Bed side approach and clinical methodology (clerkship)

A.Y. 2021/2022
Overall hours
MED/09 MED/18
Learning objectives
Practical activities will be used, through simulation or in the ward, to consolidate technical and soft knowledge and skills developed during frontal lectures.
Expected learning outcomes
Students are expected to:
- take the history of the patient
- perform a clinical examination of the thorax: inspection, palpation, percussion, auscultation
- perform a clinical examination of the precordial region: palpation, auscultation
- examine the arterial pulses
- measure blood pressure
- perform a clinical examination of the abdomen: inspection, auscultation, percussion, palpation (liver, spleen).
Course syllabus and organization

Single session

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.
No other specific pre-requirements are needed.
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.
Internal medicine
Course syllabus
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
Signs and symptoms. Beginning the physical examination: general survey, vital signs and pain.

Overview of general examination
The thorax, lung and cardiovascular system: techniques of examinations
The abdomen examination related to medical approach (liver, spleen and pancreas problems)
Surgeon's behaviour in the Operating room, basic principles of asepsis and patient's preparation to surgery
Physical examination and clinical signs of the abdomen, chest, breast (surgery related), and genito-urinary apparatus, vascular system, lump, masses and ulcer

Doctor-patient relationship: clinical cases
Behaviour and mental status: cognitive processes and function
The process of clinical reasoning. Identifying problems and making diagnosis, generating the problem list
Communication fallacies
Teaching methods
Not provided
Teaching Resources
· Lynn Bickley. Bates' Physical examination and history taking. Lippincott. 12th Edition. 2017 Woulter Kluwers
· Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano
General surgery
Course syllabus
The course is based on a strong integration of different disciplines, thus the program of the single disciplines cannot be extracted form the program of the whole course which is reported in module Internal Medicine
Teaching methods
Not provided
Teaching Resources
· Hamilton Bailey's Physical signs: Demonstrations of physical signs in clinical surgery. 19th Edition. CRC Press, 2016
· Papers will be provided during lessons.
General surgery
MED/18 - GENERAL SURGERY - University credits: 1
Clerkship (professional training): 25 hours
Internal medicine
MED/09 - INTERNAL MEDICINE - University credits: 1
Clerkship (professional training): 25 hours
Group 1
Professor: Fracanzani Anna Ludovica
Group 2
Professor: Tobaldini Eleonora
by appointment arranged by e-mail
Padiglione Guardia Accettazione - Fondazione IRCCS - floor -1