Bed Side Approach and Clinical Methodology

A.Y. 2023/2024
6
Max ECTS
72
Overall hours
SSD
M-PSI/01 MED/09 MED/18
Language
English
Learning objectives
The course will provide the theoretical and practical basis for a comprehensive clinical bedside approach to patients by integrating the internal medicine and general surgery modules with a psychological one, focused on the acquisition of practical as well as methodological skills.
Expected learning outcomes
At the end of the practical activities, students should be able to: Students will learn: the processes of clinical reasoning, to identify problems and making diagnostic hypothesis theoretical basis of information processing and communication, with particular attention to cognitive models basic notion on psychological and behavioural signs and symptoms.
Single course

This course cannot be attended as a single course. Please check our list of single courses to find the ones available for enrolment.

Course syllabus and organization

Single session

Responsible
Prerequisites for admission
To take the Bed Side Approach and Clinical Methodology exam, students must have already passed all the exams of the first year (Fundamentals of Basic Sciences, Cells, Molecules and Genes 1 and 2, Human Body) and the exam of Functions.
Assessment methods and Criteria
Students' assessment is based on an oral examination. The final mark is the average of the marks obtained in the three disciplines, internal medicine, general surgery and general psychology, weighted for the number of credits in each discipline.
The exam is deemed to be passed successfully if the final grade is equal to or higher than 18/30. In the event of a full grade (30/30) honors (lode) may be granted with the consent of all the professors. Attendance is required to be allowed to take the exam. Unexcused absence is tolerated up to 34% of the course activities. University policy regarding excused illness is followed.

Registration to the exam through SIFA is mandatory.
Internal medicine
Course syllabus
The program of the single disciplines must be considered embedded in the program of the whole course focusing on Internal Medicine, General Surgery and General Psychology
Topic 1. Course presentation
Patient assessment - Comprehensive and focused
· Determining the scope of assessment
· Subjective versus objective data
The surgical patients
· Brief history of surgery and recent development. The operating room and current available technologies

Topic 2. Behaviour and mental status: cognitive processes and functions

Topic 3. Information research, clinical reasoning, assessment and plan: the process of clinical reasoning. Identifying problems and making diagnosis, generating the problem list
Topic 4. History taking: a comprehensive health history, the techniques of skilled interviewing, the sequence and context of the interviewing, cultural and cognitive contest, exploring patients' perspective
Topic 5. Communication fallacies
Topic 6. Signs and symptoms. Beginning the physical examination: general survey, vital signs and pain- Overview of general examination
Topic 7. The thorax, lung and cardiovascular system: techniques of examinations
Topic 8. The abdomen examination related to medical approach (liver, spleen and pancreas problems)
Topic 9. Surgeon's behaviour in the Operating room, basic principles of asepsis and patient's preparation to surgery
Topic 10: Physical examination and clinical signs of the abdomen, chest, breast (surgery related), and genito-urinary apparatus part 1
Topic 11: Physical examination and clinical signs of the abdomen, chest, breast (surgery related), and genito-urinary apparatus part 2 )
Topic 12. The vascular system
· Arterial diseases
· Venous and lymphatic diseases
· Vascular diagnosis and anamnesis + English/Italian dictionary
Topic 13. Lump, masses and ulcer
Topic 14. Doctor-patient relationship: clinical cases
Topic 15. Doctor-patient relationship: clinical cases - the physician perspective
Topic 16. PRACTICE LESSON: Case method and problem solving - clinical cases, a multidisciplinary approach
· The foot
· The big belly
· The fainter
Topic 17. PRACTICE LESSON: Clinical tools
· Chest Rx
· ECG
· Blood gases analysis
· Abdominal ultrasonography
· Vascular ultrasonography
Topic 18. PRACTICE LESSON: Video and multimedia material for asyncrous activities
Teaching methods
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Teaching Resources
Lynn Bickley. Bates' Physical examination and history taking. Lippincott
Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
General surgery
Course syllabus
The program of the single disciplines must be considered embedded in the program of the whole course focusing on Internal Medicine, General Surgery and General Psychology
Topic 1. Course presentation
Patient assessment - Comprehensive and focused
· Determining the scope of assessment
· Subjective versus objective data
The surgical patients
· Brief history of surgery and recent development. The operating room and current available technologies

Topic 2. Behaviour and mental status: cognitive processes and functions

Topic 3. Information research, clinical reasoning, assessment and plan: the process of clinical reasoning. Identifying problems and making diagnosis, generating the problem list
Topic 4. History taking: a comprehensive health history, the techniques of skilled interviewing, the sequence and context of the interviewing, cultural and cognitive contest, exploring patients' perspective
Topic 5. Communication fallacies
Topic 6. Signs and symptoms. Beginning the physical examination: general survey, vital signs and pain- Overview of general examination
Topic 7. The thorax, lung and cardiovascular system: techniques of examinations
Topic 8. The abdomen examination related to medical approach (liver, spleen and pancreas problems)
Topic 9. Surgeon's behaviour in the Operating room, basic principles of asepsis and patient's preparation to surgery
Topic 10: Physical examination and clinical signs of the abdomen, chest, breast (surgery related), and genito-urinary apparatus part 1
Topic 11: Physical examination and clinical signs of the abdomen, chest, breast (surgery related), and genito-urinary apparatus part 2 )
Topic 12. The vascular system
· Arterial diseases
· Venous and lymphatic diseases
· Vascular diagnosis and anamnesis + English/Italian dictionary
Topic 13. Lump, masses and ulcer
Topic 14. Doctor-patient relationship: clinical cases
Topic 15. Doctor-patient relationship: clinical cases - the physician perspective
Topic 16. PRACTICE LESSON: Case method and problem solving - clinical cases, a multidisciplinary approach
· The foot
· The big belly
· The fainter
Topic 17. PRACTICE LESSON: Clinical tools
· Chest Rx
· ECG
· Blood gases analysis
· Abdominal ultrasonography
· Vascular ultrasonography
Topic 18. PRACTICE LESSON: Video and multimedia material for asyncrous activities
Teaching methods
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Teaching Resources
Hamilton Bailey's Physical signs: Demonstrations of physical signs in clinical surgery. 19th Edition. CRC Press, 2016GENERAL
General psychology
Course syllabus
The program of the single disciplines must be considered embedded in the program of the whole course focusing on Internal Medicine, General Surgery and General Psychology
Topic 1. Course presentation
Patient assessment - Comprehensive and focused
· Determining the scope of assessment
· Subjective versus objective data
The surgical patients
· Brief history of surgery and recent development. The operating room and current available technologies

Topic 2. Behaviour and mental status: cognitive processes and functions

Topic 3. Information research, clinical reasoning, assessment and plan: the process of clinical reasoning. Identifying problems and making diagnosis, generating the problem list
Topic 4. History taking: a comprehensive health history, the techniques of skilled interviewing, the sequence and context of the interviewing, cultural and cognitive contest, exploring patients' perspective
Topic 5. Communication fallacies
Topic 6. Signs and symptoms. Beginning the physical examination: general survey, vital signs and pain- Overview of general examination
Topic 7. The thorax, lung and cardiovascular system: techniques of examinations
Topic 8. The abdomen examination related to medical approach (liver, spleen and pancreas problems)
Topic 9. Surgeon's behaviour in the Operating room, basic principles of asepsis and patient's preparation to surgery
Topic 10: Physical examination and clinical signs of the abdomen, chest, breast (surgery related), and genito-urinary apparatus part 1
Topic 11: Physical examination and clinical signs of the abdomen, chest, breast (surgery related), and genito-urinary apparatus part 2 )
Topic 12. The vascular system
· Arterial diseases
· Venous and lymphatic diseases
· Vascular diagnosis and anamnesis + English/Italian dictionary
Topic 13. Lump, masses and ulcer
Topic 14. Doctor-patient relationship: clinical cases
Topic 15. Doctor-patient relationship: clinical cases - the physician perspective
Topic 16. PRACTICE LESSON: Case method and problem solving - clinical cases, a multidisciplinary approach
· The foot
· The big belly
· The fainter
Topic 17. PRACTICE LESSON: Clinical tools
· Chest Rx
· ECG
· Blood gases analysis
· Abdominal ultrasonography
· Vascular ultrasonography
Topic 18. PRACTICE LESSON: Video and multimedia material for asyncrous activities
Teaching methods
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Teaching Resources
Papers will be provided during lessons.
General psychology
M-PSI/01 - GENERAL PSYCHOLOGY - University credits: 1
Lessons: 8 hours
: 4 hours
Professor: Mazzocco Ketti
General surgery
MED/18 - GENERAL SURGERY - University credits: 2
Lessons: 18 hours
: 6 hours
Internal medicine
MED/09 - INTERNAL MEDICINE - University credits: 3
Lessons: 24 hours
: 12 hours