Course Syllabus
Obiettivi
tirocinio nell'Unità di Gastroenterologia & Endoscopia: consolidamento, verifica di apprendimento e accertamento delle capacità dello studente relative al «saper fare e al saper essere medico» nell'ambito gastroenterologico : applicare le conoscenze biomediche e cliniche alla pratica medica, nel risolvere questioni di deontologia professionale e di etica medica, nel dimostrare attitudine a risolvere problemi clinici inerenti la gastroenterologia & endoscopia.”
Contenuti sintetici
frequenza presso le strutture dell'unità, a contatto con i pazienti (rapporto 1:1 con tutor):
- unità di degenza ordinaria
- ambulatorio e ambulatorio multispecialistico
- Day Hospital & Day Service setting
- consulting activities
- GI tumor board multidisciplinary meetings (settimanale)
- IBD multidisciplinary meetings (settimanale)
- journal club (mensile)
- aggiornamento linee guida (periodico)
Programma esteso
acquisire competenze in:
- pratiche del rapporto medico-paziente (colloquio, relazione, informazione, chiarezza, acquisizione del consenso)
- Relazione con colleghi e personale sanitario
- comunicazione con paziente e familiari; discutere rischi/benefici di un trattamento
- Raccogliere anamnesi familiare, fisiologica, patologica remota e prossima
- Raccolta anamnestica remota e prossima focalizzata sulla patologia specialistica
- Diary & chart management (osservare le seguenti procedure e manovre):
- Misurazione frequenza cardiaca centrale e periferica
- Misurazione di frequenza respiratoria e rilevazione caratteristiche del respiro
- Misurazione di pressione arteriosa in situazioni diverse
- Rilevazione di polso centrale e polsi periferici (caratteristiche)
- Interpretazione di una curva termica
- Posizionamento di ago canula venosa
- Effettuazione di iniezioni endovenose, intramuscolari, intradermiche/sottocutanee
- Applicazione O2 terapia - Saturimetria - Esame obiettivo (acquisire competenze in):
- Stato di coscienza /sincope/ encefalopatia epatica
- Diuresi, alterazioni dell'alvo (diarrea e stipsi)
- Vomito, dispepsia
- Prurito, alterazioni cutanee, pigmentazione - ittero - Infezioni cutanee - esantemi
- astenia, anemia, segni di sanguinamento gastrointestinale
- struttura corporea / segni distintivi di carattere sessuale / attitudini e attività sessuali
- stato nutrizionale, idratazione , peso corporeo, BMI, circonferenza dell'addome
- Edemi, versamento addominale
- ingrossamento linfonodi e milza
- segni di sanguinamento e trombosi
- alterazioni idroelettrolitiche - apprendere i principi di biopsia epatica (su parenchima e su nodulo)
- cnoscenza dei principi di richiesta di esami specialistici e di laboratorio (Gastroenterologia ed epatologia)
- rudimenti dell'apprendimento dell'interpretazione di referti radiologici, dei referti di laboratorio relativi alle principali patologie Gastro-epatologiche
- rudimenti di indicationi e interpretazione di procedure endoscopiche del tratto GI
Prerequisiti
l'internship può essere frequentata da studenti iscritti al 3°, 4°, 5° & 6° anno di corso di SMS (come indicato dal piano di study)
Modalità didattica
Rapporto Tutore : Studente = 1:1
Frequenza in Reparto di degenza, in ambulatorio, in Day Hospital (attività tutorata)
esercitazioni al letto del paziente
partecipazione ad incontri multidisciplinari
partecipazione a journal club & aggiornamenti periodici in Epatogastroenterologia
Materiale didattico
Attività quotidiane in regime di degenza ed ambulatoriale (protocolli operativi della struttura)
- Digestive Diseases book: coordinamento nazionale docenti universitari di Gastroenterologia (UNIGASTRO ed 2022-20225 e successive) disponibile a richiesta in Segreteria
- Seidel's physical examination handbook 9ᵗʰ Ed.- Solomon, Ball et al. 2018
- Harrison’s Principles of Internal Medicine 20ᵗʰ ed- Fauci et Al 2018
- Oxford Handbook of Clinical and Laboratory Investigation, Drew Provan Oxford University press, 2018
- Physical Examination for Surgeons: An Aid to the MRCS OSCE. Petrut Gogalniceanu, James Pegrum, William Lynn. Cambridge University Press; 1st edition. ISBN-10: 1107625548; ISBN-13: 978-1107625549.
Periodo di erogazione dell'insegnamento
tutto l'anno
Modalità di verifica del profitto e valutazione
valutazione intermedia da parte del tutor, condidvisa tra Tutor e Coordinatore didattico, con score sintetico in lettere con valori corrispondenti a:
A: Eccellente; B: Ottimo; C: Buono; D: soddisfacente; E: Sufficiente;
valutazione finale da parte dei coordinatori: IDONEO/non IDONEO
Orario di ricevimento
su appuntamento per e mail
Sustainable Development Goals
Aims
practical clerkship in the Gastroenterology & Endoscopy Unit: consolidation, verification of learning and assessment of the student's skills relating to "know-how and knowing how to be a doctor": applying biomedical and clinical knowledge to medical practice, in solving questions of professional ethics and medical ethics, in demonstrating aptitude for solving clinical problems in the gastroenterological & endoscopic setting
Contents
presence in the different sections of the Gastroenterology & Endoscopy unit with patient' involvement (student/tutor ratio 1:1):
- admitted patients (ordinary)
- specialistic outpatient care & multispecialistic outpatient clinic
- Day Hospital & Day Service setting
- consulting activities
- GI tumour Board multidisciplinary meetings (weekly)
- IBD multidisciplinary meetings (weekly)
- journal club (monthly)
- guidelines update (periodical)
Detailed program
to acquire initial skills(observe the following manouvres):
- patient-physician relationship (presentation, relationship, information, clearness, consent acquisition)
- Relationship with collegues and health personell
- how to collect a family, physiosocial, past and present pathologic history
- Diary & chart management (to observe the following manouvres):
- central & peripheral hearth rate
- respiratory rate, features of respiratory functions
- arterial pressuse measurement in differen clinical conditions
- Thermic courve
- Positiong of a venous vascular access
- how ti practice e.v. , i.m, s.c. injections
- saturimetry & 02 therapy - initial knowledge on how to compile a clinical chart, define a medical history, prepare a medical report, consent request
- learning the correct infection protection measures
- phisical examination of the patient:
- Examination of the abdomen
- State of conscousness / Syncope - Hepatic Hencephalopathy
- Diuresis, Bowel alterations Diarrhea and constipation (stool exam)
- Vomiting, Indigestion,
- Pruritus, skin alterations-pigmentation- Jaundice/Skin disorders /Infectious exanthemas
- Fatigue /Anemia/Gastrointestinal bleeding
- Body conformation/Grade of sexual development/differentiationLibido and sexual activity
- Nutritional Status /Idratation/ Unintentional weight loss- BMI, waist circumference / Thirst / Hunger
- Edemas Abdominal swelling and ascites
- Enlargement of lymph nodes and spleen
- Bleeding and thrombosis - basics of the indications and interpretation of Liver biopsy (principles)
- basics of requesting specialistic & biochemical tests (Gastroenterology & Hepatology)
- basics on how to read imaging reports ((Gastroenterology & Hepatology)
- basics of indications and Interpretation of the endoscopic procedures of the GI Tract
"Aspects of the medical profession
"The student is able to put into practice the principles of the patient-doctor relationship: medical interview, contact, information, clarity, acquisition of consent.
"The student is capable to obtain medical history and perform a physical examination in the outpatient context
"The student has knowledge and capacity to apply the clinical reasoning: to distinguish between primary urgent complaints and secondary problems; to suggest a diagnostic hypothesis and to individualise the diagnostic methods of greater specificity and sensitivity to confirm or reject the hypothesis
"The student is skilled to interpret the laboratory exams
- The student is skilled to interpret the medical reports of the diagnostic imaging examinations
- The student is oriented in decision-making regarding the pharmacological treatment
- The student is able to judge the appropriateness of the hospital discharge and to suggest the rehabilitation solutions or recovery in other facilitiesThe student is able to compile the report of hospital admission/discharge and to write a discharge letter
- The student is capable to frame the reason of ospitalization taking into account possible chronic illnesses, further critical conditions and patient’s frailty
- The student is able to demonstrate the skills of prevention and sanitary education
- The student demonstrates the knowledge and awareness of the National Healthcare System and Local Healthcare System
- The student respects the shift schedule, wears appropriate clothes and is well-equipped
- The student shows knowledge and awareness of the ward and/or ambulatory
- The student interacts in an appropriate manner with medical personnel, nurses and technicians
- The student demonstrates the awareness and knowledge of the different roles of the medical team members
- The student demonstrates active attitude: makes questions, candidates to perform activities
Prerequisites
the internship can be attended by students at the 3rd, 4th, 5th & 6th year of SMS course (as indicated according with the SMS study course plan)
Teaching form
Tutor : Student ratio = 1:1
Attendance in the inpatient ward, outpatient clinic, day hospital (tutored activity)
Bed side activities
participation at multidisciplinary meetings
participation at journal club & guidelines adjournment in epatogastroenterology
Textbook and teaching resource
Daily activities in hospital and outpatient settings (operating protocols of the facility)
Internal Medicine
- Digestive Diseases book: coordinamento nazionale docenti universitari di Gastroenterologia (UNIGASTRO ed 2022-20225 e successive) available upon request at the secretery
- Seidel's physical examination handbook 9ᵗʰ Ed.- Solomon, Ball et al. 2018
- Harrison’s Principles of Internal Medicine 20ᵗʰ ed- Fauci et Al 2018
- Oxford Handbook of Clinical and Laboratory Investigation, Drew Provan Oxford University press, 2018
- Physical Examination for Surgeons: An Aid to the MRCS OSCE. Petrut Gogalniceanu, James Pegrum, William Lynn. Cambridge University Press; 1st edition. ISBN-10: 1107625548; ISBN-13: 978-1107625549.
Semester
whole year
Assessment method
intermediate evaluation from the tutor, in accordance with the Coordinator, uring the following letters for a synthetic evaluation: A: Excellent; B: Very good; C: Good; D: Satisfactory; E: Sufficient; F: Insufficient.
Final evaluation by from the tutor, in accordance with the Coordinator: ELIGIBLE/NOT ELIGIBLE
Office hours
by appointment by e-mail