Universitat Internacional de Catalunya
Surgical Practicums
Other languages of instruction: English, Spanish,
Teaching staff
By arrangement via email
Introduction
The assignature of "Surgical Clinical Practice" aims students to acquire the clinical skills they need for the detection, diagnosis and initial treatment of the most prevalent diseases of surgical specialties.
The core clinical clerkship in surgery is an immersion experience that includes the student in an array of clinical scenarios and learning opportunities designed to enhance their skills and knowledge. Students will interact with patients and their families in all aspects of surgical care; hospital wards, operating rooms, outpatient clinics, intensive care units, etc. Goals and objectives are very similar in most surgical clerkships.
Some of these goals and objectives are: help the student understand when surgery is the most effective and efficient mode of therapy; recognize when patients need referral to a surgeon; understand and develop skills in managing and recognizing surgical problems; understand the nature of surgical diseases and surgical intervention as a curative and/or palliative agent in their treatment and develop independent learning skills.
The course has four ETCS and 108 hours spread over clinical practice of surgery for 4 weeks in 4th grade. It is complemented by a second rotation practices in 6th grade: a mandatory clerkship in traumatology and orthopedics surgery and an optional second-level in general surgery.
Students can be assigned to different surgical services, and will interact very closely with surgical residents and faculty in all activities on that particular service. General surgery services are the main component of surgical rotations, but stays can be combined in other surgical specialties and subspecialities to give the student the opportunity to evaluate other options for their future careers.
In addition to the attendance at the practical centers, the student will attend four compulsory workshops of two hours and 1 optional personal tutorial of approximately half an hour. This last tutorship is very convenient, but voluntary. Both the workshops and the tutoring will be led by one of the academic tutors. This academic tutorial will be reflected in the final evaluation.
Pre-course requirements
To take this course is essential to have passed:
• Structure and Function: digestive and endocrine system
• Clinical Semiology and Physiopathogenia
• Surgical Pathophysiology
Objectives
General objectives
1. Help the student understand when surgery is the most effective and efficient mode of therapy.
2. To recognize when patients need referral to a surgeon.
3. To understand and develop skills in managing and recognizing surgical problems
4.To understand the nature of surgical diseases and surgical intervention as a curative and/or palliative agent in their treatment and develop independent learning skills.
Competences/Learning outcomes of the degree programme
- 04 - Develop professional practice with respect for patient autonomy, beliefs and culture.
- 06 - Develop professional practice with other health professionals, acquiring teamwork skills.
- 13 - Obtain and develop a clinical history that contains all relevant information.
- 14 - Perform a physical examination and a mental assessment.
- 15 - Ability to formulate an initial diagnosis and establish a rationalised diagnostic strategy.
- 21 - Listen carefully, obtain and synthesize relevant information about the problems affecting the patient and understand the contents of this information.
- 22 - To write and maintain medical records and other medical documents which can be understood by third parties and are adapted to the protocols and information that is required.
- 23 - Communicate effectively and clearly, both orally and in writing with patients, family members, media and other professionals.
- 24 - Establish good interpersonal communication skills that enables efficient and empathetic communication with patients, relatives, media and other professionals.
- CTI-1 - To know how to communicate effectively through written and oral communication in a foreign language that will allow them to work in an international context.
- CTP-2 - To develop a perception and understanding of their own emotions and those of others, as well as the intelligence adjust answers.
- CTP-3 - To develop critical thinking and reasoning as well as self-assessment skills.
Learning outcomes of the subject
1. Clinical history. Make a complete anamnesis, focusing on the characteristics of the surgical patient.
2. Physical examination. Make a complete physical examination, focusing on the characteristics of the surgical patient.
3. Physical examination. Recognize anomalies typical of surgical diseases.
4. Clinical documentation. Write and differentiate the contents of the medical records, the note of admission, the clinical course, and surgical report .
5. Communication. Communicate properly with the patient and family.
6. Communication. Get informed consent process in surgery.
7. Communication. Oral presentation on case reports and clinical research.
8. Multidisciplinary work. Learn and practice the clinical work in the setting of multidisciplinary teams or committees, and the continuum of care with primary care and the rest of the health team.
9. Process diagnosis. Set up a diagnosis and differential diagnosis, choose the appropriate complementary examinations.
10. Therapy. Establish a basic treatment plan based on the diagnosis of the most prevalent surgical diseases.
11. Basic surgical care. Mastering the technique of surgical scrub, surgical asepsis, antisepsis and skin infiltration with local anesthetics.
12. Basic surgical care. Perform simple surgical care, sutures and bandages.
13. Critical patient . To recognize, diagnose and direct the management of life-threatening situations in the surgical patient.
14. Activity in the operating room. Know the rules and behavior in the surgical area.
15. Activity in the operating room. Participate as assistant in major surgeries. Knowing the basic surgical instruments.
Teaching and learning activities
In person
Clinical practice promotes learning from the model. Doctors and other medical staff are models for students who come to learn their jobs. Eventually students themselves end up deploying skills that allow a certain degree of autonomy supervised. The professional model who acts as a mentor to facilitate learning.
The PC consists of a period of four weeks that are made to hospital services in general surgery and / or urology. Students are assigned a mentor teacher, which will share in different care units: hospitalization, emergency and outpatient surgical area.
The practice schedule is from 9 to 14 h with maximum integration into the medical team assigned.
Role of the student. The student’s responsibility on the surgery clerkship is to proactively immerse themselves in the daily activities of their team in order to both assist the team in completing its duties and to meet the educational goals of the clerkship as set out by the clerkship director. More specifically, they should be active participants during morning rounds on patient floors. This involves pre-rounding on their patients, recording vitals, and writing a note in the patient’s chart as per surgical note protocol.
Students will participate in cases in the OR and are expected to prepare in advance. Students should read about the disease process for which the patient is having surgery, know the risk factors for the disease process involved, know the expected benefits or goals for the surgery, the risks and dangers of the surgery and the pertinent anatomy involved in the case. After the case, they will write a post-operative note and assist in transferring the patient from the OR table onto the recovery room bed. Students may also be scheduled to participate in clinic office hours with an attending preceptor. If so, the frequency will depend on the institution.
Students may be expected to take call throughout the clerkship, although the length and assignments will vary at each institution. Call may be overnight or partial, may be in-house or taken from home. Coordinators are responsible for creating the call schedule(s)
Students are expected to spend some periods on call during the rotation in modules of 12 or 24 hours.
Feedback Sessions. A half rotation is convenient to make a meeting to review the student’s performance, evaluations and progress. During these sessions, students give verbal feedback of their learning experience and their clinical activities. This is a great opportunity for the student to bring up any issues they may have encountered.
Seminars. In order to promote the objectives of the course at the start of the clinical students will have a one-hour seminars. The aim of the seminars is to achieve the active participation of students, with dialogue between teacher and students, stimulating learning, emphasizing the connection between the theoretical and practical concepts and clarify doubts. The seminars are compulsory and essential to be able to pass the subject.
Evaluation systems and criteria
In person
The active participation of the student in the medical care service will be taken into account, as well as its attitude towards learning and its interpersonal relationships.
Attendance at the seminars is mandatory.
During the practices four sections will be evaluated:
• Clinical record and surgical anamnesis
• Physical examination
• Discharge report. A written discharge report, gathering the clinical record, anamnesis, physical examination, interpretation of tests, identification of problems, diagnostic and therapeutic approach.
• An oral presentation of a clinical case (10 minutes, followed by group discussion), is recommended. If so, the clinical tutor will consider this in his final evaluation. Oral presentation of a clinical case for 10 minutes.
Evaluation scale
- Tutor evaluation (50% of the final grade)
- Personal growth workshops (10%)
- Epicrisis report (15%)
- Surgical report (15%)
- Reflective epicrisis report (10%)
Second call
For the evaluation of the 2nd call exam, the entire or part of the clinical stage should be repeated, depending on which sections require recovery. It is also necessary to contribute again all the documents of the subject. A written examination of brief questions related to a clinical case may be added.
If the cause of the failing grade is non-attendance at the seminars (without justification), the student will be asked to carry out a task related to the contents of the seminars, which will have to present to the person in charge of the course.
At the end of the academic year there will be an integration of knowledge (3rd and 4th courses) Exam, in
which all the contents of the subjects taught in these two courses will be tested.
This exam will be mandatory and will affect the marks for Surgical clinical hands-on training subjects as
long as a grade = o >4 is obtained in said exam.
The increase in the grade will be progressive: 0.2 (if the grade is 4) to 1.5 (if the grade is 10).
This increase will not be applicable if the student has not passed the course.
Bibliography and resources
Bibliografia
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Peter J. Morris (Editor), William C. Wood (Editor).Oxford Textbook of Surgery.
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F. Brunicardi , Dana Andersen, Timothy Billiar, David Dunn John Hunter, Jeffrey Matthews, Raphael E. Pollock. Schwartz's Principles of Surgery, Ninth Edition.
Recursos d’internet