The Department continued to offer courses in Epidemiology & Medical Statistics to various undergraduate students; Biostatistics for the College of Nursing; Principles of Epidemiology; Special Epidemiology & Health Management for health statistics students from the College of Science; the Hospital & Community Attachment course for M.D. students; the Research Methodology course and the Student Project for M.D. students in Phase II of the curriculum.
PRE-CLERKSHIP
Introduction:
During the Pre-Clerkship module that last for 10 weeks, skills, knowledge and attitude are required to elicit the history and perform physical examination as a pre-requisite to the clinical management of an individual will be covered. It was constructed to equip students with generic skills (such as communications, history taking and physical examination skills) that will help their subsequent bed-side-learning. Such was supplemented with necessary basic behavioral medicine knowledge as a theoretical pre-requisite and complimented with ethics and medical records (in hard and electronic HIS formats) management skills. The main objective of this section is to prepare the students to start clinical rotations.
Course Objectives:
A. Knowledge
1. Define and describe the different diagnostic features and list common causes of the symptoms originating from relevant systems covered in each week module.
2. Relate the causes to underlying patho-physiological mechanisms.
3. Discuss the patho-physiological mechanism of key abnormal physical examination findings.
4. Discuss interpretation of common investigations of relevant systems covered in each week module.
B. Skills
1. Demonstrate the ability to obtain an accurate and focused history of symptoms in a chronological manner developing the “presenting illness” including pertinent positive and negative history in simulated-patients/ patients
2. Demonstrate the ability to perform an appropriate, logical and thorough clinical examination of the appropriate system including relevant general assessment in simulated patients
3. Demonstrate the ability to detect normal and abnormal physical findings on screening physical examinations on patients
4. Demonstrate the ability to modify the sequence of history taking and performing physical examination depends on the patient conditions and circumstances.
5. Demonstrate the ability to record the patient’s history and physical examination findings in accurate and concise format
6. Present and discuss orally an accurate and concise history and physical examination findings of patients with the tutor
7. Formulate differential diagnoses based on the history and physical examination data gathered
8. Formulate logical investigations and treatment options based on the differential diagnoses (broad principles only).
C. Attitude
1. Demonstrate effective interpersonal relationship with simulated patients/patients and families while gathering and providing information during and at the end of history and physical examination, including self-introduction at the beginning and thanking at the end. (Students, being early learners SHOULD NOT inform their findings, diagnoses or treatment options to the patients they encounter in the wards; instead direct such patients to the physician-in-charge)
2. Demonstrate the ability to obtain verbal consent before physical examination.
3. Apply the principles of hand hygiene before and after physical examinations
4. Demonstrate consideration for simulated patient’s/ patient’s feelings and privacy during history taking and physical examination and modify the approach depends on the patient characteristics like age, sex, physical and emotional condition of the patient.
5. Demonstrate reliability, dependability, integrity and courtesy during history taking, physical examination and communication with simulated patients/ patients/ relatives/ tutors/ fellow students/ other health related professionals.
Assessment:
1. In course assessment: a. Mini Cex: 60%
Average of nine Mini-Cex scheduled every 3rd week. Mini-Cex assesses clinical skills, communication skills, professionalism and skills of using electronic health records.
2. Final assessment: 40%
a. MCQ (A type): 20%
b. SAQ (Short Answer Type): 20%
End of pre-clerkship module- on week 10 (Tuesday).
Assessment includes all topics covered in the lectures, workshops and clinical skills learned in the ward/skills lab. Examination will be administered in Moodle; you are advised to enroll Moodle course: PRECLERKSHIP at the beginning of the programme.
3. Pass/ Fail criteria: as per Sultan Qaboos University: College of Medicine and Health Sciences: Examination policy 2009
Course Coordinator:
Dr. Maha Al-Jabri
Specialist (A)
Department of Family Medicine and Public Health
College of Medicine and Health Sciences
Sultan Qaboos University
Tel #: (+968) 2414-7231
E-mail: maha.jabri@squ.edu.om
JUNIOR CLERKSHIP
Introduction:
The Junior Clerkship rotation is a 5-week rotation where the students get the opportunity to practice taking focused history, performing focused physical examination, proposing differential diagnosis and plan the management. The emphasis is on the acquisition of knowledge that is required to manage a wide variety of health conditions (physical, social and psychological) in the context of family, culture, work and community. The rotation explores further the principles of patient-centered care. This will take place within the context of workplace-based learning and tutorials. Daily clinical teaching takes place in the SQUH FAMCO Heath Centre as well as in a number of accredited MOH Local Health Centres. The learning setting will enable students to learn by participation.
Course Objectives:
At the end of this junior clerkship rotation, students are expected to be able to:
1. Establish relationship with patients and their families.
2. Obtain a focused history.
3. Conduct a focused physical examination appropriate to the age of the patient and nature of the clinical problem.
4. Generate relevant differential diagnosis.
5. Select and interpret appropriate diagnostic tests/investigations.
6. Master the patient’s management in a comprehensive way including:
a. Holistic approach.
b. Patient Centered Care.
c. Patient’s ideas, concerns and expectations.
d. Non-pharmacological and pharmacological management.
e. Continuity of care.
f. Community medicine.
g. Health promotion and preventive measures.
7. Observe/perform common procedures typically conducted in family practice settings.
8. Recognize risk factors.
9. Participate in the different health facilities that are provided by the primary care services including: Vaccination, antenatal care, Integrated Management of Childhood Illness (IMCI), school health, community health, etc.).
10. Objectives of the IMCI are:
a. To practice and use IMCI guidelines and manuals through (visiting EPI clinic, practicing how to asses feeding problems and giving advices accordingly, use AL-shefa_automated IMCI manuals).
b. To understand the syndromic case management steps of sick child (eliciting general danger signs).
c. To conduct proper chest examination for assessment of cough including counting breath in one minute.
d. To look for signs of diarrhea with dehydration (skin pinch test, sunken eye sign).
e. To check for throat and ear problems with the best position for examining the child.
f. To practice measurements of anthropometric parameter for each child including head circumference.
g. To understand the management of sick child in the clinic (nebulizer session; paracetamol syrup, tipped water sponging).
h. To demonstrate good communication skills with caretaker and child.
Assessment:
In-Course (Formative): 50%
- Observed long cases ------------------------------------------------------------------------20%
- One observed long cases
- Minimum duration = 30 + 15 minutes (30 min observation, 15 min discussion)
- When = workplace-based (in the morning during or at the end of OPD)
- Feed-back required = optional
- Mini-CEX ------------------------------------------------------------------------------------20%
- Two Mini-CEX
- Duration = 15 minutes
- When = workplace-based (in the morning during or at the end of OPD)
- Feed-back required = Must (5 minutes)
- Learning Portfolio (PCCP, Case Summary, Observe/conduct procedures) -------10%
End-of- Junior Clerkship Year (Summative): 50%
- MCQ ------------------------------------------------------------------------------------------30%
- OSCE -----------------------------------------------------------------------------------------20%
Course Coordinator:
Dr. Maisa Al-Kiyumi
Specialist A
Department of Family Medicine and Public Health
College of Medicine and Health Sciences
Sultan Qaboos University
Tel #: (+968) 2414-3407
E-mail: drmaysa@squ.edu.om
SENIOR CLERKSHIP
Introduction:
The Senior Clerkship in Family Medicine explores further the principles and practice of patient-centered care, which were introduced in Junior Clerkship. The clerkship course takes place in an out-of-hospital setting in the FAMCO clinic and a selection of nearby Ministry of Health (MOH) clinics. The student learns how to deal with undifferentiated health problems presented to the family doctor as well as how to manage chronic illnesses among the members of the community. In addition, the course emphasizes an outcome of graduate general (undifferentiated) physicians who are competent to deal with the issues described above in accordance with the current best medical practice and in a professional manner. The learning setting will enable students to learn by participation. Students will be empowered to build and expand their knowledge and skills for clinical reasoning and decision-making. The duration of Senior Clerkship is for three weeks.
Course Objectives:
To enable the student to:
1. Effectively communicate with patients and their families, health-care team and other health-care professionals.
2. Obtain a focused history, generate relevant differential diagnoses as well as eliciting and interpreting relevant information from the patient, family and other sources in a holistic way.
3. Perform a focused physical examination and to select appropriate laboratory and other diagnostic investigations/procedures given the differential diagnoses generated.
4. Generate a final diagnosis and to negotiate a treatment plan with the patient.
5. Discuss clinical decisions based on current best evidence and sound clinical judgments in order to offer an effective treatment plan to patients.
6. Critically evaluate risk versus benefit as well as cost versus effectiveness of therapeutic options.
7. Provide opportunistic health promotion/preventive measures, including occupational and environmental counseling,
Assessment:
The assessment would consist of ‘In-Rotation’ and ‘End-of-Clerkship’ rotation as follows:
- In-rotation assessment 50%
- End-of-clerkship assessment 50%
In-rotation assessment would consist of the following:
Assessment method Rationale
- Mini CEX Clinical skills + Professionalism
- Case-Based Discussion(CBD) Clinical reasoning + Record keeping
- Portfolio Clinical skills + Presentation Skills
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- Assessment of tutorials
- Case summaries
- Practical skills (procedures)
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-
- Mini CEX (ONE per student) 20%
Done in MOH
-
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- Case-Based Discussion (CBD) (ONE per student) 20%
Done in FAMCO
-
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- Learning Portfolio: case summaries, procedures 10%
& Case-Based Learning (CBL)
End-of-Year Clerkship Assessment:
FAMCO in block with Medicine, Therapeutics, Lab and Adult Haematology.
Assessment will constitute 50% of the total marks and consist of three integrated examinations:
- MCQs 15% Knowledge + Reasoning
- SAQ / MEQ 5% Clinical Reasoning
- OSCE 30% Clinical Skills
Failure in up to two integrated examinations would mean:
- Re-sit in the buffer period
- Failure in the re-sit would mean repeating all the components of the failed exam.
Course Coordinator:
Dr. Rahma Al-Hadhrami
Senior Specialist
Department of Family Medicine and Public Health
College of Medicine and Health Sciences
Sultan Qaboos University
Tel #: (+968) 2414-1129
E-mail: rahmasaid@squ.edu.om