Clinical practice 5th year (clerkship)
A.A. 2023/2024
Obiettivi formativi
Students are trained to the basic surgical and medical skills through attendance in the ward and in the operating room. Students attend the departments of General Surgery, Thoracic surgery, Urology and Internal medicine. During the clerkship students are involved in an overview of Internal Medicine, urology and its subspecialties through rotation (organized by work shifts) in clinics, ward work, and operating room. Practical activities are used to consolidate technical and soft knowledge and skills developed during frontal lectures through: - Ward round and clinical examination of admitted patients - Execution of a complete physical examination and recognition of pathological pictures -Discussion of possible differential diagnoses and related exams prescription - Setting of a therapeutic scheme - Physical examination of operated patients - Multidisciplinary meeting attendance - Operating room attendance - Endoscopy service attendance.
Risultati apprendimento attesi
Students are expected to achieve general and specific requirements: - Surgical hand scrub - Management of sterility during surgery - Surgical incision and principles of hemostasis - How a wound is sutured - Peripheral venous cannulation - Physical examination of the abdomen - Wound care - Management of abdominal drainage - Discussion of thoracic surgery clinical cases - Basic knowledge of standard thoracic surgery steps - Knowledge of guidelines and basic principles to correctly address prognostic perspective of patients suffering form lung cancers. how to take general and urologic histories and physicals (including digital rectal examination) - how to manage patients affected by renal pain (medical therapy, bladder and kidney ultrasound, interpretation of radiological exams, indications for surgical treatment) - how to manage patients affected by hematuria (acute treatment with bladder irrigation, bladder and kidney ultrasound, diagnostic cystoscopy) - how to make a differential diagnosis between anuria and urinary retention (including bladder and kidney ultrasound) - how to insert a urethral catheter and eventually perform the urethral catheterization
Periodo: annuale
Modalità di valutazione: Esame alla fine del gruppo
Giudizio di valutazione: Inserire codice AF
Corso singolo
Questo insegnamento non può essere seguito come corso singolo. Puoi trovare gli insegnamenti disponibili consultando il catalogo corsi singoli.
Programma e organizzazione didattica
Edizione unica
Responsabile
Prerequisiti
To attend the Clinical Practice course, students must have already passed all the exams of the first and second year (Fundamentals of Basic Sciences, Cells, Molecules and Genes 1 and 2, Human Body, Functions and Mechanisms of Diseases).
Modalità di verifica dell’apprendimento e criteri di valutazione
TThe exam will be organized at the end of the 1st semester of the 6th year, when the course will be completed, and will cover all the topics of Clinical Practice 5th year and Clinical Practice 6th year courses. Students' fulfillment of competencies will be assessed by 2 written tests and an oral session. It is mandatory to pass both the written test to be admitted to the oral examination.
WRITTEN EXAMINATION
1) Written test of General Surgery
A written test using multiple choices Q&A questionnaire. 40 questions, each question has 4 answers, and each answer can be true or false. The questionnaire will be prepared on the slides presented at the frontal lessons (uploaded in the University website for student access) and on the official Textbook. The written test will be considered valid when at least 75% of responses will be answered correctly.
2) Written test of the following disciplines:
Plastic Surgery; Thoracic Surgery; Urology; Clinical Pathology; General psychology; Pharmacology; MED-EF/01
10 questions with 4 answers for each discipline, with only one correct answer. To pass this test students must answer correctly to 6/10 questions in each module.
3) Oral examination of Internal Medicine and General Surgery
ORAL EXAMINATION
For each exam session, the oral examinations of Internal Medicine and General Surgery are scheduled in two separate dates.
An oral discussion with the Course Director and/or Collaborators focused on clinical cases, multi-disciplinary analysis, risk-benefit of various therapeutic alternatives and clinical/research speculations on surgical patients presenting with clinical conditions described in the synchronous and asynchronous learning material as well as in the suggested Textbook. Contents of the asynchronous activities (e.g. Surgery Blog) will be valued, as part of the general assessment of student's participation and acquired knowledge.
The final mark is the weighted average of the two marks obtained in the oral examinations of Internal Medicine and General Surgery.
Written tests and Oral examinations can be taken in different exam sessions. Once passed, the written tests and the oral examinations remain valid. For general information about Exams required skills see also the section "Expected Outcome" below.
BIOSTATISTICS ASSESSMENT
Student assessment is based on the evaluation of a presentation of the work conducted during the practical activities. Students are required to present a draft research protocol for a clinical trial or an observational study. The presentation will be made in the presence of selected components of the exam commission and other students. The presentations will be prepared by small groups of students (maximum 3) and will be divided equally among the group members.
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.
WRITTEN EXAMINATION
1) Written test of General Surgery
A written test using multiple choices Q&A questionnaire. 40 questions, each question has 4 answers, and each answer can be true or false. The questionnaire will be prepared on the slides presented at the frontal lessons (uploaded in the University website for student access) and on the official Textbook. The written test will be considered valid when at least 75% of responses will be answered correctly.
2) Written test of the following disciplines:
Plastic Surgery; Thoracic Surgery; Urology; Clinical Pathology; General psychology; Pharmacology; MED-EF/01
10 questions with 4 answers for each discipline, with only one correct answer. To pass this test students must answer correctly to 6/10 questions in each module.
3) Oral examination of Internal Medicine and General Surgery
ORAL EXAMINATION
For each exam session, the oral examinations of Internal Medicine and General Surgery are scheduled in two separate dates.
An oral discussion with the Course Director and/or Collaborators focused on clinical cases, multi-disciplinary analysis, risk-benefit of various therapeutic alternatives and clinical/research speculations on surgical patients presenting with clinical conditions described in the synchronous and asynchronous learning material as well as in the suggested Textbook. Contents of the asynchronous activities (e.g. Surgery Blog) will be valued, as part of the general assessment of student's participation and acquired knowledge.
The final mark is the weighted average of the two marks obtained in the oral examinations of Internal Medicine and General Surgery.
Written tests and Oral examinations can be taken in different exam sessions. Once passed, the written tests and the oral examinations remain valid. For general information about Exams required skills see also the section "Expected Outcome" below.
BIOSTATISTICS ASSESSMENT
Student assessment is based on the evaluation of a presentation of the work conducted during the practical activities. Students are required to present a draft research protocol for a clinical trial or an observational study. The presentation will be made in the presence of selected components of the exam commission and other students. The presentations will be prepared by small groups of students (maximum 3) and will be divided equally among the group members.
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
Programma
Internal medicine:
Clinical approach to admitted patients: execution of a complete physical examination and recognition of pathological pictures, discussion of possible differential diagnoses and related exams prescription, setting of a therapeutic scheme. Multidisciplinary meeting attendance.
Clinical approach to admitted patients: execution of a complete physical examination and recognition of pathological pictures, discussion of possible differential diagnoses and related exams prescription, setting of a therapeutic scheme. Multidisciplinary meeting attendance.
Metodi didattici
Clerkship attendance and sufficient exposure to practice (i.e. simulation lab, formal patients examination at bedside, training of basic medical-surgical techniques etc.) will be registered, as clinical teaching will be based also on direct participation of the students to different aspects of the hospital life.
Materiale di riferimento
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/)
UP To Date - Evidence Based Clinical Decision Support resource
UP To Date - Evidence Based Clinical Decision Support resource
Thoracic surgery
Programma
Surgery
Clinical approach to surgical patient:
Operating Room Attendance: Surgical hand scrub, management of sterility during surgery. Assist to surgical incision and principles of hemostasis, wound suture, peripheral venous cannulation.
Physical examination of operated patients: physical examination of the abdomen, wound care, management of abdominal drainage
Basic knowledge of standard thoracic surgery steps
Clinical approach to patients suffering form lung cancers.
Clinical approach to surgical patient:
Operating Room Attendance: Surgical hand scrub, management of sterility during surgery. Assist to surgical incision and principles of hemostasis, wound suture, peripheral venous cannulation.
Physical examination of operated patients: physical examination of the abdomen, wound care, management of abdominal drainage
Basic knowledge of standard thoracic surgery steps
Clinical approach to patients suffering form lung cancers.
Metodi didattici
Clerkship attendance and sufficient exposure to practice (i.e. simulation lab, formal patients examination at bedside, training of basic medical-surgical techniques etc.) will be registered, as clinical teaching will be based also on direct participation of the students to different aspects of the hospital life.
Materiale di riferimento
Shields' General Thoracic Surgery by Joseph LoCicero III MD 8th Edition, Wolters Kluwer
Pearson's Thoracic and Esophageal Surgery Churchill Livingstone last Edition
Pearson's Thoracic and Esophageal Surgery Churchill Livingstone last Edition
Urology
Programma
Surgery
Clinical approach to surgical patient:
Operating Room Attendance: Surgical hand scrub, management of sterility during surgery. Assist to surgical incision and principles of hemostasis, wound suture, peripheral venous cannulation.
Physical examination of operated patients: physical examination of the abdomen, wound care, management of abdominal drainage
Basic knowledge of standard thoracic surgery steps
Clinical approach to patients suffering form lung cancers.
Clinical approach and physical examination to patients affected by renal pain (kidney ultrasound, interpretation of radiological exams, indications for surgical treatment), patients affected by hematuria (acute treatment with bladder irrigation, bladder and kidney ultrasound, diagnostic cystoscopy), patients with anuria and urinary retention
Assist and eventually perform the urethral catheterization.
Clinical approach to surgical patient:
Operating Room Attendance: Surgical hand scrub, management of sterility during surgery. Assist to surgical incision and principles of hemostasis, wound suture, peripheral venous cannulation.
Physical examination of operated patients: physical examination of the abdomen, wound care, management of abdominal drainage
Basic knowledge of standard thoracic surgery steps
Clinical approach to patients suffering form lung cancers.
Clinical approach and physical examination to patients affected by renal pain (kidney ultrasound, interpretation of radiological exams, indications for surgical treatment), patients affected by hematuria (acute treatment with bladder irrigation, bladder and kidney ultrasound, diagnostic cystoscopy), patients with anuria and urinary retention
Assist and eventually perform the urethral catheterization.
Metodi didattici
Clerkship attendance and sufficient exposure to practice (i.e. simulation lab, formal patients examination at bedside, training of basic medical-surgical techniques etc.) will be registered, as clinical teaching will be based also on direct participation of the students to different aspects of the hospital life.
Materiale di riferimento
Smith & Tanagho's GENERAL UROLOGY, Jack W. McAninch & Tom F. Lue, 18th or 19th Edition
General surgery
Programma
Surgery
Clinical approach to surgical patient:
Operating Room Attendance: Surgical hand scrub, management of sterility during surgery. Assist to surgical incision and principles of hemostasis, wound suture, peripheral venous cannulation.
Physical examination of operated patients: physical examination of the abdomen, wound care, management of abdominal drainage
Clinical approach to surgical patient:
Operating Room Attendance: Surgical hand scrub, management of sterility during surgery. Assist to surgical incision and principles of hemostasis, wound suture, peripheral venous cannulation.
Physical examination of operated patients: physical examination of the abdomen, wound care, management of abdominal drainage
Metodi didattici
Clerkship attendance and sufficient exposure to practice (i.e. simulation lab, formal patients examination at bedside, training of basic medical-surgical techniques etc.) will be registered, as clinical teaching will be based also on direct participation of the students to different aspects of the hospital life.
Materiale di riferimento
Sabiston's Textbook of Surgery.- The Biological Basis of Modern Surgical Practice. 20th Edition Elsevier 2017
Additional material is provided by the slide-presentation used during frontal lessons and seminars, uploaded in the Ariel platform of the University for student access.
Additional material is provided by the slide-presentation used during frontal lessons and seminars, uploaded in the Ariel platform of the University for student access.
Moduli o unità didattiche
General surgery
MED/18 - CHIRURGIA GENERALE - CFU: 2
Clerkship (att.prof.): 50 ore
Docente:
Mazzaferro Vincenzo Maria
Internal medicine
MED/09 - MEDICINA INTERNA - CFU: 1
Clerkship (att.prof.): 25 ore
Docenti:
Aversano Maria Gloria, Santelia Alfonso
Thoracic surgery
MED/21 - CHIRURGIA TORACICA - CFU: 1
Clerkship (att.prof.): 25 ore
Docente:
Spaggiari Lorenzo
Urology
MED/24 - UROLOGIA - CFU: 1
Clerkship (att.prof.): 25 ore
Docenti:
Albo Giancarlo, Montanari Emanuele
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