Universitat Internacional de Catalunya

Primary Care Rotation

Primary Care Rotation
3
10428
6
Annual
PR
Main language of instruction: Catalan

Other languages of instruction: Spanish

Teaching staff


  • Coordinator: Dra. Marta Elorduy (melorduy@uic.es)
  • Practice Rotations administration: Tania Martínez (practicas medicina@uic.es)
  • Academical secretary: Quim Torres (qtorres@uic.es)

Introduction

(Common to all subjects of the Clinical Rotation)

During the sixth year, “tutored clinical practice rotations” are conducted,in which students, supervised by a tutor practice medicine with greater autonomy (hereafter, “Rotatorio”). Thath implies a qualitative leap in regard to clinical practices they have been carrying out in previous courses.

The purpose is that by rotating students through different levels of care and clinical specialties, they acquire a higher level of professional competence and become able to deal with more complex pathologies and integrate knowledge and skills acquired, in a manner that allows them to take sound decisions and develop patient-centred ethical attitudes, values and conduct.

The “Rotatorio” consists of 6 subjects that move the student to pass through the following levels of assistance:

  • Primary care
  • Hospital care (Medicine, Surgery, Emergencies, Specialties ...)
  • Social healthcare and geriatrics
  • Attention in services to the community. (Community Health Rotation)

Pre-course requirements

The student must have passed the subject of "Family Medicine" (4th year) and preferably have taken the Clinical Practices in Primary Care course in the 5th year.

For evaluation of clinical rotation, students must have passed 95% of the credits from previous courses.

Objectives

(Common to all subjects of the Clinical Rotation, except for the Community Health Rotation that can be done since the fourth year)

Clinical rotation objectives are as follows:

  • Promote integration of knowledge and clinical skills acquired so far in the practical environment.
  • Acquire clinical experience and develop professional practice skills with greater autonomy in a real health care environment.
  • Have contact with real patients with complex health problems.

Incorporate into the work environment of the profession in its care aspect

Competencies

  • 01 - Recognise the essential elements of the medical profession, including ethical principles, legal responsibilities and patient-centered professional skills.
  • 02 - Understand the importance of central principles, in particular of professional confidentiality for the benefit of patients, society and the profession.
  • 04 - Develop professional practice with respect for patient autonomy, beliefs and culture.
  • 06 - Develop professional practice with other health professionals, acquiring teamwork skills.
  • 09 - Understand and recognize the effects, mechanisms and manifestations of disease on the structure and function of the human body.
  • 10 - To understand and recognise the agents and risk factors which determine health status, and learn how they determine the symptoms and natural development of acute or chronic diseases in individuals and populations.
  • 11 - Understand and recognize the effects of growth, development and aging on the individual and their social environment.
  • 12 - Understanding the foundations for action, the indications and efficacy of therapeutic interventions, based on available scientific evidence.
  • 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.
  • 17 - Establish the diagnosis, prognosis and treatment, applying principles based on the best information possible and safe clinical practice..
  • 18 - To indicate the most appropriate (pharmacological, surgical, psychological, social or other) treatments that are pertinent to the most prevalent procedures, in terms of rehabilitation and also terminally ill patients, including an evaluation of their effectiveness.
  • 19 - Propose preventive measures appropriate to each clinical situation.
  • 20 - Acquire adequate clinical experience in hospitals, health centers and other health institutions under supervision, as well as basic knowledge of clinical management and patient-centered proper use of tests, drugs and other health system resources.
  • 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.
  • 27 - Recognize role in multidisciplinary teams, assuming leadership when appropriate, for the delivery of health care, such as interventions for health promotion.
  • 31 - Understand, critically evaluate and know how to use sources of clinical and biomedical information to obtain, organize, interpret and communicate scientific and health care information.
  • 32 - Know how to use information and communication technology in clinical, therapeutic, preventive health care and research.
  • 33 - Maintain and use records with patient data for later analysis, preserving the confidentiality of the data.
  • CB-2 - To know how to apply and incorporate knowledge, an understanding of it and its scientific basis and the ability to solve problems in new and loosely defined environments, including multidisciplinary contexts that include both researchers and highly specialised professionals.
  • 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.
  • CTS-1 - To know the principles of leadership and decision making in ordinary situations or in conflicts with and between various ethical, legal and professional elements.

Learning outcomes

(Common to all the subjects of the Clinical Rotation with the exception of the Community Health Rotation)

Aspects or areas

Learning outcomes

Theoretical knowledge

-     Integrates and appropriately apply knowledge acquired.

-     Foresees possible complications and abnormal progress.

-     Recognizes the steps of a protocol.

-     Keeps scientific knowledge up to date for study of clinical cases.

-     Demonstrates these learning results adapted to simulated patients.

-     Knows the rights and duties of patients and professionals, as well as bioethical principles.

Technical skills

-     Suitably gathers and documents the clinical history thereby obtaining the most useful information.

-     Performs a physical examination appropriate to each situation and is able to gain the maximum benefit from it.

-     Conducts techniques and procedures effectively and with the least risk and discomfort for the patient.

-     Drafts clear, precise clinical reports and prepares them in a timely manner.

-     Proposes treatments tailored to the diagnosis.

-     Knows how to judiciously apply the steps of a clinical protocol.

Diagnostic skills

-     Focuses/guides diagnoses and problems.

-     Raises various differential diagnosis hypotheses in terms of aetiopathogenesis.

-     Uses reasonable criteria when making a diagnosis or approaching problems.

Use of resources

-     Proposes the proper use of complementary examinations (in terms of risk, effectiveness and taking into account expense/benefit).

-     Know the limitations of the tests.

-     Properly interprets results from diagnostic tests performed.

Decisions making

-     Takes decisions when asked.

-     Assumes the role held within the care team in simulated or real situations.

-     Performs clinical management actions required for a simulated patient in the specified time.

-     Make decisions in work situations as part of a team with colleagues/students.

Use of information

-     Locate, riddle and synthesizes reliable and updated information.

-     Manages properly personal and health information, with the required level of confidentiality.

Professional, patient and family relationship

-     Facilitates patients general information required, risks and alternatives to decide autonomously and knowledge, before a test or treatment requiring consent.

-  Acts accordingly to the rights and duties of the patients.

-  It facilitates to the patients and relatives the necessary general information, of risks and alternatives to be able to decide with autonomy and knowledge, before a test or treatment that requires the consent.

-  Learn about the social and community transcendence of medicine.

-  Demonstrates interest in sharing knowledge with the rest of professionals / students.

-  Assume professional secrecy.

-  It behaves as an effective and active member of the healthcare team.

Professionalism

-     Respect the life and dignity of the patients it treats.

-     Respect the rights and duties of patients and act accordingly.

-     Consult when you feel insecure without waiting to make the decision wrong.

-     You know when you cannot take responsibility.

-     Recognize your limitations.

-     Reflect on own experience and professional practice.

-     Assume patients as their own.

Syllabus

The complete “Rotatorio” consists of 30 weeks of face-to-face training, held in full days from Monday to Friday and a minimum of 6 emergency shifts of 12 hours. The student has to integrate in the assistance teams and attending general clinical or service sessions or seminars that are specifically prepared to complete their training.

The distribution of the 30 weeks will be made according to the following distribution.

•  Medical rotation - 9 weeks

•  Surgical rotation - 9 weeks (At least 2 weeks of Traumatology and 2 of Gynecology/Obstetrics)

•  Free rotation - 6 weeks (Any specialty in minimum periods of 2 weeks (*))

•  Primary Assistance Rotation - 2 weeks

•  Health and Social Care Rotation - 2 weeks (Includes geriatrics, palliative care, convalescence ...)

•  Community Health Rotation - 2 weeks (*). Volunteer and social care.

•  6 Emergency shifts of 12 continued hours out of the schedule of the Rotation practices.

(*) It will not be possible to choose a free choice to expand the rotation of a social type.

The choice of hospitals in which the student has to rotate will be coordinated by the university. The students will choose the specialties and center paths, by order of file. Placements will be carried out in the associated centers. Some of the weeks (not more than 16) can be carried out on other centers than those associated.

Anyway, all the centers of practice need to assure the accreditation for teaching degree-level courses and need an updated agreement with the university. Also, accept the requirements, teaching objectives and evaluation system, committing itself to allowing the student to perform the practices with certain autonomy. Explicit consent by the center for the student’s health insurance coverage is needed, and an agreement between the center and the university, is required.

Teaching and learning activities

In person



It will be used the next teaching methodology:

Clinical practice in healthcare institutions: Learning is performed based on the model of doctors and other medical staff in a real environment. In this course, the student already has had to develop a sufficient level of competence that allows a certain degree of autonomy.

In clinical practice, the students are assigned to different clinical tutors who accompany them during their stay, supplying their learning. Through direct and indirect observation, allow to evaluate their performed at the end of this clinic stay. Scenarios or jobs are as varied as the same care practice: acute hospital wards, emergency departments, outpatient clinics, surgical areas, intensive care services or primary care areas, social or socio- medical devices....

In addition to the internships, students will receive theoretical and practical sessions at the facilities in Universitat Internacional de Catalunya.

Practical laboratory simulation and clinical skills: Students have the opportunity to integrate and implement the theoretical, technical and clinical skills in the training center without risk to patients. The wil go trhough clinical procedures, behavioral situations, training of "decision making", etc. 

The tutors track and reinforce knowledge, skills or procedures in order to prepare students for and "Objective Structured Clinical Evaluation" ( OSCE), that will be used as an additional assessment methodology to reports, made by clinical tutors during their stays.

Individual and group tutoring:  A tutor will be assigned to the student that will accompany him/her throughout the year, helping him/her to have a global vision of learning and acquisition of skills in the entire rotatory. The tutor will have an special attention to train in professionalism and transversal competences, as well as a good orientation towards the choice of specialty.

Master Class - Exhibition method: The teacher exposes and transmits the knowledge in a classroom to the whole group of students promoting the maximum participation, with the intention of the integration of the knowledge acquired throughout the whole degree.

Debate and discussion:  The development of debates and discussions in a large or small group that favor critical sense and judgment. Participation and initiative are encouraged, the construction of constructive questions and the presentation of new problems that promote critical thinking.

Evaluation systems and criteria

In person



The student must prepare a final reflective report of the subject that will be evaluated by the Rotatory tutors at the end of the course.

In addition, he/she will deliver a specific material in each stay, which has been agreed with the assigned clinical tutor or he/she can choose from the list of materials that are proposed in the Rotatory Guide.

The clinical tutor is expected to provide personalized feedback to the the student in each stay on outstanding aspects or those that should be reinforced or improved.

The academic tutor is in charge of global monitoring, assessing participation in the various organized tutorial activities (independent of stays at the centers), and reviews the final reports for each subject.

These are the instruments and evaluation percentages of the subject:

25%: Evaluation of clinical tutors

  • Each rotation collects an evaluation sheet from the clinical tutor (as many as rotations the student has made)
  • Calculation of the grade for each rubric:
    • 70% Knowledge and skills section
    • 30% section of "Values, attitudes, communication and professional behavior
    • 0% Material delivered to the clinical tutor. This material helps to put the note to the tutor in the different sections.
  • A score higher than 6 must be obtained in the rubric to apply the weighting of the other evaluation items.

10%: Academic tutoring and professionalism, which will consist of:

  • The tutorial and continuous monitoring of the student, reviewing compliance with the requirements of each rotation, participation in the mandatory tutorials, proposal of improvement actions and personal self-evaluation.
  • Global vision of the evaluations of clinical tutors, ...
  • Assessment of the final report of the subject.

65%: OSCE (FAce to face and virtual)

The Objective and Structured Clinical Evaluation (OSCE). It will consist of two tests:

  • A face-to-face OSCE, carried out at the University at the end of the sixth year. 
  • a virtual OSCE that is carried out jointly with other medical schools nationwide

It consists on the observation of the clinical performance carried out by each student in front of different clinical situations presented in a clinical simulation scenario. (Virtual or face-to-face)

In case of failing some of the sections of the OSCE, the assessment committee will decide to repeat partial or totally the scenarios or some rotations. A new assessment will be required to give the OSCE as passed, and it will be evaluated on second call.

The evaluation is carried out by the Rotatory Evaluation Commission made up by the Rotatory coordinator, the course coordinator, the Rotatory tutors and the members of the OSCE Commission.

In case of failing the subject, it will be decided whether the stays that make up the course have to be repeated in whole or in part.  The complete subject will be evaluated in the second call.

In case of failing professionalism, the student will carry out the activity proposed by the Rotary Evaluation Commission, and also a reflective report about the meaning of professionalism, the reason for having failed and the actions that he/she thinks will make him/her a better professional.

The Social Rotation and Social Health Rotation have a specific evaluation, specified in the Syllabus of the subjects

 

 

Teaching and learning material