The University of Southampton
Courses

MEDI3041 Primary Medical Care and Long Term Conditions

Module Overview

This module provides the students with the opportunity to gain experience of history taking and clinical examination in the primary care environment. The BM programmes are however highly contextualised and integrated programmes in which the application of knowledge and understanding, clinical skills and professional practice applicable to medicine are learned through a range of modules none of which are stand- alone modules, therefore this module should be recognised by students and teachers alike as part of the whole year and programme. The Primary Care and Long Term Conditions module in BM Year THREE is studied along with 2 other clinical teaching modules in Surgery and Orthopaedics and General Medicine and Elderly Care; 2 student selected units, a Scientific basis of Medicine Module; an Assessment Module and other modules depending upon which programme of the study students are taking. The emphasis of the assessments for each of the modules aligns with the focus of learning for that module, however the integrated nature of the course means that there will undoubtedly be overlap and aspects of the assessment in each module will draw upon learning from modules studied in earlier years as well as modules studied in that year. In addition, the BM Year THREE assessment module has been purposely designed to assess learning outcomes covered in any of modules within the programme. This module will normally take the format of an 8 week placement. The timing will vary for different student groups and the teaching staff will vary for different practices and student groups. As is the nature of clinical placements, the exact learning experiences of each student will be variable however all students will receive the same broad opportunities sufficient to achieve the learning outcomes of the module and it is expected that students will take responsibility for making the most of the opportunities provided and being pro-active in securing experiences in areas in which they feel they are weak and/or they have had least learning experiences.

Aims and Objectives

Module Aims

• Give students experience and insight into working in the primary care environment • Continue to develop students’ history taking and examination skills and adapt them to a primary care context • Gain insight and awareness of the roles of members of the primary care team and how they interact with each other and with secondary care • Continue to develop an understanding of the impact of illness on patients and their families and how this affects the way they present in primary care • Improve students’ communication skills with patients and colleagues • Look at some common long term conditions or disabilities and consider, holistically, the effect these have on individual patients and those close to them.

Learning Outcomes

Learning Outcomes

Having successfully completed this module you will be able to:

  • To recognise symptoms and signs of common diseases seen in primary care [1.1a, 1.1b]
  • Assess and recognise the severity of a clinical presentation and a need to immediate emergency care [2.4]
  • Explain the use of clinical investigations and their impact on the patient and health services [1.1c, 2.2c, 3.1b, 3.4g]
  • Understand the concept of the primary care team and have an awareness of the roles of its members [3.3a, 3.3b]
  • Demonstrate respect for patients and colleagues [3.1d, 3.3a
  • Show an understanding of the duties of confidentiality in your contact with colleagues and patients [2.7c, 3.1c, 3.4c]
  • Interact with patients and colleagues whose cultural backgrounds, beliefs and values may differ from your own in a sensitive and non-judgmental manner [2.3b, 3.1d, 3.1e]
  • Take responsibility for your own learning and your continuing professional development [3.2b]
  • Demonstrate an ability to reflect and use appropriate resources including IT to support your own learning and aid patients’ understanding [3.2c, 2.2h, 2.7b, 2.7d]
  • Develop insight into your learning needs in the professional workplace and recognise the need for support and guidance in managing challenging situations; and reflect on your own learning style and how it may need to be adapted to the clinical environment [3.2a, 3.2b, 3.2e, 3.4a, 3.4i]
  • Show awareness of a wide variety of ways in which you learn in the workplace, often not defined by the curriculum, and which includes role models [3.3a, 2.3h]
  • Demonstrate understanding of the diversity and complexity of presentations in primary care and the factors that influence how patients present [1.2a, 1.2b, 1.2c, 1.2d, 1.3c, 1.4b]
  • Demonstrate awareness of professional responsibility both to patients and to members of the multi-professional team and to student colleagues and reflect on how poor performance or poor professional behaviour should be addressed [3.1d, 3.1f, 3.3c, 3.3d, 3.4j]
  • Understand and have experience of the principles and methods of improvement including audit, and how to use the results of audit to improve practice [3.4e]
  • Have gained understanding regarding the presentation and impact of some common long term conditions/ disabilities which are often managed in primary care [1.1b]
  • Establish a relationship with a patient, explore and acknowledge their concerns [2.3a, 2.1b]
  • Take a focused history in order to reach a differential diagnosis [2.1a]
  • Take a medication history, including details of any complementary or alternative therapies the patient is using, and begin to consider the role of medication on the presentation and management of patients [2.5a, 2.5g, 2.5h
  • Conduct an appropriate examination and communicate with the patient including patients and relatives of those who have a cognitive or sensory impairment. [2.1c, 2.3a, 2.3b]
  • Understand the use of time as a diagnostic tool [2.2f]
  • Demonstrate competency in the clinical skills as per the student portfolio requirements [2.6a, 2.6b, 2.6c]

Syllabus

Students will spend 3 days each week in a general practice and a half day a week within the university. A lot of the learning will be informed by the patients that present during the students’ time in primary care and they will be expected to identify their knowledge gaps and be self-directed in their learning to fill these The broad areas that are covered will be: • Communication skills • Focused history taking • Examination skills • Use and interpretation of investigations • Common diseases seen in general practice • Long Term conditions – including pathology, psychology, sociology, management and public health • Prescribing of common treatments • Role of primary care in the NHS • Use of health information • Risk management • Coping with uncertainty • Multidisciplinary team working within primary care and with secondary care • The use of reflection Suggested topics to cover a breadth of long term conditions are: • Diabetes • COPD • Hypertension and heart failure • Osteoarthritis • Dementia • Stroke • Childhood atopic disease • Cancer In the BM(EU) Programme, some clinical sessions will be with community specialists to enable students to gain an equivalent experience of clinical scenarios in a different healthcare system

Special Features

Reasonable adjustment will be made for students as appropriate.

Learning and Teaching

Teaching and learning methods

The module will be taught through a range of learning and teaching strategies which will include: • One to one teaching with GP and other members of the primary care team • Patient based learning • Small group learning • Symposia • Reflection • Case based learning • Personal learning logbooks • Peer discussion groups • Online learning including SCRIPT and virtual patients Doctors work in shift patterns and rotas throughout much of their working lives and to prepare you for such working once you graduate, throughout your programme you will be expected to undertake placements in the evenings, at nights and at weekends. This will not be an onerous requirement and will be negotiated well in advance so that students with carers’ requirements will be able to ensure appropriate arrangements are in place for cover Within this module there may be some core/compulsory activities that will take place in the evenings, nights or weekends therefore students will commitments that will be affected by these should be pro-active in securing details of these activities well in advance of the start of the module. In addition, many non-core learning opportunities will be available during these times and students are encouraged to take advantage of them

TypeHours
Teaching24
Placement192
Independent Study159
Total study time375

Resources & Reading list

Simon C et al (2002). Oxford handbook of General Practice. 

Stephenson A.. A textbook of General Practice. 

Managing Long-Term Conditions and Chronic illness in Primary Care: A guide to good practice. 

Intelligent Kindness: Reforming the culture of Healthcare. 

Peter Tate Radcliffe (2003). The Doctor’s Communication Handbook. 

Kumar PJ, Clark M. Editors (2005). Kumar & Clark Clinical Medicine. 

Neighbour R (1989). The inner consultation: how to develop an effective and intuitive consulting style. 

Healthtalk online (formally DiPEX) is a useful site for students to hear about patient experiences of various conditions and their feelings about what is important in their care.

Fraser RC. (1999). Clinical Method: a General Practice approach. 

C Heneghan, P Glasziou, M Thompson, P Rose, J Balla, D Lasserson, C Scott, R Perera (2009). Diagnosis in General Practice: Diagnostic strategies used in primary care. BMJ. ,338 , pp. 946.

(2013). Patients with long-term condtions, their carers, and advocates. Review McEvoy P.BJGP. ,63 , pp. 148-149.

Resources for this module will be signposted to you through the Blackboard Page for this module. An indicative content is provided in the Resources, however the blackboard module and/or log book will provide the most up to date guidance on resources for .

Storr E et al (2008). Clinical Cases Uncovered. 

YouTube has a lot of useful teaching material, including listening to heart murmurs, how to do the Epley Manoeuvre, and home nasal irrigation. It is a medium many students are happy with and can be used really productively.

Assessment

Assessment Strategy

This module will be assessed by an end of module sign off form to include elements of: • Professional behaviour • Evaluation of clinical and overall performance relative to learning outcomes • Satisfactory learning log book recording the breadth of their activity and experience during the course • Satisfactory completion of an audit • Satisfactory use of virtual patients • A case presentation related to a long term condition • Formative ACC

Summative

MethodPercentage contribution
End of Placement Evaluation %
The GP Group facilitator %

Referral

MethodPercentage contribution
Supplementary activity %

Repeat Information

Repeat type: Internal

Costs

Costs associated with this module

Students are responsible for meeting the cost of essential textbooks, and of producing such essays, assignments, laboratory reports and dissertations as are required to fulfil the academic requirements for each programme of study.

In addition to this, students registered for this module typically also have to pay for:

Travel Costs for placements

The students pay £100 per year to cover the cost of travel throughout the academic year

Please also ensure you read the section on additional costs in the University’s Fees, Charges and Expenses Regulations in the University Calendar available at www.calendar.soton.ac.uk.

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