Chc study guide 2012 2013

INTRODUCTION TO COMPREHENSIVE HEALTH CARE MODULE

MEDICINE & SOCIETY II B

COMPREHENSIVE HEALTH CARE MODULE (FFFF2622)

I. DIRECTORY OF TEACHING STAFF

NO. NAME OF LECTURERS/TUTORS TEL NO. E-MAIL

A. Department of Family Medicine

1. Dr Rashidi Mohd Pakri 012-3945786 [email protected]

2. Dr Hizlinda Tohid 019-2222109 [email protected]

3. Dr Aida Jaffar 9145 6126 [email protected]

4. Dr Tan Chai Eng (Module Coordinator) 9145 6126 012-3343145

[email protected]

5. Dr Saharuddin Ahmad 012-3838204 [email protected]

6. Dr Mohd Fairuz Ali 9145 6116 [email protected]

7. Dr Zuhra Hamzah 9145 6124 [email protected]

8. Dr Syahnaz Mohd Hashim 9145 6124 [email protected]

9. Dr Noorlaili Mohd Tauhid 9145 6120 [email protected]

B. Faculty of Pharmacy

1. Dr Noraida Mohamed Shah9289 8038

[email protected]

2. Puan Siti Azdiah Abd Aziz 9289 7964 [email protected]

3. Dr Adyani Md Redzuan 9289 7987 [email protected]

4. Cik Adliah Mohd Ali 9289 7964 [email protected]

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mailto:[email protected]

C. Department of Nursing

1. Puan Gurbinder Kaur a/p Jit Singh 9145 6254 [email protected]

2. Cik Hasnah Yahaya 9145 6261 [email protected]

3. En. Che Salim Sulaiman 9145 6260 [email protected]

4. Puan Nour Dhiaeyah Supuan Zaki9145 6266

[email protected]

D. Department of Parasitology

1. Dr ‘Azlin Muhammad @ Mohd Yassin 9289 7229 [email protected]

2. Dr. Aishah Hani Bt Azil 9289 7209 [email protected]

E. Department of Community Health

1. Prof Madya Dr Azmi Mohd Tamil 9145 5890 [email protected]

2. Dr Azmawati Mohammad Nawi 9145 6404 [email protected]

3. Dr Jamsiah Mustafa 9145 5906 [email protected]

4. Dr Ahmad Taufik Jamil 9145 5888 [email protected]

E. Department of Medical Education

1. Dr Mohd Arif Kamaruddin 9145 6241 [email protected]

2. Dr Mohd Nasri Awang Besar 9145 6241 [email protected]

3. Dr Md Nurman 019-2272269

[email protected]

4. Pn Siti Mariam Bujang 013-3335233

[email protected]

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II.

This module is aimed to introduce the concept of comprehensive health care according to the modern medical principle. It includes the principle of solving health problems at the individual, family and community level. The module discusses the holistic approach in patient management. It also emphasizes on the concept of patient, family and community interactions from the aspect of health. The students will be exposed to the needs of patient with chronic diseases and how it is assessed and managed comprehensively. Functions of health organizations and health facilities at various levels in the community are also discussed.

PRE-REQUISITES

The students should have prior knowledge of

1. Medicine & Society I

2. Medicine & Society IIA

III. MODULE OBJECTIVES

This is a 2 credit module (80 hours of students learning time) conducted throughout 16 weeks during semester 4 of the undergraduate medical program. Second year medical students and third year pharmacy students will participate in this module. Students will be divided into small groups consisting of 5 -6 students. Each small group will be assigned to a patient with chronic illness. Students are required to work as a team to:

1. Identify and describe the impact of the illness on the patient as well as on the family and community.

2. Identify their roles as health professionals in addressing the bio-psycho-social issues faced by the patient, from the aspect of health promotion, prevention, treatment and rehabilitation.

3. Identify relevant community and other facilities and services available for the patient.

4. Provide relevant advice to the patient regarding the use of these facilities and services.

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IV. METHODS OF ASSESSMENT

Continuous assessment based on

o Family Case Study Presentation (group work) 30%

o Family Case Study Report (group work) 30%

o Reflective writing (individual) 25%

o Peer Assessment 5%

o Facilitator’s Report 5%

o Attendance 5%

Total 100%

Note: Students are required to submit their Family Case Study Report (group work)

and reflective writing (individual) on-line by week 15 (10th May 2013 by 2400hrs). Please avoid sending in your assignments on the date line because your actions may “freeze” the system. (http://www.medicine.ukm.my/apps/e.learning)

Family Case Study Presentation, Family Case Study Report and reflective writing assignments are marked by the respective facilitators.

Satisfactory attendance is only considered when students attend at least 80% of all teaching-learning activities (Lectures, Small group discussions, Visits).

V. RESOURCE MATERIALS

1. Reagan, P.A. Brookins-Fisher, J. Community Health in the 21st Century. 2nd

Edition. San Francisco: Pearson Education, Inc; 2002.2. Phoon, W.O. Chen, P.C.Y. Textbook of Community Medicine in South East Asia.

Singapore: John Wiley & Sons; 1986.3. Mc Whitney, I. R. Freeman T. A Text Book of Family Medicine. 3rd ed. Oxford

University Press; 2009.4. Rakel, R.E. Text Book of Family Medicine. 7th ed. Philadelphia: Saunders; 2007.

5.

6.

Taylor, R. Fundamentals of Family Medicine: The Family Medicine Clerkship Textbook. 3rd ed. Springer Pub. Co; 2003.Unwin BK, Jerant AF. The Home Visit. American Family Physician. 1999; Vol 60: 1481-8.

VI. TEACHING-LEARNING TOPICS AND SPECIFIC OBJECTIVES

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Concept Lectures

At the end of the lectures, students should be able to:

L1&

L2.

Comprehensive Health Care I & II

describe characteristics of comprehensive health care at the individual, family and community level

describe the function of family and ‘at risk’ family describe various stages of disease prevention at the individual, family and

community level

L3. Family Case Study

approach and discuss the patient’s problems in a holistic manner identify and analyze the health problems in relation to the patient, family and

community appreciate that any health issues have an impact towards the patient, family and

community understand the management of relevant health problems by means of health

promotion, prevention, and appropriate treatment and rehabilitation measures with appropriate and effective use of resources

recognize the value of home visits in assisting health personnel to assess patient’s condition at home (e.g.: family dynamics, surroundings etc).

realize the importance of adopting a non-judgmental attitude and being sensitive to religious and cultural diversity as well as differing moral values and beliefs.

L4. Holistic Approach to Medicine

define the meaning of `holistic’ discuss the concept of `mind-body medicine’ recognize the importance of a holistic approach in patient care understand how to practice holistic patient care

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Small Group Discussion (SGD)

During the following SGDs, students should:

SGD 1 - Receive information regarding their assigned patients

- Learn how to organize a home visit and respective organizational visit.

- Plan their activities during each visit

SGD 2&3 - Update their facilitator and discuss the progress of their family case study

- Clarify particular issues or problems they are facing.

- Arrange corrective measures to overcome these problems

- Discuss with their facilitator regarding the family case study presentation.

SGD 4 - Present their Family Case Study

- Prepare their Family Case Study Report.

Visits

A. Home Visit

During the home visit, students should:

Evaluate holistically patient’s problems and status (e.g. health and functional) at home.

Evaluate patient’s home environment (e.g. physical conditions, social environment such as family dynamic, safety issues etc) and assess the impacts of this environment on his/her health and function.

Identify ‘at-risk’ patient (e.g. at-risk of abuse, neglect or social isolation). Identify potential home-based interventions that are suitable for the patient. Evaluate patient’s support system and functions of family members. Evaluate coping behavior of the patient and family members. Identify medical, psychosocial, environmental and financial problems faced by the

patient and family members. Identify impacts of patient’s illness on his/her own life, family and community Identify and promote disease prevention and health promotion to the patient and

family members. Plan appropriate management (e.g. treatment, rehabilitation measures etc) for the

patient, family members and community Demonstrate non-judgmental attitude and sensitivity to religious and cultural diversity

as well as differing moral values and beliefs.

B. Visit to relevant organizations that provide aftercare to the respective patient

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(where applicable)

identify appropriate resources (e.g. NGOs, facilities, programs etc) available for the patient in his/her community

identify the roles and functions of these resources incorporate the related community resources in the patient’s rehabilitation plan

Reflective Writing

Each student is required to write a reflection on:

Working together with other healthcare professionals in patient care

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STUDENT’S ASSIGNMENT

Format for Family Case Study Presentation(Duration of presentation: 15 – 20 minutes)

Title of Slides Description

1. Title slide Title of case studySGD group and name of members

2. Introduction Patient Demographic Data(Why do you think it is important to know about this case and to approach it in a holistic/ comprehensive manner?)

3. Clinical Summary Summary of the clinical history and physical findings from your own observation or clinical examination – please do not copy from the case note.(list it in chronological order)

4. Investigations List appropriate investigations and interpretation of the results.

5. Home Visit/Visit to relevant organization

Students are expected to synthesize important / relevant data from the home visit as well as visit to relevant organization and apply them appropriately into their case study in a holistic perspective for the patient’s overall care and quality of life.

6. Summary and Problem list Summary of the patient’s condition and “List of problems” (according to the bio-psycho-social model).

7. Management & Discussion Non-pharmacological and pharmacological management (short/long term)Multidisciplinary care and community resourcesImportant points of discussion

8. Reflection & Conclusion Conclusion and recommendations for further or better care (as appropriate).Add your reflection on how this Family Case Study can help you in the future, your learning issues, how would you deal with this patient differently.

9. References List them in UKM or Vancouver style.References should be the most recent available.

Additional instruction: Present using Microsoft Office PowerPoint. Discuss with facilitators as to what to present and flow of presentation. As the Family Case Study is a report of events that happened in the past, it should

be written in the past tense. Please ensure consistent formatting, line spacing and choice of fonts. Photos of the house, lesions/disease, and surroundings may help in your case

presentation. (Only with permission from the patients) Do ‘spelling and grammar’ check.

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Format for Family Case Report (3000 words, include relevant photos only)

SGD Group: Name of members:Facilitator’s name:

Demographic data

Date of clerking:Name: Registration No:Contact Address:Contact Number:Primary Care Giver details: (where applicable)

Title Description

1 Introduction Why do you think it is important to know about this case and to approach it in a holistic/ comprehensive manner?

2. Summary of clinical history and physical findings (from your own observation or clinical examination – please do not copy from the case notes).

(List in chronological order)

History: presenting complaint, history of present illness, systemic reviews.Past history: medical/surgical/obstetric historyMenstrual historyGrowth & developmental historyHistory of allergies:Drug history/medications (indications) - over the counter medication/prescribed drugs/street drugs etc.Smoking, Alcohol, Assessment of Risk behaviors.Social history& Financial historyDietary historyProgression of disease (as appropriate)Physical examination (with your interpretations of what abnormal findings means and its relevance)

3. Investigations: List of all appropriate investigations based on your own knowledge and clinical judgment (If results are available, state the dates when the tests were done, normal ranges and your interpretation of the results)

4. Home Visit/Visit to relevant organizationSynthesize important / relevant data from the home visit and visit to relevant organizations. Apply them appropriately into the case study in a holistic perspective for the patient’s overall care and quality of life.

Floor plan, neighborhood, exterior &interior of home ( crowding, housekeeping, homely environment, privacy)Water, electricity, sewage, air circulation, windows, toilets.Any animals or petsAssess to transportation (private or public)/ other basic amenities.

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Title Description

5. Summary and Problem list Summary of the patient’s condition and “List of problems” (according to the bio-psycho-social model).Impact of the disease

o On the patiento On the family o On the community

6. Management & Patient’s progress

Non-pharmacological and pharmacological treatment/managementMultidisciplinary care / role of other support groups / NGO’s.Long term management plans (as appropriate)Any recommendations specific to the disease (other drugs, simpler regimes, less costly alternatives, etc.).Disease related complicationsResponse to treatment or deterioration in clinical condition

7. Discussion Patient’s bio-psycho-social-spiritual issues/problemsImpact on the patient, family and community, and managementStudents should incorporate Evidence-based Medicine and cite the sources of information. Discuss these relevant to the case.

8. Conclusion Conclusion and recommendations for further or better care (as appropriate).Thoughts:Add your reflection on how this Family Case Study can help you in the future, your learning issues, how would you deal with this patient differently.

8. References List them in UKM or Vancouver style.References should be the most recent available.

Additional instruction:

As the Family Case Study is a report of events that happened in the past, it should be written in the past tense.

Assessment is based on the ability to identify the bio-psychosocial and spiritual issues of the patient and how it has impacted the patient, family and community.

Add photos of the house and surroundings (if possible and with permission of patient) Do NOT discuss medical information like a textbook. Do NOT cut and paste from

websites or reference materials. Please ensure consistent formatting, line spacing and choice of fonts. Do ‘spelling and grammar’ check.

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Vancouver style referencing

You may refer to the following website:

http://www.library.uq.edu.au/training/citation/vancouv.pdf

UKM style referencing

You may refer to the following website:

http://www.ukm.my/pps/pdf/Penulisan%20Gaya%20UKM.pdf

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http://www.ukm.my/pps/pdf/Penulisan%20Gaya%20UKM.pdf

http://www.library.uq.edu.au/training/citation/vancouv.pdf

Format for Reflective Writing:

REFLECTION

Please write the learning points (BASED ON THE PROVIDED THEMES) you have picked up during this session and relate it to the objectives of the Comprehensive Health Care Module. (300 – 500 words)

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Marks:……../ 10

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ASSESSMENT COMPONENTSFamily Case Study Evaluation Sheet

Case Presentation

SGD Rooms:

Name of Group:

(Please refer to the list of names provided)

Facilitator:

Date of Case Presentation:

Items Marks Marks allocated

Content

- holistic and comprehensive in approach

25

Style of presentation / Overall presentation

10

Group work( active participation of other group members)

5

Total 40

Facilitator’s comments:

Facilitator’s Signature:

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Family Case Study Evaluation Sheet

Case Report

SGD Rooms:

Name of Group:

Facilitator:

Date of Family Case Study Received:

Marks Marks allocated1. Introduction & Demographic Data 22. Clinical history & Physical Examination 103. Problem List / Diagnosis (bio-psycho-social

model)10

4. Patient’s progress / Discussion & Management 305. Conclusion 56. References/Lay out 3

TOTAL 60

Facilitator’s comments:

Facilitator’s Signature:

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Scoring System in Reflective writing

ELEMENT OF REFLECTION SCORE

Brief description of event

Time, place, location, who were involved (the job title, not the name of the person) 0-1

Attending to feeling (during the incident)

Explore your affective (feelings) reaction to the eventWhat were your concerns and thoughts at that time?

What do you think other people (friends, facilitator) felt at that time, and how do you know what they felt?

0-1

Critical analyses

Your thoughts, your assumptions, other people involved and the context (place, time, set-up)

0-3

Synthesis/Evaluation

Weighing up different interest, room for dilemma and uncertainties, evaluate own position and emancipation.

-What have you learnt from the event?How does this relate with your previous experiences?

In what ways do theories or underlying knowledge explain the situation?

0-3

Outcomes(learning needs, changed of perception, behavior or acquired new skill)

Given a similar situation in the future, how would you behave?Has this changed your way of practice?

What are your learning needs arising from this experience?What are your strategies to achieve those learning needs?

0-2

Total 10

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Peer Assessment

Student’s Name: Date:

Domains Overall rating

Item

Team work Able to establish a shared understanding among members.Actively participate in the activitiesDisplay individual accountability and responsibilityHandle conflicts in a positive mannerBeing supportive towards each other.

Communication Using terms or phrases that can be understood by all members ( no professional jargons)Actively participate in the discussion in a positive manner.

Task management

Participate actively in planning and preparation in a positive mannerAble to complete the assigned task within the time frame and standards.

Leadership Able to display good leadership skills.Professional Attitudes

Display punctuality.Being proactive and motivated.

Knowledge Able to gather relevant information required.Able to understand and interpret information gathered.Able to approach the case discussed in a comprehensive manner.Able to anticipate future requirements or demands relevant to the case discussed.Able to offer other options or new ideas relevant to the case discussed.

Standard: The standard should be judged against the standard expected at completion of the stage of training based on the program objectives or outcomes.

***Rating scale:1- Very Poor; 2- Poor; 3- Average; 4-Good; 5- Excellent ;

1- Very Poor: Performance potentially effects patient safety and quality care. Serious intervention plan and action is needed

2- Poor: Performance indicated cause of concern, consider further improvement plan and action is needed.

3- Average: Performance was of a satisfactory standard but could be improved.4- Good: Performance was consistent and at good standards, enhancing patient’s safety

and quality care.5- Excellent: Performance was consistent and at high standards, enhancing patient’s safety

and quality care. It could be a positive reference for others.

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Facilitator’s Report

Student’s Name:

Domains Overall rating

Item

Team work Able to establish a shared understanding among members.Actively participate in the activitiesDisplay individual accountability and responsibilityHandle conflicts in a positive mannerBeing supportive towards each other.

Communication Using terms or phrases that can be understood by all members ( no professional jargons)Actively participate in the discussion in a positive manner.

Task management

Participate actively in planning and preparation in a positive mannerAble to complete the assigned task within the time frame and standards.

Leadership Able to display good leadership skills.Professional Attitudes

Display punctuality.Being proactive and motivated.

Knowledge Able to gather relevant information required.Able to understand and interpret information gathered.Able to approach the case discussed in a comprehensive manner.Able to anticipate future requirements or demands relevant to the case discussed.Able to offer other options or new ideas relevant to the case discussed.

Standard: The standard should be judged against the standard expected at completion of the stage of training based on the program objectives or outcomes.

***Rating scale:1- Very Poor; 2- Poor; 3- Average; 4-Good; 5- Excellent ;

1- Very Poor; Performance potentially effects patient safety and quality care. Serious intervention plan and action is needed

2- Poor; Performance indicated cause of concern, consider further improvement plan and action is needed.

3- Average; Performance was of a satisfactory standard but could be improved.4- Good; Performance was consistent and at good standards, enhancing patient’s safety

and quality care.5- Excellent. Performance was consistent and at high standards, enhancing patient’s safety

and quality care. It could be a positive reference for others.

Facilitator’s Name & Signature :

Date:

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Chc study guide 2012 2013

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