Surgery and Orthopaedics | MEDI3050 | University of Southampton

Module overview

This module focuses on the general surgical and elective orthopaedic basic knowledge and understanding, practitioner and professional skills required of a newly qualified doctor and the assessments within this module will focus on these areas.

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 surgery and orthopaedics module in BM Year three is studied along with 2 other clinical teaching modules in Primary Care and Long Term Conditions and General Medicine and Elderly Care and 2 Assessment Modules, the (Applied Knowledge Assessment and CPSA).

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 modules have been purposely designed to assess learning outcomes covered in any of modules within the programme.

This module will normally take the format of a placement in one or more partner trusts. 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 fewest learning experiences.

The module will give student exposure to a broad range of surgical patients and their treatment pathway. The students will be attached to a named consultant-trainer. Their learning opportunities will be on the wards, in theatres and endoscopy, and in the outpatient environment.

Aims and Objectives

Learning Outcomes

Having successfully completed this module you will be able to:

Examine normal and abnormal systems with particular reference to surgical disease (musculoskeletal, breast, neck, groin, vascular system, abdomen)
Make a preliminary assessment of a patient’s likely surgical or orthopaedic problem, and have an understanding of the processes by which doctors make and test a differential diagnosis
Demonstrate understanding of basic sciences and pathology underlying common disorders relating to surgical and orthopaedic patients
Describe and justify the selection of appropriate investigations for surgical and orthopaedic cases, and be able to discuss the principles underlying these investigations
Recognise symptoms and signs of common diseases seen in surgery and orthopaedics
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
Describe how you would relate clinical disorders to patients and family
Develop good relationships with all members of the surgical team (medical and non-medical)
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
Demonstrate awareness of professional responsibility both to patients and to members of the multiprofessional team and to student colleagues and reflect on how poor performance or poor professional behaviour should be addressed
Take responsibility for your own learning and your continuing professional development and develop an enquiring basis to learning
Show an understanding of the duties of confidentiality in your contact with colleagues and patients
Demonstrate understanding of the roles of different team members within the inter-professional setting
Understand the patient pathway in a surgical and operating theatre setting
Assess and recognise the severity of a clinical presentation and a need to immediate emergency care
Interact with patients and colleagues whose cultural backgrounds, beliefs and values may differ from your own in a sensitive and non-judgemental manner
Understand the use and justification for clinical investigations and their impact on the patient and health services
Establish a relationship with a patient, explore and acknowledge their concerns
Demonstrate competency performing stipulated clinical skills as per the student portfolio requirements
Understand the use of time as a diagnostic tool
Take a history of the presenting complaint, relevant past surgical history, associated disease particularly those relevant to anaesthesia, and the medication and social history, particularly family and home circumstances which may influence postoperative management
Communicate effectively in the following ways: a. Communicate effectively with the patients and be able to explain to the patient the results of your clinical examination b. Written clinical record suitable for inclusion in case notes c. Formal oral case presentations to your colleagues and senior medical staff
Demonstrate an appreciation of basic safety principles - for patients and staff - in the operating theatre and in the post-operative setting; to include understanding of infection control and antibiotic resistance

Syllabus

The module comprises 7 weeks in total. Students are attached to one or more named consultant surgeons and their extended teams, and will gain exposure to general and specialist (orthopaedics/breast and endocrine/urological/vascular) surgery. Experience in the clinical team includes emergency work.

There will be opportunities to consolidate clinical skills teaching which will include tuition in practical procedures, examination techniques, perioperative care, critical illness assessment, and radiology tutorials.

Clinical skills taught

Venesection and cannulation
Breast examination
Suturing
Male intimate examinations
Male catheterisation
Urinalysis pregnancy testing
Gloving and Gowning in preparation for theatre
Blood sugar monitoring
Aseptic non -touch technique and wound , nose and throat swabbing

Details of these attachments and a course handbook will be available during the introductory week. Specific diseases covered in the module will include:

Common upper gastrointestinal diseases

Gallstones and pancreatitis
Peptic ulcer disease
Pancreatobiliary malignancy
Oesophagogastric malignancy

Common lower gastrointestinal diseases :

Diverticular disease
Colorectal cancer
Inflammatory bowel disease
Perianal conditions

Common urological conditions

Renal tract stones
Incontinence and benign prostatic hypertrophy
Prostate cancer
Bladder cancer
Urological emergencies

Common vascular surgical conditions

Peripheral vascular disease
Carotid arterial disease
Abdominal aortic aneurysm
Venous disease

General surgical conditions

Herniae
Skin lumps
The acute abdomen

Common orthopaedic conditions

Osteoarthritis and elective joint replacement

Learning and Teaching

Teaching and learning methods

The module will be taught through a range of learning and teaching strategies which will include:

Lectures
Guided self-study
Group work
Patient based learning
eLearning
Learning Logbooks
Reflection

Within this module there may be some activities that will take place in the evenings, nights or weekends, students are encouraged to make the most of these opportunities.

Study time
Type	Hours
Placement	224
Independent Study	151
Total study time	375

Resources & Reading list

Textbooks

Cuschieri A, Steele RJC, Moossa AR. (2001). Essential surgical practice: basic surgical training. London: Arnold.

Duckworth, T (1995). Lecture notes on orthopaedics and fractures. Oxford: Blackwell Science.

Garden OJ, Bradbury AW, Forsythe JLR, Parks RW. (2007). Principles and Practice of Surgery. Edinburgh: Churchill Livingstone.

McRae, R (2004). Clinical orthopaedic examination. Churchill Livingstone.

Ellis H, Calne R, Watson C. (2006). Lecture notes on General Surgery.. Oxford: Blackwell Science.

Apley, A G and Solomon, L Concise (2005). System of Orthopaedics and Fractures. Oxford: Butterworth- Heinemann.

Niethard, FU, Pfeil, J; Biberthaler, P. (2009). Duale Reihe Orthopädie und Unfallchirurgie.

Siewert, Jörg-Rüdiger (2006). Chirurgie.

(2007). Oxford Handbook of Clinical Surgery. Chirurgie.

Browse LN, Black J,Burnand KG, Thomas WEG (2005). Browse's Introduction to the Symptoms & Signs of Surgical Disease. London: Hodder Education.

Assessment

Assessment strategy

Students will be assessed on:

Professional behaviour
Evaluation of clinical and overall performance relative to learning outcomes
Satisfactory log book recording the breadth of their activity and experience during the course to include surgical and orthopaedic experience.
Portfolio including cases presented to senior medical / nursing staff with reflection
Written description of case observed through the surgical patient journey from the ward into the operating theatre with specific reflection on issues of patient safety and risk reduction

Summative

This is how we’ll formally assess what you have learned in this module.

Breakdown
Method	Percentage contribution
End of module sign off form	100%

Referral

This is how we’ll assess you if you don’t meet the criteria to pass this module.

Breakdown
Method	Percentage contribution
Supplementary activity	100%

Repeat Information

Repeat type: Internal