MedInTO Medicine and Surgery

Interprofessional Clerkship 1

Introduction to Patient Care

Academic year 2022/2023

Sommario del corso

• Course objectives
• Results of learning outcomes
• Course delivery
• Learning assessment methods
• Support activities
• Program
• Teaching tools

Course objectives

INTENDED STUDENTS
1st year MD students in tandem with 3rd year nursing students.
At the teaching location, students will be supported by 3rd year nursing students, who will act as peer coachers, under the supervision of a clinical tutor.

GENERAL COURSE OBJECTIVES
Identifying key aspects of caretaking.
Identifying and experimenting with tools and the practice of caretaking.

SPECIFIC COURSE OBJECTIVES
At the end of the course, students will have had an introduction to:

• Understanding the centrality of the person;
• Training on some basic skills like moving patients confined to bed, checking arterial pressure and vital signs, practicing a venipunture and female urinary catheterization;
• Identifying basic rules and dynamics in the relationship and communication with the patient;
• Making a reflection on their future role, nurse role and the value of inter-professional synergy.

Results of learning outcomes

Ability to practicing a venipunture and female urinary catheterization in the correct way according to an expert's observation

Ability of checking arterial blood pressure

Soft skills as being conscious of one'a future role, being able to communicate with peers a tutors

Ability to Identify further educational need basing of the experience of the clerckship

Course delivery

ADVANCED MEDICAL SIMULATION CENTRE (AMSC) 

Before atttending the wards, students will train on some basic skills like moving patients confined to bed, checking arterial pressure and vital signs, practicing a venipunture and female urinary catheterization in the AMSC in tandem with 3rd year nursing students and under the supervision of a clinical tutor

WARDS
Various wards are involved in this clerkship. They include all the key wards for inpatient care at S. Luigi Gonzaga University Hospital.
The full list of wards with the names of the medical director, the nurse coordinator and the nursing student tutor, will be defined by the teaching staff, together with the attendance calendar

Learning assessment methods

ENROLLMENT CRITERIA AND CALENDAR
Criteria to be included in the IP Clerkship are:

1. “Medico competente” pass received;
2. Language category received;
3. Agreement with pair/ward/date randomization.

The Course will fix the 100 students in 50 pairs, on the basis of skill in the two languages (ideally 1 student with proficient Italian + 1 student with proficient English) and set the calendar.
Each pair will be randomly assigned to a single ward, where the students will spend 5 days, with time for activities at the patient’s bed and time for discussion, review and logbook compiling.

ASSESSMENT
This clerkship does not require a formal assessment with an exam.
Evaluation will be linked, in particular, to how the logbook is used.
LOGBOOK:

• A tool to reflect during/after the clerkship;
• A room for analysis and ideas, useful for:
  • Teachers, in order to keep courses increasingly consistent with the needs of learners;
  • Learners, to train in analysis and self-analysis for an increasingly full awareness of their professional role.

To pass the clerkship the student must:

• Attend the whole scheduled program;
• Complete and upload the logbook at the moodle link: https://elearning.unito.it/medicina/course/view.php?id=13587

Support activities

Briefing and debriefing session before and after the AMSC e wards session, in order to explain respectively the scheduled activities and to reconceptualize the experience done

Program

TRAINING REQUIREMENTS AND OUTLINE FOR THE LOGBOOK

Therapeutic environment and professional roles (max 200 words)

Objective: to document the main elements of the structure and organization of a medical ward, taking into consideration the type of patients and the roles and activities of the staff
Methods: with the help of the nursing student (and nursing tutor), students must collect and report information, in summary, regarding:

• Ward structure and main medical equipment;
• Type of patients (main illnesses and needs for care);
• Main care activities.

Your experience as body contact with the patient (max 300 words)
Objective: To describe and analyze your experience in physical contact with patients
You will see some patients. Their clinical condition and treatment needs will be introduced with the help of the student nurse, or ward nurse, or both.
You will participate in activities that involve body contact with the patient (example: mobility, physical preparation for surgical intervention, arterial pressure assessment, etc.).
After these experiences, please write down:

• Brief description of the patients (age, reason for admission, independence level in basic life skills);
• Treatment activities you took part in; your role;
• Your thoughts and feelings; any difficulty in the physical interaction with a sick person;
• Follow-up observations comparing yourself with the nurse or student who participated with you.

Your communication with patient/family (max 300 words)
Objective: to describe and analyze your first direct experience of communication with patients
You will participate in activities that foster a meaningful relationship (examples: treatment at admission or dismissal, medical examination, information on procedures or treatments, informed consent, preparation for surgical procedures, etc.).
Write down a description of any significant emotional aspect of your communication (content and feelings) with the patient. 
Also describe behaviours/attitudes of the nurse/doctor or student, that you felt more effective (or not).

Blood pressure (BP) (max 300 words)
Objective: acquire the skill of assessing BP and start using it in the early steps of clinical reasoning.
Before starting IP clerkship:

• Go to campusnet and look at a video (in Italian) on basics in measuring BP (https://www.youtube.com/watch?v=AEO7g4GQV08);
• Read basic parts of reference guidelines on BP (Whelton PK et al., 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017 Nov 7.  PubMed PMID: 29146535) (http://www.medinto.unito.it/do/didattica.pl/Show?_id=0dv6) (Sections 3 & 4, pages 21-38);
• During the clerkship, with the help of the student nurse or ward nurse or both, train yourself to measure BP;
• In any case of elevated BP/hypertension, ask for help or read reference guidelines for an orientation on diagnosis and clinical reasoning (Section 5, pages 39-54) and general measures (Section 6, pages 55-61);
• Write down what you learned most about this topic.

Express your opinion about this clerkship and any improvement you suggest. They will be taken into account to improve it in the future YOUR ASSESSMENT (max 300 words)

• Teaching materials
• Exams and finals
• Go to Moodle
• Visit the forums