language
English
Learning objectives
The course will provide the theoretical and practical basis for a comprehensive clinical bedside approach to patients by integrating the internal medicine and general surgery modules with a psychological one, focused on the acquisition of practical as well as methodological skills.
Expected learning outcomes
At the end of the practical activities, students should be able to:
Students will learn:
the processes of clinical reasoning,
to identify problems and making diagnostic hypothesis
theoretical basis of information processing and communication, with particular attention to cognitive models
basic notion on psychological and behavioural signs and symptoms.
Course syllabus and organization

Single session

Responsible
More specific information on the delivery modes of training activities for academic year 2021/22 will be provided over the coming months, based on the evolution of the public health situation.
Prerequisites for admission
To take the Bed Side Approach and Clinical Methodology exam, students must have already passed all the exams of the first year (Fundamentals of Basic Sciences, Cells, Molecules and Genes 1 and 2, Human Body) and the exam of Functions.
Assessment methods and Criteria
Students' assessment is based on an oral examination. The final mark is the average of the marks obtained in the three disciplines, internal medicine, general surgery and general psychology, weighted for the number of credits in each discipline.
The exam is deemed to be passed successfully if the final grade is equal to or higher than 18/30. In the event of a full grade (30/30) honors (lode) may be granted with the consent of all the professors.

Registration to the exam through SIFA is mandatory.
Internal medicine
Course syllabus
Topic 1. Course presentation

Patient assessment - Comprehensive and focused
· Determining the scope of assessment
· Subjective versus objective data
The surgical patients
· Brief history of surgery and recent development. The operating room and current available technologies

Topic 2. Behaviour and mental status: cognitive processes and functions

Topic 3. Information research, clinical reasoning, assessment and plan: the process of clinical reasoning. Identifying problems and making diagnosis, generating the problem list

Topic 4. History taking: a comprehensive health history, the techniques of skilled interviewing, the sequence and context of the interviewing, cultural and cognitive contest, exploring patients' perspective

Topic 5. Communication fallacies
Topic 6. Signs and symptoms. Beginning the physical examination: general survey, vital signs and pain- Overview of general examination
Topic 7. The thorax, lung and cardiovascular system: techniques of examinations
Topic 8. The abdomen examination related to medical approach (liver, spleen and pancreas problems)
Topic 9. Surgeon's behaviour in the Operating room, basic principles of asepsis and patient's preparation to surgery

Topic 10: Physical examination and clinical signs of the abdomen, chest, breast (surgery related), and genito-urinary apparatus part 1

Topic 11: Physical examination and clinical signs of the abdomen, chest, breast (surgery related), and genito-urinary apparatus part 2 )

Topic 12. The vascular system
· Arterial diseases
· Venous and lymphatic diseases
· Vascular diagnosis and anamnesis + English/Italian dictionary

Topic 13. Lump, masses and ulcer
Topic 14. Doctor-patient relationship: clinical cases

Topic 15. Doctor-patient relationship: clinical cases - the physician perspective
Topic 16. PRACTICE LESSON: Case method and problem solving - clinical cases, a multidisciplinary approach
· The foot
· The big belly
· The fainter

Topic 17. PRACTICE LESSON: Clinical tools
· Chest Rx
· ECG
· Blood gases analysis
· Abdominal ultrasonography
· Vascular ultrasonography

Topic 18. PRACTICE LESSON: Video and multimedia material for asyncrous activities
Teaching methods
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Teaching Resources
· Lynn Bickley. Bates' Physical examination and history taking. Lippincott
· Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
General surgery
Course syllabus
Topic 1. Course presentation

Patient assessment - Comprehensive and focused
· Determining the scope of assessment
· Subjective versus objective data
The surgical patients
· Brief history of surgery and recent development. The operating room and current available technologies

Topic 2. Behaviour and mental status: cognitive processes and functions

Topic 3. Information research, clinical reasoning, assessment and plan: the process of clinical reasoning. Identifying problems and making diagnosis, generating the problem list

Topic 4. History taking: a comprehensive health history, the techniques of skilled interviewing, the sequence and context of the interviewing, cultural and cognitive contest, exploring patients' perspective

Topic 5. Communication fallacies
Topic 6. Signs and symptoms. Beginning the physical examination: general survey, vital signs and pain- Overview of general examination
Topic 7. The thorax, lung and cardiovascular system: techniques of examinations
Topic 8. The abdomen examination related to medical approach (liver, spleen and pancreas problems)
Topic 9. Surgeon's behaviour in the Operating room, basic principles of asepsis and patient's preparation to surgery

Topic 10: Physical examination and clinical signs of the abdomen, chest, breast (surgery related), and genito-urinary apparatus part 1

Topic 11: Physical examination and clinical signs of the abdomen, chest, breast (surgery related), and genito-urinary apparatus part 2 )

Topic 12. The vascular system
· Arterial diseases
· Venous and lymphatic diseases
· Vascular diagnosis and anamnesis + English/Italian dictionary

Topic 13. Lump, masses and ulcer
Topic 14. Doctor-patient relationship: clinical cases

Topic 15. Doctor-patient relationship: clinical cases - the physician perspective
Topic 16. PRACTICE LESSON: Case method and problem solving - clinical cases, a multidisciplinary approach
· The foot
· The big belly
· The fainter

Topic 17. PRACTICE LESSON: Clinical tools
· Chest Rx
· ECG
· Blood gases analysis
· Abdominal ultrasonography
· Vascular ultrasonography

Topic 18. PRACTICE LESSON: Video and multimedia material for asyncrous activities
Teaching methods
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Teaching Resources
Hamilton Bailey's Physical signs: Demonstrations of physical signs in clinical surgery. 19th Edition. CRC Press, 2016
General psychology
Course syllabus
Topic 1. Course presentation

Patient assessment - Comprehensive and focused
· Determining the scope of assessment
· Subjective versus objective data
The surgical patients
· Brief history of surgery and recent development. The operating room and current available technologies

Topic 2. Behaviour and mental status: cognitive processes and functions

Topic 3. Information research, clinical reasoning, assessment and plan: the process of clinical reasoning. Identifying problems and making diagnosis, generating the problem list

Topic 4. History taking: a comprehensive health history, the techniques of skilled interviewing, the sequence and context of the interviewing, cultural and cognitive contest, exploring patients' perspective

Topic 5. Communication fallacies
Topic 6. Signs and symptoms. Beginning the physical examination: general survey, vital signs and pain- Overview of general examination
Topic 7. The thorax, lung and cardiovascular system: techniques of examinations
Topic 8. The abdomen examination related to medical approach (liver, spleen and pancreas problems)
Topic 9. Surgeon's behaviour in the Operating room, basic principles of asepsis and patient's preparation to surgery

Topic 10: Physical examination and clinical signs of the abdomen, chest, breast (surgery related), and genito-urinary apparatus part 1

Topic 11: Physical examination and clinical signs of the abdomen, chest, breast (surgery related), and genito-urinary apparatus part 2 )

Topic 12. The vascular system
· Arterial diseases
· Venous and lymphatic diseases
· Vascular diagnosis and anamnesis + English/Italian dictionary

Topic 13. Lump, masses and ulcer
Topic 14. Doctor-patient relationship: clinical cases

Topic 15. Doctor-patient relationship: clinical cases - the physician perspective
Topic 16. PRACTICE LESSON: Case method and problem solving - clinical cases, a multidisciplinary approach
· The foot
· The big belly
· The fainter

Topic 17. PRACTICE LESSON: Clinical tools
· Chest Rx
· ECG
· Blood gases analysis
· Abdominal ultrasonography
· Vascular ultrasonography

Topic 18. PRACTICE LESSON: Video and multimedia material for asyncrous activities
Teaching methods
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Teaching Resources
Papers will be provided during lessons.
General psychology
M-PSI/01 - GENERAL PSYCHOLOGY - University credits: 1
Lessons: 12 hours
Professor: Mazzocco Ketti
General surgery
MED/18 - GENERAL SURGERY - University credits: 2
Lessons: 24 hours
Internal medicine
MED/09 - INTERNAL MEDICINE - University credits: 3
Lessons: 36 hours
Professor(s)
Reception:
by appointment arranged by e-mail
Padiglione Guardia Accettazione - Fondazione IRCCS - floor -1