Early Clinical Experience and Communication Skills Module Current Academic Year 2009-2010

Module Title:

Early Clinical experience an Communication skills CLC332

Module Code: School: Year Three: Module Co-ordinator:

Semester 5 Prof/Merdad & Dr.Fatma

Office number: Level: Credit Rating: Duration: 3 2H 10 weeks

18207

Module Aims
The aim of this module is to enable the student to: Build an early clinical experience in the medical field. 2. Develop an experience in the life-clinical situations & make up an early orientation. 3. Acquire knowledge, attitude & skills in doctorpatient communications and the human, ethical, psychological, and legal aspects of healthcare. 4. To develop a basic understanding of the concepts and applications of a range of communication skills and apply these in an educational context.
1.

Learning Outcomes
Upon completing this module, the student should be able to: 1. Demonstrate an open-minded, respectful attitude to human experiences and diversity. 2. Appreciate the difference between acute and chronic cases, and outline the basic skills of dealing with common emergencies 3. Apply the skills of interview & communication in clinical practice. 4. Recognize the basic ethical and legal issues in daily clinical practice. 5. Develop a positive attitude towards patients, families and community through hospital and community visits.

Syllabus
Lectures: Early clinical experience lecture:
1. Introduction to ECE, History taking and

Clinical examination 2.Normal and abnormal clinical findings & clinical reasoning. 3. Outline of management strategies & patient safety. 4. Laboratory and radiological investigation

Practical:
1. History taking and Biohazards in clinical practice. 2.Clinical examination

Early Clinical Experience

Lecture1: Introduction to ECE & History taking and clinical examination DEPARTMENT: community medicine. TUTOR:DR/MAHDI.

TEACHING LOCATION:. LEARNING OBJECTIVES:

At the end of the lecture the student will be able to : 12Know well the course objectives and contents. Be motivated to early clinical experience.

3- know the methods of assessments of the course and method of assessment. 4- Understand the outline of History taking and clinical examination

DETAILED Procedure:
Description of the course. Orientation about the different departments of health care services. Methods of assessment and evaluation. outline of History taking and clinical examination.

READING:
1-Introduction to clinical examination. Michael j ford, Lain Hennessey, Alan japp. 2- History taking and clinical examination from Browse; An introduction to the symptoms and signs of surgical disease. 3-Clinical examination. Nicholas J Talley, 'Connor.

Lecture2: Normal and abnormal clinical findings & clinical reasoning DEPARTMENT: community medicine. TEACHING LOCATION:.
At the end of the lecture the student will be able to : 1- recognize the concept of normal and abnormal clinical findings in history, examination and laboratory investigations. 2- To know some examples of the normal and abnormal clinical findings. 3- Know the concept of clinical reasoning and hypothesis testing in clinical practice.

TUTOR:DR/MAHDI.

DETAILED Procedure:
- Examples of normal and abnormal findings in history, examination and laboratory investigations . - Meaning of clinical reasoning and hypothesis testing

READING:
Clinical examination. Nicholas J Talley, 'Connor. Clinical methods (Hutchinson). Barbara Bates. A guide to clinical thinking. J.B. Lippincott company.

Lecture3: Outline of management strategies & patient safety. DEPARTMENT: community medicine. TEACHING LOCATION:.
At the end of the lecture the student will be able to :

TUTOR:DR/MAHDI.

1- recognize the different modalities of strategies used in patient treatment.

2- be motivated for the comprehensive and holistic approach in patient management. 3. Recognize the sources of medical errors and the risks to the patients in the medical care. 4. Be motivated to be very attentive to medical errors and risks. DETAILED Procedure: reassurance & explanation . - non-pharmacological - pharmacological. - referral. - investigations. - observation. - prevention. - rehabilitation, home care and palliative therapy - Types and sources of medical errors. - Tips of patient safety and Patient education about patient safety. - Examples and pictures of a real cases of medical errors.
-

READING: - Robin C Fraser. Clinical method A general practice approach. Butterworth Heinemann. - Selected articles about patient safety.

Lecture4: Laboratory and radiological investigation DEPARTMENT: community medicine. TEACHING LOCATION:.
At the end of the lecture the student will be able to : 1- Aquire basic knowledge about the basic and radiological investigation required for patient with medical disease.

TUTOR:DR/MAHDI.

DETAILED Procedure:
Common test (such as CBC, Urea, Electrolytes, Blood sugar profile. Liver function tests, serum lipids,calcium, phosphate, magnesium and uric acid, stool and urine analysis) what is normal and abnormal of ?these tests and what is the clinical implication of each abnormality Common radiological test (chest x-ray, plain abdominal x-ray, barium swallow, wrists x-ray). What is ?normal and abnormal

READING:
- Oxford hand book of laboratory investigations.Povan - Imaging for students by A. lislie - Sutton's radiology for medical students by D. Sutton - Clinical examination. Nicholas J Talley, 'Connor. Clinical methods (Hutchinson).

Practical(1): History taking and Biohazards in clinical practice.

TUTOR: . SUMMARY: In the skills lab the students will see and practice history taking . Also they will learn the the different biohazards in clinical practice and the preventive measure to prevent these hazards. They will be enabled to use some of the protective equipments and materials. OBJECTIVES: 1. Practicing and observing doing different parts of history taking. 2. Knowing the different biohazards in clinical practice and the preventive measure to prevent these hazards.

READING:

- Introduction to clinical examination. Michael j ford, Lain Hennessey, Alan japp. - The 2 chapters of history taking and clinical examination from Browse; An introduction to the symptoms and signs of surgical disease. - Clinical examination. Nicholas J Talley, 'Connor. - Clinical methods (Hutchinson). - American public health association. Control of communicable diseases manual.

Practical(2): Clinical examination

TUTOR: . SUMMARY: In the skills lab the students we see and practice the general and major systems examination

OBJECTIVES:

To see and practice: a- the general examination b- major systems examination

READING:

- Introduction to clinical examination. Michael j ford, Lain Hennessey, Alan japp. - The 2 chapters of history taking and clinical examination from Browse; An introduction to the symptoms and signs of surgical disease. - Clinical examination. Nicholas J Talley, 'Connor. - Clinical methods (Hutchinson).

Communication skills lecture:

1. Introduction to communication skills

2.
3.

Intrapersonal Communication

4.
5.
6.

INTERPERSONAL COMMUNICATION CONFLICT MANAGEMENT.

Group Communication Patient Interview & patient centered communication

7.

BREAKING BAD NEWS 8. GUIDELINES IN COMMUNICATING WITH SPECIAL PATIENTS 9. COMMUNICATING WITH PATIENTS FAMILY . INFORMED CONSENT 10. LISTENING AND EMPATHIC RESPONDING
11.

Public Communication & assertiveness

Practical:
Skills in health communication skills 1-Team Building ,group communication & public speaking.
The group will be divided in to groups,in each group 10 students , the objective is To recognize the importance of team building Learn to perform more effectively in project teams 1. Then to select leader or coordinator , the objective is to learn how to select leader & each group will write to the module corrdinator ,the criteria of selecting a leader.each group will select a name for the group,the same group will work together during the module course.each group will select topic in communication skills or common medical problems ,the objective is to explain the requirements for choosing a topic and to describe the options for choosing a topic and to assess the appropriateness of a topic for speaker, audience, and occasion.then they will prepare presentation outline, Identify the purposes of the three main parts of a speech,Identify suitable content for the three main parts of a speech & Use websites to find examples of outlines present .their presentation will be conducted during student day presentation.

2-breaking bad news

1. 2. 3. 4. 5. 6. Dying patient Cancer patient Critically ill or injuired patient Child abuse Intrauterine fetal death Delivery of baby with down syndrom or congenital anomaly

3-informed consent :

1. 2. 3. 4. 5.

Mastectomy Amputation Colostomy Hernia repair Lumbar puncture

Assessment: Total mark: Continuous Assessment: Assessment (Final) 100% 60 % 40 %

Reference: 1. Hutchison's Clinical Methods by Swash. Saunders 2. Introduction to Clinical examination. By Ford & Munro-Churchill Livingstone. 3. The New Consultation: Developing Doctor-Patient Communication. By Pendleton, & Tate. Schofield, Oxford University Press. 4. Communication skills in Pharmacy Practice 4th Edition, by william Tindall, R. Beardsley, & C. Kmberlin 5. Communication Making Connections,6th edition.by William Seiler & Melissa Beall,Allyn & Bacon. 6. Communication and Education Skills for Dietetics Professionals, 3rd or 4th edition,by Betsy B.Holli & Richard J.Calabrese.Williams & Wilkins.

COMMUNICATION SKILLS
Lecture #5 ,6 Introduction to communication skills & Intrapersonal Communication. DEPARTMENT: surgery TEACHING LOCATION: . LEARNING OBJECTIVES: 1. Understand the role of communication in your daily life. 2. Describe how competent communication can affect your career development. 3. Discuss the effects of ethical behavior, culture, technology, and thinking on your communication. 4. Learn the essential components of the communication process. 5. Distinguish among the various types of communication: intrapersonal, interpersonal (including group), and public communication. 6. Identify and debunk five common myths about communication. 7. Make the connection between self-concept and perception. 8. Suggest ways to improve self-concept. 9. Interpret perceptions as well as improve your communication competence. DETAILED CONTENT: 1. 2. 3. 4. 5. Human communication definition. The purposes of communication. Distinguish among the various types of communication. Communication characteristics, model. The essential components in the communication process TUTOR:FATMA

6. Identify & debunk five common myths about communication. 7. Make the connection between perception & communication competence. 8. perception. Reading: Communication Making Connections,6th edition.by William Seiler & Melissa Beall,Allyn & Bacon.

COMMUNICATIONSKILLS
Lecture # 7,8: INTERPERSONAL COMMUNICATION & CONFLICT

MANAGEMENT.
DEPARTMENT:Surgery . TEACHING LOCATION: . LEARNING OBJECTIVES:
1. Improve your interpersonal communication. 2. Analyze the motivation of others and how it relates to interacting with others. 3. Know the connection and differences between online and face-to-face interaction. 4. Improve your small talk when attempting to initiate relationships. 5. Become a more competent communicator in your use of self-disclosure. 6. Understand the stages of relationship development and deterioration. 7. Know how dialectic tensions push and pull on relationships. 8. Explain what interpersonal conflict is and how to resolve it. 9. Determine when a relationship is in trouble and how to use relational repair strategies. 10. Improve your interpersonal communication skills and competencies in personal and professional relationships.

TUTOR:FATMA

DETAILED CONTENT: 1. Interpersonal communication characteristics 2. Relationship development motives 3. Reducing uncertainty 4. Relationship development stages 5. Self-disclosure 6. Interpersonal conflict management 7. Conflict nature and its healthy side 8. Dialogue and diversity understanding. Reading: Communication Making Connections,6th edition.by William Seiler & Melissa Beall,Allyn & Bacon.

COMMUNICATION SKILLS
Lecture # 9: Group Communication. DEPARTMENT: SURGERY . TEACHING LOCATION: LEARNING OBJECTIVES:
1. Make the connection between group communication and other types of communication discussed in previous chapters. 2. Explain what a group is and what it is not and understand the importance of groups in our lives. 3. Distinguish between primary and secondary groups and their purposes. 4. Learn to perform more effectively in special types of groups, such as project teams, work teams, and focus groups. 5. Avoid the disadvantages and limitations of group communication. 6. Ensure that members of groups that you participate in are ethical. 7. Utilize technology to communicate effectively in groups. 8. Conduct efficient and effective group meetings. 9. Use effective problem-solving and decision-making steps. 10. Manage and use conflict strategies to ensure positive outcomes. 11. Develop and use criteria for evaluating groups.

TUTOR: Dr. FATMA

DETAILED CONTENT: 1. Small group definition and how it differs from dyads. 2. Small group types, purposes and characteristics 3. Factors affecting group communication 4. Performance versus human/dimensions 5. Improving group communication 6. Working team formation and its success factors 7. Decision making and problem solving in small groups.
Reading: Communication Making Connections,6th edition.by William Seiler & Melissa Beall,Allyn & Bacon.

Lecture 10# Patient Interview & patient centered communication DEPARTMENT: Surgery TUTOR:Fatma

TEACHING LOCATION : LERNING OBJETIVES: The Student will able to:

1. 2. 3. 4. 5. 6. 7. 8. Understand the functions of the patient interview Comprehend the basic skills required to conduct a satisfying patient interview Demonstrate skills, in an elementary fashion, during a patient interview Development the skills of observation in the context of the doctor-patient interactions. Recognize appropriate techniques of communication with patients. illustrate five dimensions of patient-Centred carer. Recognize appropriate techniques of interviewing patients. Define and identify critical elements of therapeutic communication

DETAILED CONTENT:
1. 2. 3. Patient-centred Communication Encourage Patients to Share their Experience with Therapy and Eliciting Feedback Interview and assessment a. Interview steps and Organizing the interview b. Interview and assessment c. Interview steps d. Organizing the interview Purposes of the interview, Rapport building, Patient interview and Interview reports

4.

REFEENCE:
Communication skills in pharmacy Practice 4th Edition, by William Tindall, R. Beardsley,& C. Kimberlin

LECTURE # 11 BREAKING BAD NEWS DEPARTMENT: Surgery TEACHING LOCATION : LERNING OBJETIVES:
To Understand : How to communicate sensitive news to patients and their relatives. How patients and their relatives cope with bad news. The process of giving bad news.

TUTOR:FATMA

DETAILED CONTENT:
What is bad news? What is difficult about giving bad news? Options for managing difficult situations? How to give bad news?

REFEENCE:
Communication Skills of Medicine: Margaret Lloyd. Robert Bor.

LECTURE # 12

GUIDELINES IN COMMUNICATING WITH SPECIAL PATIENTS & COMMUNICATING WITH PATIENTS FAMILY & INFORMED CONSENT

DEPARTMENT: TEACHING LOCATION : LERNING OBJETIVES:

TUTOR:

1. To understand how to Communicate with children and adolescent. 2. To understand how to Communicate with critically ill patient,dying patient. 3. To understand how the family can help in diagnosis, treatment and care. 4. To understand how to communicate with patient family. 5. To understand how to take consent.

DETAILED CONTENT:
1. 2. 3. 4. 5. 6. 7. 8. 9. Management of children Guidelines for helping parents manage their sick child Dealing with adolescents Dealing with critically ill patient. Identifying the patient's family. The Family's influence on care and treatment and care. Responding to and managing the concerns and fears of relatives. Guidelines for dealing with patient's family. Guidelines for taking consent

REFEENCE:
Communication Skills of Medicine: Margaret Lloyd. Robert Bor.

LECTURE # 13 LISTENING AND EMPATHIC RESPONDING DEPARTMENT: Surgery TEACHING LOCATION : LERNING OBJETIVES:
The Student will able to:
1. 2. 3. 4. Understand the importance of listening to patients. Understand the skills of listening to patients . Understand the types of empathic responding. Understand the problems in establishing helping relationships with paients.

TUTOR:Fatma

DETAILED CONTENT:
Listening well. Empathic responding. Attitudes underlying empathy. Nonverbal aspects of empathy. Problems in establishing helping relationships.

REFEENCE:
Communication skills in pharmacy Practice. William N .Tindall, R. Beardsley,& C. Kimberlin Communication Skills of Medicine: Margaret Lloyd. Robert Bor.

Lecture # 14 Public Communication & assertiveness.

DEPARTMENT: surgery. TUTOR:FATMA TEACHING LOCATION:.

LEARNING OBJECTIVES:
1. 2. 3. 4. 5. To recognize that speech is an important tool for thinking and learning. To know the types of speech. To be able to prepare a good presentation. To know and use the appropriate techniques for public speech. To Initiate communication and communicate in an atmosphere of trust.

DETAILED CONTENT: 1. Informative and persuading speech 2. preparing and writing a speech 3. Presentation Skills 4. Evaluating the presentation 5. Assertive response 6. Non -assertive response: Passive response & Aggressive response
Reading: Communication Making Connections,6th edition.by William Seiler & Melissa Beall,Allyn & Bacon.

KING ABDULAZIZ UNIVERSITY Faculty of Medicine Early clinical experience And Communication skills Module

The log book for the activities and the visits of the self-directed learning
Supervisor Dr: . Student name: .. Computer number:

To hospital staff
Our 3rd medical students will perform supervised visits to different departments of your hospital.

We highly appreciate your cooperation.

Members of the Early Clinical Experience & Communication Skills Module Faculty of Medicine King Abdul-Aziz University

1-Prof.Adnan Abdulmotee Merdad.

of the Module)

(Head

2-Prof. Mohammad Sader M. Alsadi. 3-Dr.Amin Jefri 4-Dr.Mahdi Qadi. 5-Dr.Bassam Addas. 6-Dr. Fatemah Althubaiti. (Coordinator of
the Module)

7-Dr.Samar Alsagaf. 8-Dr.Nesmah Mansouri. 9-Prof.Omymah. Aboalola.

10-Dr.Mawiah A. KHafaje.

Dear student:
You are expected during the hours of SDL to go to these different clinical and related sites to be exposed to its activities and skills done in it. You may also go to it in other times other than the scheduled afternoon time. These activities can be done in KAUH, other governmental hospitals, primary health care centers. One of the House Officers (Interns) will supervise your group and activities.

At the end of the module term he or she will fulfill your activities evaluation form. In the log book in the activities tables you will put in brief what you have seen, what you do and the educational benefits you gain (You may use more than table for one activity if needed).

1-

The suggested sites and what to be done:

Any out-patient clinic: (Must DO). (Primary Health Care Clinic, Medical, Surgical, Pediatric, Obstetric, Orthopedic, ENT, Ophthalmology, Dermatology, Psychiatry, Urology) - You will notice there how patients present, how history and examination is done, the investigations requested and the management. 2- Emergency Room (Must DO). - As for the clinics plus the emergency skills and procedures 3- Radiology department (Must DO). - Seeing how simple x-ray, ultra-sound, CT scan and MRI are

done - Seeing and reading simple X-rays (e.g.; chest X-ray). 4- The blood bank (Must DO). 5- Trauma clinic or cast clinic (Must DO). . 6- Day-care center (Must DO). 7- Attending scientific clinical lecture or symposium (Must DO). 8- Dressing Room(optional) . -Seeing different types of wounds and dressing. -Seeing and participating if suitable in taking vital signs . -Seeing and participating if suitable in intramuscular injections. -Seeing any other activities done in it. 9- Laboratories (optional). - Seeing the different laboratory sections - Seeing how some tests are done (e.g.; Urine Analysis, Stool Analysis, CBC) -Some results of some simple tests and knowing its normal ranges -Frozen section in pathology lab. 10- Isolation room (optional). - Types of cases - Types of precautions - Protection equipments and materials . 11- Endoscopy unit (optional). - Seeing upper and lower GIT endoscopy - Seeing different endoscopic equipments 12- Hospitals wards (optional). - To know the type of cases admitted in the different departments wards - To attend some of the rounds in the departments - To see some of the cases if possible with one of the Working Staff. - To know the type of cases admitted there - To see some of the cases if possible with one of the Working Staff.

13- Skill lab (optional). - Training on examination with the present resources

LOG OF activities
Data, Place & Authentication Date:

No . .

Place:

Attended with Name:

Signature

No . .

Data, Place & Authentication Date:

Place:

Attended with Name:

Signature