Post Basic BSc in

Anaesthesia Curriculum

7/9/2019
Background and Rationale

Anesthesiology as a branch of medical practice represents a unique, exciting, specialized, and

challenging art and science that deals with perioperative and ICU management of a surgical and/or
medical patient. Moreover, it also plays a role in promotional and curative services at community level.
As a young and dynamic profession, it requires keeping abreast of evolving changes. The recent
innovations in educational techniques, frequent changes and new developments in anesthesia on the
wide spectrum of services require professional graduates to be more of task-oriented.

Anesthesia training for non-physicians in Ethiopia started in the mid-1970s in Addis Ababa in
previous Duke of Harar Memorial Hospital currently Tikur Anbessa Specialized Hospital. Since that
time, anesthesia training has developed from advanced diploma level to BSc and MSc levels gradually.
Initially, the BSc in Anesthesia enrolled practicing nurses and more recently, a ‘generic’ BSc in
Anesthesia has been developed to train anesthesia practitioners straight from leaving school, without
the requirement of previous clinical experience. This ‘generic’ BSc in Anesthesia was first started in
University of Gondar in 2003 and is taught in more than a dozen of governmental Universities since
2004. Currently, in Ethiopia, anesthesia is predominantly provided by non-physician anesthetists as
there is a shortage of physician anesthesiologists.
As stated in HDP IV, there is a significant un-met need for qualified anesthesia professionals,
especially when considering the long lead time and limited involvement of the private sector in training
these professionals. Moreover, the lack of retention mechanism for mid-level anesthesia professionals
(Level V and diploma graduates) worsened the task force crisis. Though it’s known that few
institutions started post basic anesthesia training to solve these problems, all have been following
different curricula with different duration of trainings to award similar BSc degree. Cognizant this, the
Federal Ministry of Health took the initiative to produce a competency based harmonized, integrated
and modular curriculum at bachelor degree level to train Anesthetists as post-basic program in 2015.
The whole endeavor is directed towards examining if the objectives of the program are attainable,
clear and appropriate to the courses offered and are capable of producing the desired type and level
of competencies. Besides, this curriculum review aimed at assuring that the anesthesia service needs
of the country are satisfied through the production of qualified anesthetists who can manage all new
techniques for all general and specialty surgeries encompassed under the scope of these professionals.
Post-basic Anesthesia education has the study of general education courses from natural, social
sciences as well as basic courses from the biomedical sciences and moreover will enforce general

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nursing care courses in an integrated fashion. Anesthesia professional courses assist the attainment of
knowledge and skills and the development of attitudes and values essential to competent clinical
anesthesia practice and beginning professional leadership through extensive lab practice and clinical
field experience as well as evidenced based theory. The goal of this particular program is to prepare a
competent Anesthesia professional and to provide a foundation for under graduate education
programs in Post Basic BSc Anesthesia.

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Acknowledgment

This curriculum was developed by the Federal Ministry of Health (FMOH) in collaboration with
Federal Ministry of Education, the Education Sector Ethiopian Public Higher Educational
Institutions, Education Strategic Center, and the Strengthening Human Resources for Health Project-
Jhpiego.
The members of the task force who developed the curriculum are the following: Lidya Tesfaye
(FMOH), Aselef Tasew (FMoSHE),Tesfaye Negewo (HESC), Leulayehu Akalu (EAA), Yohannes
Molla (Jhpiego), Eyayalem Melese (Addis Ababa U), Wosenyeleh Admasu (Addis Ababa U), Ashenafi
Seifu (Harare HSC), Moges Gelaw (Debretabor U.), Simegnew Kibret (Debretabor U.), Amare
Hailekiros (University of Gondar), Tadesse Belayneh (University of Gondar) , Girmay Fitiwi
(University of Gondar), Habtamu Getnet(University of Gondar) , Yophtahe woldegerima (University
of Gondar), Sileshi Abiy(Dilla U.) , Nugusu Ayalew (Dilla U.), Hailemariam Mulugeta, (Dilla U.),
Haftom Berhane (Mekele U), kore Menjie (Mekele U.).Bacha Abera (Aksum U.), Sualih Mohammed
(Wollo University), KokebDesta (Debreberhane University), Abdulrehman Tune (Arsi U), Negeso
Gobena (Hawassa University) ,Dawit Tesfaye (Dire Dawa University), Alazar Kefyalew (Arbaminich
University), AbuluTesfa (Jimma University), Berhanu Mengestu (Jimma University), Bedilu Girma
(Wolaita Sodo U.), Getahun Dendir (Wolaita Sodo U.), Tesfaye Dadi (Koteb Metropolitian U), Merga
Haile (Ambo university), Gebrehiwot Asfaw (Baherdar U), Fentahun Tarekegn (Baherdar U).

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Acronym & Abbreviation

ACLS: Advanced Cardiac Life Support

BLS: Basic Life Support
CGPA: Cumulative Grade Point Average
COC: Certificate of Competence
Docs: Directly Observed Clinical Skill
ECIP: Emergency & Critically Ill Patient
ECTS: European Credit Transfer System
EDHS: Ethiopia Demography and Health Survey
ER: Emergency Room
ETCO2: End Tidal Carbon Dioxide
Etcts: Ethiopian Credit Transfer System
FMOH: Federal Ministry of Health
HC: Health Centers
HIV: Human Immunodeficiency Virus
HSDP: Health Sector Development Plan
ICU: Intensive Care Unit (ICU)
IPD: Inpatient Department
MDG: Millennium Development Goal
MV: Mechanical Ventilator/ Ventilation
OPD: Outpatient Department
OR: Operation Room
OSCE: Objectively Structured Clinical Examination
OSPE: Objectively Structured Practical Examination
PACU: Post Anesthesia Care Unit
RR: Recovery Room
SDL: Skill Development Lab
SPH: Social and Public Health
TTP: Team Training Program
TVET: Technical and Vocational Education & Training
FMOSHE: Federal Ministry of Science & Higher Education

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Table of Contents
Background and Rationale ..............................................................................................................................1
Acknowledgment ..............................................................................................................................................3
Acronym & Abbreviation ................................................................................................................................4
Mission and Objectives of the Program.......................................................................................................8
Mission ................................................................................................................................................................. 8
Objectives............................................................................................................................................................ 8
The Post Basic Anesthesia Curriculum Graduates Competencies........................................................ 9
Social, epidemiologic & cultural context of Surgery & Anesthesia ........................................................ 9
Anesthesia clinical care provision/ Anesthesia professional .................................................................. 10
Interpersonal relationship and communication ........................................................................................ 18
Organizational management & leadership ........................................................................................... 19
Research, educational & professional development .......................................................................... 20
Professional, legal & ethical practice ..................................................................................................... 21
Curricular Model, Approach and Delivery strategy............................................................................... 23
Student-centered ....................................................................................................................................... 23
Integration ......................................................................................................................................................... 23
Community Based Education ........................................................................................................................ 24
Systematic and planned learning .................................................................................................................. 24
Teaching and Learning Methods ................................................................................................................. 24
Assessment Methods .................................................................................................................................... 28
Program Requirement for Post Basic Anesthesia professional ........................................................... 32
Admission Requirement .......................................................................................................................... 32
Graduation Requirement......................................................................................................................... 32
Grading & Promotion ................................................................................................................................... 34
Requirement for promotion ....................................................................................................................... 34
Degree Nomenclature.................................................................................................................................. 35
Quality Improvement, Monitoring and Evaluation ................................................................................. 35
Program Structure, Composition and Duration ..................................................................................... 36
Modules Composition & Duration of Training ....................................................................................... 38
Year I Modules Syllabi: I ............................................................................................................................... 40
Communication Skills ............................................................................................................................... 41

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 Civics & Ethical Education ....................................................................................................................... 46
Computer Application in Health Science ............................................................................................ 51
Introduction to Anesthesia I ................................................................................................................... 55
Body Fluids, Blood Cells, Immunology and Hemostasis ................................................................... 74
Respiratory System ................................................................................................................................... 79
Cardiovascular and Lymphatic System ................................................................................................. 84
Genitourinary System............................................................................................................................... 91
Endocrine System ...................................................................................................................................... 97
Nervous System ...................................................................................................................................... 103
Year I Modules Syllabi: II ............................................................................................................................ 111
Basic Writing Skills.................................................................................................................................. 112
Gastrointestinal System ......................................................................................................................... 118
Musculoskeletal and Integumentary System ...................................................................................... 124
Introduction to Anesthesia II................................................................................................................ 130
Physical diagnosis ..................................................................................................................................... 141
Diagnostic modalities ............................................................................................................................. 145
Determinants of Health ......................................................................................................................... 150
Basics of Anesthesia I ............................................................................................................................. 158
Year II modules ............................................................................................................................................ 173
Basics of anesthesia II ............................................................................................................................. 174
Anesthesia for General surgery and Thoracic emergency surgery module .............................. 194
Measurement of Health and Disease .................................................................................................. 206
Regional Anesthesia and Pain Management Module ........................................................................ 213
Obstetric and Gynecological Anesthesia ........................................................................................... 227
Anesthesia for Coexisting diseases ..................................................................................................... 239
Health Promotion and Disease Prevention ....................................................................................... 248
Community-Based Training Program (CBTP) Syllabus ................................................................... 260
Year III modules ........................................................................................................................................... 278
Anesthesia for Trauma, Burn and Orthopedic Surgeries:.............................................................. 279
Critical care .............................................................................................................................................. 296
Geriatrics Anesthesia ............................................................................................................................. 317
Anesthesia for Neonatal and Pediatrics surgeries ........................................................................... 331

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 Research Methodology .......................................................................................................................... 351
ENT, Maxillofacial, Ophthalmic and Day Case Anesthesia ............................................................ 357
Remote anesthesia .................................................................................................................................. 370
Leadership and management ................................................................................................................ 382
Neurosurgery Anesthesia module ...................................................................................................... 391
Team Training Program ......................................................................................................................... 402
Student Research project/paper .......................................................................................................... 407
Annex 01:- Assessment tools ................................................................................................................... 409
Direct observed procedure (DOP) .................................................................................................... 409
Practical clinical evaluation (PCE) ........................................................................................................ 410
Case based discussion (CBD) ............................................................................................................... 412

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Mission and Objectives of the Program
Mission

To produce competent Post Basic Anesthesia professionals who will provide the full scope of
Anesthesia Service, as defined by the professional scope of practice, with good knowledge, clinical
skills, Attitude and critical thinking abilities.

Objectives

 To equip post Basic Anesthesia professionals with solid knowledge of biomedical science, clinical
and public health practice
 Prepare post basic anesthesia students to assess and optimize patients with co morbidity for
surgery and anesthesia
 Prepare post basic Anesthesia students in providing individualized anesthesia clinical care using
anesthesia management plan.
 Equip post basic anesthesia students on the management of patients with multiple Co-existing
diseases using the existing scientific knowledge
 To enable post basic anesthesia students practice in a professional manner on all level of anesthesia
clinical care setting
 Train Post basic anesthesia student in developing professional communication skill in dealing with
patients family and other health professionals
 Prepare the post basic Anesthesia students participate in conducting and utilizing relevant research
findings
 Train post basic anesthesia students apply evidence based Anesthesia clinical care practice
 Train the post basic anesthesia student in practical skills based on theoretical foundation
 Equip the post basic anesthesia students with leadership and management skills
 Equip post basic anesthesia students with critical thinking and decision-making skills which lead
to reflective and responsible practice
 Equip with basic knowledge and skill in emergency and critical care which help them to handle
critically ill patients

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The Post Basic Anesthesia Curriculum Graduates Competencies

After critical review of existing local and international documents on learning outcomes & scope of
practices, the core (essential) competencies Post Basic Anesthesia students must demonstrate at the
point of graduation are defined. The core competencies are organized in six domains or thematic
areas:
 Social, epidemiologic and cultural context of Surgery & Anesthesia
 Anesthesia clinical care provision /Medical expert
 Interpersonal relationship and communication
 Organizational management & leadership
 Research, educational & professional development
 Professional, legal & ethical practice

Social, epidemiologic & cultural context of Surgery & Anesthesia

Competency: Post Basic Anesthesia professionals apply the knowledge and skills from Basic science,
the social sciences, public health and ethics that form the basis of high quality anesthesia clinical care.
The post basic anesthesia professional demonstrates competence in the domain of the social,
epidemiological & cultural context when s/he:
 Develops an epidemiological profile concerning the incidence, prevalence, morbidity and
mortality of life threatening conditions in order to practice evidence based assessment
 Establishes priorities in relation to the problems according to severity as determined by the
complexity and multiplicity of problems including the life threat and impingement on the
patient’s quality of life.
 Creates anesthesia practice environment that reduces environmental risks for surgical team
members and health care users including families, for example, reduced risk for transmission
of infections
 Assesses Anesthesia practice environment for risks such as air quality, cylinder & machine
leakage, noise, odor, obstacles like cords, temperature, and light that negatively affect clients
& staff
 Takes action to prevent or report a hostile work environment
 Undertakes timeout and appropriate conflict resolution among staff and various disciplines

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  Assists the health care user including the family to make informed choices in relation to
treatment options, alternatives, risks, benefits and costs for treatment and care according to
acceptable performance standard
 Treats colleagues with respect, trust and dignity including recognition and utilization of their
potential
 Promotes the anaesthesia profession by interpreting its role for the health care users, families
and the profession as a whole.
 Models expert practice to anaesthesia profession
 Introduces, evaluates and manages innovation and change in the Operating room setting
through encouraging creativity
 Participate in health promotion and disease prevention activities
 Apply principles of community-based primary care using health promotion and disease
prevention and control strategies
 Apply methodology for conducting death review and near miss audits
 Conduct health education discussions with and for clients requiring anaesthesia and their
families

Anesthesia clinical care provision/ Anesthesia professional

Competency: Post basic Anesthesia professional applied direct interaction with patients, families and
groups of patients to promote health or well-being and improve quality of life. These interactions are
characterized by a holistic perspective in the anesthesia management of different surgical cases, illness
and disease states. The post basic anesthesia professional demonstrates competence in the domain of
the anesthesia clinical care provision when s/he:
A. Preparation and optimization of patients for theatre & patient safety;
 Assess patient/ client of any age group presenting for anesthesia/ analgesia,
 Optimize patients for surgery preoperatively,
 Analyzes legal issues surrounding informed consent for anesthesia and surgery,
 Analyzes the assessment, significance, and limitations of the ASA score,
 Aware of anesthetic factors in the pre-operative clinical assessment of patients,
 Applies principles of airway assessment to predict potentially difficult intubation and/ or
ventilation,

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  State fasting guidelines and clinical aspects of fasting,
 Analyzes the anesthetic consequences of morbidities,
 Explains the significance of pre-operative investigations, & can demonstrate a basic level of
interpretation (e.g. ECG, Echocardiography, organ function tests, other laboratory tests, X-
ray films and etc.),
 Apply principles of premedication and preoperative therapy,
 Explain regional techniques and local blocks, possible side effects and complications to
patients preoperatively,
 Able to complete routine pre-operative WHO surgical safety checklist,
 Assess and plan safe perioperative anesthetic care,
 Maintain patient’s comfort and dignity throughout the perioperative period,
 Recognizes signs of anxiety, their effects on anesthesia and offers reassurance,
 Follows standard precautions for known or suspected infection risks (e.g. HIV / Hepatitis B
/ serious or resistant organism infection),
 Protect patients from iatrogenic complications,
B. Care of anesthetic machine, monitoring, related equipment & drugs
 Sets up anesthesia machine, check it, pass it as safe to use and record this information
appropriately (includes routine between-case checks),
 Explains the safety features of the anesthetic machine,
 Identifies common breathing systems, state their Mapleson classification and their functional
characteristics, check them and pass them as safe to use,
 Analyzes purpose and features of an anesthetic machine,
 Safely handles and stores gas cylinders,
 Identifies and corrects anesthesia machine problems which may occur during use,
 Demonstrates ability to correctly apply standard patient monitoring routinely & interpret data
obtained from them for clinical decision making,
 Applies electrical safety precautions,
 Implement safety measures required during surgical use of lasers or x-ray equipment,
 Systematically introduce and care for new anesthetic equipment,

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  Implement standard precautions for infection control during the handling of anesthesia
equipment,
 Identifies and manages faulty or broken equipment,
 Explains the principles associated with train-of-four NMJ assessment,
 Sets up and applies train-of-four stimulator,
 Explains principles of nerve stimulation during local anesthesia,
 Explains anesthetic aspects of pacemakers and implantable cardiac defibrillators (ICD),
 Prepares, applies and monitors arterial tourniquet equipment,
 Sets up and prepares equipment for target controlled infusion (as infusion pumps or PCA),
 Adheres to approved policies for the secure storage and management of medicines, including
controlled drugs,
 Maintains clear, accurate and complete records of drug use,
 Calculates dosages and concentrations appropriate for clinical use,
 Understands the clinical indications, storage requirements, clinical preparation, labelling and
disposal requirements of drugs relevant to anesthetic clinical practice,
 Sets up equipment to deliver nebulized drugs,
C. Post-anesthesia care
 Handovers a patient in recovery, summarizing relevant clinical features of the patient’s pre-
and intraoperative care,
 Systematically assesses a patient in recovery using the ABC headings and appropriate
monitoring,
 Assesses & successfully manage post-operative pain,
 Assesses & manage post-operative nausea and vomiting,
 Understands the important conditions which must be met before a patient can be discharged
on the day of anaesthesia,
 Maintains airway patency using either maneuvers and/or adjuvants,
 Applies effective communication skills in order to promote clinically effective patient care,
 Establishes and maintain effective, professional relationships with patients and staff in all
disciplines,
 Explain patient admission and discharge criteria to and from PACU,

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  Support & promote clinical effectiveness by developing an evidence-based approach to
postoperative care,
 Understands how to recognize a critical incident or near miss and follow local and national
reporting mechanisms,
 Demonstrates and promote the delivery of recovery care within a professional, ethical & legal
framework,
 Assess conscious level in the postoperative patient and take appropriate action,
 Performs charting of physiological data and describes patient's clinical status appropriately to
other staff members,
 Can manage patients with central neuraxial and peripheral nerve block
D. Emergency and critical care
 Recognize & assess the critically ill patient systematically following ABCDE approach,
 Implement the principles of managing the shocked patient,
 Manages cyanosis, stridor/ laryngeal spasm, bronchospasm and cardiac dysrhythmias,
 Participate in development and implement local protocol for management of sudden life-
threatening illness
 Recognize pathophysiology of malignant hyperthermia (MH) including management of
patient with proven MH susceptibility,
 Perform basic and advanced cardiac life support,
 Perform needle/ cannula thoracocenthesis to manage emergency pneumothorax,
 Perform cannula cricothyrodotomy as part of difficult airway management plan
E. Provision of Obstetrics anesthesia
 Demonstrates awareness of physiological effects of pregnancy and labor,
 Assess a women with normal pregnancy or with factors complicating pregnancy,
 Administers aspiration prophylaxis (including techniques) & drugs acting on the uterus for
pregnant patient,
 Assess, prepare and consent obstetrics clients including discussion of GA versus regional,
 Provide information about analgesia and anesthesia to pregnant women, with or without
complicating factors, to anesthesia and other professional groups,
 Provide anesthesia/ analgesia for instrumental delivery,

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  Provide spinal anesthesia for caesarean section, and other operative deliveries,
 Manage complications of regional block and of failure to achieve adequate block,
 Administer safe anesthesia for non-obstetric procedures during pregnancy,
 Provide general anesthesia for caesarean section using rapid sequence induction,
 Administer anesthesia for other obstetric interventions such as cervical suture insertion,
management of 3rd and 4th degree tears, evacuation of vulval hematoma & manual removal
of placenta
 Manage post-delivery pain,
 Manage post-dural puncture headache (PDPH),
 Participate in high dependency care of obstetric patients,
 Optimize the ‘at risk’ baby,
 Provide neonatal resuscitation services for a needy newborn,
 Manage obstetrics emergencies including difficult or failed intubation, major hemorrhage
(APH & PPH), dilutional coagulopathy, amniotic fluid embolus, total spinal, pre-eclampsia,
eclampsia and HELLP syndrome,
 Recognize patients in whom neuraxial anaesthesia is contraindicated or inappropriate,
 Provide combined general and regional anaesthesia,\Recognize and manage adverse effects of
regional anaesthesia,
F. Provision of ENT & Maxillofacial surgery anesthesia
 Explain the aesthetic management of the shared airway including the surgical use of lasers,
 Administer anaesthesia for tracheostomy, including the use of cuffed / un-cuffed
tracheostomy tubes,
 Can set up equipment & administer anaesthesia for minor laryngeal surgery (laryngoscopy &
biopsy),
 Explain anaesthetic aspects of middle-ear surgery,
 Demonstrate anaesthetic management principles for facial injury surgery,
 Administer general anaesthesia in adults and children for ophthalmic surgery,
 Weigh up the relative merits of local versus general anaesthesia for individual ophthalmic
procedures,
G. Provision of Neurosurgery anesthesia

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  Participates in the management of raised intracranial pressure and manipulation of cerebral
perfusion pressure,
 Participates in the cerebral protection and prevention of cerebral ischemia/secondary brain
injury,
 Administer anaesthesia for to intracranial surgery
 Explain anaesthetic issues relevant to intracranial surgery,
H. Provision of Paediatrics and neonatal anaesthesia
 Understands paediatric aspects of airway management,
 Select appropriate equipment (airway and others) for paediatrics,
 Explains paediatric aspects of anaesthetic machine, the principles of use of the Ayre’s T-Piece,
the features of, and principles of use of paediatric ventilators,
 Explains paediatric aspects of monitoring,
 Communicate effectively with children, parents or carers,
 Secure venous access (including local anaesthesia premedication) and interosseous cannulation
in paediatric patients,
Apply principles of anaesthetic management of the child with a full stomach,
 Demonstrate induction of anaesthesia using inhalational or intravenous techniques & maintain
anaesthesia for children of any age,
 Management of fluids, glucose, electrolytes and temperature preoperatively, Manage
extubation,
 Apply sedation techniques for diagnostic and therapeutic procedures,
 Manage and stabilize a child following trauma,
 Manage pain in children; including the use of local and regional anaesthetic techniques
(including caudal), the use of simple analgesics, NSAIDs and opioids,
 Manage anaesthetic emergencies in children: acute airway obstruction, including croup and
acute epiglottitis, loss of airway, laryngospasm, failed venous access, suxamethonium apnea
and anaphylaxis,
 Provide paediatric resuscitation services,
I. Provision of Trauma and orthopedic anesthesia
 Assess and manage trauma patient immediately using the primary and secondary surveys,

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  Apply trauma scoring systems to prioritize care,
 Apply principles of resuscitation (based on ATLS),
 Teach other members of the trauma team and more junior anesthetists on the necessary
knowledge and skills required,
 Assess airway of patients with neck pathology,
 Care and immobilize cervical spine,
 Relief tension pneumothorax on emergency by performing using needle thoracocenthesis,
 Recognize and manage haemorrhagic shock & associated coagulopathy,
 Use Glasgow coma scale to determine level of consciousness of patients,
 Recognize the need for appropriate investigations (such as Hb, cross-match, chest X-ray),
 Administer appropriate analgesia for a trauma victim,
 Apply non-surgical management of head trauma patients, the resuscitation of patients with
decreased conscious levels secondary to injury,
 Resuscitate and manage burns early including maintenance of temperature,
 Recognize and treat airway problems in relation to burns,
 Administer analgesia for the burned patient,
 Assess and optimize high-risk patients for trauma surgery preoperatively,
 Provide safe anaesthesia for emergency/ elective orthopaedic surgery including multiple
trauma,
 Safely position patient (including prone and lateral positions) for orthopaedic surgery,
 Demonstrate safe application and use of tourniquets correctly,
 Apply principles of spinal techniques for orthopaedic procedures,
J. Provision of Pain management & regional anesthesia
 Assess and manage acute pain: post-operative and post-traumatic,
 Monitor acute pain and pain relieving methods,
 Demonstrate the use of simple analgesics: Paracetamol, NSAIDs,
 Demonstrate the use of opioids: intramuscular, intravenous, intrathecal,
 Demonstrate effective use of both regular and ‘as required’ medications for any age group,
 Explain of analgesic methods; oral, sublingual, subcutaneous, IM, IV, inhalational analgesia,
possible side effects and complications,

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  Assess and manage side effects of pain relieving medication and procedures,
 Demonstrate basic assessment of patients with chronic pain,
 Recognize neuropathic pain,
 Demonstrate effective communication in management of pain and work as a part of a
multidisciplinary team,
 Recognize patients in whom regional techniques are contra-indicated or inappropriate,
 Perform peripheral nerve blocks for emergency, intra-operative and postoperative pain
management,
 Demonstrate practical use of a nerve stimulator,
 Perform nerve blocks at the elbow and wrist,
 Perform combined general and regional anaesthesia,
 Manage patients who have had regional blocks on postoperative periods,
 Describes detailed management of patient with local anaesthetic toxicity,
 Apply audit to pain management
K. Provision of General surgery, urology and emergency thoracic surgery anesthesia
 Perform preoperative assessment of patient undergoing major surgery,
 Perform preoperative assessment of emergency surgical patient,
 Perform preoperative assessment of patients with multiple co-existing diseases,
 Optimize high-risk patients preoperatively by taking appropriate time for resuscitation,
 Use of vasoactive agents appropriately,
 Appropriate use sedation techniques,
 Techniques of providing one-lung anaesthesia (patient- or manikin-based),
 Present a balanced judgment to the patient and their relatives on the perceived risks and
complications of anaesthesia and surgery,
 Recognize problems posed by sepsis,
 The resuscitation of patients of all ASA grades for elective and emergency surgery and
intraoperative critical care management,
 Provide effective postoperative analgesia,
 Perform caudal block,
 Perform TAP block,

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  Perform abdominal field blocks
 Perform penile block,
 Assess surgical patients for recognition of need for higher level care postoperatively,
 Coordinate with other professionals within a team to enable efficient and coordinated
treatment

Interpersonal relationship and communication

Competency: The post basic anesthetist collaborates at an advanced level by committing to authentic
engagement and constructive patient, family, system, and population-focused problem-solving. The
post basic anesthesia professional demonstrates competence in the domain of the interpersonal
relationship & communication when s/he:
 Participate in discussion with patient family and surgical care team for patient management
 Uses skilled communication to foster true inter and intra-professional collaboration in the
interest of continuity of patient care and professional development
 Establishes and enforces channels of communication (written and verbal) within the facility
structures
 Communicates effectively and timely within the surgical team in relation to consultation and
referral of complex problems or deterioration in the patient’s status
 Role models for and encourages staff on therapeutic communication especially in relation to
patients with compromised communication ability in a highly technological environment, for
example, making time to communicate with patients and families (availability), active listening,
being sensitive to cultural diversity, ensuring privacy, assurance of confidentiality, paying
attention to non-verbal cues, etc.
 Communicates effectively with surgical and critically ill patients whose communication skills
are compromised from intubation, sedation and loss of consciousness from the disease
process employing verbal and non-verbal communication Communicates with the surgical/
critically ill patient irrespective of the level of consciousness to explain and orientate the patient
on all interventions carried out based on the assumption that hearing is the last sense to die
 Advocates for the patient in relation to difficult decision making for patients with poor
prognosis

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  Communicates with the family of the surgical/ critically ill patient to orientate them about the
anaesthesia interventions, technology and the patient status especially when there is a change
in the patient status and to foster smooth transition of the patient across the surgical setting.
 Establishes trust in the critically ill patients and families through constant availability, listening,
giving honest answers, non-judgmental attitude, etc.
Organizational management & leadership
Competency: The post basic anesthesia graduate manages change and empower others to influence
anesthesia clinical practice and political processes both within and across systems. The anesthesia
professional demonstrates competence in the domain of the organizational management & leadership
when s/he:
 Engages staff and the organization to incorporate performance improvement, quality and
safety initiatives into practice,
 Ensures constant availability of adequate, operational, cost effective, safe and efficient
equipment and technology for the care of anesthesia clinical care,
 Ensures availability of back up airway, oxygenation and hemodynamic management,
 Designs evaluation strategies to demonstrate cost effectiveness, cost benefit and efficiency
(fitness
 for purpose) factors associated with anesthesia clinical care practice,
 Considers fiscal and budgetary implications in decision making related to practice and practice
modifications, for example:
 Evaluates the use of products and services for appropriateness and cost/benefit in meeting
anesthesia clinical care needs,
 Conducts cost/benefit analysis of new anesthesia clinical care technology
 Evaluates the impact of introducing or withdrawal of products, services and technologies,
 Engages in commissioning of anesthesia clinical care unit with confidence based on sound
knowledge of the needs and resource requirements of an OR & other anesthesia related
setting,
 Ensures adequate coverage of all shifts with appropriately qualified anesthesia professional
staff with the organizational policies, guidelines and norms,
 Assigns aspects of anesthesia clinical care based on a careful assessment of the needs and
condition of the patient, the potential risks/harm, availability and competence of anesthesia
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 clinical care providers and applicable policy, norms and legal framework like the Scope of
Practice,
 Shares, fosters and translates the vision and mission of the organization into the practice of
anesthesia clinical Care Setting,
 Coordinates anesthesia clinical care continuum to ensure smooth/seamless transition through
the anesthesia clinical care continuum, enhance anesthesia care delivery and achieve optimal
patient outcomes,
 Participates in efforts to influence health care policy on behalf of anesthesia clinical care users
and the profession,
 Develops and implements a succession plan to ensure continuity of anesthesia clinical car,
Participates in key roles on committees, councils and administrative teams in the interest of
empowering anesthesia clinical care Practice, that of colleagues and the profession,
 Influences decision making bodies to improve anesthesia clinical Care Practice environment
and patient outcomes,
 Participates in designing systems that support effective teamwork and positive outcomes
Research, educational & professional development
Competency: The post basic anaesthesia professional must actively engage in searching for,
interpretation, and use of evidence in anaesthesia clinical practice and quality improvement, as well as
active participation in the conduct of research. The anaesthesia professional demonstrates competence
in the domain of the research, educational & professional development when s/he:
 Contributes to anaesthesia knowledge by conducting or synthesizing research and other
evidence that discovers, examines and evaluates current practice, knowledge, theories, criteria
and creative approaches to improve anaesthesia service,
 Promotes a climate of research and clinical inquiry in the anaesthesia clinical care setting,
 Analyzes and discusses the findings of anaesthesia research studies within the health care team
in the field of anaesthesia to negotiate for applicable findings in its own work environment,
 Oversees the care given by others while retaining accountability for the quality of anaesthesia
clinical care given to the patients and their families,
 Mentors junior colleagues in acquisition of anaesthesia clinical knowledge, skills, abilities and
judgment,

20
  Engages in self-evaluation of its own practice on a regular basis, identifying areas of strength
as well as areas in which professional growth would be beneficial,
 Obtains formal and informal feedback regarding one’s own practice from health care users,
peers, professional colleagues and others,
 Actively engages with the intra and inter-professional peers and colleagues contributing one’s
professional perspective to enhance one’s own professional practice or role performance,
 Provides peers with formal and informal constructive feedback regarding their practice or role
performance to enhance professional development/advancement,
 Demonstrates commitment to personal growth through self-reflection, and inquiry as well as
engagement in and keeping of a record of lifelong learning,
 Demonstrates sensitivity to cultural, professional and technological diversity within the
multidisciplinary team and anaesthesia continuum of care,
 Speaks up when appropriate to question anaesthesia clinical care practice when necessary for
safety and quality improvement
Professional, legal & ethical practice
Competency: Anaesthesia professionals practice within legal requirements, demonstrate professional
integrity and act to uphold professional standards of practice and codes of ethics. The post-basic
anaesthesia professional demonstrates competence in the domain of professional, legal and ethical
anaesthesia practice when s/he:
 Demonstrate a commitment to carryout anaesthesia professional responsibilities and
adherence to ethical principles,
 Accepts accountability for increased responsibility for its own professional and clinical
judgment, actions, anaesthesia clinical care outcomes and continued competence in
accordance with the prescribed scope of practice and anaesthesia professionals code of
conduct,
 Maintain confidentiality while communicating data, plan, and results in a manner that preserve
the dignity and privacy of the patient and provide legal record of anaesthesia clinical care,
 Practices within the realm of anaesthesia scope of practice and knowledge based in accordance
with the advances, current evidence and trends in anaesthesia care,
 Fosters anaesthesia professional autonomy and accountability in self and others,

21
 Participates and advocates for anaesthesia profession in policy development on health care in
particular anaesthesia service and professional affairs,
 Participates actively and expertly in consultative activities or affairs of the professional
associations and regulatory bodies especially in relation to anaesthesia practice to enhance
personal and professional development,
 Practices in accordance with the relevant International and National Legislative Framework,
local policies and anaesthesia management tools such as clinical guidelines, protocols and
algorithms,
 Delivers care in a manner that preserves and protects the autonomy, dignity, rights, values,
beliefs and preferences of the health care user and family in the midst of dehumanizing
environment for example research of vulnerable patients who are unconscious, heavily sedated
and with communication barriers within the relevant multidisciplinary team,
 Recognizes the significance of the patient and family in ethical decision making within the
surgical team ensuring that they take informed decisions,
 Upholds and advocates for the patient confidentiality within the legal and ethical framework
in particular because the anesthetized patient is not in control of his/her situation,
 Engages in ethical and legal debates concerning some complex decisions.
 Takes appropriate action in case of illegal, unethical or inappropriate behavior that exposes
the patient to risk and jeopardize the best interest of the patient, for example, reports and
documents adverse events to relevant structures including the regulatory body,
 Participates and advocates for the patient and anaesthesia profession in decision making about
ethical dilemma,
 Provides information on the risks, benefits, and outcomes of anaesthesia clinical care regimens
to allow informed decision making by health care users, including informed consent and
refusal,
 Demonstrates sensitivity to medico-legal risks related to monitoring and therapeutic
interventions in anaesthesia and consciously avoids them or reports them accordingly,

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Curricular Model, Approach and Delivery strategy

The design and development of this curriculum is competency (outcomes)-based and followed the
Following key steps.
1. Formulation of graduate profile /core competencies which are directly linked to the key
occupational tasks and are integrated cluster of domain-specific and generic competencies.
2. Elaborating competency descriptions: the core competencies were elaborated in terms of
description of the competency, the outcome of the behavior that requires the competency.
3. Knowledge and skills (contents) linked to the core competencies were listed
4. Cluster existing contents into modules: integrates contents of related nature into an
organized and structured unified whole (Module) to offer complete and blended
knowledge, skills and values to learners that are transferable into practical work life. Within
the framework, the following innovative educational strategies are used in the
development of the curriculum.

Student-centered

In this curriculum, students are given greater responsibility for their own learning by integrating a
more learner-centered teaching and learning and assessment methods such as self-initiated case base
discussions, personal research and reflection exercise and portfolio-based learning, Problem based
learning and assessment. This has the advantage of putting the emphasis on the student, increasing
students’ motivation and preparing them to become lifelong learners.

Integration

Recognizing the short falls of the subject-based organization of the traditional curriculum, related
contents of subjects and learning experiences are integrated throughout this curriculum. There is both
horizontal and vertical integration. Integration is done using surgical practice specialty approach as
thematic areas to organizing framework. Regarding basic and clinical sciences, emphasis is given
through integration of their contents in to specialties while clinical sciences take the upper hand in
later times of each module. Clinical exposure starts in year one with progressive increase in intensity,
complexity and student responsibility over the years. On early phases of the 3 years training, basic
Anesthesia modules will provide context and relevance to the learning of basic sciences & basic
principles of anesthesia clinical practice. Social and population health modules are organized around
competency functions and run as a longitudinal thread throughout the curriculum. The advantages of
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integration are reducing fragmentation of anesthesia professional courses and demonstrating unity of
courses, motivating students and shaping their attitude towards anesthesia profession, improving
educational effectiveness of teaching and learning, encouraging development of higher level
objectives, longitudinal coverage of all domains of competencies, promoting staff communication and
collaboration and bringing about rationalization of teaching resources. The clinical attachments for
every professional module will be delivered following & together with the theoretical (classroom) and
skill lab based sessions.

Community Based Education

To prepare anesthesia professional who are able and willing to address priority health needs of their
communities, community-based learning is added to complement the hospital-based learning. In this
curriculum, students are scheduled to have a 4-weeks in the mid of their education to identify and
prioritize problems in the community and a 4-weeks long team training program (TTP) during final
semester to intervene the identified problems. Advantages of community-based learning include
providing community-orientation to the curriculum, providing useful learning experiences for
competencies that may not be adequately developed in a hospital setting, making use of untapped
resources, encouraging active learning, exposing students to patients that have not been seen by
healthcare providers and introduction to the healthcare system.

Systematic and planned learning

In this curriculum, simulation, clinical and community teaching and learning activities are planned and
so that all students gain the necessary experiences for developing essential competencies. To this end,
model schedules of essential learning activities in the skills learning labs, clinical settings and
communities are developed, systematic rotations are proposed and lists of essential skills and
procedures to be performed by each student are specified.

Teaching and Learning Methods

Selection of appropriate teaching and learning methods is of critical importance in a competency or

outcomes-based curriculum. In selection of the teaching and learning methods, the following
considerations were made and faculty should keep in mind these features in appraising and revising
teaching and learning methods during implementation of the curriculum:

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Alignment. The selected methods are closely aligned with the intended learning outcomes across the
three learning domains (knowledge, skills and attitude) and the expected level of performance by the
learner thereby maximizing the chances that learners will master the required knowledge, skills and
attitude.
Learner focused. In terms of learning, the activities of the learner are the ones that ultimately
determine the likelihood of competency development. Methods that emphasize learner activities are
selected to this end.
Variety. One size does not fit all. What might be considered as the best teaching and learning method
for a certain learning outcome may not be so for another learning outcome. In addition, using different
methods is likely to stimulate and motivate learners. Hence, a variety of teaching and learning methods
are suggested to be used in the curriculum.
Collaborative. Where possible, methods that encourage collaboration and cooperation among
learners are proposed. The major teaching and learning methods suggested to be used in the
implementation of the curriculum are described below when and where.
1. Interactive lecture: Lecture is an efficient way to integrate and present information from multiple
sources on complex topics1. Additional advantage of lectures is that it gives students a chance to
follow and model the way an expert thinks, reasons and asks questions2. Lecture is appropriate for
teaching knowledge objectives. Lectures can be made interactive by enhancing them with engagement
of learners mentally and physically using questions, brainstorming, discussion, think pair- share,
debate, role play, case study, providing opportunities for reading, talking, listening, writing and
reflecting, and other learner activities.
2. Role play: In a role play, learners play out different roles or parts-such as of a patient and provider-
in a simulated situation. Role play addresses knowledge, skills and attitude objectives. Role plays
promote learning through behavior modeling, observation, feedback, analysis and conceptualization.
They are also often useful for exploring, discussing and influencing behaviors and attitudes of learners,
as well as for helping learners develop skills such as history-taking, physical examination and
counseling. It is also useful for teaching management and supervision skills.
3. Case study: Case studies present realistic scenarios/situations that focus on a specific issue or
problem, which may be related to diagnosis or treatment of patients, interpersonal skills or any of a
wide range of managerial or organizational problems. Learners typically read, study and react to the
case study individually or in small groups. Case studies are important to teach higher order knowledge
objectives (application, analysis and synthesis) and critical thinking skills.

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4. Simulated practice (clinical skills lab): Simulated practice is the use of simulated person, device
or set of conditions for instructional purpose. The learner is required to respond to the situation
as he or she would under natural circumstances. Simulation takes various forms. Simulation can
be static (like using anatomical models that closely resemble the human body or parts of it) or
automated using advanced computer technology. Some are individual, prompting solitary
performance, or interactive, involving groups of people. In medical education, simulation
complements patient-based education and is best employed to prepare learners for real patient
contact. It allows them to practice and acquire patient care skills in a controlled, safe and forgiving
environment. Simulations are used to develop psychomotor, procedural and clinical decision-
making skills. Simulation also aids development of communication and teamwork skills as well as
the ability to respond to medical emergencies systematically. Simulated teaching facilitates learning
under the right conditions including, but not limited to, learners receiving feedback on their
performance, learners having the opportunity for repetitive practice and simulation being an
integral part of the curriculum. Clinical skills lab is suggested to be used in the whole years of the
post-basic anesthesia curriculum.
5. Clinical practicum: Clinical practicum or clinical teaching is the use of direct patient or client
experiences to develop and practice knowledge, skills and attitude required for healthcare delivery
or patient care under the supervision of a skilled clinical instructor or preceptor. These skills
include generic skills (communication skills, mental and physical examination skills and basic
clinical testing and procedural skills), problem-based clinical skills (skills related to patient
complaints or diagnoses), discipline-specific clinical skills (such regional anesthesia management)
and continuum of care skills. Clinical learning opportunities include placements at a variety of
clinical and community settings for outpatient emergency care, resuscitation service (outpatient
and inpatient), preoperative assessment & optimization, intraoperative anesthetic management,
postoperative care (RR or PACU or ICU), pain management services (OPD and IPD), wellness
and preventive care, and population-based healthcare (community, public health). Outpatient
departments are appropriate to practice interviewing, interpersonal and counseling skills as well as
clinical skills. Inpatient departments (OR, PACU, ICU & ER) are good to teach patient
management, practice healthcare delivery skills including documentation of care plan and
treatment given and demonstrate management of rarely seen conditions. Clinical teaching and
learning uses a variety of techniques including observation, demonstration, role-modeling,
practice, coaching, feedback, discussion and reflection. Clinical teaching will be provided parallel

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 to theoretical aspect of each professional module and runs throughout the post basic anesthesia
curriculum increasing in complexity, level of involvement and responsibility.
6. Community-based learning: Community-based education refers to learning activities that take
place outside academic hospital in the community setting. These settings include, but are not limited
to, clinics, outreach sites, schools and prison facilities. Uses of community-based education include
increasing the willingness and ability of anesthetists to work in rural and underserved communities
thereby contributing to solution of inequity in health service delivery; enhancing learning by providing
opportunities for students to learn in situations similar to those in later professional lives and
opportunities to elaborate on previously acquired knowledge; equipping students with competencies
that they would never learn adequately otherwise, e.g., leadership skills, ability to work in a team, the
capability to interact with the community, the need for continuity of care, the effect illness has on a
family and the early signs of disease and spectrum of health problems; offering an opportunity to learn
and work with other health professionals; keeping the curriculum responsive to changing needs of the
community; rendering opportunities for partnerships between the community, the university and the
government. Hence, on the last semester, students will have a team training program for a blocked 4
weeks. During this attachment, depending on student number and logistics, students will be
distributed among different community-learning sites.
7. Laboratory practice: Students will have opportunities for demonstration, guided practice and
coaching in labs to deepen their understanding and apply principles and methods of basic and clinical
sciences.
8. Portfolio-based learning: Portfolio is collection of products collected by the student that provides
evidence of learning and achievements related to a learning plan. Portfolio develops self-directed
learning and reflective ability. It provides personal and professional educational evidence for student
learning, contextualizes learning, links experience with personal interpretation, enhances interactions
between students and teachers, allows students to receive feedback, stimulates the use of reflective
strategies and expands understanding of professional competence. The basic structure of the portfolio
may include a title page (giving student’s name, year of training and name of the mentor), contents
page (listing what is in the portfolio with page references), a list of learning objectives (whose
achievement the evidence in the portfolio claims to demonstrate), a short reflective overview
(summarizing the learning that has taken place since the last portfolio review, and indicating which
items of evidence relate to which learning objectives) and the evidence itself (probably grouped
together into the areas contained in the learning objectives.

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8. Mentoring is crucial for portfolio-based learning, as it enhances the feedback process and
stimulates students’ reflections. Students will have individual mentors (preferably with same
background) from first year and will stay with one mentor until the point of graduation. The aims of
the mentoring are to provide feedback, stimulate reflection, support students in compiling portfolio,
monitor students’ competency development, support students in developing a better awareness and
understanding of their strengths and weaknesses, support students in drawing up a learning plan for
the coming period and motivate/inspire students, The Mentor will evaluate portfolio of the students
at least two times a year and hold discussion to provide feedback.
9. Personal research and reflection exercise: In this methodology the student selects content area
from list of topics provided (e.g. examine the impact of culture on the delivery of health care) then
use journals, self- reflection, community based research, clinical experiences, discussions etc., and is
expected to present the findings (in writing and /or orally). This will help the student apply literature
review, self-reflection and critical thinking as a method of professional exploration and growth to
enhance their research and communication skill and deepen and broaden their knowledge.
10. Whole group session: During years 1 to 3, all students and faculty will meet on Friday afternoon
for whole group session. The purpose of the session is to consolidate and reflect on the different
learning activities covered during the week. The session is student-centered discussion that will be
facilitated by one or more faculty.

Assessment Methods

Assessment plays a central role in education process: it determines much of the work students
undertake affects their approach to learning and is an indication of which aspects of the course are
valued most highly. The purposes of assessment are to motivate students to learn, create learning
opportunities, to give
Feedback to students and teachers, grading and quality assurance. There is a distinction between a
formative assessment, which is mainly intended to help the student learn and a summative assessment,
which is intended to identify how much has been learned. Formative assessment is most useful part
way through the module and will involve giving students feedback which they can use to improve
future performance. Faculty should conduct at least two formative assessments of each student during
a given module or rotation. Summative assessment is used to make a pass/fail or, promotion decision;
findings of formative assessment are not used to make pass/fail decisions, however. That being said
both formative and summative assessments are equally important; however, psychometric rigor is

28
required more from summative assessment strategies. The following principles are considered in
selection of assessment strategies and faculty should keep in mind these principles in appraising and
revising assessment methods during implementation. Validity and reliability are of utmost importance
but it is also recommended to consider feasibility and cost.
Reliability: Reliability is the reproducibility or consistency or generalizability of assessment scores.
An assessment result is said to be reliable if students will get the same score if they re-take the exam.
Similarly, for essay type and performance assessment, assessment scores are reliable, if the same results
are obtained with different raters. Reliability of assessments can be improved by increasing the number
of questions (or cases in clinical performance examination), aiming for middle difficulty questions,
writing clear and unambiguous questions and increasing the number of raters.
Validity: Validity is the ability of an assessment to measure what it is supposed to measure. Validity
is not about the method refers to the evidence presented to support or refute the meaning or
interpretation assigned to assessment results. Simply put, assessment results are valid if they accurately
distinguish competent from incompetent students and if the student who gets “A” grade is actually
an “A” student, a student who gets a “B” grade is actually a “B” student, a student who gets an “F”
grade is actually an “F” student, etc. Examples of factors that affect validity in written assessment are
too few written questions to sample the content adequately, preparing questions from some chapters,
mismatch of assessment questions with content covered in the curriculum, poorly constructed
questions, too difficult or too easy questions, rater subjectivity and cheating. For performance (clinical)
assessment, too few cases or observations to generalize performance, unrepresentative cases, rater
bias, flawed rating scales/checklists and indefensible pass/fail cut off points are threats to validity.
Note that reliability is a necessary but not sufficient condition for validity.
These are the descriptions of the major assessment methods including when and where they would
be used in the curriculum.
1. Direct observation of Practice (DOP)
The purpose of DOPs or mini-clinical evaluation exercise3 is to assess clinical skills while a student
interacts with patients in different settings. Typically it takes 15-20 minutes and the assessor follows
the student with a checklist and gives feedback at the end. The DOPs offers students immediate and
ongoing feedback about their observed clinical skill and performance (interviewing skills, physical
examination skills, and professionalism, clinical judgment, counseling skills, organization/efficiency
and overall clinical competence). This method will be used in all years of the training and there will be

29
at least two DOPs to be performed by a student in each module. This assessment method enables
one to follow the progress of the student and will be used for formative assessment.
2. Objective structured examination
Objective structured clinical examination (OSCE) is a performance-based exam. During the
exam, students are observed and evaluated as they go through a series of 8 or more stations. It allows
assessment of multiple competencies. It is Objective, because examiners use a checklist for evaluating
the trainees; structured , because every student sees the same problem and performs the same tasks in
the same time frame; Clinical , because the tasks are representative of those faced in real clinical
situations. These increase the reliability and validity of the assessment. OSCE1 is a standardized means
to assess history taking, physical examination skill, communication skills, ability to summarize and
document findings, ability to make a differential diagnosis or plan and execute different anesthesia
management options/ techniques, clinical judgment based on patient ‘s note and procedural skills.
OSCE may use manikins and simulators, standardized patients and real patients. Standardized patients
are healthy persons trained to simulate a medical condition in a standardized way. Health science
students, health facility staff and faculty may serve as standardized patients. Objective structured
practical exam (OSPE) is a variant of OSCE to assess students’ knowledge and skill in a non-clinical
setting. Both OSCE/OSPE will be part of the summative assessment and will be implemented from
year 1-3 in the post-basic anesthesia program.
3. Practical Clinical Examination (PCE)
Practical Clinical Examinations assessment presents the student with a complete and realistic clinical
challenge thereby enabling the evaluator to see the complete picture of the student’s ability in
addressing the challenges. The use of multiple cases improves reliability of the examination, which is
a major weakness in the traditional long case. Additional improvements to the traditional long case
that would improve reliability are observing the student-patient interaction and using checklist and
increasing the number of examiners.
4. Standardized oral exam
The standardized oral examination2 is a type of performance assessment using realistic patient cases
for questioning the examinee. The examiner begins by presenting to the examinee a clinical problem
in the form of a patient case scenario and asks the examinee to manage the case. Questions probe the
reasoning for requesting clinical findings, interpretation of findings, and treatment plans. In efficiently
designed exams each case scenario takes three to five minutes. One or two faculty serve as examiners

30
and students can be tested on several different clinical cases. Oral exam will be part of the summative
assessment in final year comprehensive examination.
5. Written exam
Written assessments may include different item formats such as multiple choice questions, matching,
true false, essay and short answer. Written assessment methods will help to evaluate knowledge and
understanding of basic, clinical, public health and psychosocial sciences and professionalism and
ethics. Important point to remember is to ensure written exams assess higher order knowledge in
addition to recall and comprehension. Written assessments would be parts of both as formative and
summative assessment in all years of the post-basic anesthesia program.
6. Logbook
Logbook documentation serves as evidence of scope of patient care and community experience to
meet requirements or specific learning outcomes. Maintaining logbook will encourage students to
make use of all possible learning opportunities for clinical/procedural skills and community skills to
fulfill minimum requirement. Regular review of logbook can be used to help the student track what
procedures or experiences must be sought to meet requirements. The logbook document should be
counter signed by faculty. The number reported in a logbook may not necessarily indicate competence.
Logbook will be part of the formative assessment throughout the post-basic anesthesia curriculum.
7. Portfolio
Portfolio1 is collection of papers and other forms of evidence that learning has taken place. It provides
evidence for learning and progress towards learning objectives. Reflecting upon what has been learned
is an important part of constructing portfolio. In addition to products of learning, the portfolio can
include statement about what has been learnt, its application, remaining learning need, how they can
be met. Portfolio helps to assess learning outcomes including those that are not easy to assess with
other methods like personal growth, self-directed learning, reflective ability, self-assessment of
personal growth and professionalism. Portfolio allows assessment of progress towards learning
outcomes by using chronological work samples collected at different points in time. Portfolio will be
part of the formative assessment throughout the duration of the post-basic anesthesia training and
can be used as a summative assessment during professional anesthesia practice.
8. Global Rating
Global Rating is assessment of general categories of ability (e.g. patient care skill, medical knowledge,
interpersonal and communication skills, professionalism, etc.) retrospectively based on general
impression over a period of time and derived from multiple source of information. The purpose is to

31
evaluate knowledge, skill and attitude over a period of time during and at the end of specialty clinical
attachment thereby helping the evaluation of the student’s effort across time. Global rating will be
main part of both formative and summative assessment of students throughout the duration of
the post-basic anesthesia Curriculum. Some of the simple but critical assessments will be either passed
or failed, whilst the others will be marked out of 4 points. 4 is considered excellent, 3.5 good, 3.0
satisfactory, 2.0 “needs to improve” and 1.0 is poor. A grade point average of 3.0 or more in each
Module is required to successfully complete the module.

Program Requirement for Post Basic Anesthesia professional

Admission Requirement

Admission to this post basic program in Anesthesia requires

1. Diploma/ Advanced diploma in Anesthesia or Level 5 Anesthesia certificate or Diploma in

clinical nursing or a TVET level 4 nursing certificate from a recognized institution
2. Must pass & certified with updated COC examination
3. A minimum of 2 years full-time clinical experience
4. Applicant must be healthy and physically fit for the profession
5. The applicant must successfully pass the screening process including entrance exam &
interview
6. If two candidates score equal results on above criterion, nurses with anesthesia and Level 5
Anesthesia certificate will get priority from general clinical nurses.
7. Sponsorship letter from sponsoring institution

Graduation Requirement

Graduation requirement will be according to each university rule and regulation. Thus, a student
enrolled in the Post Basic BSc anesthesia program is eligible for graduation if and only if he/she:

 Has taken all the required Modules for the program and obtained a minimum CGPA of 2.
 Student should be able to pass comprehensive exam of the school, both in theory and practice
before graduation.
 Has not scored ‘F’ grade in any module, and should not score ‘D’ grade in any professional
(core) module.

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 The minimum grade for the professional course module is C
 Has carried out a student research project on a selected and agreed topic of research problem
and scored a minimum of ‘C’ grade in his/her thesis report.
 Present approved and signed log/performance book with a minimum of 250 cases of which
the graduate:
o Performs pre-anesthetic assessment for 250 clients
o Performs 200 endotracheal intubations
o Performs of 20 LMA insertions
o Performs of 200 endotracheal and/or LMA extubation
o Performs 50 intravenous cannulation
o Major General Anesthesia for 200 cases
o Attended 15 pediatrics &/ or Neonatal Anesthesia
o Delivers Anesthesia for 50 Obstetrics clients
o Handles 30 emergency cases requiring Anesthesia
o Provided sedation (analgesia) without intubation for 20 cases
o Performs minimum of 50 regional blockade (caudal, spinal, abdominal field blocks
and peripheral nerve blocks etc.)
 Produce thesis
 Student must pass Final Year Comprehensive Exam
o Internal exam 40% (written -10%, Oral (10%), OSCE (10% ) & Progressive ass’t -
10% and
o External examination 60% (practical & oral); this is non-credited but is (Passed/failed)
o If a student can’t pass the exam he /she will be delayed for 5 months and re-examined.
o Examined by group senior Anesthesia professionals from different universities

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Grading & Promotion

Letter grades shall be given based on the points earned out of 100. The letter grading system
has a fixed scale as described in the table below

Raw Mark Interval Corresponding Corresponding Letter Status

(100%) Fixed Number Grade Description
Grade

90 ≤ x ≤ 100 4.0 A+
Excellent
85 ≤ x < 90 4.0 A

80 ≤ x < 85 3.5 B+ Very Good

70 ≤ x < 80 3.0 B Good

65 ≤ x < 70 2.5 C+ Satisfactory

60 ≤ x < 65 2.0 C Fair

50 ≤ x < 60 1.0 D Unsatisfactory

< 50 0 F Fail

The weights of different assessment methods in each respective module and attachment are described
in the syllabi.

Requirement for promotion

1. Promotion will be conducted every time when a module is completed

2. Pass mark for any module will be at least a C grade (for Professional modules) & any grade for
general/ supportive modules.
3. If the student fail in one core/ Professional/ module (with module ECTS less than 5), He /She
can repeat the assessment while continuing the next module
4. If a student has failure in more than one module or a module of greater than 5 ECTS, remedial
exams will not be allowed and the student will be required to repeat the failed module(s) in the
next year.
5. Any student who fails a remedial exam will repeat the modules.
6. Any student who fails in the final comprehensive qualifying examination is required to work
under supervision for 5 months duration and re-examined.

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Degree Nomenclature

Upon completion of the three years program, the graduate will be awarded the degree of
‘Bachelor of Science in Anesthesia’ and in Amharic ‘የሳይንስ ባችለር ዲግሪ በአንስቴዝያ’

Quality Improvement, Monitoring and Evaluation

1. Higher institutions delivering this program will establish a health sciences education
development center (HSEDC) to lead and coordinate quality assurance and program
monitoring and evaluation. Quality assurance will be guided by Anesthesia program level
educational standards defined by the Higher Education Relevance and Quality Agency.
2. The ongoing quality of the Post Basic Anesthesia education will be monitored and ensured
through: Establishment of a curriculum committee under the HSEDC to oversee the
implementation of the curriculum, develop standard guidelines for teaching and assessment
and make necessary adjustments along the way. Self-review of the educational inputs,
processes and outputs (including human resources physical infrastructure, teaching/learning
in classroom, skills lab, clinical and community settings, student assessment, management and
governance and student performance results) semi-annually and taking action. This will be
coordinated by the quality assurance committee or team.
3. Organizing regular faculty development and support programs on instructional methods,
technical updates, research, leadership, etc. This will be coordinated by the faculty
development committee or team.
4. Establishment of an assessment committee or team under the HSEDC to develop and
maintain exam banks and coordinate, review and administer student assessment practices
5. Evaluation of teaching effectiveness by systematic collection of feedback from students and
at the end of each module or attachment and use it for program improvement Peer and
module/rotation evaluation by instructors at the end of module delivery
6. Annual assessment of the program by the teaching staff
7. Exit interviews at graduation and for all those who drop out for any reason
8. Monitoring students’ pass rate in national qualification (pre-licensure) exam and comparing
it with other Anesthesia schools
9. Establishing alumni of graduates as a mechanism to assess their career choice and
development

35
 10. Evaluation of graduates performance including obtaining feedback from employers and
society and use the information for program improvement
11. Review of curriculum every Four years to be led by the curriculum committee under the
HSEDC
Resource Profile
Human Resources –Staff Profile
 BSc in Anesthesia
 MSc in Anesthesia
 MD+ (Internist, Surgeon, Pediatrician, Gynecologist/ Obstetrician, Pathologist)
 MPH
 Anatomist (MSc)
 Physiologist (MSc)
 Laboratory technologist (MSc)
 Pharmacologist (MSc)

Program Structure, Composition and Duration

The duration of the post basic anesthesia education is three years (3) with the following components:
Introduction to Basic sciences, Basic foundations of Anesthesia, Specialty focused
professional clinical anesthesia care practice and social and population health (as shown in
table below). In the Foundations of Post Basic Anesthesia phase, students acquire
foundational knowledge, skills and attitudes in basic Anesthesia practice, patient-anesthetist
relationship and public health. Parallel to these, common courses are offered to strengthen
students’ understanding of civics and ability to communicate in English and use information,
communication technology in anesthesia. Integrated modular based Anesthesia clinical care
modules provide the basic knowledge, skills and attitude that are necessary to practice
Anesthesia profession. During this time, students develop clinical knowledge, skills and
attitude through intensive patient-based teaching and guided practice in different specialty
areas with opportunities to review pertinent basic biomedical sciences. They also acquire
knowledge and skills of health systems, management and anesthesia research. Then, post basic
anesthesia students must pass a final qualification exam including comprehensive internal and

36
external exam to progress to professional Anesthesia practice. Professional Anesthesia practice
provides students with the opportunity to work under supervision in different clinical
departments preparing them for autonomous practice. Before the end of third year training,
students have a month long community attachment (TTP) to offer opportunities for learning
and application of knowledge learned in the respective years in the community setting.

37
Modules Composition & Duration of Training

Year I Modules
Module
Module Code Module Name ECTS Week Delivery
EnLaM-3013 Communicative English 5 20 Parallel
CvEtM-3023 Civics & Ethical Education 3 20 Parallel
HInFM-3033 Computer Application to HS + HMIS 3 20 Parallel
AnstM-3041 Introduction to Anesthesia I + Ethics 5 20 Parallel
BioMM-3052 Body Fluids 2 3 Block
BioMM-3062 Respiratory system 3 4 Block
BioMM-3072 Cardiovascular & Lymphatic System 5 5 Block
BioMM-3082 Genitourinary system 3 5 Block
BioMM-3092 Endocrine system 2 3 Block
BioMM-3102 Nervous system 4 4 Block
Total 35

Year I Modules
Module
Module Code Module Name ECTS Week Delivery
EnLa M-3113 Basic Writing Skills 5 20 Parallel
BioMM-3122 Gastrointestinal system 3 2 Block
BioMM-3132 Musculoskeletal and integumentary system 2 3 Block
AnstPM-3141 Introduction to Anesthesia II 2 20 Parallel
MedM-3152 Physical Diagnosis 2 2 Block
DiMoM-3162 Diagnostic Modalities 3 2 Block
SPHM-3172 Determinants of Health 4 20 Parallel
AnstM-3181 Basics of Anesthesia I 14 17 Parallel
Total 35

38
Year II Modules
Module
Module Code Module Name ECTS Week Delivery
AnstM-4191 Basics of Anesthesia II 15 20 Parallel
General surgery & Thoracic emergency Parallel
AnstM-4201 Anesthesia 15 20
SPHM-4212 Measurements of Health and Disease 4 20 Parallel
Break (2 Weeks)
AnstM-4221 Regional anesthesia and Pain Management 10 20 Parallel
AnstM-4231 Obstetrics and Gynecologic Anesthesia 10 16 Parallel
Anesthesia for patients with coexisting
AnstM-4241 diseases and Psychiatry 7 20 Parallel
SPHM-4252 Health Promotion & Disease Prevention 4 16 Parallel
SPHM-4262 CBTP 1 4 4 Block
Total 69

Year III Modules

Module
Module Code Module Name ECTS Week Delivery
AnstM-5271 Trauma, burn and Orthopedic Anesthesia 6 20 Parallel
AnstM-5281 Emergency and Critical Care 6 19 Parallel
AnstM-5291 Geriatrics Anesthesia 5 20 Parallel
AnstM-5301 Neonatal and Pediatrics Anesthesia 9 19 Parallel
SPHM-5312 Research Methods and EBM 5 20 Parallel
Break (2 Weeks)
ENT, Maxillofacial, Ophthalmic & Day
AnstM-5321 Anesthesia 9 14 Parallel
AnstM-5331 Remote Anesthesia 3 14 Parallel
SPHM-5342 Leadership and Management 4 14 Parallel
AnstM-5351 Neurosurgery Anesthesia 7 14 Parallel
AnstM-5361 Comprehensive Examination 0 1 Block
AnstM-5371 Research Project 6 1 Block
AnstM-5382 TTP 4 4 Block
Total 62
Total of Totals 203

39
Year I Modules Syllabi: I

1. Communicative English
2. Civics & Ethical Education
3. Computer Application to HS + HMIS
4. Introduction to Anesthesia I + Ethics
5. Body Fluids
6. Respiratory system
7. Cardiovascular & Lymphatic System
8. Genitourinary system
9. Endocrine system
10. Nervous system

40
Communication Skills

Module Title: Communication Skills

Module Code: EnLaM-3013
Module ECTS: 5
Module Duration: 20 Weeks
Course Description: This course is intended to develop and improve students' language competence.
This course is aimed at developing trainees’ communicative abilities in English which will help
students to develop their communicative skills and overall language competence in English. Generally,
this course will cover the specific language aspects described below. Developing basic functions of
English language skills: reading (scanning, skimming, reading for details, summarizing, understanding
the structure of a text); listening (listening for the gist, listening for details, recognizing discourse
markers, noticing the structure of a lecture, understanding speaker intentions, recognizing signposting,
attending and following skills); writing (summarizing a text, synthesizing choppy sentences, writing
argumentative texts, writing research report, writing a project report); speaking (introducing oneself
and others, interviewing, discussions, stating and supporting propositions, stating one’s opinions,
organizing and taking part in a debate, making a persuasive speech, questioning); vocabulary
(working out meanings from context, synonyms, antonyms, collocations, definitions); grammar
(relative clauses, modals, voice, conditionals, tense, reported speech).
Learning Outcomes
At the end of this course, students will be able to:
 Express their ideas in various communicative contexts (in group/ pair discussion, in public
speaking settings)
 Present oral reports
 Write short reports
 Read various materials and make their own notes
 Identify the structure of oral and written discourses
 Attend their academic work at ease and with clarity

Assessment Methods
Students will be assessed out of 100% in this course. Of which 60% will be allotted for the Continuous
Assessment (CA) that will be done throughout the semester. The remaining 40 % will be for the final
examination. The CA includes varied types of activities that will allow the students to express

41
themselves like real speaker or communicator. Thus, Students will be assessed continuously at least
once in each of the six components. A final exam is administered to assess students’. Break down of
the assessment can be seen bellow:
Continuous Assessment
 Debates 10%

 Speech Delivery (2) (Impromptu & Prepared) (52) 10%

 Group Assignment 10%
 Report (Oral & Written) 10%
 Summary & Review 10%
 Listening 10%
 Final Examination 40%
100%
References
1. Dean, M.1988. Write it; Writing Skills for intermediate learners of English. Cambridge
University Press
2. DEFLL, 1996.College English: volume I and II.AAU.AAU Printing Press
3. Gregory.1999.Public speaking for college and career (Fifth Ed).New York: McGraw Hill
College
4. Hewings, M. 1999.Advanced Grammar in use: self-study Reference Practice Book for
Advanced Learners of English. Cambridge: CUP.
5. MOE, 2005.Improve Your English: A Course for Ethiopian Teachers (Grade 1-4)-Face to
Face Learner's Books 1&2.Addis Ababa: EMPDE
6. Mohammedtahir and Tibebe Kasahun, 2005.Communicative English Skills II (unpublished).
Jimma University Press
7. Strong, W.1991. Writer's Choice: Grammar and Composition. Illinois: McGraw Hall

42
 Tentative Schedule
Week Study Hours Main Topic/Sub topic/s/ Chapter Reading material Student Activities
/assignments
1st & 2nd 1.Introductory Unit College English VL.I - Introduce
Lecture 1.1. Listening and Speaking: Finding out PP 4-10 themselves to their
Hours= 2hrs about other people partners
Home Study= 1.2. Vocabulary: Learning to learn English Communicative -find out
2hrs vocabulary Grammar pp 34-48 information about
Discussion = 1.3. Grammar: Learning to use others
4hrs grammar for facilitating
meaning
LH= 2hrs 1.4. Reading: What is involved - College English -Participate in
3rd & 4th DH= 2hrs in understanding text? VL.I group discussions
PH= 2hrs 1.5. Speaking: Introducing oneself and introduce
HS=2hrs others - Communicative themselves
1.6. Writing: A short Personal description English Skills II- write a personal
or story unpublished description
- Writer’s Choice
4th – 6th 2.AIDS Listen to texts and
LH= 3hrs 2.1. Listening and Speaking: College English- identify markers of
HS=4hrs 2.1.1. Understanding markers of Teacher’s Guide addition and
DH= 4hrs addition and relating relating,
2.1.2. Listening for gist
2.1.3. Responding to the speaker's identify the gist of
purpose the talk,
2.1.4. Writing a brief summary of a talk College Reading + write summary of
2.2. Vocabulary McCarthy the talk
2.2.1. Using component parts of a word -guess the meaning
as clues to meaning of words
2.2.2. Using topic relationships in order Advanced Grammar depending on
to learn words in Use + Grammar clues, topic
2.2.3. Being aware of how words for English Language relationship and
collocate with each other Teachers 350-79 collocation
2.2.4. Working out word meanings
from context College English VL.I
2.3. Grammar College English VL.I
2.3.1. Using relative clauses
2.3.2. Expressing warning and advice

43
6th – 10th LH=3hrs 2.4 Reading
DH=4hrs 2.4.1. Identifying the intended audience of College English VL.I -read passages and
PH=4hrs a text and other critical reading skills + work on
HS= 4hrs 2.4.2. Relating a diagram to a text comprehension
questions
2.5 Speaking
2.4.3. Brain storming Public Speaking for -practice and
2.4.4. Public speaking College and Career present public
speeches

2.6 Writing: Writing a short summary of a College English VL.I Write summary of
talk a talk
3.Culture and Values Listen to texts and
12th - SH=6hrs 3.1. Listening and Speaking College English- identify structure
14th LH=3hrs 3.1.1. Identifying the structure of a talk Teacher’s Guide of the talk
DH=4hrs 3.1.2. Completing a note framework
Guess meaning of
3.2. Vocabulary College English VL.I words based on
3.2.1. Using topic relationships to learn their origin & topic
new words relationship
3.2.2. Words of Greek and Latin origin
3.2.3. Using a vocabulary network to Practice using
learn words active & passive
constructions
3.3. Grammar
3.3.1.Using active and passive Grammar for
constructions for descriptive writing English Language
3.3.2. using time clauses for descriptive Teachers p.287
writing
14th - 16th 3.4. Reading College English VL.I -read passage and
SH= 4 3.4.1. Critical reading identify main idea
DH= 4 3.4.2. Reading for main ideas and specific details
LH= 3 3.4.3. Reading for detail
PH=3 3.5. Speaking -participate in
3.5.1. Understanding reference Public Speaking for debating organized
3.5.2. Brainstorming College and Career in the classroom
3.5.3. Organizing and taking part in a -write summary
debate and descriptive
3.6. Writing paragraph
3.6.1. Writing a brief summary of key Writer’s Choice +
ideas from a text Essentials of Writing
3.6.2. Writing a descriptive essay about
a marriage ceremony

44
16th& 4.Improving Study Practices -listen to lectures
18th LH=3hrs 4.1. Listening and speaking College English- and take notes
HS=5hrs 4.1.1. Thinking about what you do when Teacher’s Guide - identify main
DH= 4hrs you listen to a lecture and take notes sections of a
4.1.2. Understanding listing and lecture
sequencing markers
4.1.3. Listening for a main sections of a talk -work out meaning
of words from
4.2. Vocabulary context
4.2.1. Using a dictionary College Reading +
4.2.2. Working out word meanings from Objective English -Practice using
context conditional clauses
4.3. Grammar Grammar for
4.3.1. Using Conditional I,II and III English Language
Teachers p231 +
College English
4.4. Reading College English VL.I
18th& LH=3hrs 4.4.1. Skimming for gist -read passage and
19th HS=5hrs 4.4.2. Critical reading and evaluating identify references
DH= 4hrs 4.4.3. Using reference/textual markers College English VL. and textual markers
I
4.5. Speaking
4.5.1. Brainstorming and discussing on -practice writing
what makes a good learner summary and
Writers’ Choice essays
4.6 Writing
4.6.1. Summarizing a talk
4.6.2. Summarizing an academic article
4.6.3. Writing an essay on learning English
20th Final Exam

45
Civics & Ethical Education

Module Name: Civics & Ethical Education

Course Code: CvEtM-3023
Module ECTS: 3 ECTS
Module Duration: 20 Weeks

Module Description: The major emphasis of this module is to familiarize students with basic themes
civics and ethics, morality and law, state government, citizenship, constitution and constitutionalism,
democracy and human right, conflict resolution and environment and sustainable development. The
method of delivery in this course will be through brainstorming, group discussion and interactive
lecture. Moreover, the students’ progress will be assessed both in formative and summative ways of
evaluation.

General objective: At the end of the module, the student will be able to generalize the basic concepts
of civics and Ethics, morality and law, professional ethics, civic virtue state, government, citizenship,
constitution and constitutionalism, human and democratic rights, conflict and conflict resolution,
international relation and sustainable development.

Prerequisite: None
Assessment Methods

 Continuous assessment (class participation, Group and Individual assignment, quizzes,

test---60%
 Final written examination ---40%

Course policy: Because this course will involve numerous discussions and class activities, students
expected to attend all classes. The course module delivered to you is only to guide you to read different
martial so that students are expected to refer intensively more materials from the library and other
source. Absence from class will lead to disqualification from sitting for final examination. Any sound
of cell phone is strictly forbidden in the classroom. In additional you are expected to be punctual.

Learning outcome: at the end of the course, the student will be able to:
 Define the subject matter of civics and ethics C, Ll,
 Describe the concept of state, and government L1
46
 Describe the concept of citizen and citizenship C,L1
 Discuss on the concept of democracy and human right AL2
 Generalize principles and values of democracy

47
 Module schedule - UNIT ONE
Introduction to the concept of civic and ethical education (4hr)

Unit objectives at the end of this unit Content Delivery method

,students will be able to:
1.1 Define the term civics 1.1 Definition of civic education
education.CL1 1.2 Source and interdisciplinary
1.2 Explain source and nature of civic and ethical
interdisciplinary nature of civic education Interactive
and ethical education.CL2 1.3 The objective and significance Lecture
1.3 List the objective and of civic education Group
significance of civic education 1.4 The origin and development of Discussion
.CL1. civics education
1.4 Explain the organ and
development of civics education
CL2

UNIT TWO
Ethics and ethical issues (11hr)

Unit objectives at the end of this Content Delivery method

unit, students will be able to:

2.1 define ethics CL1 Interactive lecture and

2.2 Explain type of ethics CL2
2.3 Explain the need for ethical
education CL2
2.4 Explain the major ethical
school of thoughts CL2
2.5 identify the major ethical
perspectives CL-2
2.6 Explain profession ethics CL2
2.1 the definition of ethics Group discussion
2.3 types of ethics
 Normative ethics
 Non –normative ethics
2.4 the need for ethical education
2.5. the major ethical school of thoughts
 Ethical relativism
 Ethical universalism
2.6 major prospective on making
decisions and actions moral
 Consequentialism/teleological
ethical theory
 Utilitarianism
 Ethical altruism
 Deontological ethical theory
 Prima-facie duets
 Kant’s categorical
imperative
2.7 professional ethics

48
3.1. define state CL1
3.2. explain form of state structure
CL2
3.3. explain government CL1
3.4. discuss on citizen and
citizenship CL1
4.1. define constitution and
constitutionalism CL1
4.2. explain the purpose and type
of constitution CL2
4.3. summarize the historical
development of constitution in
Ethiopian CL2
5.1. define democracy, democratic
and human right CL1
52.2 describe election and electoral
process CL2
5.3. Explain electoral procedure
and institution in Ethiopia CL2
5.4. Summarize the electoral
development in Ethiopia CL2
Unit objectives at the end of this
unit ,students will be able to :
6.1 Define conflict and conflict
resolution CL1
6.2 Distinguish types and stages of
conflict CL2
6.4 Explain the mechanisms of
conflict resolution CL2
7.1 define international relation cl1
7.2 Explain foreign policy CL2
7.3 Explain globalization CL1
3.1. definition of state Interactive lecture and
- theory of state formation Group discussion
- Elements of the state
3.2. form of state striation
3.3. government
 definition of government
 function of government
 organs of government
3.4 citizen and citizenship
 ways of acquiring citizenship
 ways of losing citizenship
4.1. definition of Interactive lecture and
 constitution and Group discussion
 constitutionalism
4.2. purpose and type of constitution
4.3. historical development of constitution
in Ethiopia
5.1. definition of democracy democratic
and human right Generation and
characteristics of human right
5.2. election and electoral process
 Electoral system
- Majoritarian and proportional
electoral system
5.3. Electoral procedure and institution in
Ethiopia
5.4. Electoral development in Ethiopia
Content Delivery method
6.1 Definition of conflict Interactive lecture and
 Conflict resolution Group discussion
 Conflict management and
conflict protection
6.2 types and stage of conflict
6.3 consequence of conflict
6.4 the mechanisms of conflict resolution
= formal
= informal
7.1 Definition of international relation Interactive lecture and
 Actors in the international relation Group discussion
7.2 foreign policy
 Actors in foreign policy
 Diplomacy
7.3 definition of globalization
 Tensions of globalization
49
CHAPTER EIGHT –Environment and sustainable development (3hr)

Unit objectives at the end of this unit Content Delivery method

,students will be able to :

8.1 Define environment and 8.1. definition of environment and

sustainable development CL1 development
Interactive lecture and
8.2 explain corruption and its impact
8.2 corruption and its impact on Group discussion
on development CL2
development
8.3 Describe poverty ,inequality and
8.3 poverty ,inequality and development
development AL2
8.4 identify the causes and consequence 8.4 the causes and consequence of
of environment damage CL1 environmental damage
8.5 State the impacts of greenhouse 8.5 the impacts of greenhouse effect on
effect on environment CL1 environment
8.6 List the role of citizens in
8.6 citizen and development
development CL1

50
Computer Application in Health Science

Module Name: Computer Application in HS

Module Code: HInFM-3033
Module ECTS: 3 ECTS
Module Duration: 20 Weeks

Module Description: The Module provides students a conceptual framework for understanding
health informatics and information technology as applied in the healthcare environment. The course
will include in-depth discussion of ‘meaningful use” of technology in health care systems with
emphasis on leveraging technology to improve quality and efficiency in care delivery. The course will
also highlight successes and failures in implementing health information technology and the critical
role that informaticists play in each step of the developmental process from idea inception through
systematic implementation.

Module objectives:
Learning outcome: at the end of the module, the student will be able to:
1. Understand basics of computer
2. Understand the basics of computer network and Internet
3. Define information management, information system (technology) and informatics
4. Explain the basic theoretical concept that underlies informatics practice
5. Identify how health informaticians process data into information and knowledge for health
care tasks with the support of information technology to improve patient care
6. Understand and practice the concept of Health information system and its characteristics and
describe the different types of Health information systems (routine and clinical information
systems) specific to their disciplines.
7. Explain how the use of an Electronic health record system can affect patient care safety,
efficiency of care practices, and patient outcomes
8. Identify how ongoing developments in biomedical informatics can affect future uses and
challenges related to health information systems
9. Describe the history and evolution of clinical decision support and state the fundamental
requirements of effective clinical decision support systems
10. Analyze how the integration of data from many sources assists in making clinical decisions
and discuss how tele health communication technologies support clinical care.
11. Understand and practice the concept of information retrieval techniques.

Pre requisites: Null

References

1. Shortliffe EH. Medical Informatics. Second edition, Springer-Verlag, 2001

2. Bemmel JHV, Musen MA. Handbook of Medical Informatics. Sringer-Verlag, 1977

51
 3. Curriculum development center program, Component 6: Health Management
Information Systems Instructor ManualVersion 3.0/Spring 2012
Teaching and learning Methods

 Lecture
 Demonstration
 Presentation and group discussion
 Laboratory practice
 Audiovisual
 Tutorial
 Private study

Assessment/ evaluation & grading system

Method of assessment Value (%)

Test 1 10
Test 2 10
Assignments 20
Practical exam 30
Final exam 30
Total 100

52
 Course Schedule
Week Lecture Plan Hr Practice Hrs Assignm Assig
ent n hr
Week Introduction to computer 4 Identify the types of computer 6 hrs
1-2 History of computer Observe and identify the
Characteristics of computer components of computer
Components of computer Distinguish inputs with output
Types of computer devices
Hardware Observe the processing devices
Input Identify the different memories
Output available from computer system
Processing devices Operating system installation
Memory Demonstrate GUI
Software Demonstrate cmd
System software Demonstrate Utility softwares
Operating system Demonstrate basic types of
GUI application software
Cmd based OS Practice on Microsoft word
Utility softwares
Application software
Week 3 Networking & the internet 2 Computer network overview 3 Create 2
Types of computer network email and
Network components send
Overview on the internet assignmen
Web ts on the
Tools and service on the internet internet
Purposes of the internet through it
Browsers
Browsers components
Email
Week 4 health informatics terminologies 2 3 0
Information management
Information system
Information technology
Domains of Health informatics
Information hierarchy
Data
Information
Knowledge
Wisdom
Week 5 Health Information Systems 2 3
Overview
Why health information system

53
Week Lecture Plan Hr Practice Hrs Assignm Assig
ent n hr
Classification of health information
system
Health information system reform
Week Routine health information system 4 Practice on Microsoft excel 6 3
6-7 Introduction Formula
Information cycle table
Data collection graph
Data processing Practice on Microsoft power point
Data presentation
Information utilization
Data quality
Health management information
system
HMIS in Ethiopia
Week 8 Clinical Information System 2 Demonstration and practice on 3 0
EMR EMR software
Patient Monitoring Systems Demonstration and practice on
CDSS CDSS
Chapte Information retrieval & EBM 4 Search tools 9 Practical 3
r 9-10 Search engine assignmen
Google t on
Google scholar informatio
Database n retrieval
Pubmed
Gate way
HINARI
PubMed
Evidence based practice
Week Information and computer ethics 2 0 0
10
16 40 8

54
Introduction to Anesthesia I

Module Title: Introduction to Anesthesia I

Module Code: AnstM-3041
Module ECTS: 5 ECTS
Module Duration: 20 Weeks
Pre-requisite: None

Module Description: This module is designed for first year anesthesia students to equip them with
the required knowledge, skill and attitude by giving emphasis on professionalism that govern the
profession, patient safety and the history of the profession. This module will be addressed through
interactive lecture, simulation, PBL, hospital visit

Module Competencies
 Communicate effectively with healthy clients and client’s family
 Apply ethical principles in daily practice
 Participate in providing care in compassionate and respectful manner
 Understand self and identifying their own learning needs and plan learning activities to
address their need

Learning Outcomes
In order to achieve core competencies, students at the end of this Module will be able to:
 Analyze attributes of professionalism
 Explain the key process in establishing trust with client
 Discuss what a good rapport building is like
 Discuss the self-disclosure
 Explain the ways of building a good rapport
 Evaluate the ability of health care provider in establishing rapport with client/family
 Demonstrate establishing rapport with client/family
 Establish and maintain a positive, respectful collaborative working relationship with colleagues
and teams
 Demonstrate empathy and empathic responses for the client and family
 Deal with client’s and family’s problem with tact and confidence
 Explain Principles of communication
 Discuss Therapeutic communication concepts
 Demonstrate the principles of different communication skills
 Use appropriate non-verbal communication to enhance non-verbal communication
 Elicit information clearly and effectively
 Actively listen to client/ family
 Describe the different level and factors of confidence
 Demonstrate appropriate level of confidence while communicating with patients and their
family
 Apply ethical principles in daily practice
 Understand self
 Identifying own learning needs
55
  Plan learning activities to address own need
 Identify features of compassionate and respectful care
 Demonstrate ability to provide care in compassionate and respectful manner in simulated
environment
 Work with health care team in provide care with compassionate and respectful manner
 Explain the relevance of basic physics for anesthetists practice
 Explain how electrical safety can be maintained in perioperative environment
 Define patient safety
 Explain the harm caused by health-care errors and system failures;
 Explain the difference between system failures, violations and errors;
 Apply patient safety thinking in all professional activities.
 Demonstrate the ability to recognize the role of patient safety in the delivery of safe health
care.
 Describe the roles of anesthetists in the perioperative phases of patient care and critical care
Teaching-Learning Methods
 Interactive lecture and discussion
 Facilitated discussion
 Role play
 Case study
 Video show
 Demonstration (at skills lab)
 Guided clinical practice
 Field visit (charity centres, …)
 Story telling (by guests, role models, ….)
 Peer professional guidance (senior students to assist their more junior peers by passing on
important and useful information)

Reference Books and Resources

1. Barash Clinical Anaesthesia, 8th Edition. Paul G. Barash.
2. Anaesthesia and co-existing disease, 3rd Edition. Robert K. Stoelting
3. Miller’s anaesthesia volume 1 and 2, 6th Edition. Ronald D. Miller.
4. EFHMACA regulations for health professionals EFMHCA Regulation 299/213 EFMHCA
Regulation 661/2009
5. Code of conduct for anaesthetists
6. World manual of Medical Ethics
7. Richard E. Ashcroft. Principles of health care ethics, 2nd Edn, 2007
8. Gwen Van Servellen. Communication skill for the Health Care Professional: Concepts,
Practice. Jones and Bartlett Publisher. 2009
9. Competency-based professionalism in anaesthesiology: Continuing Professional
Development (DOI 10.1007/s12630-012-9747-z)
10. Richard E. Ashcroft. Principles of health care ethics, 2nd Edn, 2007
11. Raanan Gillon. Principles of health care ethics, 1994
12. EFMOH compassionate and respectful care training manual for health work force, 2017
13. EFMHCA Regulation 299/213 (http://www.fmhaca.gov.et/)
14. EFMHCA Regulation 661/2009 (http://www.fmhaca.gov.et/)
15. Professional Code of conducts

56
 16. Interview guide questions for health professionals on threats and its solution

Teaching-Learning Materials and resources

 Checklists: Compassionate care checklist, etc
 Case studies
 Writing board
 Posters
 LCD Projector and PPTs
 White board, marker
 Laptop and Videotapes
o Sample Video of a compassionate service/help
 Role play stories from EFMOH compassionate and respectful care training manual for health
work force, 2017

Learning Assessment methods (both formative and summative)

 Written cognitive knowledge test (MCQ/essay)
 360-degree professionalism appraisal
 Review of reflective portfolio
 review of works (assignments, projects, ….) completed by students
 Case study- student analysis case on unprofessional behaviors and produce a written
reflection on the situations described in case.
 Professionalism mini-evaluation exercise (P-MEX)- Direct observation of student’s
professional behaviors
 Peer assessment of professional behaviors
 Structured Oral Examination Attendance,
 Punctuality
 Attendance
 Work being submitted on time
 Students Participation in any voluntary service

Summative assessment
 Professionalism mini-evaluation exercise (P-MEX)- Direct observation of student’s
professional behaviors= 30 %
 Written cognitive knowledge test using MCQ/essay/case study = 25%
 360-degree professionalism appraisal= 20%
 Review of students’ reflective portfolio = 15%
 Testimony that show students voluntary service/participation = 10%

57
 Module Schedule
Duration: 20 Weeks (lecture 76 hrs. hospital practice 38 hrs. self-study 25 hrs.)
Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion and Activity [4 Hrs.]  Competency-based
A. CRC: Introduction to Medical Professionalism (2 Hrs.) professionalism in
 Interactive Lecture and discussion on: anesthesiology:
o Various definitions of heath care professionalism Continuing
o Rational for professionalism Professional
o Attributes of professionalism: Development (DOI
Week 1 - Altruism 10.1007/s12630-012-
- Accountability 9747-z)
- Excellence  Creating a Framework
- Humanism for Medical
 Group discussion and reflection on: Professionalism, 2016
o Rationale for professionalism and common unprofessional acts
seen
B. Introduction to Clinical Anesthesia (2 Hrs.)
 Interactive Lecture and discussion on:
o Definition of Anesthesia as a discipline and profession
o Common terminologies in anesthesia profession

Parallel Modules Hours [10 Hrs./ Week]

 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

Hospital Visit (2 Hrs.)

 Visiting general setup of the hospital
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.

58
 Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion and Activity [4 Hrs.] 
A. CRC: Establishing Rapport (2 Hrs.)
 Interactive Lecture and discussion on:
o Principles of client provider interaction
o Establishing rapport
o Trust (trust-based relationships, process of establishing trust
o Self-disclosure
- Definition,
- Type
- Impact and limitation
 Group activity on:
o Demonstration and guided practice using role-play on
establishing Rapport
B. Introduction to Clinical Anesthesia (2 Hrs.)
 Interactive Lecture and discussion on Anesthesia history:
Week 2 o Roles of anesthetists in the perioperative and critical care

Parallel Modules Hours [10 Hrs./ Week]

 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

Hospital Visit (2 Hrs.)

 Hospital visit on preoperative assessment and patient optimization
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.

59
 Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion and Activity [4 Hrs.] 
A. CRC: Empathy (2 Hrs.)
 Interactive Lecture and discussion on:
o Definition and its therapeutic value
o Steps to arriving at empathy
Week 3 o Capacity for empathy,
 Group activity on:
o Case study
- Value of empathy in treatment outcome in small
groups
- Characteristics of empathy
o Role play
- Demonstrating empathy
B. Introduction to Clinical Anesthesia (2 Hrs.)
 Interactive Lecture and discussion on History of Anesthesia:
o Early use of ether and nitrous oxide
o Chloroform

Parallel Modules Hours [10 Hrs./ Week]

 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

Hospital Visit (2 Hrs.)

 Hospital visit on preoperative assessment and patient optimization
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.

60
 Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion and Activity [4 Hrs.] 
A. CRC: Basic Communication Skills (2 Hrs.)
 Interactive Lecture and discussion on:
o Basic communication skills (Principles of eliciting information,
interviewing skills, active listening, barriers to active listening)
o Therapeutic communication (Therapeutic interviewing skills,
use of questions, types of choice of question formats and
responses, avoiding traps of dysfunctional communication)
Week 4 o Therapeutic use of silence and pauses (Definition silence,
purpose of silence in the provide- client relationship, Analysis
of silence in client response, Negative effective of using silence)
 Group activity on:
o Demonstration and guided practice - interviewing skill/
Therapeutic communication
B. Introduction to Clinical Anesthesia (2 Hrs.)
 Interactive Lecture and discussion on History of Anesthesia:
o Inhalational anesthetics

Parallel Modules Hours [10 Hrs./ Week]

 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

Hospital Visit (2 Hrs.)

 Operation room visit
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.

61
 Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion and Activity [4 Hrs.] 
A. CRC: Non Verbal Communication (2 Hrs.)
 Interactive Lecture and discussion on:
o Non-verbal communication (Definition, Types, Characteristics)
o Identifying appropriate use of non-verbal communication
Week 5  Group activity on:
o Demonstration and guided practice - Use of nonverbal
communication
B. Introduction to Clinical Anesthesia (2 Hrs.)
 Interactive Lecture and discussion on History of Anesthesia:
o Intravenous anesthetics
o Muscle relaxants

Parallel Modules Hours [10 Hrs./ Week]

 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

Hospital visit (2 hrs.)

Hospital visit on preoperative assessment and patient optimization
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.
Interactive Lecture, Discussion and Activity [4 Hrs.] 
A. CRC: Confidence (2 Hrs.)
 Interactive Lecture and discussion on:
o Definition of confidence
o Level of confidence
o Function of communicating confidence
o Too much confidence
Week 6 o Influence of confidence on decision quality
B. Introduction to Clinical Anesthesia (2 Hrs.)
 Interactive Lecture and discussion on History of Anesthesia:
o Regional anesthesia

Parallel Modules Hours [10 Hrs./ Week]

 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

Hospital Visit (2 Hrs.)

62
 Required Reading
Week Learning Activity
(Assignment)
 Operation room visit
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.
Interactive Lecture, Discussion and Activity [12 Hrs.] 
A. CRC: Confidence (2 Hrs.)
 Group activity on:
o Case study: (30 min)
- Determining level of confidence and identifying the
influence of confidence on decision quality
- Reflection and feedback
o Group discussion: (30 min)
- On examples of confidence and non-confidence
Week 7 behaviors
o Role play: (1 Hr.)
- Demonstrate the ability to deal with client’s and
family’s problem with tact and confidence followed by
Reflection and feedback
B. Introduction to Clinical Anesthesia (2 Hrs.)
 Interactive Lecture and discussion on History of Anesthesia:
o Introduction to understanding anesthesia machine

Parallel Modules Hours [10 Hrs./ Week]

 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

Hospital Visit (2 Hrs.)

 OR visit including anesthesia machine checkup observation
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.

63
 Required Reading
Week Learning Activity
(Assignment)
Week 8 Interactive Lecture, Discussion and Activity [4 Hrs.] 
A. CRC: Advisement (2 Hrs.)
 Interactive Lecture and discussion on:
o The proper placement of advisement
o Definition of advisement
o The miss uses of advisement and option giving
o Principles behind the therapeutic use of advisement
o Communication responses related to emotional states
 Role-plays on
o Demonstrating communication responses related to emotional
states
o Responding appropriately to a communication from another
person and deliver an appropriate communication to another
person
B. Introduction to Clinical Anesthesia (2 Hrs.)
 Interactive Lecture and discussion on History of Anesthesia:
o Introduction to understanding airway equipment
o Early laryngoscopes

Parallel Modules Hours [10 Hrs./ Week]

 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

Hospital Visit (2 Hrs.)

 Operation room visit, preferably air way devices observation
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.

64
 Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion and Activity [4 Hrs.]  Applying the four
A. CRC: Ethical Practice in Healthcare (2 Hrs.) principles, February,
 Interactive Lecture and discussion on: 2013.
o Health care ethics  Richard E. Ashcroft.
o Principles of healthcare ethics Principles of health
o Medical Ethics (ASKME) for ethical case analysis care ethics, 2nd Edn,
Week 9  Group activity on case studies: 2007
o C1: Autonomy  Principles of health
o C2: Beneficence care ethics, Raanan
o C3: Non-maleficence Gillon. 1994
o C4: Justice  EFMOH
B. Introduction to Clinical Anesthesia (2 Hrs.) compassionate and
 Interactive Lecture and discussion on: respectful care
o Introduction to understanding monitoring equipment training manual for
o Indirect measurement of BP AA health work force,
2017.
Parallel Modules Hours [10 Hrs./ Week]
 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

Hospital Visit (2 Hrs.)

Operation room visit (monitoring during anesthesia)
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.

65
 Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion and Activity [4 Hrs.]  Reading assignment
A. CRC: Legal aspects in health care practice (2 Hrs.) on- proclamation,
 Interactive Lecture and discussion on: regulation, legislation
o Code of medical ethics and code of conduct
Week 10 o Law and ethics intertwine pertinent to health
o Overview on health professional negligence care in Ethiopia
o Health professional-patient relationship  Legal and ethical
 Group activity on: issues for health
o Discussing ethics and the standard of care professionals, Fourth
o Debate on selected articles from EFMHCA regulation edition, 2016
299/2013  Health ethics and law
B. Introduction to Clinical Anesthesia (2 Hrs.) for health extension
 Interactive Lecture and discussion on: workers Jimma
o Basic physics for anesthetists university, 2004

Parallel Modules Hours [10 Hrs./ Week]

 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

Hospital Visit (2 Hrs.)

 Operation room visit and record keeping for medico-legal issues
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.

66
 Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion, Video show and Activity [4 Hrs.]  EFMOH
A. CRC: Compassionate care (2 Hrs.) compassionate and
 Interactive Lecture and discussion on: respectful care
o Compassionate care training manual for
o Qualities of compassionate care health work force,
o Elements of compassionate care 2017.
o Principles of compassionate care  Sample
Week 11  Group activity on: compassionate care
o Video show on compassionate service/help- and reflection short video from
o Role paly on qualities of compassionate care from EFMOH YouTube.
CRC training package 2017.
B. Introduction to Clinical Anesthesia (2 Hrs.)
 Interactive Lecture and discussion on:
o Basic physics for anesthetists continued...

Parallel Modules Hours [10 Hrs./ Week]

 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

Hospital Visit (2 Hrs.)

 Operation room visit and record keeping for medico-legal issues
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.
Interactive Lecture, Discussion, Video show and Activity [4 Hrs.]  EFMOH
A. CRC: Respectful Care (2 Hrs.) compassionate and
 Interactive Lecture and discussion on: respectful care
o Definition of respectful care training manual for
Week 12 o Principles of respectful care health work force,
o Characteristics of disrespectful care 2017.
 Group activity on:  Role play stories from
o Case study: on dignified and respectful care EFMOH
B. Introduction to Clinical Anesthesia (2 Hrs.) compassionate and
 Interactive Lecture and discussion on: respectful care
o Electrical safety training manual for
health work force,
Parallel Modules Hours [10 Hrs./ Week] 2017.
 Communicative English: [4 Hrs./ Week]  Interview guide
 Civics and Ethical Education: [3 Hrs./ Week] questions for health
 Computer Application to HS [3 Hrs./ Week]
professionals

67
 Required Reading
Week Learning Activity
(Assignment)
Hospital Visit (2 Hrs.)
 Operation room electrical supply and safety issues observation
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.
Interactive Lecture, Discussion, Video show and Activity [4 Hrs.] 
A. CRC: Respectful Care (2 Hrs.)
 Interactive Lecture and discussion on:
o Factors affecting respectful care provision
o Demonstration of respectful care
 Group activity on:
o Group discussion: on principles of respectful care
Week 13 o Role play - respectful behaviors in as simulated environment
class room
B. Introduction to Clinical Anesthesia (2 Hrs.)
 Interactive Lecture and discussion on ‘Patient Safety’:
o What is patient safety?
o Why is patient safety relevant to health care?

Parallel Modules Hours [10 Hrs./ Week]

 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

68
 Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion, Video show and Activity [4 Hrs.]  Compassionate
A. CRC: Introduction to CRC in leadership (2 Hrs.) leadership: What is it
 Interactive Lecture and discussion on: and why do
o Compassionate leadership organizations need
Week 14 o Benefits of compassionate leadership in health care system more of it? By
 Group activity on: Meysam Poorkavoos;
o A www.roffeypark.com
B. Introduction to Clinical Anesthesia (2 Hrs.)  EFMOH, National
 Interactive Lecture and discussion on ‘Patient Safety’: CRC training
o The harm caused by health-care errors and system failures participant manual for
 Case study, discussion and reflection on: health work force,
o Socioeconomic and other consequences/ harms of a given 2017
unsafe healthcare case scenario  EFMOH, National
CRC facilitators
Parallel Modules Hours [10 Hrs./ Week] guide, 2017
 Communicative English: [4 Hrs./ Week]  Free online
 Civics and Ethical Education: [3 Hrs./ Week] Personalities tests
 Computer Application to HS [3 Hrs./ Week] (Humanmetrics.com,
16Personalities.com

69
 Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion, Video show and Activity [4 Hrs.] 
A. CRC: Self-assessment and Self-management (2 Hrs.)
 Interactive Lecture and discussion on:
o Concepts of self-management & self-management skills:
- Positivity,
- Responsibility,
- Self-awareness,
- Time management,
Week 15 - Stress management,
- Problem solving,
- Physical appearance,
- Temper management)
 Group activity on:
o Students will assess themselves using checklist and reflect in
small group
o Discussion and summary
B. Introduction to Clinical Anesthesia (2 Hrs.)
 Interactive Lecture and discussion on ‘Patient Safety’:
o Lessons about error and system failure from other industries
(E.g. spacecraft, ferries, offshore oil platforms, railway
networks, nuclear power plants etc.)
o Swiss cheese model: steps and factors associated with adverse
events

Parallel Modules Hours [10 Hrs./ Week]

 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

70
 Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion, Video show and Activity [4 Hrs.] 
A. CRC: Self-assessment and self-management (2 Hrs.)
 Group activity on:
o Individual activity- to identify self-improvement areas and
Week 16 o Develop action plan
B. Introduction to Clinical Anesthesia (2 Hrs.)
 Interactive Lecture and discussion on ‘Patient Safety’:
o History of patient safety and the origins of the blame culture
o Why do we blame?
 Group activity on:
o Discussion and reflection of a blamed anesthetist case

Parallel Modules Hours [10 Hrs./ Week]

 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

Hospital Visit (2 Hrs.)

 Operation room visit cont…
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.

71
 Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion and Activity [4 Hrs.]  How to succeed as a
A. CRC: Life-long learning (LLL) (2 Hrs.) lifelong learner.
 Interactive Lecture and discussion on: Primary Health Care.
o Benefits of LLL PHC624 Willcox A
o Qualities of LLL (2005)
Week 17 o Factors to help you Succeed in LLL  A model of self-
o Finding resources directed learning in
o Personal LLL plan development internal medicine
B. Introduction to Clinical Anesthesia (2 Hrs.) residency: a
 Interactive Lecture and discussion on ‘Patient Safety’: qualitative study using
o Violations grounded theory,
o Routine violations 2017
o Optimizing violations  Nurse Educator Core
o Necessary violations Competencies, WHO,
2016
Parallel Modules Hours [10 Hrs./ Week]
 Communicative English: [4 Hrs./ Week]
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

Hospital Visit (2 Hrs.)

 Operation room visit cont…
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.
Interactive Lecture, Discussion and Activity [12 Hrs.]  How to succeed as a
A. CRC: Life-long learning (LLL) (2 Hrs.) lifelong learner.
 Group activity on: Primary Health Care.
o Identifying individual learning needs. PHC624 Willcox A
B. Introduction to Clinical Anesthesia (2 Hrs.) (2005)
 Interactive Lecture and discussion on ‘Patient Safety’:  A model of self-
Week 18 o A model of patient safety directed learning in
o How to apply patient safety thinking in all health-care activities internal medicine
- Developing relationships with patients residency: a
qualitative study using
Parallel Modules Hours [10 Hrs./ Week] grounded theory,
 Communicative English: [4 Hrs./ Week]
2017
 Civics and Ethical Education: [3 Hrs./ Week]  Nurse Educator Core
 Computer Application to HS [3 Hrs./ Week] Competencies, WHO,
2016

72
 Required Reading
Week Learning Activity
(Assignment)
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.
Interactive Lecture, Discussion and Activity [4 Hrs.]  How to succeed as a
A. CRC: Life-long learning (LLL) (2 Hrs.) lifelong learner.
 Group activity on: Primary Health Care.
o Develop learning plan by identifying areas of medical PHC624 Willcox A
knowledge or clinical skill in which they needed improvement (2005)
or practice (conduct learning need assessment  A model of self-
o Set own learning goals and draw up an action plan indicating directed learning in
where and how will gap filled internal medicine
B. Introduction to Clinical Anesthesia (2 Hrs.) residency: a
 Interactive Lecture and discussion on ‘Patient Safety’: qualitative study using
Week 19 o The multiple factors involved in failures grounded theory,
o The role of patient safety in the delivery of safe health care 2017
 Nurse Educator Core
Parallel Modules Hours [10 Hrs. / Week] Competencies, WHO,
 Communicative English: [4 Hrs./ Week] 2016
 Civics and Ethical Education: [3 Hrs./ Week]
 Computer Application to HS [3 Hrs./ Week]

Hospital visit (2hrs) 

 Preoperative patient visit and observation on pre-operative assessment
and patient counseling
Week 20 Examination week 

73
Body Fluids, Blood Cells, Immunology and Hemostasis

MODULE CODE: BioMM-3052

ECTS: 2 ECTS
Duration: 3 weeks
Module Description: This module is intended to equip students with profound knowledge of basic
sciences and development of early clinical skills relevant to understanding of body fluids, blood cells
and Homeostasis. This module will be delivered through interactive lecture, simulation and hospital
visits.
Module Objective
By the end of this module, students will be able to apply knowledge of basic sciences for understanding
and analysing disorders of body fluids, blood cells and homeostasis.
Supporting Objectives

1. Apply knowledge of normal and abnormal structures and functions of blood cells, body
fluids and homeostasis in analysing clinical problems in a simulated setting (K3)
2. Identify the human life cycle and effects of growth, development and ageing on blood cells,
body fluids and homeostasis including developmental anomalies in a simulated setting (K3)
3. Analyse important determinants and risk factors of common blood cells, body fluids and
homeostasis disorders (K3)
4. Apply knowledge of principles of drug pharmacokinetics and pharmacodynamics that are
used for the treatment of blood cells, body fluids and homeostasis disorders in a simulated
setting (K3)
5. Make an initial assessment of a simulated patient presenting with blood cells, body fluids
and homeostasis disorder (K4 & S4)
6. Formulate a plan of investigation for a simulated patient with blood cells, body fluids and
homeostasis disorder in partnership with the patient, obtaining informed consent as an
essential part of this process (K3, S3& A3)
7. Interpret the results of basic investigations for common blood cells, body fluids and
homeostasis disorders in a simulated setting (K3)
8. Demonstrate clinical judgments and decisions, based on the available evidence in a
simulated patient with blood cells, body fluids and homeostasis disorder (K4, S3)
9. Demonstrate the ability to apply the basic principles of control of communicable diseases
related to blood cells, body fluids and homeostasis disorders in hospital and community
settings (S3)
10. Outline actions for prevention of blood cells, body fluids and homeostasis disorders and
promotion and maintenance of health (K3)
11. Demonstrate clear, sensitive and effective communication skills in interacting with a
simulated patient with blood cells, body fluids and homeostasis disorder and attendants by
listening, sharing and responding (S3, A3)
12. Show that s/he prioritizes patients’ needs and safety in a simulated setting (A3)

74
 13. Demonstrate professional values in approaching patients with blood cells, body fluids and
homeostasis disorder under simulated conditions (A3)
14. Demonstrate mutual understanding and relationship with a patient presenting with blood
cells, body fluids and homeostasis disorder and the family in a simulated setting (A3)
15. Demonstrate the ability to effectively plan and efficiently manage one's own time and
activities to cope with uncertainty, and the ability to adapt to change (A3)
16. Demonstrate the ability to use personal judgments for analytical and critical problem
solving and seek out information rather than to wait for it to be given to them (S3)
17. Demonstrate one’s recognition of the roles of complexity, uncertainty and probability in
decisions in care of patient with blood cells, body fluids and homeostasis disorders under
a simulated setting (S3)
18. Demonstrate a habit of self-reflection, responsiveness to feedback and an on-going
development of new skills, knowledge and attitude (S3)
19. Show the willingness to work with students of other professions to maintain a climate of
mutual respect and shared values (S3)
20. Identify the role of anaesthetists and those of other professions to appropriately assess and
address the healthcare needs of patients and populations with blood cells, body fluids and
homeostasis disorders (K2)
Teaching and learning methods
 Interactive lecture
 Case study
 Video show
 Demonstration
 Role play
 Observation in clinical setting
 Basic sciences lab
 Clinical skills lab
 Reflection exercise
 Portfolio
 Whole group session

References
1. Keith L. Moor, Arthur F. Dally, Anne M.R. Agur. Clinically oriented anatomy. 6 th edition.
2010
2. Snell, Richard S. Clinical anatomy. 9th edition. 2012
3. Keith L. Moore, T.V.N. Persaud and Mark G Turchia. The developing human. Clinically
oriented embryology (9th edition). 2013.
4. Junqueira’s basic histology: text and atlas. 13th edition. 2013
5. Guyton and Hall. Textbook of medical physiology. 11th edition. 2006.
6. Ashis Banerjee. Clinical physiology. An examination primer. 2005.
7. John Baynes and Marek Dominiczak. Medical biochemistry. 4th edition. 2014

75
 8. Alan Gaw. Clinical biochemistry 5th edition. 2013

Teaching and learning materials

 Videos of patient examination
 Imaging studies of different blood cell disorders
 Mannequins for procedures
Methods of assessment
Formative
 PBL progressive assessment
 Direct observation of clinical skills
 Logbook
 Global rating of performance
 Portfolio
 Personal research and reflection exercise

Summative
 Written exam (Progressive assessment) (30 %)
 Written exam (End of module assessment) (50 %)
 OSPE/OSCE (20 %)

76
 Module schedule
Date Learning Activity Required Reading/
Assignment
Week 1 Interactive lecture (8hr) Reflective portfolio
Day 1
 Introduction to the module
 Embryological development of the hematopoietic organs
 Microscopic structure and functions of the red blood cell
Day 2
 Biochemistry of RBC and other blood cells
 Disorders of the red blood cells (anemia and polycythemia)
 Agents used in anemia, hematopoietic growth factor
Day 3
 Microscopic structure and functions of white blood cell
 Resistance of body to infection, blood types, transfusion and organ transplantation
Problem-based learning [4 Hrs.]
 A case of easy fatigability
Basic science lab [2 Hrs.]
 Hemoglobin/ hematocrit determination
 Blood smear to identify normal and abnormal blood cell
 Blood grouping
Clinical skills lab [2 Hrs.]
Simulated practice:
 Approach to a patient with generalized weakness (history taking and physical
examination)
 Computer simulation showing hematopoiesis, gas exchange
Hospital visit [2 Hrs.]
 General OPD, Medical OPD, Pediatrics OPD, surgical OPD and pre-anesthesia
clinic
Whole group session
Faculty facilitated discussion and reflection on the week’s learning activities
Week 2 Interactive lecture continued WBC [8 Hrs.] Reflective portfolio
Day 1
 Disorder of white blood cells(non-neoplastic proliferation of WBC and neoplastic
proliferation of WBC)
 Drugs used to treat leukemia and lymphoma
Day 2
 Microscopic structure and functions of platelet
 Hemostasis, thrombosis and fibrinolytic system
Day 3
Bleeding disorder (DIC, thrombocytopenia, coagulation disorder)
Drugs used to treat coagulation disorders
Plasma protein and their clinical application
Problem-based learning [4 Hrs.]
 A case of a patient having repeated infections and A case of bleeding tendency
OR deep vein thrombosis??

77
 Date Learning Activity Required Reading/
Assignment
Basic science lab [2 Hrs.]
 White blood cell count and differential
 Platelet count
 Determination of blood coagulation time
Clinical skills lab [2 Hrs.]
 Simulated practice: Approach to a patient with bleeding disorder (history taking and
physical examination)
Hospital visit [2 Hrs.]
 General OPD, Medical OPD, Gyn OPD, Surgical OPD and pre-anesthesia clinic.
Whole group session
Faculty facilitated discussion and reflection on the week’s learning activities
Week 3 Monday Reflective portfolio
Review of the blood cell system
 Discussion (2 hours)
 Basic science lab (3 hours)
 Clinical skills lab (3 hours)
Tuesday and Wednesday: Study break for exam
Thursday: Written exam
Friday: OSCE

78
Respiratory System

Module Title: Respiratory System

Module Code: BioMM-3062
ECTS: 5 ECTS
Module Description: This system-based module is intended to equip anesthesia students with
profound knowledge of basic sciences and development of early clinical skills relevant to
understanding of the respiratory system and related clinical problems. This module is delivered
through instructive lecture, basic sciences lab and hospital visit.
Module Objective
 By the end of this module, students will be able to apply knowledge of basic sciences for
understanding the respiratory system and analyzing respiratory disorders.
Supporting Objectives
1. Apply knowledge of normal and abnormal structures and functions of the respiratory
system in analyzing clinical problems in a simulated setting (K3)
2. Apply knowledge of physiological mechanisms and processes of the respiratory system
in analyzing clinical problems in a simulated setting (K3)
3. Analyze important determinants and risk factors of common respiratory disorders (K3)
4. Explain drug pharmacokinetics and pharmacodynamics that are used for the treatment
of respiratory disorders in a simulated setting (K3)
5. Demonstrate the ability to take history andphysical examination from a patient with
respiratory disorder in a simulated setting (S3)
6. Make an assessment of a simulated patient presenting with respiratory disorder (K3 &
S3)
7. Formulate a plan of investigation for a simulated patient with respiratory disorder in
partnership with the patient, obtaining informed consent as an essential part of this
process (K3SA3)
8. Interpret the results of basic investigations for common respiratory disorders in a
simulated setting (K3)
9. Formulate a likely diagnosis in a simulated patient with respiratory disorder (K3, S3)
10. Formulate a plan for management of a simulated patient with respiratory disorder
according to established principles and best evidence, in partnership with the patient
and other health care teams(K3, S3
11. Demonstrate the ability to apply the basic principles of control of communicable
diseases for common respiratory disorders in hospital and community settings (S3)

79
 12. Demonstrate one’s recognition of the obligation to promote, protect and enhance the
essential elements of the anesthesia profession in interaction with patients with
respiratory disorder under a simulated setting (A3)
13. Demonstrate professional values in approaching respiratory patients under simulated
conditions (A3)
14. Identify learning needs to better understand respiratory disorders (K2)
15. Demonstrate the ability to communicate with patients, families, communities and other
health professionals in a responsive and responsible manner that supports a team
approach to the maintenance of health and treatment of respiratory disorders (S3, A3)
Prerequisites: none
Duration: 4 weeks
Teaching and learning methods
1. Interactive lecture
2. PBL
3. Case study
4. Video show
5. Demonstration
6. Role play
7. Observation in clinical setting
8. Basic sciences lab
9. Clinical skills lab
10. Community visit
11. Personal research and reflection exercise
12. Portfolio
13. Computer lab practice
14. Whole group session

References
1. Keith L. Moor, Arthur F. Dally, Anne M.R. Agur. Clinically oriented anatomy. 6th edition. 2010
2. Snell, Richard S. Clinical anatomy by regions. 9th edition. 2012
3. Keith L. Moore, T.V.N. Persaud and Mark G Turchia. The developing human. Clinically
oriented embryology (9th edition). 2013.
4. Junqueira’s basic histology: text and atlas. 13th edition. 2013
5. Guyton and Hall. Textbook of medical physiology. 11th edition. 2006.
6. Ashis Banerjee. Clinical physiology. An examination primer. 2005.
7. John Baynes and Marek Dominiczak. Medical biochemistry. 4th edition. 2014
8. Alan Gaw. Clinical biochemistry 5th edition. 2013
9. Eric Arthur Newsholme and Tony R. Leech. Functional biochemistry in health and disease.
2010.
10. Stephen Goldber. Clinical biochemistry made ridiculously simple. 1999.

80
 11. Richard N Mitchell, Ramzi S. Cotran. Robbins basic pathology. 8th edition. 2007.
12. David A Levison, Robin Reid, Alistair D Burt, David J Harrison and Stewart Fleming. Muir's
Textbook of Pathology, Fourteenth Edition
13. Abhay R. Satoskar et al. Medical parasitology. 2009
14. Color atlas of parasitology.
15. Bertram G. Katzung. Basic and clinical pharmacology. 12th edition. 2011
16. Goodman and Gilman’s. The pharmacological basis of therapeutics. 12th edition. 2011.
17. Lynn S. Bickley, Peter G. Szilagyi. Bates’ guide to physical examination and history taking. —
10th ed. 2009
18. Michael Swash and Michael Glynn. Hutschison’s clinical methods. An integrated approach to
clinical practice. 22nd edition. 2007
19. Goldman. Cecil Medicine. 23rd edition. 2007
20. Courtney M. Townsend Jr. [et al.]. Sabiston textbook of surgery: the biological basis of modern
surgical practice. 19th edition 2012
Teaching and learning materials
 Anatomical charts and mannequins
 Videos of patient examination
 Imaging studies of different respiratory conditions
 Computer-based simulations
Methods of assessment
Formative
1. PBL progressive assessment
2. Direct observation of clinical skills
3. Logbook
4. Global rating of performance
5. Portfolio
6. Personal research and reflection exercise
Summative
1. PBL progressive assessment (10 %)
2. Written exam (Progressive assessment) (30 %)
3. Written exam (End of module assessment) (30 %)
4. OSPE/OSCE (20 %)

81
 Module schedule

Date Learning Activity Required Reading/

Week 1 Interactive lecture [6 Hrs.] 1Reflective portfolio
Day 1
 The position, arrangement and parts of the respiratory system
Day 2
 Gross and microscopic structures of the thoracic wall, diaphragm and
mediastinum, blood supply, lymphatic drainage, nerve supply
 Movements of the thoracic wall and diaphragm during breathing
Day 3
 Pathophysiology of common disorders of the thoracic wall and
diaphragm
 Microbes affecting the thoracic wall and diaphragm
 Pharmacology of drugs used for treatment of common diseases of the
thoracic wall and diaphragm
Problem-based learning [4 Hrs.]
 A case of chest injury
Basic science lab [2 Hrs.]
 Anatomical charts and models
 Dissection of the thorax
 Computer-simulations of chest movement during breathing
Clinical skills lab [2 Hrs.]
 Simulated practice: Approach to a patient with chest pain (history taking
and physical examination)
 Interpretation of basic results of investigations
Hospital visit [2 Hrs.]
 General OPD, Medical OPD, Pediatrics OPD, Surgical OPD
Whole group session
Faculty facilitated discussion and reflection on the week’s learning activities

Week 2 Interactive lecture [6 Hrs.] Reflective portfolio

Day 1
Gross and microscopic structures and functions of the respiratory tract, blood
supply, lymphatic drainage, nerve supply
Day 2
 Pathophysiology of common diseases of the respiratory tract

82
 Date Learning Activity Required Reading/
Day 3
 Microbes affecting the respiratory tract
 Pharmacology of drugs used for treatment of common diseases of the
respiratory tract
Problem-based learning [4 Hrs.]
 A case of cough
Basic science lab[2 Hrs.]
 Anatomical charts and models
 Dissection of the respiratory tract
 Computer-simulations of clearance of mucus and cilia movement
Clinical skills lab[2 Hrs.]
 Simulated practice: Approach to a patient with cough (history taking and
physical examination)
 Interpretation of basic results of investigations
Hospital visit
 General OPD, Medical OPD, Pediatrics OPD, Surgical OPD
Whole group session
Faculty facilitated discussion and reflection on the week’s learning activities
Week 3 Interactive lecture(6) Reflective portfolio
Day 1
 Gross and microscopic structures and function of the lung and pleura,
blood supply, lymphatic drainage, nerve supply
Day 2
 Functions of the respiratory system (Pulmonary ventilation, pulmonary
circulation, physical principles of gas exchange, transport of oxygen and
carbon dioxide, regulation of respiration)
 The role of lung in acid-base balance
Day 3
 Pathophysiology of common diseases of the lungs and pleura
 Microbes affecting the lung and pleura
 Pharmacology of drugs used for treatment of common diseases of the
lungs and pleura
Problem-based learning [4 Hrs.]
 A case of shortness of breath
Basic science lab[2 Hrs.]
 Anatomical charts and models
 Dissection of the pleura and lungs
 Computer-simulations of pulmonary ventilation, pulmonary circulation,
gas exchange, transport of oxygen and carbon dioxide, regulation of
respiration

Clinical skills lab[2 Hrs.]

 Simulated practice: Approach to a patient with shortness of breath
(history taking and physical examination focusing on percussion and
auscultation to pick abnormalities)
 Interpretation of chest x-rays of different chest pathologies
Hospital visit[2 Hrs.]
 General OPD, Medical OPD, Pediatrics OPD, Surgical OPD

83
 Date Learning Activity Required Reading/
Week 4 Monday
Review of the respiratory system
 Discussion (2 hours)
 Basic science lab (3 hours)
 Clinical skills lab (3 hours)
Tuesday and Wednesday: Study break for exam
Thursday: Written exam
Friday: OSCE

Cardiovascular and Lymphatic System

Module Code: BioMM-3072

ECTS: 5 ECTS

Module Description: This system-based module is intended to equip anesthesia students with
profound knowledge of basic sciences and development of early clinical skills relevant to
understanding of the cardiovascular and lymphatic system and related clinical problems. This module
will be addressed through interactive lecture, simulation, PBL, hospital visit.

Module Objective
 By the end of this module, students will be able to apply knowledge of basic sciences for
understanding the cardiovascular and lymphatic system and analyzing cardiovascular and
lymphatic disorders.

Supporting Objectives
1. Apply knowledge of normal and abnormal structures and functions of the cardiovascular and
lymphatic system in analyzing clinical problems in a simulated setting (K3)
2. Apply knowledge of physiological mechanisms and processes of the cardiovascular and
lymphatic system in analyzing clinical problems in a simulated setting (K3)
3. Analyze important determinants and risk factors of common cardiovascular and lymphatic
disorders (K3)
4. Explain the principles of drug pharmacokinetics and pharmacodynamics that are used for the
treatment of cardiovascular and lymphatic disorders
5. Demonstrate the ability to take history and physical examination from a patient with
cardiovascular and lymphatic disorder in a simulated setting (S3)

84
 6. Make an assessment of a simulated patient presenting with cardiovascular and lymphatic
disorder (K3 & S3)
7. Formulate a plan of investigation for a simulated patient with cardiovascular and lymphatic
disorder in partnership with the patient, obtaining informed consent as an essential part of this
process (K3SA3)
8. Interpret the results of basic investigations for common cardiovascular and lymphatic disorders
in a simulated setting (K3)
9. Formulate a likely diagnosis in a simulated patient with cardiovascular and lymphatic disorder
(K3, S3)
10. Formulate a plan for management of a simulated patient with cardiovascular and lymphatic
disorder according to established principles and best evidence, in partnership with the patient
and other health care teams (K3, S3)
11. Demonstrate one’s recognition of the obligation to promote, protect and enhance the essential
elements of the anesthesia profession in interaction with patients with cardiovascular and
lymphatic disorder under a simulated setting (A3)
12. Demonstrate professional values in approaching cardiovascular and lymphatic patients under
simulated conditions (A3)
13. Identify learning needs to better understand cardiovascular and lymphatic disorders (K2)
14. Demonstrate the ability to communicate with patients, families, communities and other health
professionals in a responsive and responsible manner that supports a team approach to the
maintenance of health and treatment of cardiovascular and lymphatic disorders (S3, A3)

Duration: 5weeks

Teaching and learning methods

 Interactive lecture
 PBL
 Case study
 Video show
 Demonstration
 Role play
 Observation in clinical setting
 Basic sciences lab
85
  Clinical skills lab
 Reflection exercise
 Whole group session
Teaching and learning materials
1. Anatomical charts and mannequins
2. Color atlas of anatomy, embryology, histology, pathology, microbiology and parasitology
3. Videos of patient examination
4. Imaging studies of different cardiovascular and lymphatic conditions
5. Computer-based simulations
References
1. Keith L. Moor, Arthur F. Dally, Anne M.R. Agur. Clinically oriented anatomy. 6th edition. 2010
2. Snell, Richard S. Clinical anatomy by regions / Richard S. Snell. 9th edition. 2012
3. Keith L. Moore, T.V.N. Persaud and Mark G Turchia. The developing human. Clinically
oriented embryology (9th edition). 2013.
4. Junqueira’s basic histology: text and atlas. 13th edition. 2013
5. Guyton and Hall. Textbook of medical physiology. 11th edition. 2006.
6. Ashis Banerjee. Clinical physiology. An examination primer. 2005.
7. Gray’s anatomy for students. 2007
8. Eric Arthur Newsholme and Tony R. Leech. Functional biochemistry in health and disease.
2010.
9. Stephen Goldber. Clinical biochemistry made ridiculously simple. 1999.
10. John Baynes and Marek Dominiczak. Medical biochemistry. 4th edition. 2014
11. Alan Gaw. Clinical biochemistry. An illustrated color text. 5th edition. 2013
12. Richard N Mitchell, Ramzi S. Cotran. Robbins basic pathology. 8th edition. 2007.
13. David A Levison, Robin Reid, Alistair D Burt, David J Harrison and Stewart Fleming. Muir's
Textbook of Pathology, Fourteenth Edition
14. Jawetz, Melnick, &Adelberg's. Medical Microbiology, 24th Ed, 2007
15. Kayser Medical Microbiology, basic principles (2005)
16. Kuby, Goldsby. Immunology. 5thed, 2007.
17. Abhay R. Satoskar [et al.] Medical parasitology. 2009
18. Bertram G. Katzung. Basic and clinical pharmacology. 12th edition. 2011

86
19. Goodman and Cardiovascular and lymphatic lman’s. The pharmacological basis of
therapeutics. 12th edition. 2011.
20. Lynn S. Bickley, Peter G. Szilagyi. Bates’ guide to physical examination and history taking. —
10th ed. 2009
21. Michael Swash and Michael Glynn. Hutchison’s clinical methods. An integrated approach to
clinical practice. 22nd edition. 2007
22. Goldman. Cecil Medicine. 23rd edition. 2007
23. Courtney M. Townsend Jr. [et al.]. Sabiston textbook of surgery: the biological basis of modern
surgical practice. 19th edition 2012

Methods of assessment
Formative
 PBL progressive assessment
 Direct observation of clinical skills
 Logbook
 Global rating of performance
 Reflection exercise
Summative
 PBL progressive assessment (20 %)
 Written exam (Progressive assessment) (30 %)
 Written exam (End of module assessment) (30 %)
 OSPE/OSCE (20 %)

87
 Module schedule
Date Learning Activity Required Reading/
Assignment
Week 1 Interactive lecture (10hrs)
Day 1
 Introduction to the module
 The position, arrangement and parts of the cardiovascular and lymphatic system
 Gross and microscopic structures of the heart
Day 2
 Blood supply, lymphatic drainage, nerve supply of the heart
 The heart muscle: The heart as a pump and function of heart valves
 Energy metabolism of the heart, lipid transport and metabolism
Day 3
 Rhythmical excitation of the heart
 The normal electrocardiogram
 Lipoproteins: structure, function, metabolic fate, and diagnostic importance
 Pathophysiology of common diseases of the heart (heart failure, congenital heart
disease, hypertensive heart disease, cardiomyopathies, cardiac tumors)
Problem-based learning [4 Hrs.]
 A case of congestive heart failure.
Basic science lab [2 Hrs.]
 Anatomical charts and models
 Observe Dissected heart
 Computer-simulations of the heart as a pump
 Demonstration of properties of cardiac muscle in a lab animal
 Exercise stress test/heart function test
 ECG measurement and interpretation
 Cardiac biomarkers of injury, AST, CK, LDH, Troponin, Myoglobin
Clinical skills lab [2 Hrs.]
 Simulated practice: Approach to a patient with heart disease (history taking and
physical examination of the CVS)
 Audio recordings of normal heart sounds
 Chest x-ray of the normal heart
 Simulated practice: Approach to a patient with heart disease (history taking and
physical examination of the CVS)
 Chest x-rays or computer simulations of abnormal heart conditions
Whole group session
 Faculty facilitated discussion and reflection on the week’s learning activities
Week 2 Interactive lecture (10hrs)
Day 1

88
 Date Learning Activity Required Reading/
Assignment
 Microbes affecting the heart and the pericardium (Valvular heart disease, infective
endocarditis, pericarditis)
 Pharmacology of drugs used for treatment of heart failure
 Pharmacology of drugs used for treatment of ischemic heart disease
 Pharmacology of anti-arrhythmic drugs
 Pharmacology of drugs used for treatment of infective endocarditis and
pericarditis
Day 2
 Gross and microscopic structures and functions of blood vessels
 Overview of blood circulation: Medical physics of pressure, flow and resistance
 Vascular distensibility and functions of the arterial and venous system
Day 3
 The microcirculation and the lymphatic system
Problem-based learning [4 Hrs.]
 A case of circulatory shock
Basic science lab [2 Hrs.]
 Audio recordings or computer simulations of the dynamics of heart valves and
sounds in valvular and congenital heart diseases
 Computer-simulations of drug actions on the heart
 Dissection of blood vessels
Clinical skills lab
 Simulated practice: Approach to a patient with heart disease (history taking and
physical examination of the CVS)
 Chest x-rays or computer simulations of abnormal heart conditions
 Measuring blood pressure and pulse
Hospital visit [2 Hrs.]
 General OPD, Medical OPD, Pediatrics OPD, Surgical OPD
Whole group session
 Faculty facilitated discussion and reflection on the week’s learning activities
Week 3 Interactive lecture (10hrs)
Day 1
 The local humoral control of blood flow
 Nervous regulation of the circulation and rapid control of arterial pressure
 Role of kidney in long-term regulation of blood pressure
Day 2
 Pathophysiology of hypertensive vascular disease
Day 3
 Pharmacology of drugs used for treatment of hypertension and hypotension
Problem-based learning [4 Hrs.]
 A case of hypertension
Basic science lab [2 Hrs.]
 Computer simulations of blood pressure control
 Computer simulations of pathogenesis of hypertensive vascular disease
 Pathology tissue slides and specimen
 Computer simulations of effect of anti-hypertensive agents on blood pressure

89
 Date Learning Activity Required Reading/
Assignment
Clinical skills lab [2 Hrs.]
 Measuring blood pressure in different positions and after exercise
 Measuring arterial pulse after exercise, temporary arterial occlusion and applying
temperature
Hospital visit [2 Hrs.]
 General OPD, Medical OPD, Pediatrics OPD, Surgical OPD
Whole group session
 Faculty facilitated discussion and reflection on the week’s learning activities
Week 4 Interactive lecture (9hrs)
Day 1
Mechanism of atherosclerosis (LDL/HDL)
 Dyslipidaemia
 Familial hypercholestrolaemia
 Severe hypertriglyceridaemia
Day 2
 Pathophysiology of venous disorders (varicose vein, thrombophlebitis)
 Pharmacology of agents used in hyperlipidemia
Day 3
 Gross and microscopic structures and functions of the lymphatic system
 Infectious and non-infectious disorders of the lymphatic system
 Infectious and non-infectious disorders of the spleen and thymus
Problem-based learning [4 Hrs.]
 A case of atherosclerosis
Basic science lab(2)
 Anatomical charts and models
 Computer simulations of atherosclerosis an microcirculation and lymphatic
drainage
 Lipid profile tests
Clinical skills lab[2 Hrs.]
 Simulated practice: Examination of the vascular system and lymphatic system
Hospital visit[2 Hrs.]
 General OPD, Medical OPD, Pediatrics OPD, Surgical OPD and pre-anesthesia
clinic
Whole group session
 Faculty facilitated discussion and reflection on the week’s learning activities
Week 5 Monday [2 Hrs.]
Review of the cardiovascular and lymphatic system
 Discussion (2 hours)
 Basic science lab (3 hours)
 Clinical skills lab (3 hours)
Tuesday and Wednesday: Study break for exam
Thursday: Written exam
Friday: OSCE

90
Genitourinary System

Module Title: Genitourinary System

Module Code: BioMM-3082
ECTS: 3 ECTS

Module Description: This module is intended to equip students with profound knowledge of basic
sciences and development of early clinical skills relevant to understanding of renal system. This module
is delivered through instructive, basic science lab and hospital visit.

Module Objective
 By the end of this module, students will be able to apply knowledge of basic sciences for
understanding and analyzing disorder of the renal system.

Supporting Objectives
 Apply knowledge of normal and abnormal structures and functions of the renal and
reproductive systems in analyzing clinical problems in a simulated setting (K3)
 Apply knowledge of physiological mechanisms and processes of the renal and reproductive
systems in analyzing clinical problems in a simulated setting (K3)
 Analyze important determinants and risk factors of common renal and reproductive disorders
(K3)
 Explain drug pharmacokinetics and pharmacodynamics that are used for the treatment of renal
and reproductive disorders in a simulated setting (K3)
 Demonstrate the ability to take history and physical examination from patients with renal and
reproductivedisorder in a simulated setting (S3)
 Make an assessment of a simulated patients presenting with renal and reproductive disorder
(K3 & S3)
 Formulate a plan of investigation for simulated patients with renal and reproductive disorder
in partnership with the patient, obtaining informed consent as an essential part of this process
(K3SA3)
 Interpret the results of basic investigations for common renal and reproductive disorders in a
simulated setting (K3)
 Formulate a likely diagnosis in simulated patients with renal and reproductive disorder (K3,
S3)

91
  Formulate a plan for management of simulated patients with renal and reproductive disorder
according to established principles and best evidence, in partnership with the patient and other
health care teams(K3, S3)
 Demonstrate the ability to apply the basic principles of control of communicable diseases for
common renal and reproductive disorders in hospital and community settings (S3)
 Demonstrate one’s recognition of the obligation to promote, protect and enhance the essential
elements of the anaesthesia profession in interaction with patients with renal and reproductive
disorder under a simulated setting (A3)
 Demonstrate professional values in approaching renal and reproductive patients under
simulated conditions (A3)
 Identify learning needs to better understand renal and reproductive disorders (K2)
 Demonstrate the ability to communicate with patients, families, communities and other health
professionals in a responsive and responsible manner that supports a team approach to the
maintenance of health and treatment of renal and reproductive disorders (S3, A3)

Prerequisites: None

Duration: 5 weeks

Teaching and learning methods

1. Interactive lecture
2. PBL
3. Case study
4. Video show
5. Demonstration
6. Role play
7. Observation in clinical setting
8. Basic sciences lab
9. Clinical skills lab
10. Community visit
11. Personal research and reflection exercise
12. Portfolio
13. Computer lab practice
14. Whole group session

92
Teaching and learning materials
1. Videos of patient examination
2. Imaging studies of different renal health issues
3. Mannequins for procedures
References
1. Keith L. Moor, Arthur F. Dally, Anne M.R. Agur. Clinically oriented anatomy. 6th edition. 2010
2. Snell, Richard S. Clinical anatomy. 9th edition. 2012
3. Keith L. Moore, T.V.N. Persaud and Mark G Turchia. The developing human. Clinically
oriented embryology (9th edition). 2013.
4. Junqueira’s basic histology: text and atlas. 13th edition. 2013
5. Guyton and Hall. Textbook of medical physiology. 11th edition. 2006.
6. Ashis Banerjee. Clinical physiology. An examination primer. 2005.
7. John Baynes and Marek Dominiczak. Medical biochemistry. 4th edition. 2014
8. Alan Gaw. Clinical biochemistry. An illustrated color text. 5th edition. 2013
9. Eric Arthur Newsholme and Tony R. Leech. Functional biochemistry in health and disease.
2010.
10. Stephen Goldber. Clinical biochemistry made ridiculously simple. 1999.
11. Richard N Mitchell, Ramzi S. Cotran. Robbins basic pathology. 8th edition. 2007.
12. David A Levison, Robin Reid, Alistair D Burt, David J Harrison and Stewart Fleming. Muir's
Textbook of Pathology, Fourteenth Edition
13. Abhay R. Satoskar [et al. Medical parasitology. 2009
14. Color atlas of parasitology.
15. Bertram G. Katzung. Basic and clinical pharmacology. 12th edition. 2011
16. Goodman and Renal lman’s. The pharmacological basis of therapeutics. 12th edition. 2011.
17. Lynn S. Bickley, Peter G. Szilagyi. Bates’ guide to physical examination and history taking. —
10th ed. 2009
18. Michael Swash and Michael Glynn. Hutschison’s clinical methods. An integrated approach to
clinical practice. 22nd edition. 2007
19. Goldman. Cecil Medicine. 23rd edition. 2007
20. Courtney M. Townsend Jr. [et al.]. Sabiston textbook of surgery: the biological basis of modern
surgical practice. 19th edition 2012

Methods of assessment
93
Formative
1. PBL progressive assessment
2. Direct observation of clinical skills
3. Logbook
4. Global rating of performance
5. Portfolio
6. Personal research and reflection exercise

Summative
1. PBL progressive assessment (30 %)
2. Written exam (Progressive assessment) (20 %)
3. Written exam (End of module assessment) (30 %)
4. OSPE/OSCE (20 %)

94
 Module schedule

Date Learning Activity Required Reading/

Assignment
Week 1 Interactive lecture [8 Hrs.] Reflective portfolio
Day 1
 Gross and microscopic structure and functions of the renal system
 Urine formation by kidney – glomerular filtration, renal blood flow, tubular
processing of glomerular filtrate
Day2
 Role of kidney in regulating extracellular fluid osmolarity and electrolyte
concentration;
Day 3
 Regulation of acid-base balance ;integration of renal mechanisms for the
control of blood volume and extracellular fluid volume
Problem-based learning [4 Hrs.]
 A case of generalized body swelling
Basic science lab [2 Hrs.]
 Atlas (anatomy, histology) or charts showing gross and microscopic structure
of the renal and urinary system, congenital anomalies of the urinary system
 Observe Dissected kidney, ureter and bladder
 Video showing micturition cycle (filling phase and storage phase, initiation
phase and voiding phases) and urodynamic assessment
 Computer simulation of urine formation
 Urine analysis
Clinical skills lab [2 Hrs.]
 Simulated practice: Approach to a patient with renal failure and patients with
renal/Ureteric colic (history taking and physical examination)
Hospital visit [2 Hrs.]
 General OPD, Medical OPD, Pediatrics OPD, surgical OPD, pre-anesthesia
clinic
Whole group session
Faculty facilitated discussion and reflection on the week’s learning activities
Week 2 Interactive lecture(7hrs)
Day 1 Reflective portfolio
 Pathophysiology of common kidney diseases (glomerular diseases, diseases
affecting the tubules and interstitium), diseases of the blood vessels, cystic
diseases of the kidney and tumors
 Pathophysiology of urinary outflow obstruction
Day 2
 Common microbes affecting renal system
 Pharmacology of drugs used for treatment of renal and urinary tract
infections
 Pharmacology of diuretic agents

Day 3: PBL
Thursday and Friday: Study break for exam
Week 3 Interactive lecture [4 Hrs.]

95
 Date Learning Activity Required Reading/
Assignment
Day 1
 Introduction to the module (reproductive system)
 Embryology of reproductive system
 Gross and microscopic structures and functions of the reproductive organs
 Spermatogenesis, male sexual act and male sex hormones
 Female hormonal system, monthly ovarian cycle, functions of the ovarian
hormones regulation of female monthly rhythm and female sexual act
Day 2
 Pathophysiology of common problems of the sexual and reproductive system
 Pharmacology of androgens and other anabolic steroids
 Sexual and reproductive tract infections Pharmacology of agents used for
treatment of sexual and reproductive tract infections
Problem-based learning [4 Hrs.]
 Vaginal bleeding
Basic science lab [2 Hrs.]
 Atlas (anatomy, histology) or charts showing gross and microscopic structure
of the male reproductive organ, congenital anomalies
 Computer simulations/video showing spermatogenesis, congenital
anomalies of male genital tract
 Sperm analysis and count
Clinical skills lab [2 Hrs.]
 Simulated practice: Approach to a patient with uterine/vaginal bleeding
(history taking and physical examination)
Hospital visit
 General OPD, Medical OPD, Pediatrics OPD, surgical OPD and pre-
anesthesia.
Week 4 Interactive lecture [4 Hrs.]
Day 1
Physiology of pregnancy, childbirth and lactation
Pathophysiology of common pregnancy, childbirth and lactation problems
Pharmacology of uterotonics, abortifacients, uterine relaxants and drugs affecting
milk production
Pharmacology of contraceptives
Problem-based learning [4 Hrs.]
A case of vaginal discharge
Basic science lab [2 Hrs.]
 Gram staining and KOH of vaginal/urethral discharge
Clinical skills lab[2 Hrs.]
Simulated practice: Approach to a client who has vaginal discharge (history taking
and physical examination)
Hospital visit
General OPD, Medical OPD, Gyn. OPD, Surgical OPD
Whole group session
Faculty facilitated discussion and reflection on the week’s learning activities
Week 5 Tuesday and Wednesday: Study break for exam Reflective portfolio
Thursday: Written exam
Friday: OSCE

96
Endocrine System

Module Title: Endocrine System

Module Code: BioMM-3092
ECTS: 3
Module Description: This module is intended to equip students with profound knowledge of basic
sciences and development of early clinical skills relevant to understanding of endocrine systems
(endocrine and nervous system). This module will be addressed through interactive lecture, PBL,
simulation and hospital visits.
Module Objective
By the end of this module, students will be able to apply knowledge of basic sciences for understanding
and analyzing disorder of the endocrine system.
Supporting Objectives
1. Apply knowledge of normal and abnormal structures and functions of the endocrine
systems in analyzing clinical problems in a simulated setting (K3)
2. Apply knowledge of the human life cycle and effects of growth, development and ageing
on the endocrine systems including developmental anomalies in a simulated setting (K3)
3. Apply knowledge of physiological mechanisms and processes of the endocrine systems in
analyzing clinical problems in a simulated setting (K3)
4. Apply knowledge of the various causes (genetic, developmental, metabolic, toxic,
infectious ,autoimmune , neoplastic, degenerative and traumatic) of diseases of the
endocrine systems and their pathogenesis in analyzing clinical problems in a simulated
setting (K3)
5. Analyze important determinants and risk factors of common endocrine systems disorders
(K3)
6. Apply knowledge of principles of drug pharmacokinetics and pharmacodynamics that are
used for the treatment of disorders of the endocrine in a simulated setting (K3)
7. Demonstrate the ability to take history skills from a patient with disorder of the endocrine
systems in a simulated setting (S3)
8. Demonstrate the ability to do physical examination of a endocrine systems in a simulated
setting (S3)
9. Make an initial assessment of a simulated patient presenting with endocrine systems
disorder (K4 & S4)
10. Formulate a plan of investigation for a simulated patient with endocrine systems disorder
in partnership with the patient, obtaining informed consent as an essential part of this
process (K4, S4 & A3)
11. Formulate a likely diagnosis in a simulated patient with endocrine systems disorder (K4,
S4)
12. Demonstrate clinical judgments and decisions, based on the available evidence in a
simulated patient with endocrine systems disorder (K4, S3)

97
13. Formulate a plan for management of a simulated patient with endocrine systems disorder
according to established principles and best evidence, in partnership with the patient (K4,
S4)
14. Discuss important life-style, genetic, demographic, environmental, health system, social,
economic, psychological and cultural determinants of endocrine systems diseases (K2)
15. Analyze global and national trends in morbidity and mortality of endocrine systems
disorders of public health significance (K4)
16. Outline actions for prevention of endocrine systems disorders and promotion and
maintenance of health (K3)
17. Demonstrate clear, sensitive and effective communication skills in interacting with a
simulated patient with endocrine systems problem and attendants by listening, sharing and
responding (S3, A3)
18. Show that s/he prioritizes patients’ needs and safety in a simulated setting (A3)
19. Demonstrate professional values in approaching patients with endocrine system problem
under simulated conditions (A3)
20. Demonstrate that s/he recognizes his/her limitations in knowledge and clinical skills as
related to the endocrine systems, and commit to continuously improve one’s knowledge
and ability (A3)
21. Identify learning needs to better understand endocrine systems disorders (K2)
22. Demonstrate one’s ability to teach other students on the endocrine systems (S3)
23. Demonstrate one’s willingness to adhere to infection prevention principles in dealing with
a patient with endocrine systems disorder under a simulated setting (A3)
24. Demonstrate the ability to maintain accurate, legible and complete records of clinical and
community activities in the endocrine systems (S3)
25. Demonstrate the ability to search, collect, organize and interpret health and biomedical
information from different databases and other sources for understanding the sciences
underlying endocrine systems problems including health promotion (S3)
26. Demonstrate one’s recognition of the power and limitations of the scientific thinking
based on information obtained from different sources in establishing the causation and
prevention of endocrine systems diseases (S3)
27. Demonstrate the ability to use personal judgments for analytical and critical problem
solving and seek out information rather than to wait for it to be given (S3)
28. Identify and formulate simulated endocrine systems problems using scientific thinking and
based on information obtained and correlated from medical and scientific literature (S3)
29. Demonstrate a habit of self-reflection, responsiveness to feedback and an on-going
development of new skills, knowledge and attitude (S3)
30. Show the willingness to work with students of other professions to maintain a climate of
mutual respect and shared values (S3)
31. Identify the role of anesthetist and those of other professions to appropriately assess and
address the healthcare needs of patients and populations with endocrine systems disorders
(K2)

98
 32. Demonstrate the ability to communicate with patients, families, communities and other
health professionals in a responsive and responsible manner that supports a team
approach to the maintenance of health and treatment of endocrine systems disorders (S3,
A3)
Duration: 3 weeks
Teaching and learning methods
1. Interactive lecture
2. PBL
3. Case study
4. Video show
5. Demonstration
6. Observation in clinical setting
7. Basic sciences lab
8. Clinical skills lab
9. Community visit
10. Reflection exercise
11. Computer lab practice
12. Whole group session
Teaching and learning materials
1. Anatomy atlas and charts
2. Videos of patient examination
3. Imaging studies of different GI conditions
4. Mannequins
5. Computer-based simulations
References
1. Gray’s anatomy for students. 2007
2. Keith L. Moor, Arthur F. Dally, Anne M.R. Agur. Clinically oriented anatomy. 6 th
edition. 2010
3. Snell, Richard S. Clinical anatomy by regions / Richard S. Snell. 9th edition. 2012
4. Keith L. Moore, T.V.N. Persaud and Mark G Turchia. The developing human.
Clinically oriented embryology (9th edition). 2013.
5. Junqueira’s basic histology: text and atlas. 13th edition. 2013
6. Guyton and Hall. Textbook of medical physiology. 11th edition. 2006.
7. Ashis Banerjee. Clinical physiology. An examination primer. 2005.
8. John Baynes and Marek Dominiczak. Medical biochemistry. 4th edition. 2014
9. Alan Gaw. Clinical biochemistry. An illustrated color text. 5th edition. 2013
10. Eric Arthur Newsholme and Tony R. Leech. Functional biochemistry in health and
disease. 2010.
11. Stephen Goldber. Clinical biochemistry made ridiculously simple. 1999.
12. Richard N Mitchell, Ramzi S. Cotran. Robbins basic pathology. 8th edition. 2007.

99
 13. David A Levison, Robin Reid, Alistair D Burt, David J Harrison and Stewart Fleming.
Muir's Textbook of Pathology, Fourteenth Edition
14. Abhay R. Satoskar [et al. Medical parasitology. 2009
15. Color atlas of parasitology.
16. Bertram G. Katzung. Basic and clinical pharmacology. 12th edition. 2011
17. Goodman and Gilman’s. The pharmacological basis of therapeutics. 12th edition. 2011.
18. Lynn S. Bickley, Peter G. Szilagyi. Bates’ guide to physical examination and history
taking. — 10th ed. 2009
19. Michael Swash and Michael Glynn. Hutschison’s clinical methods. An integrated
approach to clinical practice. 22nd edition. 2007
20. Goldman. Cecil Medicine. 23rd edition. 2007
21. Courtney M. Townsend Jr. [et al.]. Sabiston textbook of surgery: the biological basis
of modern surgical practice. 19th edition 2012
Methods of assessment
Formative
1. PBL progressive assessment
2. Direct observation of clinical skills
3. Logbook
4. Global rating of performance
5. Reflection exercise
Summative
1. PBL progressive assessment (30 %)
2. Written exam (Progressive assessment) (20 %)
3. Written exam (End of module assessment) (30 %)
4. OSPE/OSCE (20 %)

100
 Module schedule

Date Learning Activity Required Reading

Week 1 Interactive lecture (15hrs)
Day 1
 Introduction to the module (endocrine system)
 Embryology of the anterior and posterior pituitary gland
 Gross and microscopic structure and functions of the pituitary gland
 Pituitary hormones and their control by the hypothalamus
 Common diseases of the pituitary gland (hyperpituitarism, hypopituitarism and
posterior pituitary syndrome)
 Pharmacology of gonadotropins, GnRH receptor antagonist, prolactin,
Vasopressin and Oxytocin drugs
Day 2
 Embryology of the thyroid and parathyroid gland
 Gross and microscopic structure and functions of the thyroid and parathyroid
gland
 Thyroid metabolic hormones and their regulation
 Parathyroid hormone, calcitonin, calcium and phosphate metabolism, vitamin D,
bone, and teeth
 Pathophysiology of the common diseases of the thyroid and parathyroid glands
 Pharmacology of thyroid and anti-thyroid drugs
 Agents affecting mineral ion homeostasis
Day 3
 Gross and microscopic structure and functions of the adrenal gland
 Adrenocortical hormones (ACTH, glucocorticoids and aldosterone)
 Pathophysiology of the common diseases of the adrenal gland(hyperfunction,
insufficiency and neoplasm)
 Pharmacology of adrenal cortex (Adrenocorticosteroids, synthetic corticosteroids,
mineralocorticoids

Problem-based learning tutorial [4 Hrs.]

A case of goiter
Basic science lab [2 Hrs.]
 Anatomical atlas or charts showing gross structure of the anterior and pituitary
glands
 Computer simulation of the pituitary axis
 Anatomical charts and atlas of the thyroid, parathyroid and adrenal glands
 Tissue dissection of thyroid, parathyroid and adrenal glands
Hormone assay: T3 and T4 determination, serum calcium cortisol, catecholamine
Clinical skills lab [2 Hrs.]
Simulated practice: Approach to a patient with goiter (history taking and physical
examination)
Simulated practice: Approach to a patient with Cushing syndrome or
pheocromocytoma (history taking and physical examination)
Hospital visit [2 Hrs.]
General OPD, Medical OPD, Pediatrics OPD, surgical OPD
Whole group session [1 Hr.]
Faculty facilitated discussion and reflection on the week’s learning activities
Week 2 Interactive lecture (9hrs)

101
 Date Learning Activity Required Reading
Day 1
 Insulin, glucagon and blood glucose regulation
 Pathophysiology of diabetes mellitus
 Metabolic derangements in diabetes mellitus
Day 2
 Pharmacology of insulin and oral anti-diabetic agents
Day 3
Interactive lecture
Review of the endocrine system
 Discussion (2 hours)
 Basic science lab (3 hours)
 Clinical skills lab (3 hours)
Problem-based learning [4 Hrs.]
 A case of diabetes mellitus
Basic science lab [4 Hrs.]
 Computer simulations of blood glucose homeostasis Testing blood glucose
Clinical skills lab [2 Hrs.]
 Simulated practice: Approach to a patient with diabetes mellitus (history taking
and physical examination)
Hospital visit [2 Hrs.]
 General OPD, Medical OPD, Pediatrics OPD, Surgical OPD
Whole group session [1 Hr.]
 Faculty facilitated discussion and reflection on the week’s learning activities
Week 3 Exam week
Monday –Wednesday study days
Thursday -written exam
Friday -OSCE

102
Nervous System

MODULE CODE: BioMM-3102

ECTS: 4 ECTS
Module Description: This module is intended to equip students with profound knowledge of basic
sciences and development of early clinical skills relevant to understanding of nervous system systems
(endocrine and nervous system). This module will be addressed through interactive lecture, PBL,
simulation and hospital visits.

Module Objective
By the end of this module, students will be able to apply knowledge of basic sciences for understanding
and analysing disorder of the nervous system.

Supporting Objectives
1. Apply knowledge of normal and abnormal structures and functions of the nervous systems in
analysing clinical problems in a simulated setting (K3)
2. Apply knowledge of the human life cycle and effects of growth, development and ageing on
the nervous systems including developmental anomalies in a simulated setting (K3)
3. Apply knowledge of physiological mechanisms and processes of the nervous systems in
analysing clinical problems in a simulated setting (K3)
4. Apply knowledge of the various causes (genetic, developmental, metabolic, toxic, infectious
,autoimmune , neoplastic, degenerative and traumatic) of diseases of the nervous systems and
their pathogenesis in analysing clinical problems in a simulated setting (K3)
5. Analyse important determinants and risk factors of common nervous systems disorders (K3)
6. Apply knowledge of principles of drug pharmacokinetics and pharmacodynamics that are used
for the treatment of disorders of the nervous in a simulated setting (K3)
7. Demonstrate the ability to take history skills from a patient with disorder of the nervous
systems in a simulated setting (S3)
8. Demonstrate the ability to do physical examination of a nervous systems in a simulated setting
(S3)
9. Make an initial assessment of a simulated patient presenting with nervous systems disorder
(K4 & S4)

103
10. Formulate a plan of investigation for a simulated patient with nervous systems disorder in
partnership with the patient, obtaining informed consent as an essential part of this process
(K4, S4 & A3)
11. Formulate a likely diagnosis in a simulated patient with nervous systems disorder (K4, S4)
12. Demonstrate clinical judgments and decisions, based on the available evidence in a simulated
patient with nervous systems disorder (K4, S3)
13. Formulate a plan for management of a simulated patient with nervous systems disorder
according to established principles and best evidence, in partnership with the patient (K4, S4)
14. Discuss important life-style, genetic, demographic, environmental, health system, social,
economic, psychological and cultural determinants of nervous and diseases (K2)
15. Analyse global and national trends in morbidity and mortality of nervous systems disorders of
public health significance (K4)
16. Outline actions for prevention of nervous systems disorders and promotion and maintenance
of health (K3)
17. Demonstrate clear, sensitive and effective communication skills in interacting with a simulated
patient with a nervous and endocrine systems problem and attendants by listening, sharing
and responding (S3, A3)
18. Show that s/he prioritizes patients’ needs and safety in a simulated setting (A3)
19. Demonstrate professional values in approaching patients with nervous system problem under
simulated conditions (A3)
20. Demonstrate that s/he recognizes his/her limitations in knowledge and clinical skills as related
to the nervous systems, and commit to continuously improve one’s knowledge and ability
(A3)
21. Identify learning needs to better understand nervous systems disorders (K2)
22. Demonstrate one’s ability to teach other students on the nervous systems (S3)
23. Demonstrate one’s willingness to adhere to infection prevention principles in dealing with a
patient with nervous and endocrine systems disorder under a simulated setting (A3)
24. Demonstrate the ability to maintain accurate, legible and complete records of clinical and
community activities in the nervous systems (S3)
25. Demonstrate the ability to search, collect, organize and interpret health and biomedical
information from different databases and other sources for understanding the sciences
underlying nervous systems problems including health promotion (S3)

104
26. Demonstrate one’s recognition of the power and limitations of the scientific thinking based
on information obtained from different sources in establishing the causation and prevention
of nervous systems diseases (S3)
27. Demonstrate the ability to use personal judgments for analytical and critical problem solving
and seek out information rather than to wait for it to be given (S3)
28. Identify and formulate simulated nervous systems problems using scientific thinking and based
on information obtained and correlated from medical and scientific literature (S3)
29. Demonstrate a habit of self-reflection, responsiveness to feedback and an on-going
development of new skills, knowledge and attitude (S3)
30. Show the willingness to work with students of other professions to maintain a climate of
mutual respect and shared values (S3)
31. Identify the role of anaesthetist and those of other professions to appropriately assess and
address the healthcare needs of patients and populations with nervous and disorders (K2)
32. Demonstrate the ability to communicate with patients, families, communities and other health
professionals in a responsive and responsible manner that supports a team approach to the
maintenance of health and treatment of nervous systems disorders (S3, A3)

Duration: 6 weeks

Teaching and learning methods

1. Interactive lecture
2. PBL
3. Case study
4. Video show
5. Demonstration
6. Observation in clinical setting
7. Basic sciences lab
8. Clinical skills lab
9. Community visit
10. Reflection exercise
11. Computer lab practice
12. Whole group session

Teaching and learning materials

105
 1. Anatomy atlas and charts
2. Videos of patient examination
3. Imaging studies of different GI conditions
4. Mannequins
5. Computer-based simulations

References
1. Gray’s anatomy for students. 2007
2. Keith L. Moor, Arthur F. Dally, Anne M.R. Agur. Clinically oriented anatomy. 6th edition. 2010
3. Snell, Richard S. Clinical anatomy by regions / Richard S. Snell. 9th edition. 2012
4. Keith L. Moore, T.V.N. Persaud and Mark G Turchia. The developing human. Clinically
oriented embryology (9th edition). 2013.
5. Junqueira’s basic histology: text and atlas. 13th edition. 2013
6. Guyton and Hall. Textbook of medical physiology. 11th edition. 2006.
7. Ashis Banerjee. Clinical physiology. An examination primer. 2005.
8. John Baynes and Marek Dominiczak. Medical biochemistry. 4th edition. 2014
9. Alan Gaw. Clinical biochemistry. An illustrated color text. 5th edition. 2013
10. Eric Arthur Newsholme and Tony R. Leech. Functional biochemistry in health and disease.
2010.
11. Stephen Goldber. Clinical biochemistry made ridiculously simple. 1999.
12. Richard N Mitchell, Ramzi S. Cotran. Robbins basic pathology. 8th edition. 2007.
13. David A Levison, Robin Reid, Alistair D Burt, David J Harrison and Stewart Fleming. Muir's
Textbook of Pathology, Fourteenth Edition
14. Abhay R. Satoskar [et al. Medical parasitology. 2009
15. Color atlas of parasitology.
16. Bertram G. Katzung. Basic and clinical pharmacology. 12th edition. 2011
17. Goodman and Gilman’s. The pharmacological basis of therapeutics. 12th edition. 2011.
18. Lynn S. Bickley, Peter G. Szilagyi. Bates’ guide to physical examination and history taking. —
10th ed. 2009
19. Michael Swash and Michael Glynn. Hutschison’s clinical methods. An integrated approach to
clinical practice. 22nd edition. 2007
20. Goldman. Cecil Medicine. 23rd edition. 2007

106
21. Courtney M. Townsend Jr. [et al.]. Sabiston textbook of surgery: the biological basis of modern
surgical practice. 19th edition 2012

Methods of assessment
Formative
1. PBL progressive assessment
2. Direct observation of clinical skills
3. Logbook
4. Global rating of performance
5. Reflection exercise
Summative
1. PBL progressive assessment (30 %)
2. Written exam (Progressive assessment) (20 %)
3. Written exam (End of module assessment) (30 %)
4. OSPE/OSCE (20 %)

107
 Module schedule

Date Learning Activity Required

Reading
Week 1 Interactive lecture (12hrs) Reflective
Day 1 portfolio
 Introduction to the nervous system module
 Embryologic development of the nervous system
 Gross and microscopic structure and functions of the brain and spinal cord
 Gross and microscopic structure and functions of peripheral nerves
Day 2
 Cerebral blood flow, cerebrospinal fluid and brain metabolism
 Motor functions of the spinal cord; cord reflexes
 Neurochemistry
 Neurotransmitters
Day 3
 Pathophysiology of common brain disorders (e.g., Cerebro-vascular disease, CNS
trauma, tumor, primary disease of the myelin, acquired metabolic and toxic
disturbance, degenerative disease and dementia)Common infections of the nervous
system
 Pharmacology of drugs used for treatment of common CNS infections and brain
tumors
 Pharmacology of drugs used for Parkinsonism, Alzheimer’s disease

Problem-based learning [4 Hrs.]

 A case of head and spinal cord injury, case of unconscious patient
Basic science lab [2 Hrs.]
 Anatomical charts and models of the CNS
 Dissection of the brain, spinal cord and peripheral nerves
 Computer-simulations of the CNS
 Computer simulations of neurotransmission
 Tissue and pathology slides and specimens
 CSF analysis
Clinical skills lab [2 Hrs.]
 Simulated practice: Examination of the nervous system (history taking and
physical examination)
 Simulated practice: Approach to a patient with loss of consciousness (history
taking and physical examination)
Hospital visit [2 Hrs.]
 General OPD, Medical OPD, Pediatrics OPD, Surgical OPD
Whole group session [1 Hr.]
 Faculty facilitated discussion and reflection on the week’s learning activities
Week 2 Interactive lecture (15hrs) Reflective
Day 1 portfolio
 Gross and microscopic structure and function of the autonomic nervous system
 Sympathetic and parasympathetic systems functions
 Autonomic reflexes
 Stimulation of organs by the sympathetic and parasympathetic systems
Day 2

108
 Date Learning Activity Required
Reading
 Introduction to pharmacology of autonomic drugs
 Pharmacology of cholinergic drugs
 Pharmacology of anticholinesterase drugs
 Pharmacology of adrenoceptor agonists and sympathomimetic
 Pharmacology of adrenoceptor antagonists and skeletal muscle relaxants
Day 3
 Common brain function disturbance (sleep disorder, psychiatric diseases and
depression)
 Pharmacology of sedative/hypnotics and anti-seizure
 Pharmacology of antipsychotic and antidepressants
 Pharmacology of pain medication (NSAIDs and Opioid analgesics)
Problem-based learning [4 Hrs.]
 A case of pain
Basic science lab [2 Hrs.]
 Computer simulation of autonomic nervous system
 Autonomic function testing: Valsalva manoeuver
 Anatomical charts and models
 Dissection of the spinal cord
 Tissue slides, pathology slides and specimens
 Computer-simulations of spinal cord transection
Clinical skills lab [2 Hrs.]
 Simulated practice: Approach to a patient with poisoning (history taking and
physical examination)
 Simulated practice: Approach to a patient with pain (history taking and physical
examination)
Hospital visit [2 Hrs.]
 General OPD, Medical OPD, Pediatrics OPD, Surgical OPD
Whole group session [1 Hr.]
 Faculty facilitated discussion and reflection on the week’s learning activities
Week 3 Interactive lecture (16hrs) Reflective
Day 1 portfolio
The special senses: the eye, the sense of hearing
 Gross and microscopic structure and function of the eye
 Optics of vision
 Receptor and neural function of retina
 Neurophysiology of vision
 Pathologies of the eye
 Ocular pharmacology
 Gross and microscopic structure and function of the ear
 Tympanic membrane and ossicular system
 Cochlea
 Central auditory mechanisms
 Hearing abnormalities
Day 2
Chemical senses
 The sense of taste

109
 Date Learning Activity Required
Reading
 Taste loss
 The sense of smell
 Anosmia
Day 3
Review of the nervous system
 Discussion (2 hours)
 Basic science lab (3 hours)
 Clinical skills lab (3 hours)
Problem-based learning tutorial [4 Hrs.]
 A case of hearing difficulty
Basic science lab [2 Hrs.]
 Anatomical charts and models
 Computer-simulations of seeing, hearing, tasting and smelling functions

Clinical skills lab [2 Hrs.]

 Simulated practice: Visual acuity testing
 Simulated practice: Hearing testing
Hospital visit [2 Hrs.]
 General OPD, Medical OPD, Pediatrics OPD, Surgical OPD
Whole group session
Faculty facilitated discussion and reflection on the week’s learning activities
Week 4 Exam week
Monday –Wednesday study days
Thursday -written exam
Friday –OSCE

110
Year I Modules Syllabi: II

1. Basic Writing Skills

2. Gastrointestinal system
3. Musculoskeletal and integumentary system
4. Introduction to Anesthesia II
5. Physical Diagnosis
6. Diagnostic Modalities
7. Determinants of Health
8. Basics of Anesthesia I

111
Basic Writing Skills

Module Name: Basic Writing Skills

Module Code: EnLa M-3113
Module ECTS: 5
Module Duration: 20 Weeks

Module Description: Sentence level writing: sentence structure, sentence types, functional and
structural category, common sentence errors (fragments, comma splices, run-on sentences, dangling
modifiers and agreement errors); Paragraph level writing : paragraph, topic sentence and supporting
details, structure, essentials of a paragraph, basic types of paragraphs (expository, narrative, descriptive
and argumentative ) and techniques of paragraph development; essay level writing : structure of an
essay, thesis statement and supporting paragraphs, types of essays and techniques of essay
development.

Learning Outcomes:
At the end of this course, students will be able to:
 Construct meaningful sentences in English;
 Learn to compose a paragraph that has a clearly stated topic sentence and details ;
 Use appropriate coordination and subordination skills to relate ideas;
 Identify and correct common sentence problems: fragments, comma splices, and run-on
sentences, dangling modifiers and agreement errors.
 Compose paragraphs that have clearly stated topic sentences and supporting details.
 Write a well-structured essay of different types ( descriptive, narrative, expository and
argumentative)

112
 Module schedule
Tentative Schedule
We Study Topics and Sub Topics Student Roles and Required Texts
ek Hours activities
General introduction about the course,
1 Lecture: and setting ground rules Main worksheet 1
3hrs Activities: Identifying subject page 1-2
Home St: Unit One: Writing Effective and predicate- Writer’s
4hrs Sentences: Choice:pp452-454 ( exercise 1-6), Practical English Handbook
Ass’nt: overview of writing effective sentences - A concise Guide to composition page 15-17,26-28 Writer’s
2hrs sentence definition, Identifying sentence page:124;expanding subject Choice :451-457,512 A Guide
parts (subject and predicate), writing and predicate- Writer’s Choice to Better Writing pp261-269;
complete sentences; sentence types: pp455(exercise7and9),Functiona Writer’s Choice501-505;A
functional category (declarative, l category- A concise Guide to concise Guide to composition
interrogative, imperative and composition page:125 pp119-122 Main worksheet
exclamatory sentences) 1
page 2-5
Writing Effective Sentences (continued-- Activities: structural
--) classification-A Guide to A concise Guide to composition
Identifying sentence types: structural Better Writing pp270-71, page:Pp129-140 A concise
Category ( simple, compound, complex Writer’s Choice pp502- Guide to composition
1& and compound complex); Joining ideas 504(exercise 4-8) page:Pp129-140
2 :coordination, subordination, correlation Writer’s Choice513-517
and using relative pronouns Main worksheet 1
Lecture: Activities: correcting faulty page 5-7
3hrs sentences- A concise Guide to
Home St: Writing Effective Sentences (continued-- composition page:174-
4hrs --) 177;Writer’s Choice pp513-
Ass’nt: Identifying and correcting faulty 515(Ex 21-23),College English Practical English Handbook pp
2hrs sentences :fragments, run-ons, comma Writing; pp418-443 125-171
splices, Writer’s Choice pp 675-
Activities: correcting faulty
sentences- A concise Guide to Main worksheet 2
2& Writing Effective Sentences (continued-- composition page:174-177 page 1-2
3 --) Identifying and Effective Academic Writing
correcting faulty sentences: dandling Activities on using punctuation 2 pp 1-8
Lecture: modifiers and agreement errors; marks Practical English From Paragraph to Essay
3hrs Handbook pp 125,128,131,136 pp 3-15
Home St: Writing Effective Sentences (continued-- 137,139,144, A Guide to Better Writing 83-
4hrs --) 145,149,15,157(Ex 1- 150
Ass’nt: Using punctuation(a period, comma, 11)Writer’s Choice
2hrs semi-colon, colon, quotation mark) and pp675,676,677,679,
capitalization 681,683,686(Ex1-8) Main worksheet 2
page -6

113
3 Effective Academic Writing 2
Lecture: Unit Two: Writing Effective Paragraphs; pp9-15
3hrs overview of writing effective A concise Guide to composition
Home St: Paragraphs- paragraph definition, nature pp28-32
4hrs of a paragraph, Identifying topic
Ass’nt: sentence and supporting details, writing Activities: Identifying topic
2hrs topic sentences( with topics and sentences and supporting A Guide to Better Writing 83-
controlling idea), nature and position of details Effective Academic 150
topic sentences in paragraphs, narrowing Writing pp 3-8(Ex1-8) Effective Academic Writing 1
4 Lecture: a title From Paragraph to Essay pp 8- pp 30-142; Effective Academic
3hrs 9,11,12 Writing3 pp88-109
Home St: Writing Effective Paragraphs A concise Guide to composition
4hrs (continued…) pp32-39
Ass’nt: structure of a paragraph, essentials of a
2hrs paragraph: unity, coherence(ways of
achieving coherence: using transitional
devices, pronouns, key words and Activities: achieving coherence Main worksheet 2
synonyms) and adequate development; and unity in a paragraph page 7-8
organization: space, time and order of Effective Academic Writing 2
importance pp9-14 A concise Guide to Main worksheet 3
composition pp40-42 page 1-2
4& Writing Effective Paragraphs Effective Academic Writing2
5 (continued…) pp16-26
Writing basic types paragraphs: Effective Academic Writing3pp
Lecture: expository, descriptive, narrative and 2-30
3hrs argumentative; Activities: types and methods of College Writing Skills; pp 135-
Home St: paragraph development 145
4hrs Techniques of paragraph development: Effective Academic Writing1
Ass’nt: definition, exemplification/illustration, pp35-37(Ex 4-6),pp56-60(Ex3-
4 2hrs classification, cause and effect, 5),pp81-83(3-5); A Guide to Main worksheet 3
comparison, contrast, description( Better Writing pp 86-87,89- page 3-4 Effective Academic
process, objective and impressionistic), 90,94-95,97-98,102,104- Writing2 pp16-26Effective
and listing/enumeration 105,110; A concise Guide to Academic Writing3pp 2-30
Lecture: composition pp42-43 College Writing Skills; pp 135-
3hrs Writing Effective Paragraphs 145
Home St: (continued…)
4& 4hrs Developing a paragraph: guided and
5 Ass’nt: free writing guided writing-arranging
2hrs given sentences in a logical order, Main worksheet 3
writing a paragraph by developing topic Activities on free and guided page 3-4 Effective Academic
sentence and specific details using given writing Writing2 pp16-26
points of a title Main worksheet 2 page 7-8 Effective Academic Writing3pp
Free writing –writing a paragraph on a 2-30
given title or on your own title

114
5& Lecture: College Writing Skills; pp 135-
6 3hrs 145
Home St: Unit Three Essay Writing
4hrs Stimulating idea on features of an essay
Ass’nt: Definition of an essay, structure of an Activities on nature and structure
2hrs essay: introduction, body and of an essay Effective Academic
6 conclusion; reviewing paragraph Writing2 pp17-18,19,25 Effective A Guide to Better Writing
Lecture: structure vs essay structure Academic Writing3 pp3-7,10-11 165-225
3hrs Identifying thesis statement and A Guide to Better Writing College Writing Skills; pp 161-
Home St: supporting paragraphs, elements of the pp170-173,188 Main 319
4hrs thesis statement: topic and controlling worksheet 3 page 1-2 Effective Academic
7 Ass’nt: idea Writing2pp28-74
2hrs Activities on nature and structure Effective Academic
of an essay, how t o write the Writing3pp88-109
Essay Writing (continued…) introduction part
7& Achieving unity and coherence within an Effective Academic Writing3
8 Lecture: essay pp12-19 College Writing Skills;
3hrs Writing the introduction ( writing the pp138-145 Main worksheet 3
Home St: hook, the background and the thesis page 3-4
4hrs statement)
8 Ass’nt:
2hrs Essay Writing (continued…)
Lecture: Writing the body and the concussion
3hrs Steps in writing an essay:
9 Home St: Planning(questioning, making list, Activities on how to write the body
4hrs clustering, preparing outline), drafting, and the conclusion and steps on
Ass’nt: revising, and editing essay writing Activity Effective
2hrs Academic Writing3 pp10,11
9& Lecture: College Writing Skills;
10 3hrs Essay Writing (continued…) pp25,27,28,31-32,35-37,38-47
Home St: Writing the basic types of essays (
4hrs expository, descriptive, narrative and Activities on writing different types
Ass’nt: argumentative)by employing the of essays
2hrs different techniques Effective Academic Writing2
Lecture: Essay Writing (continued…) pp28-31,34-36,37-38,55-63,76-
3hrs Writing the basic types of essays ( 78 Effective Academic
Home St: expository, descriptive, narrative and Writing3pp93-97
4hrs argumentative)by employing the College Writing Skills;
10 Ass’nt: different techniques pp189,203-4,220-226
2hrs
Lecture: Essay Writing (continued…) Activities on writing different types
3hrs Writing the basic types of essays ( of essays
Home St: expository, descriptive, narrative and Effective Academic Writing2
4hrs argumentative)by employing the pp28-31,34-36,37-38,55-63,76-
different techniques 78

115
 Ass’nt: First Semester final Exam Week Effective Academic Writing3pp93-
2hr 97
Lecture:
3hrs Activities on writing different types
Home St: of essays
4hrsAss’nt Effective Academic Writing2
: 2hrs pp28-31,34-36,37-38,55-63,76-
78
Effective Academic Writing3pp93-
97
Teaching and learning methods Classroom contact/Lecture, group work, interactive tutorial sessions (group and pair
work/discussions and individual work (independent learning).
Assessment Continuous assessment Competence to be assessed
Students are most frequently 1 quiz and two individual writing assignments Skill and knowledge of:
evaluated through their written 50 % identifying components of a
assignments (30%) and Quiz: Sentence level writing (10%) week 3; sentence, completing a sentence
classroom quiz (10%). There is with appropriate components,
also final exam (50%) Assignment 1 and 2 Paragraph writing (20%) identifying types of sentence,
week 8; identifying elements of a paragraph,
Writing a topic sentence and
Assignment 3 Essay writing (10%) week 12 supporting details and a concluding
sentence identifying and writing a
thesis statement, hook, background
writing an introductory paragraph,
body and conclusion of an essay. of
an essay
writing descriptive, expository,
Two group writing assignments 20% narrative and argumentative
Assignment 1 paragraph level writing (10%) paragraph
week 10 Assignment 2 Essay level writing writing an essay (outlining, drafting,
(10%) week13 revising, editing)
Three Quizzes (15%) identifying and correcting common
Quiz 1 on sentence writing 5% week 4; sentence errors
Quiz 2 on paragraph writing 5% week 6 identifying types of a paragraphs
Quiz 3 on essay writing 5% week 14 and methods of developing a
paragraph
organizing paragraphs to make a
complete essay( unity and
coherence)
Final exam 50 week 16

116
Course Expectation Preparedness: you must come to class prepared by bringing with you the appropriate
materials like the worksheet, text books and completed assignments. Complete the
reading assignments and other activities on time. You must plan your own learning.
Since the course is a writing course, it is demanding, and you are expected to work
much individually to meet the requirement of the course. You have to use your time for
group work and home study effectively.
Participation: make active participation during discussions (you must participate in
class). You are not participating if you are talking to a neighbour, doing homework,
daydreaming, or not doing what the rest of the class is doing. If you are working in a
group or with a partner, you must talk to your group members or partner and be a part
of the group. You cannot learn English by being silent. Always be ready and willing to
give constructive feedback to partners/group members and to listen to their comments
on your work.
Medium: use only English during group and pair work, in the class room and out of class
room discussions.

Course Policy Attendance: It is compulsory to come to class on time and every time. If you are going
tomiss more than three classes during the term, you should not take this course.
Assignments: you must do your assignment on time. No late assignment will be
accepted.
Tests/Quizzes: you will have short quizzes and tests almost every week. If you miss the
class or, are late to class, you will miss the quiz or test. No makeup tests or quizzes will
be given. You are expected to observe the rules and the regulations of the University as
well.
Cheating/plagiarism: you must do your own work and not copy and get answers from
someone else. The only way to learn English is to do the work yourself.
Also, please do not chew gum, eat, listen to recorders or CD players, wear sunglasses, or
talk about personal problems. Please be sure to turn off pagers and cell phonesbefore
class and exam sessions

Reference Writer’s Choice : Grammar and Composition

Rorabacher ,L A Concise Guide to Composition (3rd Ed). London Harper and Row
publishers(1976)
A Guided Writing to Composition
Langan,J College Writing Skills. sixth Edition. Boston: Mcgraw-Hill (2005).
Savage, A.and M. Shafiei,Effective Academic Writing 1. Oxford: Oxford University Press.
(2007)
Savage, A.and P. Mayer Effective Academic Writing 2 Mcgraw-Hill (2005). Oxford
University Press. (2005)
Davis,J and R,Liss Effective Academic Writing 3 The Essay. Oxford University Press. (2005)

117
Gastrointestinal System

Module Title: Gastrointestinal System

Module Code: BioMM-3122
ECTS: 3ECTS

Module Description: This system-based module is intended to equip anaesthesia students with
profound knowledge of basic sciences and development of early clinical skills relevant to
understanding of the gastrointestinal system and related clinical problems. This module will be
addressed through interactive lecture, basic science lab and hospital visits.

Module Objective
 By the end of this module, students will be able to apply knowledge of basic sciences for
understanding the gastrointestinal system and analysing gastro-intestinal disorders.

Supporting Objectives
1. Identify normal and abnormal structures and functions of the GI system in analysing clinical
problems in a simulated setting (K2)
2. Apply knowledge of normal and abnormal structures and functions of the GI system in
analysing clinical problems in a simulated setting (K3)
3. Apply knowledge of physiological mechanisms and processes of the GI system in analysing
clinical problems in a simulated setting (K3)
4. Analyse important determinants and risk factors of common GI disorders (K3)
5. Explain drug pharmacokinetics and pharmacodynamics that are used for the treatment of GI
disorders in a simulated setting (K3)
6. Demonstrate the ability to take history and physical examination from a patient with GI
disorder in a simulated setting (S3)
7. Make an assessment of a simulated patient presenting with GI disorder (K3 & S3)
8. Formulate a plan of investigation for a simulated patient with GI disorder in partnership with
the patient, obtaining informed consent as an essential part of this process (K3SA3)
9. Interpret the results of basic investigations for common GI disorders in a simulated setting
(K3)
10. Formulate a likely diagnosis in a simulated patient with GI disorder (K3, S3)

118
11. Formulate a plan for management of a simulated patient with GI disorder according to
established principles and best evidence, in partnership with the patient and other health care
teams(K3, S3)
12. Demonstrate the ability to apply the basic principles of control of communicable diseases for
common GI disorders in hospital and community settings (S3)
13. Demonstrate one’s recognition of the obligation to promote, protect and enhance the essential
elements of the anaesthesia profession in interaction with patients with GI disorder under a
simulated setting (A3)
14. Demonstrate professional values in approaching GI patients under simulated conditions (A3)
15. Identify learning needs to better understand respiratory disorders (K2)
16. Demonstrate the ability to communicate with patients, families, communities and other health
professionals in a responsive and responsible manner that supports a team approach to the
maintenance of health and treatment of GI disorders (S3, A3)

Duration: 3 weeks

Teaching and learning methods

1. Interactive lecture
2. PBL
3. Case study
4. Video show
5. Demonstration
6. Role play
7. Observation in clinical setting
8. Basic sciences lab
9. Clinical skills lab
10. Community visit
11. Portfolio
12. Whole group session

References
1. Gray’s anatomy for students. 2007

119
 2. Keith L. Moor, Arthur F. Dally, Anne M.R. Agur. Clinically oriented anatomy. 6th edition.
2010
3. Snell, Richard S. Clinical anatomy by regions / Richard S. Snell. 9th edition. 2012
4. Keith L. Moore, T.V.N. Persaud and Mark G Turchia. The developing human. Clinically
oriented embryology (9th edition). 2013.
5. Junqueira’s basic histology: text and atlas. 13th edition. 2013
6. Guyton and Hall. Textbook of medical physiology. 11th edition. 2006.
7. Ashis Banerjee. Clinical physiology. An examination primer. 2005.
8. John Baynes and Marek Dominiczak. Medical biochemistry. 4th edition. 2014
9. Alan Gaw. Clinical biochemistry 5th edition. 2013
10. Eric Arthur Newsholme and Tony R. Leech. Functional biochemistry in health and disease.
2010.
11. Stephen Goldber. Clinical biochemistry made ridiculously simple. 1999.
12. Alan Gaw (et al). Clinical biochemistry. An illustrated color text. 2nd edition. 1999.
13. Richard N Mitchell, Ramzi S. Cotran. Robbins basic pathology. 8th edition. 2007.
14. David A Levison, Robin Reid, Alistair D Burt, David J Harrison and Stewart Fleming. Muir's
Textbook of Pathology, Fourteenth Edition
15. Abhay R. Satoskar [et al. Medical parasitology. 2009
16. Color atlas of parasitology.
17. Bertram G. Katzung. Basic and clinical pharmacology. 12th edition. 2011
18. Goodman and Gilman’s. The pharmacological basis of therapeutics. 12th edition. 2011.
19. Lynn S. Bickley, Peter G. Szilagyi. Bates’ guide to physical examination and history taking.
— 10th ed. 2009
20. Michael Swash and Michael Glynn. Hutschison’s clinical methods. An integrated approach
to clinical practice. 22nd edition. 2007
21. Goldman. Cecil Medicine. 23rd edition. 2007
22. Courtney M. Townsend Jr. [et al.]. Sabiston textbook of surgery: the biological basis of
modern surgical practice. 19th edition 2012
23. Anatomy atlas and charts
24. Videos of patient examination
25. Imaging studies of different GI conditions
26. Mannequins

120
Teaching and learning materials
 Computer-based simulations

Methods of assessment
Formative
 Global rating of performance
 Reflection exercise
 portfolio
 PBL
Summative
 Written exam (Progressive assessment) (30 %)
 Written exam (End of module assessment) (30 %)
 PBL (20%)
 OSPE/OSCE (20 %)

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 Module schedule

Date Learning Activity Required Reading/

Week 1 Interactive lecture (9hrs) Reflective portfolio
Day 1
 Introduction to the module
 The position, arrangement and parts of the GI tract
 Gross and microscopic structure and functions of the oral cavity, esophagus
, stomach, intestine and pancreases
Day 2
 Digestion of food
 Absorption of food
 Pathophysiology of common diseases of the oral cavity, esophagus, stomach,
intestine and pancreases

Day 3
 Microbes and parasites affecting the GI system
 Pharmacology of drugs used for treatment of common diseases of the GI
system
 Nutrients metabolism
Problem-based learning [4 Hrs.]
 A case of jaundice
Basic science lab [2 Hrs.]
 Anatomical charts and models
 Dissection of the GI system
 Computer-simulations of mastication and deglutition process
 Anatomical charts and models
 Dissection of the liver and hepatobiliary system
 Computer-simulations of liver metabolism
 Liver function tests
Clinical skills lab[2 Hrs.]
 Simulated practice: Examination of the oral and GI system (history taking
and physical examination)
 Simulated practice: Approach to a patient with jaundice (history taking and
physical examination)
Hospital visit [2 Hrs.]
 General OPD, Medical OPD, Pediatrics OPD, Surgical OPD
Whole group session
 Faculty facilitated discussion and reflection on the week’s learning
activities
Week Interactive lecture (9hrs) Reflective portfolio
Day 1
 Gross and microscopic structures and functions of the liver and
hepatobiliary system
 Liver metabolism
 Pathophysiology of common diseases of the liver and hepatobiliary system
Microbes and parasites affecting the liver and hepatobiliary system

122
Date Learning Activity Required Reading/
Day 2[2 Hrs.]
Pharmacology of drugs used for treatment of common diseases of the liver and
hepatobiliary system
Review of the gastrointestinal system
 Discussion (2 hours)
 Basic science lab (3 hours)
 Clinical skills lab (3 hours)

Thursday and Wednesday: Study break for exam

Friday: Written exam and OSCE
Whole group session
 Faculty facilitated discussion and reflection on the module learning
activities

123
Musculoskeletal and Integumentary System

Module Title: Musculoskeletal and Integumentary System

Module Code: BioMM-3132
ECTS: 2ECTS

Module Description: This system-based module is intended to equip anaesthesia students with
profound knowledge of basic sciences and development of early clinical skills relevant to
understanding of the musculoskeletal and Integumentary system and related clinical problems. This
module will be addressed through interactive lecture, simulation and hospital visits.

Module Objective
By the end of this module, students will be able to apply knowledge of basic sciences for understanding
the musculoskeletal and integumentary system and analysing disorder of the musculoskeletal and
integumentary system

Supporting Objectives
1. Apply knowledge of normal and abnormal structures and functions of the musculoskeletal
and integumentary system in analysing clinical problems in a simulated setting (K3)
2. Apply knowledge of physiological mechanisms and processes of the musculoskeletal and
integumentary system in analysing clinical problems in a simulated setting (K3)
3. Analyze important determinants and risk factors of common musculoskeletal and
integumentary disorders (K3)
4. Explain drug pharmacokinetics and pharmacodynamics that are used for the treatment of
musculoskeletal and Integumentary disorders in a simulated setting (K3)
5. Demonstrate the ability to take history and physical examination from a patient with
musculoskeletal and Integumentary disorder in a simulated setting (S3)
6. Make an assessment of a simulated patient presenting with musculoskeletal and
Integumentary disorder (K3 & S3)
7. Formulate a plan of investigation for a simulated patient with musculoskeletal and
Integumentary disorder in partnership with the patient, obtaining informed consent as an
essential part of this process (K3SA3)
8. Interpret the results of basic investigations for common musculoskeletal and integumentary
disorders in a simulated setting (K3)

124
 9. Formulate a likely diagnosis in a simulated patient with musculoskeletal and Integumentary
disorder (K3, S3)
10. Formulate a plan for management of a simulated patient with musculoskeletal and
integumentary disorder according to established principles and best evidence, in partnership
with the patient and other health care teams(K3, S3)
11. Demonstrate the ability to apply the basic principles of control of communicable diseases
for common musculoskeletal and integumentary disorders in hospital and community
settings (S3)
12. Demonstrate one’s recognition of the obligation to promote, protect and enhance the
essential elements of the anesthesia profession in interaction with patients with
musculoskeletal and integumentary disorder under a simulated setting (A3)
13. Demonstrate professional values in approaching musculoskeletal and integumentary
patients under simulated conditions (A3)
14. Identify learning needs to better understand musculoskeletal and integumentary disorders
(K2)
15. Demonstrate the ability to communicate with patients, families, communities and other
health professionals in a responsive and responsible manner that supports a team approach
to the maintenance of health and treatment of musculoskeletal and integumentary disorders
(S3, A3)

Teaching and learning methods

 Interactive lecture
 PBL
 Case study
 Video show
 Demonstration
 Role play
 Observation in clinical setting
 Basic sciences lab
 Clinical skills lab
 Community visit
 Personal research and reflection exercise
125
  Portfolio
 Computer lab practice
 Whole group session

References
1. Gray’s anatomy for students. 2007
2. Keith L. Moor, Arthur F. Dally, Anne M.R. Agur. Clinically oriented anatomy. 6th edition. 2010
3. Snell, Richard S. Clinical anatomy. 9th edition. 2012
4. Keith L. Moore, T.V.N. Persaud and Mark G Turchia. The developing human. Clinically
oriented embryology (9th edition). 2013.
5. Junqueira’s basic histology: text and atlas. 13th edition. 2013
6. Guyton and Hall. Textbook of medical physiology. 11th edition. 2006.
7. Ashis Banerjee. Clinical physiology. An examination primer. 2005.
8. John Baynes and Marek Dominiczak. Medical biochemistry. 4th edition. 2014
9. Alan Gaw. Clinical biochemistry 5th edition. 2013
10. Eric Arthur Newsholme and Tony R. Leech. Functional biochemistry in health and disease.
2010.
11. Stephen Goldber. Clinical biochemistry made ridiculously simple. 1999.
12. Alan Gaw (et al). Clinical biochemistry. An illustrated color text. 2nd edition. 1999.
13. Richard N Mitchell, Ramzi S. Cotran. Robbins basic pathology. 8th edition. 2007.
14. David A Levison, Robin Reid, Alistair D Burt, David J Harrison and Stewart Fleming. Muir's
Textbook of Pathology, Fourteenth Edition
15. Abhay R. Satoskar [et al. Medical parasitology. 2009
16. Color atlas of parasitology.
17. Bertram G. Katzung. Basic and clinical pharmacology. 12th edition. 2011
18. Goodman and Musculoskeletal and integumentary lman’s. The pharmacological basis of
therapeutics. 12th edition. 2011.
19. Lynn S. Bickley, Peter G. Szilagyi. Bates’ guide to physical examination and history taking. —
10th ed. 2009
20. Michael Swash and Michael Glynn. Hutschison’s clinical methods. An integrated approach to
clinical practice. 22nd edition. 2007

126
21. Courtney M. Townsend Jr. [et al.]. Sabiston textbook of surgery: the biological basis of modern
surgical practice. 19th edition 2012

Teaching and learning materials

 Videos of patient examination
 Imaging studies of different musculoskeletal conditions
 Mannequins for procedures

Methods of assessment
Formative
 PBL progressive assessment
 Direct observation of clinical skills
 Logbook
 Global rating of performance
 Portfolio
 Personal research and reflection exercise
Summative
 PBL progressive assessment (30 %)
 Written exam (Progressive assessment) (20 %)
 Written exam (End of module assessment) (30 %)
 OSPE/OSCE (20 %)

127
 Module schedule
Date Learning Activity Required Reading/
Assignment
Week 1 Interactive lecture [5 Hrs.] Reflective portfolio
Day 1 [2 Hrs.]
 Introduction to the module
 Gross and microscopic structure and functions of the skin and muscle
 Biochemistry of skin and muscle Biochemistry and physiology of physical activity
(muscle metabolism)
Day 2 [3 Hrs.]
 Pathology of the skin (inflammatory dermatoses, infectious dermatoses) and
muscle (muscle atrophy, dystrophy, myopathy, disease of the neuromuscular
junction, skeletal muscle tumor)
 Common microbes and parasites affecting the skin and muscle
 Pharmacology of agents acting at the neuromuscular junction
 Dermatologic pharmacology
Problem-based learning [4 Hrs.]
 A case of myasthenia gravis
Basic science lab [2 Hrs.]
 Anatomy and Anatomic atlas showing skin and muscle structure
 Dissection of the skin and muscle
Clinical skills lab [2 Hrs.]
 Simulated practice: Examination of the integumentary and musculo-skeletal system
(history taking and physical examination)
 Approach to a patient with muscle wasting (history taking and physical
examination)
 Computer simulation to study muscles origin, insertion and action

Hospital visit [2 Hrs.]

 General OPD, Medical OPD, Pediatrics OPD, surgical OPD, Dermatology clinic
Whole group session
Faculty facilitated discussion and reflection on the week’s learning activities
Week 2 Interactive lecture [4 Hrs.] Reflective portfolio
Day 1 [3 Hrs.]
 Gross and microscopic structure and functions of bone and joint supporting structure
 The arrangement and position of joints and supporting structure
 Calcium and bone metabolism
 Pathology of common diseases of the bone ( congenital diseases of bone, acquired
diseases of bone development, fracture, bone tumor) and joints (arthritis, joint
tumor)
 Common microbes affecting joints
 Common microbes causing osteomyelitis
Day 2 [1 Hr.]
 Pharmacology of agents affecting the bone
 Pharmacology of agents used for the treatment of common joint problems
Problem-based learning [4 Hrs.]
 Rheumatoid Arthritis
Basic science lab [2 Hrs.]
 Anatomical charts and models of bones and joints

128
 Date Learning Activity Required Reading/
Assignment
Clinical skills lab [2 Hrs.]
 Simulated practice: Approach to a patient with disease of bone and joints (history
taking and physical examination)
Hospital visit[2 Hrs.]
 General OPD, Medical OPD, Pediatrics OPD, Surgical OPD
Whole group session
Faculty facilitated discussion and reflection on the week’s learning activities
Week 3 Monday [2 Hrs.] Reflective portfolio
Review of the musculoskeletal system
 Discussion (2 hours)
 Basic science lab (3 hours)
 Clinical skills lab (3 hours)
Tuesday and Wednesday: Study break for exam
Thursday: Written exam
Friday: OSCE

129
Introduction to Anesthesia II

Module Title: Compassionate and Respectful Care (CRC) Level II

Module Code: - AnstPM-3141

Module ECTS: 2 ECTS

Module Duration: 20 Weeks

Pre-requisite: CRC module I

Module Description: This module is a continuity of CRC module 1 and designed to equip
students with the required Knowledge, Skill and Attitude by giving emphasis on communication
with ill patient and patient’s family, health care team, and preventive ethics that enable to students to
demonstrate the ability to provide care in compassionate and respectful manner. On top of this it
also gives emphasis on operation room techniques, infection prevention, basic clinical skills and
patient safety.

Module Competencies

 Effectively communication with ill patient and patient’s family, and health care team,
 Apply preventive ethics in daily clinical practice
 Demonstrate the ability to provide care in compassionate and respectful manner
 Implement professional development plan that promote lifelong learning
 Demonstrate the ability to build and manage team

Learning outcomes

 Accurately convey relevant information and explanations to patients and families, colleagues
and other professionals
 Demonstrate the ability to provide information for the patient, clients and their families on
the need for ordering investigation, patient diagnosis, treatment and prognosis.
 Effectively counsel patients and clients and their families on serious but not-deadly
conditions
 Effectively communicate within and across health care teams

130
  Demonstrate the ability to communicate in difficult circumstances including sensitive issues
such as alcohol consumption, smoking or obesity.
 Demonstrate the ability to provide care in Compassionate and Respectful manner
 Apply preventive ethics in daily clinical practice
 Implement professional development plan that promote lifelong learning
 Demonstrate the ability to build and manage health care team

Teaching-Learning Methods
 Interactive lecture and discussion
 Facilitated discussion
 Role play
 Case study
 Video show
 Demonstration (at skills lab)
 Guided clinical practice
 Field visit (charity centres, …)
 Story telling (by guests, role models,)
 Peer professional guidance (senior students to assist their more junior peers by passing on
important and useful information)

Reference Books and Resources

17. Barash Clinical Anaesthesia, 8th Edition. Paul G. Barash.
18. Anaesthesia and co-existing disease, 3rd Edition. Robert K. Stoelting
19. Miller’s anaesthesia volume 1 and 2, 6th Edition. Ronald D. Miller.
20. EFHMACA regulations for health professionals EFMHCA Regulation 299/213 EFMHCA
Regulation 661/2009
21. Code of conduct for anaesthetists
22. World manual of Medical Ethics
23. Richard E. Ashcroft. Principles of health care ethics, 2nd Edn, 2007
24. Gwen Van Servellen. Communication skill for the Health Care Professional: Concepts,
Practice. Jones and Bartlett Publisher. 2009

131
 25. Competency-based professionalism in anaesthesiology: Continuing Professional
Development (DOI 10.1007/s12630-012-9747-z)
26. Richard E. Ashcroft. Principles of health care ethics, 2nd Edn, 2007
27. Raanan Gillon. Principles of health care ethics, 1994
28. EFMOH compassionate and respectful care training manual for health work force, 2017
29. EFMHCA Regulation 299/213 (http://www.fmhaca.gov.et/)
30. EFMHCA Regulation 661/2009 (http://www.fmhaca.gov.et/)
31. Professional Code of conducts
32. Interview guide questions for health professionals on threats and its solution

Teaching-Learning Materials and resources

 Checklists: Compassionate care checklist, etc
 Case studies
 Writing board
 Posters
 LCD Projector and PPTs
 White board, marker
 Laptop and Videotapes
o Sample Video of a compassionate service/help
 Role play stories from EFMOH compassionate and respectful care training manual for health
work force, 2017

Learning Assessment methods (both formative and summative)

 Written cognitive knowledge test (MCQ/essay)
 360-degree professionalism appraisal
 Review of reflective portfolio
 review of works (assignments, projects, ….) completed by students
 Case study- student analysis case on unprofessional behaviors and produce a written
reflection on the situations described in case.
 Professionalism mini-evaluation exercise (P-MEX)- Direct observation of student’s
professional behaviors
 Peer assessment of professional behaviors

132
  Structured Oral Examination Attendance,
 Punctuality
 Attendance
 Work being submitted on time
 Students Participation in any voluntary service

Summative assessment
 Professionalism mini-evaluation exercise (P-MEX)- Direct observation of student’s
professional behaviors= 30 %
 Written cognitive knowledge test using MCQ/essay/case study = 25%
 360-degree professionalism appraisal= 20%
 Review of students’ reflective portfolio = 15%
 Testimony that show students voluntary service/participation = 10%

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 Module Schedule

Duration: 20 Weeks (lecture 38 hrs. hospital practice 10 hrs. self-study 13 hrs.)

Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion and Activity [2 Hrs.]  Competency-based
C. CRC: Interactive lecture and Presentation: (2 hrs.) professionalism in
Team communication skills, pervasive nature of groups, Equality, anesthesiology:
diversity and communication, diagnosing group communication Continuing
problems, understanding communication and resolving dispute, Process Professional
of conflict resolution Development (DOI
Week 1 Activity on: 10.1007/s12630-012-
9747-z)
 Case sturdy -Team communication  Creating a Framework
 Role play - Team communication for Medical
Professionalism, 2016
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.
Interactive Lecture, Discussion and Activity [2 Hrs.] 
C. CRC: Interactive lecture and Presentation: (2 hrs.)
Importance of discussing patient diagnosis, treatment and prognosis with
patients with minor condition and Principles of providing clear and
understandable information
Activity on:
• Demonstration and guided practice - Communicating patients with
minor conditions

Hospital Visit (2 Hrs.)

 Hospital visit (personal observation on professionals approach and
communication with patients)
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
Week 2 including the department head.
Interactive Lecture, Discussion and Activity [2 Hrs.] 
B. CRC: Interactive lecture and Presentation: (2 hrs.)
Principles of patient counseling
Activity on:
• Demonstration and guided practice - Patient counseling
Week 3

Hospital Visit (2 Hrs.)

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 Required Reading
Week Learning Activity
(Assignment)
 Hospital visit on patient counseling and health education
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.
Interactive Lecture, Discussion and Activity [2 Hrs.] 
B. CRC: Interactive lecture and Presentation: (2 hrs.)
 Reporting medical encounters
Activity on:
• Multiple role play - Reporting medical encounter

Whole Group Session (2 Hrs.)

 Students will discuss on the progress of the week’s teaching and
Week 4 learning process in the presence of their instructors and coordinators
including the department head.
Interactive Lecture, Discussion and Activity [2 Hrs.] 
B. CRC: Interactive lecture and Presentation: (2 hrs.)
 preventive ethics
 Ethical case analysis
 Priority setting
Week 5  Ethical consultation
Activity on:
 Case study - Ethical analysis and ethics consultation

Whole Group Session (2 Hrs.)

 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.
Interactive Lecture, Discussion and Activity [2 Hrs.] 
B. CRC: Interactive lecture and Presentation: (2 hrs.)
 Why preventive ethics in health care
 How to setup preventive ethics practice
 Support mechanisms for preventive ethics
 Importance of Ethical consultation
Activity on:
Week 6
 Case study on ethical issues

Hospital Visit (2 Hrs.)

 Hospital visit to identify ethical malpractice
Whole Group Session (2 Hrs.)

135
 Required Reading
Week Learning Activity
(Assignment)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.
Interactive Lecture, Discussion and Activity [2 Hrs.] 
B. CRC: Interactive lecture and Presentation: (2 hrs.)
 Career planning and Development
 Overview
 Stages in the health care workers careers
 Why career planning and Development important
 The career planning model
Activity
Week 7  Video watching, on how to develop the habit of lifelong Learning and
facilitated discussion
 Individual project: develop LL plan
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.
Week 8 Interactive Lecture, Discussion and Activity [2 Hrs.] 
B. CRC:
Interactive lecture and Presentation: (2 hrs.)

 Lifelong learning, what does it mean? Why you do it? And how do you
do it?
 Continuous professional development activities (: in service education,
professional development courses and self-directed Learning(SDL)
Activity on:

 continue Work on Individual project- Develop LLL plan

Whole Group Session (2 Hrs.)

 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.
Interactive Lecture, Discussion and Activity [2 Hrs.]  Applying the four
B. CRC: Interactive lecture and Presentation: (2 hrs.) principles, February,
 Factors that threatens provision of compassionate care 2013.
Activity on:  Richard E. Ashcroft.
Principles of health
 Case study- factors that threatens provision of compassionate care care ethics, 2nd Edn,
Week 9 2007

136
 Required Reading
Week Learning Activity
(Assignment)
Whole Group Session (2 Hrs.)  Principles of health
 Students will discuss on the progress of the week’s teaching and care ethics, Raanan
learning process in the presence of their instructors and coordinators Gillon. 1994
including the department head.  EFMOH
compassionate and
respectful care training
manual for health
work force, 2017.
Interactive Lecture, Discussion and Activity [2 Hrs.]  Reading assignment
B. CRC: Interactive lecture and Presentation: on: (2 hrs.) on- proclamation,
 Sign and symptom of CRC fatigue regulation, legislation
 burnout and its resolution and code of conduct
Week 10 Activity on: pertinent to health
care in Ethiopia
 Case study- sign and symptoms of fatigue, burnout and resolution  Legal and ethical
issues for health
professionals, Fourth
Whole Group Session (2 Hrs.) edition, 2016
 Students will discuss on the progress of the week’s teaching and  Health ethics and law
learning process in the presence of their instructors and coordinators for health extension
including the department head. workers Jimma
university, 2004
Interactive Lecture, Discussion, Video show and Activity [2 Hrs.]  EFMOH
B. CRC: Interactive lecture and Presentation: (2 Hrs.) compassionate and
 Characteristics CRC respectful care training
Activity on: manual for health
work force, 2017.
 Video show on Compassion, dignity and respect in health care  Sample compassionate
followed by facilitated discussion care short video from
Week 11 YouTube.
Hospital Visit (2 Hrs.)
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.
Interactive Lecture, Discussion, Video show and Activity [2 Hrs.]  EFMOH
B. CRC: Interactive lecture and Presentation: (2 hrs.) compassionate and
 Key issues of CRC respectful care training
Activity on: manual for health
Week 12 work force, 2017.
 Conduct health facility assessment using Compassionate & respectful  Role play stories from
care checklist EFMOH

137
 Required Reading
Week Learning Activity
(Assignment)
Whole Group Session (2 Hrs.) compassionate and
 Students will discuss on the progress of the week’s teaching and respectful care training
learning process in the presence of their instructors and coordinators manual for health
including the department head. work force, 2017.
 Interview guide
questions for health
professionals
Interactive Lecture, Discussion, Video show and Activity [2 Hrs.] 
 CRC: Interactive lecture and Presentation: (2hrs.)
Benefit of CRC for patient, health professionals , student and health
facility
Activity on:

 Video show/case studies - and identify CRC behaviors of health care

Week 13 providers
Hospital practice (2 hrs.)
 Clinical visit and observe CRC behaviors of HCP and reflect

Interactive Lecture, Discussion, Video show and Activity [2 Hrs.]  Compassionate

B. CRC: Interactive lecture and Presentation: (2 hrs.) leadership: What is it
 Features of Disrespectful care and why do
organizations need
Week 14 Activity on: more of it? By
Meysam Poorkavoos;
 Video show/case studies - and identify disrespectful behaviors of
www.roffeypark.com
health care providers
 EFMOH, National
 Clinical visit and observe Disrespectful behaviors of HCP and reflect
CRC training
participant manual for
health work force,
2017
 EFMOH, National
CRC facilitators guide,
2017
 Free online
Personalities tests
(Humanmetrics.com,
16Personalities.com

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 Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion, Video show and Activity [2 Hrs.] 
B. CRC: Interactive lecture and Presentation: (2 hrs.)
 Review of existing FMOH CRC checklist
Hospital practice (2 hrs.)
Week 15  Students observe and reflect CRC practice/behaviors in the health
facility

Interactive Lecture, Discussion, Video show and Activity [2 Hrs.] 

A. CRC: Interactive lecture and Presentation: (2 hrs.)
 Review of existing FMOH CRC checklist
Activity
Week 16
 Students observe and reflect CRC practice/behaviors in the health
facility
Whole Group Session (2 Hrs.)
 Students will discuss on the progress of the week’s teaching and
learning process in the presence of their instructors and coordinators
including the department head.
Interactive Lecture, Discussion and Activity [2 Hrs.]  How to succeed as a
A. CRC: Interactive lecture and Presentation: (2 hrs.) lifelong learner.
 Effective team building Primary Health Care.
 Team building leadership styles PHC624 Willcox A
 Type of team (2005)
Week 17  A model of self-
 Stages of team development
Activity on: directed learning in
internal medicine
 Team building exercise residency: a qualitative
study using grounded
Whole Group Session (2 Hrs.) theory, 2017
 Students will discuss on the progress of the week’s teaching and  Nurse Educator Core
learning process in the presence of their instructors and coordinators Competencies, WHO,
including the department head. 2016

139
 Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture, Discussion and Activity [2 Hrs.]  How to succeed as a
A. CRC: Interactive lecture and Presentation: (2 hrs.) lifelong learner.
 team management Primary Health Care.
 The importance of delegation PHC624 Willcox A
 Motivating team (2005)
 Developing team  A model of self-
Week 18 directed learning in
 Managing discipline
internal medicine
Activity on:
residency: a qualitative
 Demonstration and guided practice - Use of nonverbal study using grounded
communication theory, 2017
Whole Group Session (2 Hrs.)  Nurse Educator Core
 Students will discuss on the progress of the week’s teaching and Competencies, WHO,
learning process in the presence of their instructors and coordinators 2016
including the department head.
Interactive Lecture, Discussion and Activity [2 Hrs.]  How to succeed as a
A. CRC: Interactive lecture and Presentation: (2 hrs.) lifelong learner.
Primary Health Care.
 problem solving skills on health care team
PHC624 Willcox A
 Conflict management among health care team
(2005)
 Conflict management among health care team and clients/clients family
 A model of self-
Activity
directed learning in
C. Group presentation and discussion on the assignment provided on the internal medicine
previous session residency: a qualitative
study using grounded
Week 19 theory, 2017
 Nurse Educator Core
Competencies, WHO,
2016

Week 20 Examination week

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Physical diagnosis

Module Title: Physical Diagnosis

Module Code: MedM-21152
ECTS: 2 ECTS
Module Duration: 2 Weeks

Module Description: This Module is designed for BSc Anesthesiology Professional student’s to
apply basic Concepts and principles underlying assessment of the health status of individuals,
presented with emphasis placed on interviewing skills, health histories, and the physical and
psychosocial findings in the well person. Communication and assessment skills are developed.
Students obtain health histories, perform physical and psychosocial assessments, establish a database,
and formulate initial nursing plans using the nursing process.

Module Objective:

At the end of this module, the Anesthesiology Professional student will be able to:

 Take patient history and perform a systematic physical examination to diagnose health
problems and to distinguish between normal and abnormal physical, mental, medical and
surgical findings.

Learning Outcome:

At the end of this unit students will be able to:

1. Identify principles of history taking in the assessment process of individuals.

2. Conduct a health history, including environmental exposure and a family history that
recognizes genetic risks, to identify current and future health problems.

3. Demonstrate beginning level skill in the techniques of physical exam: inspection, palpation,
percussion, and auscultation

4. Demonstrate physical examination skills including focused physical, behavioral,

psychological, socioeconomic, and environmental assessments of health and illness

141
 parameters in patients, using developmentally and culturally appropriate approaches and
according to established criteria.

5. Document problems and needs in individuals from data discovered during the health
history and physical examination.

6. Compare and contrast the roles and responsibilities of the Anesthetists in the process of
health assessment and health promotion.

7. Differentiate between normal and abnormal assessment findings.

8. Apply relevant anatomy and physiology to the health assessment process.

9. Integrate health assessment into the Anesthesia practice.

10. Describe how cultural/ethnic differences influence the findings in a health assessment.

11. Explain how assessment techniques vary across the lifespan

Duration: 2 weeks

Teaching-Learning Methods
 Interactive lecture and discussion
 Small group learning activities: assignment, exercise, case study
 Individual reading
 Role play in Skill lab
 Student presentation
 Reflective portfolio and mentoring
 Clinical practice

Teaching-Learning Materials
1. Learning guides and checklists
2. Text books
3. Reference manual
4. Writing board
5. LCD Projector
6. White board, marker

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 7. Laptop
8. Handouts of lecture materials
9. Logbooks for entry of community experience
Reference Books
 Bate's guide to physical examination
 Principles & practice of anesthesiology, 2nd edition, Mark C.Rogers
 Clinical anesthesia, 3rd edition, Paul Barash, et,e.
Assessment Methods
Formative assessment
o Exercise and assignment
o Logbook and portfolio
o 360 degree evaluation
o Student presentation
Summative assessment
o Written exam (50 %)
o Quiz=10% and test =15%
o Attendance and class participation=5%
o Assignment and student presentation (20 %)
Module policy

Attendance: It is compulsory to attend a class on time and every time. If students are going to miss
more than three classes during the term, he/she should not take this Module.
Assignments: the student must do their assignment on time. No late assignment will be accepted.

Tests/Quizzes: There will be short quizzes and tests almost every week. If a student miss the class
or, are late to class, he/she will miss the quiz or test. No makeup tests or Quizzes will be given. The
students are expected to observe the rules and the regulations of the University as well.

143
 Duration 2 weeks (lecture 26hrs, hospital practice 4hrs, self-study 15hrs and skill lab practice 18hrs)
Weeks Topic Required Reading/
Assignment
Week 1 Classroom based Teaching (lecture, + seminars + group discussion) [6hrs.]
Introduction to clinical medicine
Introduction to the module
o Introduction to clinical medicine and the ward set up
o Introduction to comprehensive assessment
History taking
Techniques of physical examination
Nutrition status assessment
introduction to documentation and communication
General survey and measurement, introduction to mental health, nutrition
assessment
Clinical service visit (2 hrs.)
 Visit Clinical medicine, OPD, and wards

Classroom based Teaching (lecture, + seminars + group discussion) [6hrs.]

Assessment of vital signs, pain and symptom assessment
Assessment of the skin, hair, nails, head, face, neck
Assessment on Respiratory system
Clinical service visit (2 hrs.)
Practice Respiratory cardio Vascular, Abdomen and genitourinary
assessment in skill lab
Week2 Classroom based Teaching (lecture, + seminars + group discussion) [8hrs.]
Assessment on
o Cardiovascular system
o Abdomen and genitourinary system

Skill lab development (6 hrs.)

 Respiratory cardio Vascular, Abdomen and genitourinary assessment in skill
lab
Classroom based Teaching (lecture, + seminars + group discussion) [6hrs.]
Assessment on
o Central nervous system
o Breast and lymphatic
o Musculoskeletal system
o HEENT
Skill lab development (8hrs.)
o Practice Central nervous system assessment, Breast and lymphatic,
musculoskeletal system and HEENT in skill lab.
Examination

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Diagnostic modalities

Module title: - Diagnostic modalities and image interpretation

Module code: - DiMoM-3162

Module ECTS: 3 ECTS

Module duration: - 2 weeks

Module description:-

 This module is designed to equip students with the necessary knowledge, skill and attitude of
clinical laboratory methods and radiological interpretation that enable students to reach on
interpretation of findings in the application of anesthesia practices.
Module competency:-

 Interpret basic laboratory and radiological findings.

Module Objective

By the end of this module, students will be able to interpret clinical diagnostic and radiologic
findings with the underlying KSA of clinical lab methods and radiologic interpretation courses.

Supporting Objectives

To meet the above module objective the student will be expected to:

 Aware the structural organization of medical laboratory

 Identify different laboratory equipment and glass/plastic wares
 Describe and practice the collection,
 Handle different laboratory specimens
 Dispose laboratory specimens safely.
 Select appropriate lab tests
 Interpret different laboratory tests
 Interpret various & uncomplicated radiological images (x-ray)
 Select appropriate radiologic imaging modalities
 Explain the working principles of CT, MRI and ultrasound
Teaching and learning methods

 Interactive lecture & discussions

 Seminar presentations
 Video demonstrations/ show
 Case based discussions (CBD)

145
  Small group project
 Small group discussions
 Morning meeting/ grand round
 Guided clinical practice
 Inter-professional learning experience in different specialty departments
Teaching and learning materials

 Learning guides and checklists

 Text books
 Reference manual
 Writing board
 Posters/ pictures
 Anatomic models & simulators
 LCD Projector
 White board, marker
 Laptop
Student assessment

Formative

 Continuous clinical assessment

 Contributions to discussions on seminars and Interactive lectures
 Submission of assignments
Summative

 Final Written exam (60 %)

 Assignment: project work (10%)
 Progressive exam - 20%
 OSCE (clinical lab) – 10%
Reference/text books

1. Linne Jean Jergenson, Basic techniques of medical laboratory 4th ed. 2000
2. WHO, Manual of basic techniques for a health laboratory 2000
3. Chees brough M.District Laboratory manual for tropical countries, 2000 (Vol I).
4. Chees brough M.District Laboratory manual for tropical courtiers, 2000 (Vol II)
5. Seyoum B. Introduction to medical laboratory technology students lecture note series 2002.
6. Millers anesthesia volume 1 and 2 6th edition Ronald d miller
7. G. Edward Morgan clinical anesthesiology 4th edition.
8. Radiology for Anaesthesia and Intensive Care; Second Edition. Richard Hopkins, Carol
Peden and Sanjay Gandhi

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 Module schedule (Lecture hrs. =28, hospital/lab practice= 10hrs, self-study = 13hrs.)

Week /day Learning activity Required reading

(Assignment)
Day 01 Unit 01:- Introduction (1 ½ hr.)
 Definition and organization of Medical Laboratory
 Role of Clinical laboratory
 Selection, evaluation and interpretation of laboratory tests
Hospital practice (1hr)
o Hospital visit of a typical laboratory setup
Unit 02:- Laboratory Equipment’s And Wares (1hr.)
 Microscope
 Laboratory centrifuges
 Glass wares
Hospital practice (1hr)
o Observation of lab samples using microscope
Day 02 Unit 03:- Basic Hematological Tests (2 ½ hr.)
 Blood collection
 Complete blood count
 Erythrocyte sedimentation rate
 Blood film preparation and staining
 Hemostasis
 Hematological disorders (anemia, leukemia)
Hospital practice (2hr)
o Blood sample collection, film preparation and staining
o Interpretation of CBC lab results
Exam 01
Day 03 Unit 04:- Basic Clinical Chemistry & serological Tests
Basic clinical chemistry (2 ½ hr.)
 Liver Function Test
 Renal function test
 Plasma protein
 Body fluid analysis
Basic Serological Tests (1 ½ hr.)
 Introduction to serology
 Serology of Syphilis
 Pregnancy test
 Serological tests for febrile diseases
 HIV tests
Hospital practice (1hr)
o Blood sample collection for chemistry & serological tests
o Interpretation of clinical chemistry results
o Interpretation serological tests

147
Day 04 Unit 05:- Immuno-hematological (1 ½ hr.)
 Blood grouping
 Cross match
 Laboratory tests of blood transfusion reaction
Unit 06:- Basic Microbiological Test (2hr.)
 Specimen Collection And Handling
 Examination method
 Wet mount examination
 Staining
 Culture and biochemical
 Molecular and serological methods
Hospital practice (1hr)
o Blood sample collection for immune-hematological tests
o Interpretation of results of hematological tests
Day 05 Unit 07:- Urinalysis (2hr.)
 Specimen collection
 Examination methods
 Physical
 Chemical
 Microscopic
Unit 08:- Parasitological tests (1 ½ hr.)
 Types of parasitological specimen and their collection method
 Diagnostic method
 Macroscopic examination
 Microscopic examination
o Wet mount
o Concentration techniques
o Staining
Hospital practice/lab practice (1hr)
 Microscopic examination practice
Exam 03
Day 06 Unit 09:- Basic imaging (12hr.)
Introduction to basic imaging modalities (2hr)
 X-ray
 Ultrasound
 CT
 MRI
 Nature and source of Radiation
 Use of Radiation for medical diagnosis
Day 07  Basic working principles imaging modalities (2hr)
o X-ray
o Ultrasound
o CT
o MRI
Day 08  Indications for imaging modalities (2hr.)
o X-ray
o Ultrasound
o CT

148
 o MRI

Hospital practice (1hr)

 Hospital visit of a radiology suit
 Basic x-ray –(2hrs)
o Formation of image on film
o Characteristic appearance of different tissues on plain film
Day 09  Basic x-ray – (4hrs) Reading assignment
o Image interpretation Anatomy of the thorax
o Common plain x-ray interpretation with emphasis on
respiratory system
Hospital practice (2hr)
 Ward round with for interpretation of different CXR interpretation
 Video tape of different CXR
Day 10 Exam week

149
Determinants of Health

Module Title: Determinants of Health

Module Code: SPHM-3172
ECTS: 4 ECTS
Module Duration: 20 Weeks

Module Description: This Module is designed for anesthesia students to equip with the knowledge,
skill and attitude needed to analyze determinants of health in a culturally sensitive manner with full
participation of the community and other stakeholders. This Module includes sociology,
anthropology, psychology and environmental health and will be addressed through Interactive lecture,
Seminar presentations in class room teaching and structured feedbacks in real community setup.

Module Objective:
At the end of this module, the anesthesia student will be able to analyze broad determinants of
health and disease at individual, family and community level and mobilize them for action.

Module competency
Evaluate determinants of Health and disease
Engage in disaster preparedness and management including planning, handling and
restoration
Learning Outcome:

 Public health: definition, philosophy, history, development, core functions and services
 Describe essential public health functions and services
 Definition of epidemiology
 Scope of epidemiology
 Purpose and concepts of epidemiology
 Health and disease: concepts, definitions and perspectives
 Public health sciences, their scope and use in medicine
 Level of disease prevention
 Analyze socio-cultural determinants of health and disease at individual, family and community
level

150
  Analyze socio-economic determinants of health and disease at individual, family and
community level
 Analyze psychological and behavioral determinants of health and disease at individual, family
and community level
 Analyze environmental and ecological determinants of health and disease at individual, family
and community level
 Help individuals and families to identify actions to prevent and control determinants of ill
health
 Demonstrate clear, sensitive and effective communication skills in interactions with
individuals, families, communities, PHCU staff, local health department staff, peers and faculty
 Demonstrate professional values and behavior in interaction with individuals, families and
communities consistent with the future role of a physician
 Demonstrate key public health values, attitudes and behaviors such as commitment to equity
and social justice, recognition of the importance of the health of the community as well as the
individual, and respect for diversity, self-determination, empowerment, and community
participation
 Show respect for colleagues and other healthcare professionals and the ability to foster a
positive collaborative relationship with them
 Analyze community practice experience and perform practice-based improvement activities
using a systematic methodology
 Demonstrate a habit of self-reflection, responsiveness to feedback and an on-going
development of new skills, knowledge and attitude
 Search, collect, organize and interpret health and health-related information from different
sources
Duration: 20 weeks
Teaching-Learning Methods
 Interactive lecture and discussion
 Small group learning activities: assignment, exercise, case study
 Individual reading
 PHCU/Community-based learning and study trip: home visit, discussion with individuals
and families to identify and solve problems, observation, PHCU visit, Zonal and District

151
 Health Department Visit, field visit, and targeted literature review based on community
experience
 Student presentation
 Reflective portfolio and mentoring

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board
 LCD Projector
 White board, marker
 Laptop
 Handouts of lecture materials
 Logbooks for entry of community experience

Reference Books
1. Yemane Berhane, Damen Hailemariam and Helmu Kloos. Epidemiology and ecology of
Health and Disease in Ethiopia. 2006
2. EPHTI. Ecology. Lecture note series for health science students. 2007
3. White, P. Bio psychosocial medicine: An integrated approach to understanding
illness. 2005 Oxford University Press.
4. Frankel, R. M., Quill, T. E., & McDaniel, S. H. Bio psychosocial approach: Past,
present, future. 2003. University of Rochester Press.
5. Singer, M. & Baer, H. A. Introducing medical anthropology: A discipline in action
(2nd Ed.) 2011. Rowman Littlefield
6. Bernice A. Pescosolido, Jack K. Martin, Jane D. McLeod, Anne Rogers (Editors).
Handbook of the Sociology of Health, Illness, and Healing. A Blueprint for the 21st
Century. 2011
7. Bird, C. E., Conrad, P., Fremont, A. M., & Timmermans, S. Handbook of medical
sociology (6th Ed.) 2010. Vanderbilt University.

152
 8. Sobo, E. J. & Loustaunau, M. Cultural context of health, illness, and medicine (2nd
Ed.) 2010. Greenwood
9. David French et al. Health psychology (2ndEd.) 2010. Blackwell Publishing
10. By Susan Ayers, Richard de Visser. Psychology of medicine. 2011
11. WHO. Closing the gap in a generation: health equitythrough action on the social
determinants of health: final report of the commission on social determinants of health.
2008.
12. Robert H Friis. Essentials of environmental health (2nd edition). The essential public
health series. 2012.
13. Kathryn Hilgenkamp. Environmental Health: Ecological Perspectives. 2006
14. Herman Koren and Michael Bisesi. Handbook of environmental health. 2002

Assessment Methods
Formative assessment
10. Exercise and assignment
11. Logbook and portfolio
12. 360 degree evaluation
13. Student presentation
Summative assessment
14. Written exam (50 %)
15. Quiz=10% and test =15%
16. Attendance and class participation=5%
17. Assignment and student presentation (20 %)
Module policy:

Attendance: It is compulsory to attend a class on time and every time. If students are going to miss
more than three classes during the term, he/she should not take this Module.
Assignments: the student must do their assignment on time. No late assignment will be accepted.
Tests/Quizzes: There will be short quizzes and tests almost every week. If a student miss the class
or, are late to class, he/she will miss the quiz or test. No makeup tests or Quizzes will be given. The
students are expected to observe the rules and the regulations of the University as well.

153
 Weeks Topic Required
Reading/
Assignment
Week 1 Classroom based Teaching (lecture, + seminars + group discussion) [3hrs.]
Introduction to public health
Human health, society and culture (Medical sociology and anthropology)
Introduction to the module
Describe essential public health functions and services
Public health: definition, philosophy, history, development, core functions and
services
Describe essential public health functions and services
Primary health care or community visit (4 hrs.)
Introduction to the community and assignment of individual homes in their respective
team
Week 2 Classroom based Teaching (lecture, + seminars + group discussion) [3hrs.]
Introduction to Epidemiology
Definition of epidemiology
Scope of epidemiology
Purpose and concepts of epidemiology
Health and disease: concepts, definitions and perspectives
Public health sciences, their scope and use in medicine
Level of disease prevention
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective
team
Week 3 Classroom based Teaching (lecture, + seminars + group discussion) [3hrs.]
o Social and cultural aspects of human health (Socio-cultural factors affecting human
health include, but are not limited to, place of residence, urbanization, culture,
religion, ethnicity, gender views and roles, status of women, educational status,
demography, social structures (mobility and migration) and organizations (social
cohesion, support and network), laws, human rights
o Introduction to medical sociology and medical anthropology
Understanding health, illness and disease and healing: sociological and anthropological
perspective
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective
team
Week 4 Classroom based Teaching (lecture, + seminars + group discussion) [3hrs.]
o Social and cultural aspects of medicine (religion, ethno medicine, alternative and
complementary medicine)
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective
team
Week 5 Classroom based Teaching (lecture, + seminars + group discussion) [3hrs.]
o Social Institution
o Human health and socio-economic factors (Economic factors include, but are not
limited to, unemployment, poverty, income inequality, neighborhood deprivation,
assets, economic growth, globalization, healthcare cost)

154
 Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective
team
Week 6 Classroom based Teaching (lecture, + seminars + group discussion) [3hrs.]
o Social epidemiology
o Process of social interaction
o Individual and society
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective
team
Week 7 Classroom based Teaching (lecture, + seminars + group discussion) [3 hrs.]
Psychological and behavioral determinants of health
 Introduction to medical psychology
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective
team
Week 8 Classroom based Teaching (lecture, + seminars + group discussion) [3 hrs.]
Developmental psychology
(Prenatal development and birth i.e. beginning of life, prenatal stage, hazards of
prenatal development, infant and childhood disorders, Psychological aspects of
health and illness (motivation, stress, pain, personality, depression, health and
illness)
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective
team
Week 9 Classroom based Teaching (lecture, + seminars + group discussion) [3 hrs.]
Developmental psychology continued…..
(Prenatal development and birth i.e. beginning of life, prenatal stage, hazards of
prenatal development, infant and childhood disorders, Psychological aspects of
health and illness (motivation, stress, pain, personality, depression, health and
illness)
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective
team
Week 10 Classroom based Teaching (lecture, + seminars + group discussion) [3 hrs.]
o Health and human behavior
 The role of behavior in health
 Smoking
 Physical activity
 Eating behavior
 Alcohol and drug use
 Sexual health and behavior
o Chronic illness related with psychological/ behavioral factors, death and dying
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective
team

155
Week 11 Classroom based Teaching (lecture, + seminars + group discussion) [3 hrs.]
Development after Birth
Adjustment of the family to the new born, Environmental adjustment,
Psychological adjustment, Factors affecting adjustment to the new born, The nature
of the family
Reasons for giving birth, Consequence on the child development, Infancy period,
Child hood (early late), Adolescence, Adult hood, early, middle, late
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective
team
Week 12 Classroom based Teaching (lecture, + seminars + group discussion) [3 hrs.]
Psychology of personality (Definition, theory, traits, adjustment, assessment)
Abnormal psychology
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective
team
Week 13 Classroom based Teaching (lecture, + seminars + group discussion) [3 hrs.]
Psychology and healthcare practice
 Evidence-based medicine (adherence to treatment, doctor-patient communication)
 Clinical interviewing (how to communicate, difficult interviews, giving bad news)
 (Management of psychological problems)

Primary health care or community visit (4 hrs.)

Community engagement and assignment of individual homes in their respective
team
Week 14 Classroom based Teaching (lecture, + seminars + group discussion) [3hrs.]
Ecology and environmental determinants of health
Introduction to ecology and environmental health
Human ecology
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective
team
Week 15 Classroom based Teaching (lecture, + seminars + group discussion) [3hrs.]
o Human – environment interaction
o Biosphere and pollution
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective
team
Week 16 Classroom based Teaching (lecture, + seminars + group discussion) [3hrs.]
o Ecology of health and disease
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective
team
Week 17 Classroom based Teaching (lecture, + seminars + group discussion) [3hrs.]
o Components of environmental health (Housing and institutional sanitation, water
sanitation and waste disposal)
Primary health care or community visit (4 hrs.)

156
 Community engagement and assignment of individual homes in their respective
team
Week 18 Classroom based Teaching (lecture, + seminars + group discussion) [3hrs.]
Components of environmental health (vector control, food sanitation) (Food
Hygiene, Food –borne diseases, Milk hygiene, Meat hygiene, Food processing and
food preservation method)
Establishment healthy eating and drinking habits
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective team
Week 19 Classroom based Teaching (lecture, + seminars + group discussion) [3hrs.]
o Occupational health and safety
o Control of Arthropods and rodent of public Health importance
o Infection prevention
o The problem of environmental pollution.
Primary health care or community visit (4 hrs.)
Community engagement and assignment of individual homes in their respective team
Week 20 Exam

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Basics of Anesthesia I

Module Title: Basics of Anesthesia I

Module Code: AnstM-3181
Module ECTS: 14 ECTS
Module Duration: 16 Weeks

Module Description: This module is designed for second year anesthesia students to create a learning
opportunity on anesthetic pharmacology, fluid/electrolytes, acid-base balance and blood transfusion
practices that enable students to select and administer appropriate anesthetic drugs, adjuvant and other
classes of drugs used in anesthesia practices and manage fluid/electrolytes and acid base imbalance
and blood transfusion. This module will be addressed through Interactive lecture, Seminar
presentations, Skill Development Laboratory (SDL) demonstration and supervised feedbacks in
simulated environment and real hospital setting.

Module Objective
At the end of this module, students will be able to select and administer appropriate anesthetic drugs,
adjuvant and other classes of drugs used in anesthesia practices and manage fluid/electrolytes and acid
base imbalance and blood transfusion.

Module Competencies
 Select and administer appropriate anesthetic drugs, adjuvant and other classes of drugs used
in anesthesia practices
 Manage fluid/electrolytes and acid-base imbalance and blood transfusion

Learning Outcomes
In order to achieve core competencies, students at the end of this module will be able to:
 Describe the principles of pharmacodynamics, pharmacokinetics, teratogenicity and toxicity
of drugs
 Order and administer drugs for perioperative optimization & preparation of surgical patients
 Outline when to continue, discontinue and change medications used for the treatment of co-
existing diseases
 Describe the pharmacokinetics, pharmacodynamics of different classes of IVAA

158
 Describe the pharmacokinetics, pharmacodynamics of different classes LA
 Describe the pharmacokinetics, pharmacodynamics of different classes of muscle relaxants
 Describe the principles of pharmacodynamics, pharmacokinetics, teratogenicity and toxicity
of drugs
 Order and administer drugs for perioperative optimization & preparation of surgical patients
 Outline when to continue, discontinue and change medications used for the treatment of co-
existing diseases
 Describe the pharmacokinetics, pharmacodynamics of different classes of IVAA
 Describe the ideal properties of IVAA
 State the different systemic effects of commonly used IVAA
 Outline the indications, contraindications & adverse effects of commonly used IVAA
 Outline the right dose, route & concentration of commonly used IVAA
 Describe the pharmacokinetics, pharmacodynamics of different of IAA
 State the different systemic effects of commonly used IAA
 Outline the indications, contraindications & adverse effects of commonly used IAA
 Outline the right dose, route & concentration of commonly used IAA
 Describe the pharmacokinetics, pharmacodynamics of different classes LA
 Outline the mechanism of action of local anesthetics along with peripheral nerve anatomy
 Outline the indications, contraindications & adverse effects of commonly used Las
 Identify and manage local anesthetic toxicity
 Describe the pharmacokinetics, pharmacodynamics of different classes of muscle relaxants
 Describe the neuromuscular anatomy physiology & mechanism of action of (muscle relaxants)
 State the different systemic effects right dose and route of commonly used muscle relaxants
 Outline the indications, contraindications & adverse effects of commonly used MRs
 Describe principles & purpose of antagonism of neuromuscular blockade
 Describe the Mechanism of action for different types NSAIDs including Paracetamol
 Rationalize the role of NSAIDs in the WHO analgesic ladder for the management of
perioperative pain
 Outline the systemic effects of different types of NSAIDs
 State the indications, contraindications and side effects of NSAIDs
 Describe the distribution of opioid receptors in the body along with MOA of opioids

159
 Describe the pharmacokinetics & pharmacodynamics and MOA with opioid receptors of
different opioid analgesic agents
 State the systemic effects with their indications contraindications and adverse effects of
opioids
 Explain the safe usage including rate and dangers of addiction of commonly used opioids
 Rationalize the use of opioid antagonists along with their mechanism of action
 Describe the pharmacokinetics, pharmacodynamics of different classes of cholinergic and
anticholinergic drugs
 Outline the different types of cholinergic and anticholinergic drugs along with their
mechanism of action
 Identify the indications, contraindications and systemic adverse effects of cholinergic and
anticholinergic
 Describe the pharmacokinetics & dynamics of different classes of commonly used BDZs
 Outline the use of different classes of BDZs and their clinical use
 Describe the pharmacokinetics, pharmacodynamics of different classes of commonly used
adrenergic agonist agents
 Elaborate the role of different receptors for adrenergic drugs along with their mechanism of
action of commonly used adrenergic agonist drugs
 Prepare different vasoactive drugs with different concentration along with their infusion
dosing
 Outline the systemic effects of adrenergic agonist drugs
 Describe the different therapeutic regimens for patients with hypertension
 Describe the pharmacodynamics and pharmacokinetics of antihypertensive drugs used in
clinical practice
 Outline the mechanism of action of antihypertensive drugs including diuretics
 Identify the indications, contraindications and systemic adverse effects of commonly used
antihypertensive medications
 Explain classes of anti-arrhythmic agents
 State the indications contraindications and systemic effects of antiarrhythmic drugs
 Describe the mechanism of action of glucocorticoids
 State complications of glucocorticoids administration along with management options

160
  Describe the pharmacokinetics pharmacodynamics and MOAs of antiemetic medication
 State the indication contraindication and systemic effects of anti-emeticsDescribe the body
fluid composition
 Explain body fluid compartments
 Discuss about total body water and distribution of water and electrolytes
 Explain about distribution and movement of water
 Explain about tonicity and osmolarity.
 Diagnose body fluid abnormalities
 Identify the electrolyte compartments
 Diagnose electrolyte abnormalities
 Explain about Perioperative fluids
 Categorize of intravenous fluids
 Describe acid base balance and its causes
 Discuss the causes of acid base balance
 Explain the major buffering systems
 Diagnose acid base disturbances and compensatory responses
 Discussion about Blood physiology
 Identify blood components
 Explain about indication of blood transfusion
 Manage of blood transfusion complications
 Apply blood transfusion
 Apply history taking technique
 Perform physical examination
 Classify patients based on ASA status
 Perform airway examination
 Identify patients who are at risk of anesthesia complications
 Identify appropriate investigations for different cases
 Demonstrate techniques of IV cannulation
 Demonstrate consent taking and recording
 Prepare the necessary equipment before conducting General/regional/ Anesthesia

Prerequisite: None

161
Teaching-Learning Methods

 Interactive lecture and discussion

 Small group discussion
 Case study
 Bedside teaching
 Portfolio
 Clinical simulation
 Demonstration (at skills lab and basic sciences lab)
 Guided clinical practice
 PBL cases
 Inter-professional learning experience in the clinics, and community practice
 Seminar Presentations

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board
 Posters
 Anatomic models
 LCD Projector
 White board, marker
 Laptop and Videotapes

Methods of Assessment
 Formative
o Drills, essay exams, quizzes, and practical test (direct observation of skills)
o Structured feedback report
o Oral exam
o Logbook
o Portfolio

162
 o And other assessment methods
 Summative
o Progressive/ Continuous assessment:
o Objectively Structured Clinical Examination (OSCE)
o Structured Oral Examination
 Percentage allocation:
Content area Hour load Self S %
Emphasis
Pharmacology
Fluid/electrolytes, acid-base balance and blood
transfusion
Preoperative assessment, preparation and optimization
Total Hrs. 100%

Module Policy
 Attendance: It is compulsory to attend both SDL and Hospital clinical practice on time and
every time. If students are going to miss more than three classes/ hospital attachment days
during this semester, they will not be allowed to final assessment and next semester unless
otherwise proven by evidence per legislation requirement.
 Assignments: Students must complete module assignments and work based assessments on
time. Uncompleted work-based assessments and assignments will result in Incomplete (I)
grade submissions to registrar. Further consecutive procedures will be handled in line with
institutional senate legislation.
Reference Books
1. Paul G Barash: Handbook of Clinical Anesthesia (6th edition). Lippincott Williams &
Wilkins publications, 2009.
2. Paul G Barash: Clinical Anesthesia (6th edition). Lippincott Williams & Wilkins publications,
2006.
3. Ronald D. Miller: Millers Anesthesia (7th edition). Churchill Livingstone publication, An
Imprint of Elsevier, 2009.
4. Edward Morgan: Clinical Anesthesiology (4th edition). McGraw-Hill Companies, 2006
5. Ronald D. Miller: Basics of Anesthesia (6th edition). Saunders, an imprint of Elsevier, 2011.
6. Fleisher: Anesthesia and Uncommon Diseases, (5th edition). Elsevier Saunders, 2005
7. James C. Duke: Duke’s Anesthesia Secretes (5th edition). Saunders, an imprint of Elsevier,
2016.

163
 Duration: 20 Weeks (Hospital Practice will be Parallel to Classroom-based teaching)

Required Reading
Week Learning Activity
(Assignment)
Reading Assignment
Interactive Lecture and Discussion [8 Hrs.] on:
Overview of the Module (1Hr)
 Lecture presentation on Principles of pharmacology 120’
 Lecture presentation on preoperative drug administration and
demonstration on prescription writing 60’
 Seminar presentation on treatment follow up of patients with coexisting
disease 60’
 Lecture on pharmacokinetics and pharmacodynamics of IVAA 120’
 Seminar presentation on ideal properties of IVAA 60’
 Lecture on systemic effects of commonly used IVAA 60’
Week 1

Hospital Practice/ Visit [7 Hrs.]

Hospital practice on
 Taking history and physical examination in the pre-anesthetic clinic
 Practice drug preparation, IV cannulation and premedication
 Performing premedication
 Retting informed signed consent

Reading Assignment
Week 2 Interactive Lecture and Discussion [8 Hrs.] on:
 Seminar presentation on systemic effects of selected IVAA = 60’ 
 Case study on adverse effects of IVAA = 30’
 Lecture on indication contraindication and adverse effects = 60’
 Seminar presentation on indication and contraindication of selected IVAA
= 60’
 Group discussion on right dose, route & concentration of commonly used
IVAA = 60’
 Lecture on the pharmacokinetics, pharmacodynamics of different of IAA =
120’
 Seminar presentation on MAC of commonly used IAA and ideal properties
= 90’

Hospital Practice/ Visit [7 Hrs.]

Hospital practice on
 Taking history and physical examination in the pre-anesthetic clinic
 Practice drug preparation, IV cannulation and premedication
 Performing premedication
 Getting informed signed consent

164
 Required Reading
Week Learning Activity
(Assignment)

Interactive Lecture and Discussion [8:00 Hrs.]

 Seminar presentation on systemic effects of commonly used IAA = 120’
 Case study on adverse effects of drugs = 60’
 Group discussion and presentation on indications, contraindications &
adverse effects of commonly used IAA = 60’
 Lecture on the right dose, route & concentration of commonly used IAA =
120’
Week 3
 Lecture on the pharmacokinetics, pharmacodynamics of different classes
LA with their anesthetic implications = 120’

Hospital Practice/ Visit [7Hrs.]

 Hospital practice on
 Taking history and physical examination in the pre-anesthetic clinic
 Practice drug preparation, IV cannulation and premedication

Interactive Lecture and Discussion [8 Hrs.]

 Seminar presentation on MOA and structure activity relationships of LAs
with peripheral nerve anatomy = 120’
 Group discussion on the indications, contraindications, adverse effects and
importance of local anesthetic additives of commonly used LAs = 60’
 Case study and group discussion on identification and management of LAs
toxicity = 60’
 Lecture on pharmacokinetics, pharmacodynamics of different classes of
Week 4 muscle relaxants = 120’
 Seminar presentation selected MRs = 120’

Hospital Practice/ Visit [7 Hrs.]

Hospital practice on
 Taking history and physical examination in the pre-anesthetic clinic
 Practice drug preparation, IV cannulation and premedication
 Performing premedication
 Getting informed signed consent

Interactive Lecture and Discussion [8 Hrs.]

 Lecture on neuromuscular anatomy physiology & mechanism of action of
Week 5 (muscle relaxants) = 60’
 Lecture on State the different systemic effects of commonly used muscle
relaxants with dose and routes = 60’
 Seminar presentation on selected MRs = 60’

165
 Required Reading
Week Learning Activity
(Assignment)
 Group discussion on indications, contraindications & adverse effects of
commonly used MRs = 60’
 Group discussion on principles & purpose of antagonism of neuromuscular
blockade = 60’
 Lecture on the Mechanism of action for different types NSAIDs including
Paracetamol = 60’
 Group discussion on WHO analgesic ladder = 60’
 Lecture on the systemic effects of different types of NSAIDs = 60’

Hospital Practice/ Visit [7 Hrs.]

Hospital practice on
 Taking history and physical examination in the pre-anesthetic clinic
 Practice drug preparation, IV cannulation and premedication
 Performing premedication
 Getting informed signed consent

Interactive Lecture and Discussion [8 Hrs.]

 Lecture on indications, contraindications and side effects of NSAIDs = 60’
 Lecture on distribution of opioid receptors in the body along with MOA of
opioids = 60’
 Seminar presentation on pharmacokinetics & pharmacodynamics of
different opioid analgesic agents = 60’
 Lecture on the systemic effects of opioids = 60’
 group discussion on dangers of addiction related to opioids = 60’
 Seminar presentation on opioid antagonists along with MOA = 60’
 lecture on pharmacokinetics, pharmacodynamics of different classes of
cholinergic and anticholinergic drugs = 60’
Week 6
 lecture on different types of cholinergic and anticholinergic drugs along with
their mechanism of action and systemic effects = 60’

Hospital Practice/ Visit [7 Hrs.]

Hospital practice on
 Taking history and physical examination in the pre-anesthetic clinic
 Practice drug preparation, IV cannulation and premedication
 Performing premedication
 Getting informed signed consent
 Diagnose body fluid abnormalities
 Diagnose electrolyte abnormalities
 Diagnose acid base disturbances

Week 7 Interactive Lecture and Discussion [8 Hrs.]

166
 Required Reading
Week Learning Activity
(Assignment)
 Seminar presentation on the indications, contraindications and systemic
adverse effects of cholinergic and anticholinergic = 60’
 Lecture on pharmacokinetics & dynamics and MOAs of different classes of
commonly used BDZs = 60’
 Presentation on use and side effects of BDZs = 60’
 Group discussion on antagonizing BDZs overdose = 60’
 Lecture on pharmacokinetics, pharmacodynamics of different classes of
commonly used adrenergic agonist agents = 60’
 Group presentation on role of different receptors for adrenergic drugs along
with their mechanism of action of commonly used adrenergic agonist drugs
= 60’
 Demonstration on skill lab different vasoactive drugs with different
concentration along with their infusion dosing = 60’
 Lecture on systemic effects of adrenergic agonist drugs with their indication
contraindication and adverse effects = 60’

Hospital Practice/ Visit [7 Hrs.]

Hospital practice on
 Taking history and physical examination in the pre-anesthetic clinic
 Practice drug preparation, IV cannulation and premedication
 Performing premedication
 Getting informed signed consent
 Diagnose body fluid abnormalities
 Diagnose electrolyte abnormalities
 Diagnose acid base disturbances

Interactive Lecture and Discussion [6 Hrs.]

 Lecture on therapeutic regimens for hypertensive patients 60’
 Lecture on the pharmacodynamics and pharmacokinetics of
antihypertensive drugs used in clinical practice 60’
 Seminar presentation on mechanism of action and systemic effects
antihypertensive drugs including diuretics 30’
 Group discussion on the indications and contraindications and systemic
Week 8 adverse effects of commonly used anti-hypertensive drugs 30’
 Lecture on classes and MOA of antiarrhythmic agents 30’
 Group discussion on contraindications and systemic effects of
antiarrhythmic drugs 30’
 Lecture on the mechanism of action of and systemic effects of
glucocorticoids 30’
 Lecture on complications of glucocorticoids administration along with
management options 30’
 Seminar presentation on 30’

167
 Required Reading
Week Learning Activity
(Assignment)
 Seminar on the indication contraindication and systemic effects of anti-
emetics 30’

Hospital Practice/ Visit [7 Hrs.]

Hospital practice on
 Taking history and physical examination in the pre-anesthetic clinic
 Practice drug preparation, IV cannulation and premedication
 Performing premedication
 Getting informed signed consent
 Diagnose body fluid abnormalities
 Diagnose electrolyte abnormalities
 Diagnose acid base disturbances
 Blood transfusion
 Manage of blood transfusion complications

Interactive Lecture and Discussion [2 Hrs.]

 Interactive lecture on body fluid composition (2hr)

Interactive Lecture and Discussion [8 Hrs.]

 PPT presentation and group discussion about total body water and
distribution of water and electrolytes (3hr)
 PPT presentation on distribution and movement of water (2hr)
 Interactive lecture and small group discussion on tonicity and
osmolarity(3hr)

Hospital Practice/ Visit [7 Hrs.]

Hospital practice on
Week 9
 Taking history and physical examination in the pre-anesthetic clinic
 Practice drug preparation, IV cannulation and premedication
 Performing premedication
 Getting informed signed consent
 Diagnose body fluid abnormalities
 Diagnose electrolyte abnormalities
 Diagnose acid base disturbances
 Blood transfusion
 Manage of blood transfusion complications

Interactive Lecture and Discussion [8 Hrs.]

Week 10
 Presentation about the electrolyte compartments (2hr)
 Presentation about how to diagnose body fluid abnormalities (2hr)

168
 Required Reading
Week Learning Activity
(Assignment)
 Presentation about how to diagnose body electrolyte abnormalities (2hr)
 Group work about body electrolyte abnormalities( 2 hrs)

Hospital Practice/ Visit [7 Hrs.]

Hospital practice on
 Taking history and physical examination in the pre-anesthetic clinic
 Practice drug preparation, IV cannulation and premedication
 Performing premedication
 Getting informed signed consent
 Diagnose body fluid abnormalities
 Diagnose electrolyte abnormalities
 Diagnose acid base disturbances
 Blood transfusion
 Manage of blood transfusion complications

Interactive Lecture and Discussion [8 Hrs.]

 PPT presentation on perioperative fluid components and calculation (2:30
hr)
 Individual class work on case scenario about fluid calculation(2hr)
 Presentation on categorize of intravenous fluids (1:30hr)
 PPT presentation on acid base balance (2hr)

Hospital Practice/ Visit [7 Hrs.]

Week 11  Taking history and physical examination in the pre-anesthetic clinic
 Practice drug preparation, IV cannulation and premedication
 Performing premedication
 Getting informed signed consent
 Diagnose body fluid abnormalities
 Diagnose electrolyte abnormalities
 Diagnose acid base disturbances
 Blood transfusion
 Manage of blood transfusion complications

Interactive Lecture and Discussion [2 Hrs.]

 Small group discussion with presentation about the causes of acid base
Week 12 balance (2hr)
 Interactive lecture and small group discussion on buffer system (2hr)
 Presentation about how to diagnose acid base disturbances (2hr)
 Seminar on blood physiology and components (2hr)

169
 Required Reading
Week Learning Activity
(Assignment)

Hospital Practice/ Visit [7 Hrs.]

 Taking history and physical examination in the pre-anesthetic clinic

 Practice drug preparation, IV cannulation and premedication
 Performing premedication
 Getting informed signed consent
 Diagnose body fluid abnormalities
 Diagnose electrolyte abnormalities
 Diagnose acid base disturbances
 Blood transfusion
 Manage of blood transfusion complications

Interactive Lecture and Discussion [4 Hrs.]

 PPT presentation on about indication of blood transfusion
(1hr)Presentation on management of blood transfusion complications (3hr)

Interactive Lecture and Discussion [4 Hrs.]

 Interactive lecture of 30 min on Goals of the preoperative visit

 Interactive lecture of 1hr min techniques of physical examination
 Case study of 30 min on classifying patients depending on ASA status
 Discussion of 30 min on Significance and limitations of the ASA score
 Interactive lecture of 1hr on airway examination
 Video show of 30 min on different types of airway examination

Clinical Skill Development Lab [3 Hrs.]

Week 13
 Demonstration of 1hr steps of history taking
 Demonstrate of 2hr on steps of physical examination

Hospital Practice/ Visit [7 Hrs.]

 Taking history and physical examination in the pre-anesthetic clinic

 Practice drug preparation, IV cannulation and premedication
 Performing premedication
 Getting informed signed consent
 Diagnose body fluid abnormalities
 Diagnose electrolyte abnormalities
 Diagnose acid base disturbances
 Blood transfusion

170
 Required Reading
Week Learning Activity
(Assignment)
 Manage of blood transfusion complications

Interactive Lecture and Discussion [3 Hrs.]

 Interactive lecture 3hrs on Anesthetic consequences of co morbidities

Clinical Skill Development Lab [4 Hrs.]

Week 14  Demonstration of 2hrs on preparing drugs for premedication’s
 Demonstration in SDL of 2hr steps of IV cannulation

Hospital Practice/ Visit [7Hrs.]

 Practice drug preparation, IV cannulation and premedication

Interactive Lecture and Discussion [4:30 Hrs.]

 Discussion of 2hr on optimizations of patients with
 CVS disease (cardiac risk assessment)
 Respiratory disease(smoking, cough)
 Renal disease
 Bleeding disorders
 Hepatic disease
 Seizure disorders
 Pregnant women
 Endocrine disorders (thyroid & diabetics)
 Case study of 30 min on smoking and cough
 Interactive lecture of 1hron
Week 15  Principles and importance of preoperative drug therapy
 Types and pharmacology of drugs used as premedication
 Small group discussion of 1hr on
 Psychological preparation
 Aspiration prophylaxis
 Anti-sialagogue benefit
 Attenuation of SNS response
 Analgesics
 Antibiotics

Clinical Skill Development Lab [3:30Hrs.]

 Demonstration of 1hrn on recording
 Demonstration of 2hr on preparing necessary equipment before conducting
General/regional/ Anesthesia

171
 Required Reading
Week Learning Activity
(Assignment)

Hospital Practice/ Visit [7 Hrs.]

 Taking history and physical examination in the pre-anesthetic clinic
 Practice drug preparation, IV cannulation and premedication
 Performing premedication
 Getting informed signed consent
 Diagnose body fluid abnormalities
 Diagnose electrolyte abnormalities
 Diagnose acid base disturbances
 Blood transfusion
 Manage of blood transfusion complications

Interactive Lecture and Discussion [4.5Hrs.]

 Interactive lecture of 1hr on basic laboratory investigation
 Small group discussion of 1hr on standard perioperative workup

Clinical Skill Development Lab [2 Hrs.]

 Role play of 1hr min on special laboratory and radiological investigation for
special cases
 Role play of 1 min on getting informed consent

Hospital Practice/ Visit [7Hrs.]

Week 16  Taking history and physical examination in the pre-anesthetic clinic
 Practice drug preparation, IV cannulation and premedication
 Performing premedication
 Getting informed signed consent
 Diagnose body fluid abnormalities
 Diagnose electrolyte abnormalities
 Diagnose acid base disturbances
 Blood transfusion
 Manage of blood transfusion complications

Examination Week

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Year II modules
1. Basics of Anesthesia II
2. General surgery & Thoracic emergency Anesthesia
3. Measurements of Health and Disease
4. Regional anesthesia and Pain Management
5. Obstetrics and Gynecologic Anesthesia
6. Anesthesia for patients with coexisting diseases and Psychiatry

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Basics of anesthesia II

Module Title: Basics of anesthesia

Module Code: AnstM-4191
Module ECTS: 15 ECTS
Module Duration: 20 Weeks

Module Description: This module is designed for third year anesthesia students to create a learning
opportunity on airway management, pot anesthesia care unit regional anesthesia and monitoring and
equipment practices that enable students to apply basic anesthesia care. This Module will be addressed
through Interactive lecture, Seminar presentations, Skill Development Lab (SDL) demonstration and
supervised feedbacks in simulated environment and real hospital setting.

Module Objective
At the end of this module, students will be able to provide basic anesthesia care in a professional
manner

Module Competencies

 Mange normal and difficult Airway.

 Provide Post anesthesia care.
 Prepare assemble, check utilize and basic maintenance of anesthesia equipment’s
 provide regional Anesthesia

Learning Outcomes
In order to achieve core competencies, students at the end of this Module will be able to:
 Explain the normal anatomy of the airway
 Describe the physiology of the airway
 Recognize normal anatomy of the airway
 Explore different airway assessment methods
 Predict features of the airway using different airway assessment methods
 Recognize different modalities of airway management (simple airway maneuvers, BMV
ventilation, airways, SGD, laryngoscopy, endotracheal intubation)

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 Identify pathology in or around the airway
 Distinguish features of unanticipated difficult airway
 Distinguish features of anticipated difficult airway
 Recognize different modalities for managing difficult airway (unanticipated and anticipated)
(difficult mask ventilation, difficult intubation, can’t intubate, can ventilate and can’t
intubate, can’t ventilate conditions)
 Explain other alternative techniques of airway management
 (video assisted intubation, retrograde wire intubation, sub-mental intubation)
 Explain different equipment’s utilized in airway management
 Recognize complications of different airway management modalities
 Explain criteria for extubation
 Describe complications of extubation
 Outline the management of potential airway treats such as external compressions, blood
clots, foreign body…
 Explain techniques of cricothyrotomy
 Explain the indications of tracheostomy
 Outline the anesthetic principles of tracheostomy (Cross ref ENT)
 Explain the management of complications of tracheostomy
 Recognize techniques of fibre-optic intubation (awake and after induction)
 Perform airway assessment with different techniques
 Interpret airway assessment parameters
 Prepare plan of airway management according to parameters
 Prepare patients for different airway management techniques
 Assemble different equipment’s for utilized in airway management
 Collect ancillary airway equipment’s
 Apply simple airway maneuvers (jaw trust, head tilt, chin lift…)
 Perform bag, mask, and valve ventilation
 Utilize airways (naso-pharyngeal or oro-tracheal)
 Manage complications of using airways

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 Demonstrate use of supraglottic devices (SGDs) LMAs, ILMA…
 Prevent and manage complications of SGD
 Perform laryngoscopy
 Demonstrate endotracheal intubation (nasal and oral)
 Confirm proper endotracheal intubation
 Prevent and manage complications of endotracheal intubation
 Perform extubation based on extubation criteria
 Prevent and manage complications of extubation
 Manage patients with unanticipated difficult airway appropriately (difficult mask ventilation,
difficult laryngoscopy, difficult intubation, can’t intubate, can ventilate and can’t intubate,
can’t ventilate conditions)
 Perform cricothyrotomy
 Prevent and manage complications of cricothyrotomy
 Predict anticipated difficult airway
 Prepare patients with anticipated difficult airway
 Manage anticipated difficult airway according to acceptable guidelines
 Demonstrate fibre-optic intubation
 Practice tracheostomy care
 Troubleshoot and manage tracheostomy complications
 Demonstrate other alternative techniques of airway management
 (video assisted intubation, retrograde wire intubation, sub-mental intubation)
 Develop respectful communication during airway assessment
 Provide adequate information and obtain informed consent
 Assure patient safety
 Develop team working abilities
 Explain techniques of transportation postoperative patients
 Recognize methods of handover of postoperative patients
 Recognize recovery and other positions in the PACU
 Recall and describe equipment’s and monitoring required in the PACU

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 Explore strategies of follow up for different classes of patients
 Recall and analyze monitoring parameters in the PACU
 Recall methods to maintain the airway
 Identify common postoperative complications
 Explain physiology of acute pain
 Discussed adverse outcomes of untreated postoperative pain
 Assess severity of acute pain
 Explore different modalities of postoperative pain management
 Recall adverse effects of different analgesics
 Recognize the impact of PONV
 Lists the factors that predispose to PONV
 Describes the basic pharmacology of anti-emetic drugs Describes appropriate regimes for
prevention and treatment of PONV
 Recognize possible causes of hypoxia and hypoventilation
 Describes how to evaluate neuro-muscular block with the nerve stimulator
 Recall techniques of extubation
 Recall management of laryngospasm and other complications of extubation
 List indications of oxygen therapy
 Describe techniques of oxygen therapy
 Describes the causes and management of postoperative atelectasis, tachycardia, bradycardia,
arrhythmias, bleeding, hypotension and hypertension
 Describe mechanisms and management of hypothermia
 Describes the possible causes and management of postoperative confusion and cognitive
deterioration
 Identify conditions that need higher level of postoperative care
 Explain discharge criteria from PACU (in-hospital or home)
 Recognize organizational and structural requirements of the PACU
 Recognize common critical incidents (Cardiorespiratory arrest) in the PACU and early
warning assessment methods

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 Arrange the organization and requirements of safe PACU
 Demonstrate how to transport, handover and position of postoperative patient
 Turns a patient into the recovery position
 Collect equipment’s commonly utilized in the PACU
 Interpret monitoring parameters and intervene accordingly
 Evaluates neuromuscular blockade using a nerve stimulator
 Perform safe extubation
 Prevent and Manage complications of extubation
 Alleviate airway obstruction in the PACU with different techniques
 Administer oxygen with different techniques (nasal prongs, facemasks…)
 Assesses postoperative pain
 prescribes appropriate postoperative analgesia
 Prevent, assess and manage PONV
 Prescribes appropriate postoperative fluid regimes
 Prevent and manage hemodynamic disturbances (tachycardia, arrhythmias, bradycardia,
hypotension, hypertension…)
 Manage amenable bleeding and provide resuscitation
 Prevent, assess and manage hypothermia in the PACU
 Assess and manage cognitive deteriorations
 Identify patients that require to have higher levels of care in the postoperative period.
 Practice discharge from PACU (in-hospital or home) according to acceptable criteria
 Early identification of critical incidents with early warning scores
 Manage critical incidents (Cardiopulmonary arrest) in the PACU appropriately
 Reassuring and helping patients in CRC manner
 Develop interdepartmental communication and collaboration
 List out Anesthesia Equipments
 Describe medical gas sources
 Discuss cylinder parts,
 Pipeline & O2 Concentrators

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 Apply safely handles and stores of gas cylinders
 Explain important parts of anesthesia machine
 Describe purpose and features of an anesthetic machine
 Solve routine anesthesia machine malfunction
 Perform routine anesthesia machine functionality test
 Discuss the working mechanisms and indications of fiberoptic scope and defibrillator
 Explain scavenging system and its rational for use
 Explain the working mechanism and features of different anesthetic breathing systems
 Discuss the working mechanism and features of anesthetic machine ventilator
 Explain the requirement for manual resuscitator (ambu-bag) with machine at all times
 Explain the physiologic significance and working mechanisms of humidification devices
 Discuss requirements of suction equipment in anesthesia practice
 Explain latex allergy and its significance in use of anesthetic equipment
 Discuss the process for cleaning, disinfecting and sterilizing anesthetic and ancillary
equipment
 Explain about ETT, Airways, Laryngoscopes, Facemask and
 Supplemental anesthesia equipment’s like Stylet, Bougi,combitube
 Demonstrate about ETT, Airways, Laryngoscopes, Facemask and Supplemental anesthesia
equipment’s like Stylet, Bougi, combitube
 Explain what patient monitoring is
 Explain standards of patient monitoring
 Identify features of monitoring system.
 Explain the importance of physics in monitoring practice
 Identify features of monitoring system.
 Explain about Cardiovascular System Monitoring (Electrocardiogram)
 Describe noninvasive& Invasive BP monitoring CVP measurement & CV catheterization
 Discuss about Respiratory System Monitoring( Pulse oxymetry, Capnography)
 Arterial blood gas analysis Airway pressure measurement)

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 Explain about Nervous System Monitoring (EEG, Monitoring depth of anesthesia
Monitoring ICP, Additional monitoring)
 Discuss about Neuromuscular Monitoring -( Peripheral nerve stimulator)
 Discuss about Renal System Monitoring (UOP monitoring
 Discuss about Temperature monitoring
 Monitor cardiovascular, CNS, respiratory physiologic & neuromuscular blocking using
clinical parameters
 Monitor temperature in the intraoperative period
 Read and interpret variables detected by those standard monitoring equipments
 Monitor patients in the absence of monitoring instruments
 Describe the purpose of the anesthetic record
 Define the different types of regional anesthesia
 Identify the distinctive features of regional anesthesia from GA
 Describe clinically relevant anatomy for performing regional anesthesia
 Describe pain pathways and dermatomes
 Explain pharmacology of local anesthetics for regional anesthesia
 Identify ways to improve the intensity and duration of local anesthetic agents
 Describe the concerns of anticoagulation in performing regional anesthesia
 Perform preoperative evaluation
 Prepare relevant equipment and drugs for regional anesthesia
 Identify indication & contraindication of regional anesthesia
 Identify optimum position for specific regional anesthesia
 Monitor patients with regional anesthesia intraoperatively
 Perform spinal block
 Perform upper extremity axillary and digital blocks
 Perform lower extremity blocks (ankle blocks),
 Manage patients who already had epidurals
 Perform caudal anesthesia
 Perform different peripheral nerve blocks using the loss of resistance technique

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  Prevent the complication of regional anesthesia
 Identify the complications of regional block
 Manage complications of regional blocks
 Manage post-operative complications of regional blocks
 Describe discharge criteria from PACU
 Monitor patients with regional anesthesia postoperatively

Prerequisite: None
Teaching-Learning Methods

 Interactive lecture and discussion

 Small group discussion
 Role play
 Case study
 Bedside teaching
 Portfolio
 Clinical simulation
 Video show
 Demonstration (at skills lab and Basic Sciences lab)
 Guided clinical practice
 PBL cases
 Inter-professional learning experience in the clinics, and community practice
 Seminar Presentations

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board
 Posters
 Anatomic models
 LCD Projector
 White board, marker
 Laptop and Videotapes

Methods of Assessment
 Formative
o Drills, essay exams, quizzes, and practical test (direct observation of skills)
o Structured feedback report
o Oral exam
o Logbook
o Portfolio

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 o And other assessment methods
 Summative
o Progressive/ Continuous assessment:
o Objectively Structured Clinical Examination (OSCE)
o Structured Oral Examination
 Percentage allocation:
Content area Hour load Self S %
Emphasis
Regional anesthesia 52 27%
Post anesthesia care 19 10%
Airway management 49 25%
Monitoring and equipment 74 38%
Total Hrs. 160 100%

Module Policy
 Attendance: It is compulsory to attend both SDL and Hospital clinical practice on time and
every time. If students are going to miss more than one class/ hospital attachment days during
this semester, they will not be allowed to final assessment and next semester unless otherwise
proven by evidence per legislation requirement.
 Assignments: Students must complete module assignments and work based assessments on
time. Uncompleted work-based assessments and assignments will result in Incomplete (I)
grade submissions to registrar. Further consecutive procedures will be handled in line with
institutional senate legislation.
Reference Books
1. Professional Code of Ethics and Conduct for Anesthesia Working in Ethiopia. August 2011.
Addis Ababa, Ethiopia.

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 Module Schedule
Duration: 20 Weeks (Hospital Practice will be Parallel to Classroom-based teaching)
Required Reading
Week Learning Activity
(Assignment)
Reading Assignment
Interactive Lecture and Discussion [10 Hrs.] on:
Airway management (10 Hr.) 
 Physiology of airway (6 Hrs.)
 Airway management modalities airway management modalities (simple airway
maneuvers, BMV ventilation, airways, SGD, laryngoscopy, endotracheal
intubation) (4hr.)

Hospital Practice/ Visit [Hrs.]

 Tour of the hospital and introduction to staff

Week 1 Whole Group Session [Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.
Reading Assignment
Interactive Lecture and Discussion [10 Hrs.] on:
Airway management (10 Hr.) 
 Airway assessment methods (2 Hrs.)
 Difficult airway (1 Hrs.)
 Seminar and case study on features of difficult airway (unanticipated or
anticipated) (3 Hrs.)
 Alternative techniques on intubation lecture (2 Hrs.)
 Complication of different airway modalities (2 Hrs.)
Week 2
Hospital Practice/ Visit [Hrs.]
 Observation of anesthesia professional behavior
 Observation of anesthesia interaction with clients

Whole Group Session [Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [4 Hrs.] Assignment and home

Airway management (4 Hr.) studies on equipment
Week 3  Case studies on alternative techniques on intubation (1/2 Hrs.) utilized on airway
 Small group discussion on alternative techniques on intubation (1/2 Hrs.) management (6 Hrs.)
 Extubation (1/2 Hrs.)

183
 Required Reading
Week Learning Activity
(Assignment)
 Complications of extubation (1/2 Hrs.)
 Potential threats to the airway (2 Hrs.)

Hospital Practice/ Visit [Hrs.]

 Observation of patient-anesthesia encounter at OPDs and role of Anesthesia in
different setup/ units
 Talking to the Anesthesia

Whole Group Session [ Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [6 Hrs.]

Airway management (6 Hr.)
 Video assisted lecture on cricothyrotomy (2 Hrs.)
 Small group discussion and presentation on complications of tracheostomy
(1/2 Hrs.)
 Interactive lecture + video demonstration + on awake fiber-optic intubation (1
1/2 Hrs.)
 Role plays on airway assessment and interpretation of parameters and patient
preparation (2 Hrs.)

Clinical Skill Development Lab [4 Hrs.]

 Preparing airway and ancillary equipment’s (1 Hrs.)
Week 4  BMV ventilation (1 Hrs.)
 Performing laryngoscopy (2Hrs.)

Hospital Practice/ Visit [Hrs.]

 Observation of patient-Anesthesia encounter at OPDs and role of Anesthesia
in different setup/ units
 Talking to the Anesthesia

Whole Group Session [Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

184
 Required Reading
Week Learning Activity
(Assignment)

Interactive Lecture and Discussion [2Hrs.]

Airway management (2 Hr.)
 Video presentation on tracheostomy and on video assisted intubation,
retrograde wire intubation and sub-mental intubation (1 Hrs.)
 Role play on appropriate communication, obtaining informed consent and
team working abilities (1Hr.)

Clinical Skill Development Lab [8 Hrs.]

 Endotracheal intubation simple airway maneuvers (1 ½ Hrs.)
 Use of SGDs (1 Hrs.)
 Extubation perform (1lHrs.)
Week 5  on tracheostomy (1Hrs)
 Predicting and preparing patients with anticipated difficult airway (2 Hrs)
 Video assisted intubation, retrograde wire intubation and sub-mental intubation
(1½ Hrs.)

Hospital Practice/ Visit [Hrs.]

 Observation and guided practice on communicating with clients
 Observation and guided practice: OPD and IPD

Whole Group Session [Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [Hrs.]

Airway management(Hr.)


Clinical Skill Development Lab [6 Hrs.]

 Managing unanticipated difficult airway (difficult mask ventilation,, difficult
laryngoscopy, difficult intubation, can’t intubate, can ventilate and can’t
intubate, can’t ventilate conditions) (4Hrs.)
 Video presentation + SLD (2hr) + hospital practice to demonstrate fibre-optic
Week 6 intubation

Hospital Practice/ Visit [Hrs.]

 Observation and guided practice: OPD and IPD
 Observation of patient-Anesthesia encounter

Whole Group Session [Hrs.]

185
 Required Reading
Week Learning Activity
(Assignment)
 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.
Airway management (4 Hr.)

Problem based learning (4 Hrs.)

Interactive Lecture and Discussion [10 Hrs.]

Post anesthesia care (10 Hr.)
 Interactive lecture on transportation and small group discussion and
presentations on handover and positioning (1 Hrs.)
 Equipment and monitoring required in the PACU (1 Hrs.)
 Cases study on airway challenges and management in the PACU (1 Hrs.)
 Physiology, assessment, management of postoperative acute pain. (1 Hrs.)
 Lecture, case studies and SGDS on mechanisms, impacts, factors, prevention
and management of PONV (1 Hrs.)
 Lecture, case studies and SGDS on cause of hypoxia and hypoventilation,
nerve stimulator utilization, oxygen therapy (1 Hr.)
 Lecture, case studies and SGDS on identification prevention and management
of other common postoperative complications (atelectasis, tachycardia,
bradycardia, arrhythmias, bleeding, hypotension, hypertension, hypothermia,
Week 7 confusion and cognitive deterioration) (1 ½ Hrs.)
 case studies on identifying conditions that need higher level of recovery area
(30 mins)
 SGD and role play on discharge criteria and organizational arrangement (1
Hrs.)
 Role play, role model guided simulation, video demonstration on transporting,
handover and positioning of patients In the PACU (1 Hrs.)

Hospital Practice/ Visit [Hrs.]

 Observe attributes of CRC
 Observation and guided practice: OPD and IPD

Whole Group Session [Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

186
 Required Reading
Week Learning Activity
(Assignment)

Interactive Lecture and Discussion [5 Hrs.]

Post anesthesia care (5 Hr.)
 Role play pain assessment on prevention and management of pain in the
PACU (1 hr)
 Role play on assessment of PONV and management of bleeding and
resuscitation (1 hr)
 Assessment and management of Post anesthesia cognition and confusion (1hr)
 Assessment for discharge from PACU (in-hospital and home) (1hr)
 Reassuring and helping patients in CRC manner and develop interdepartmental
communication and collaboration (1 hrs.)

Week 8 Clinical Skill Development Lab [5Hrs.]

 Guided simulation (1 Hrs.)
 Managing airway obstruction and provide oxygen therapy in the PACU (2 Hrs.)
 management of common hemodynamic complications in the PACU (1 Hrs)
 management of bleeding and resuscitation (1 Hr. )

Hospital Practice/ Visit [2 Hrs.]

 Observation of documentation, admission and discharge of patient process

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [7 Hrs.]

Equipment and monitoring (7 Hr.)
 Interactive lecture on Anesthesia Equipment’s(30 minutes)
 Presentation on medical gas sources(30 minutes)
 Presentation on cylinder parts, Pipeline & O2 Concentrators (1hr)
 Presentation on important parts of anesthesia machine (1 Hrs.)
 On purpose and features of an anesthetic machine (1 Hrs.)
Week 9
 Scavenging system and its rational for use (1 Hrs)
 Working mechanisms and indications of fiberoptic scope and defibrillator (1
Hrs.)
 Video assisted presentation working mechanisms and indications of fiberoptic
scope and defibrillator (1 Hrs.)

Clinical Skill Development Lab [3Hrs]

 early warning score managing critical incidents (cardiopulmonary arrest) (3 Hrs)

187
 Required Reading
Week Learning Activity
(Assignment)

Hospital Practice/ Visit [2 Hrs.]

 Observation of documentation, admission and discharge of patient process
 Guided practice: OPD and IPD

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [7 Hrs.]

Equipment and monitoring (7 Hr.)
 Working mechanism and features of different anesthetic breathing systems (1
Hrs.)
 working mechanism and features of anesthetic machine ventilator (1 Hr.)
 the requirement for manual resuscitator (ambu-bag) with machine at all times
(1/2 Hrs)
 physiologic significance and working mechanisms of humidification devices (1
Hr.)
 requirements of suction equipment in anesthesia practice (1/2 Hr.)
 Interactive lecture on the process for cleaning, disinfecting and sterilizing
anesthetic and ancillary equipment (1 Hr.)
 Video demonstration on: Identification and preparation of airway equipment (1
Week 10 Hr.)
 Demonstration on: Preparations of airway equipment and on Identification and
preparation of airway equipment (1 Hr)

Clinical Skill Development Lab [3 Hrs.]

 Anesthesia machine (3 Hrs.)

Hospital Practice/ Visit [2 Hrs.]

 Observation of documentation, admission and discharge of patient process
 Guided practice: OPD and IPD

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [10 Hrs.]

Week 11 Equipment and monitoring (10 Hr.)
 latex allergy and its significance in use of anesthetic equipment (1/2 Hr.)

188
 Required Reading
Week Learning Activity
(Assignment)
 airway equipments (1/2 Hr.)
 Interactive lecture about patient monitoring and standards of patient
monitoring (1 Hr.)
 Small group discussion on features of monitoring system (1 Hr.)
 Presentation on the importance of physics in monitoring practice (1 Hr.)
 Presentation after group discussion on features of monitoring system. (1 1/2
Hr)
 Interactive lecture on Cardiovascular System Monitoring (3 1/2)

Hospital Practice/ Visit [2 Hrs.]

 Observation and guided practice: emergency department, surgical ward and
OPD

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [10 Hrs.]

Equipment and monitoring (10 Hr.)
 Interactive lecture on Cardiovascular System Monitoring (6 1/2 Hr)
 Interactive lecture on Cardiovascular System Monitoring (3 1/2 Hr.)

Hospital Practice/ Visit [2 Hrs.]

Week 12
 Observation and guided practice: emergency department, surgical ward and
OPD

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [10 Hrs.]

Equipment and monitoring (10 Hr.)
 Interactive lecture on Cardiovascular System Monitoring (3 Hr.)
Week 13  PPT presentation and group discussion on Respiratory system monitoring (2
Hrs.)
 PPT presentation and group discussion on CNS system monitoring (3 Hr)
 Seminar presentation renal system monitoring (1 Hr.)
 Seminar presentation temperature monitoring (1 Hr.)

189
 Required Reading
Week Learning Activity
(Assignment)

Hospital Practice/ Visit [2 Hrs.]

 Observation and guided practice: emergency department, surgical ward and
OPD

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [10 Hrs.]

Equipment and monitoring (10 Hr.)
 PPT presentation and group discussion on Respiratory system monitoring (6
Hrs.)
 Presentation on interpret variables detected by those standard monitoring
equipments (4 Hrs.)
Week 14 Hospital Practice/ Visit [2 Hrs.]
 Observation and guided practice: emergency department, surgical ward and
OPD

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [5 Hrs.]

Equipment and monitoring (5 Hr.)
 Interactive lecture about Neuromuscular Monitoring(3Hr)
 Monitor patients in the absence of monitoring instruments (1 Hr)
 Presentation on the purpose of the anesthetic record (1 Hr.)

Clinical Skill Development Lab [3 Hrs.]

Week 15
 Selecting and preparing standard patient monitoring (2 Hrs.)
 interpret variables detected by those standard monitoring equipment’s (1 Hrs)

Hospital Practice/ Visit [2 Hrs.]

 Observation and guided practice: emergency department, surgical ward and
OPD

Whole Group Session [2 Hrs.]

190
 Required Reading
Week Learning Activity
(Assignment)
 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [10 Hrs.]

Regional anesthesia (10 Hr.)
 Lecture on types of regional anesthesia (2 Hrs)
 Group discussion on regional vs general anesthesia (1 Hrs)
 Lecture presentation on relevant anatomy (2 Hrs)
 Seminar presentation on pain pathways (2 Hrs)
 Lecture on pharmacology of local anesthetics (1 Hr.)
 Group discussion on improving the intensity and duration of local anesthetics
(1 Hr)
Week 16  Group discussion on bleeding disorders and anticoagulant treatment with RA
(1 hr.)

Hospital Practice/ Visit [2 Hrs.]

 Observation and guided practice: emergency department, surgical ward and
OPD

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [10 Hrs.]

Regional anesthesia (10 Hr.)
 Seminar presentation and role play on preoperative assessment for regional
anesthesia (3 Hrs.)
 Lecture presentation and demonstration on preparation of equipment and
drugs (2 Hrs.)
Week 17
 Lecture presentation and group discussion on indication and contraindication
for regional anesthesia (3 Hrs)
 Demonstration on positioning related to specific blocks (2 Hrs)

Hospital Practice/ Visit [2 Hrs.]

 Observation and guided practice: emergency department, surgical ward and
OPD

Whole Group Session [2 Hrs.]

191
 Required Reading
Week Learning Activity
(Assignment)
 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [6 Hrs.]

Regional anesthesia (6 Hr.)
 Group discussion on monitoring patients during regional anesthesia (1 Hr)
 Lecture presentation on performance of spinal anesthesia (2 Hr)
 Lecture presentation on performance of caudal (1hr)
 Lecture /Ppt presentation on loss of resistance blocks (2 Hr)

Clinical Skill Development Lab [4 Hrs.]

 spinal anesthesia (2 Hrs)
Week 18  Lecture presentation on upper extremity blocksSDL demonstration on upper
extremity blockVideo show on upper extremity block (2 Hrs)

Hospital Practice/ Visit [2 Hrs.]

 Observation and guided practice: emergency department, surgical ward and
OPD

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [10 Hrs.]

Regional anesthesia (10 Hr.)
 Lecture on managing patients under epidural anesthesia (1 Hr)
 Lecture on complications during regional anesthesia (2 HRs)
 Case study on identifying complications related to regional anesthesia (1 Hr)
 Group discussion on identifying complications related to regional anesthesia (1
Hr.)
Week 19  Group discussion on prevention and managing complications related to
regional anesthesia (1 Hr)
 Case study on preventing and managing complications related to regional
anesthesia (1 Hr.)
 Seminar presentation on postoperative complications of regional blocks (1 Hr)
 Seminar presentations on discharge from PACU (1 Hr.)
 Seminar on PACU monitoring of regional anesthesia patients (1 Hr)

Hospital Practice/ Visit [2 Hrs.]

192
 Required Reading
Week Learning Activity
(Assignment)
 Observation and guided practice: emergency department, surgical ward and
OPD

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.
Regional anesthesia (10 Hr.)
 Problem based learning (4 Hours)
 Exam (6 Hours)
Week 20

Examination Week

193
Anesthesia for General surgery and Thoracic emergency surgery module

Module Title: Anesthesia for General surgery and Thoracic emergency surgery module

Module Code: AnstM-4201

Module ECTS: 15 ECTS
Module Duration: 20 Weeks

Module Description: This module is designed for third year BSc anesthesia students to create a
learning opportunity on provide anesthesia for thoracic emergency, gastrointestinal, genitourinary,
Hepato billary, endocrine and oncologic surgery. This Module will be addressed through Interactive
lecture, Seminar presentations, Skill Development Lab (SDL) demonstration and supervised
feedbacks in simulated environment and real hospital setting.

Module Objective
At the end of this module, students will be able to provide anesthesia for general and thoracic
emergency surgery

Module Competencies

 Provide Anesthesia for Thoracic emergency Surgeries

 Provide Anesthesia for GI and urology Anesthesia.
 Provide anesthesia for Hepato billary surgery
 Provide Anesthesia for Endocrine surgeries
 Provide anesthesia for Oncologic surgery

Learning Outcomes
In order to achieve core competencies, students at the end of this Module will be able to:
 Describe anatomy and physiology of GI
 Explain effect of different drugs on GI
 Describe common pathophysiology of GI disorders
 List and Interpret common investigation results of GI disorders
 Perform preoperative anesthetic evaluation for GI surgery
 Prepare, optimize and manage patients for GI procedures

194
 Manage postoperative complications associated with GI procedures
 Describe anatomy and physiology of GU
 Explain effect of different drugs on GU function
 Describe common pathophysiology GU disorders
 List and Interpret common investigation results of GU disorders
 Perform preoperative anesthetic evaluation for GU surgery
 Prepare, optimize and manage patients for GI and GU procedures
 Manage postoperative complications associated with GU procedures
 Describe physiology of liver and billary ducts
 Explain effect of different drugs on hepatic function and effect of liver on metabolism
of the different durgs.
 Describe common pathophysiology of Hepato billary disease
 List and Interpret common investigation results of Hepato billary disease
 Analyze the effect of anesthesia and surgery on Hepatic function.
 Perform preoperative anesthetic evaluation for Hepato billary surgery
 Explain Anesthetic consideration for laparascopic surgery
 Prepare, optimize and manage patients for Hepato billary surgery
 Manage postoperative complications associated with Hepato billary procedures
 Describe physiology of endocrine system
 Explain effect of different drugs on endocrine function
 Describe common pathophysiology of endocrine disorder
 List and Interpret common investigation results of endocrine disorder.
 Perform preoperative anesthetic evaluation for endocrine surgery.
 Prepare, optimize and manage patients for endocrine surgery
 Manage postoperative complications associated with endocrine procedures.
 Describe anatomy and physiology of thorax
 Explain effect of different drugs on respiratory and cardiovascular system
 Describe common pathophysiology of thoracic emergency
 List and Interpret common investigation igmaging modalities results of thoracic
emergency
 Perform preoperative anesthetic evaluation for thoracic emergency surgery

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  Prepare, optimize and manage patients for thoracic emergency surgery
 Perform DLI
 Manage postoperative complications associated thoracic emergency procedures.
 Identify effect of chemo/radio therapy on different system
 Describe pathophysiology of cancer on different system
 Describe pharmacologic consideration of cancer patients
 List and Interpret common investigation modalities for oncologic surgery
 Perform preoperative anesthetic evaluation for oncology surgery
 Prepare, optimize and manage patients oncology surgery
 Manage postoperative complications associated oncologic procedures.

Prerequisite: Basics of Anesthesia

Teaching-Learning Methods

 Interactive lecture and discussion

 Small group discussion
 Role play
 Case study
 Bedside teaching
 Portfolio
 Clinical simulation
 Video show
 Demonstration (at skills lab and Basic Sciences lab)
 Guided clinical practice
 Inter-professional learning experience in the hospital
 Seminar Presentations

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board

196
  Posters
 Anatomic models
 LCD Projector
 White board, marker
 Laptop and Videotapes

Methods of Assessment
 Formative
o Drills, essay exams, quizzes, and practical test (direct observation of skills)
o Structured feedback report
o Oral exam
o Logbook
o Portfolio
o And other assessment methods
 Summative
o Progressive/ Continuous assessment
o Objectively Structured Clinical Examination (OSCE)
 Investigation modalities on general surgery and thoracic emergency cases
 Double lumen tube insertion
o Direct Observational Practice
 Preoperative evaluation on general surgery and thoracic emergency cases
 Double Lumen Tube insertion
o Practical Clinical Examination
 Anesthetic management of general surgery and thoracic emergency cases
o Case Based Discussion
 Postoperative anesthetic consideration of general surgery and thoracic
emergency cases
 Preoperative anesthetic evaluation of patients schedule for urologic surgery
 Perioperative anesthetic management of acute abdomen
 Perioperative anesthetic management of thyroid surgery
o Structured Oral Examination (OSCE)

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  Percentage allocation:
Content area Hour load Self S %
Emphasis
Anesthesia for Thoracic emergency Surgeries 54 6 16%
Anesthesia for GI and urology Anesthesia 144 16 42%
Anesthesia for Hepato billary surgery 54 6 16%
Anesthesia for Endocrine surgeries 66 8 19%
Anesthesia for Oncologic surgery 24 3 7%
Total Hrs. 342 39 100%

Module Policy
 Attendance: It is compulsory to attend both SDL and Hospital clinical practice on time and
every time. If students are going to miss more than three classes/ hospital attachment days
during this semester, they will not be allowed to final assessment and next semester unless
otherwise proven by evidence per legislation requirement.
 Assignments: Students must complete module assignments and work based assessments on
time. Uncompleted work-based assessments and assignments will result in Incomplete (I)
grade submissions to registrar. Further consecutive procedures will be handled in line with
institutional senate legislation.

Reference Books

1. Clinical anesthesiology, 5th Edition. G. Edward Morgan

2. Principles and procedures in anesthesiology, Philip L. Liu.
3. Text book of anesthesia, Smith and Aithenheas’s, 3rd Edition.
4. Basic Sciences in Anesthesia books 2018
5. Miller’s Anesthesia, Ronald D. Miller 8th edition, 2015
6. Clinical Anesthesia, Paul G. Barash, 8th edition,2017
7. Stoelting’s Anesthesia and Co-Existing Disease 7th edition,2018
8. Anesthesia for urologic surgery Daneil M. Gainsburg, 2014
9. Basic Physiology for Anesthetis, David Chambers
10. Liver anesthesiology and critical care medicine 2nd edition 2018

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 Module Schedule
Duration: 20 Weeks (Hospital Practice will be Parallel to Classroom-based teaching)

Required Reading
Week Learning Activity
(Assignment)
o
Interactive Lecture and Discussion.
Introduction to Gastrointestinal system [5:30 Hr.] o Anatomy of the
gastrointestinal
Anatomy and physiology of gastrointestinal system system
Week 1 Pharmacologic consideration of the GI system o Anesthetic
management of
Hospital Practice[11Hrs.] perforated PUD

Week 2 Pathophysiology and investigation modalities of GI disorders [5:30 Hrs.]

Hiatal hernia
Achalasia
Esophageal diverticula
PUD and Gastric ulcer
Small bowel obstruction
Large bowel obstruction
Actuate appendicitis
Hospital Practice[11Hrs.]

Week 3 Perioperative Anesthetic management of GI disorders [5:30Hrs.]

Hiatal hearnia
Achalasia
APR
Appendectomy
Hospital Practice[10Hrs.]

Week 4 Perioperative Anesthetic management of GI disorders [4:30Hrs.]

Fistelectomy
Esophageal diverticulum
Laparatomy
GJ +TV
Group discussion [1Hrs.]

Postoperative complication associated with emergency laparatomy.

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 Required Reading
Week Learning Activity
(Assignment)

Hospital Practice[11Hrs.]

Week 5
Interactive Lecture and Discussion
Introduction to Genitourinary system [5:30Hrs.] o Effect of different
positing on anesthesia
Anatomy and physiology of genitor urinary system management urologic
procedures
Pharmacological consideration of the genitourinary disorders o Renal failure and fluid
electrolyte disturbance
Hospital Practice[11Hrs.]

Week 6 Pathophysiology and investigation modalities of Genitourinary disorders

[5:30 Hrs.]

Acute renal failure

Chronic renal failure
Bladder outlet obstruction
Bladder stone
Glomoerelo nephritis
Pyelonephritis
Nephritic syndrome
Hydro nephrosis
Hospital Practice[10Hrs.]

Week 7 Group discussion on [1:30Hr.]

End stage renal failure

Investigation on impaired renal function

Perioperative Anesthetic management of GU disorders [4Hrs.]

Nephrectomy
Pylolithotomy
Lithotripsy

Hospital Practice[11Hrs.]

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 Required Reading
Week Learning Activity
(Assignment)
Perioperative Anesthetic management of GU disorders [4.5Hrs.]

Extracorporal shock wave lithotripsy

Prostatectomy
 TVP
Week 8  TURP

Seminar presentation [1Hrs.]

Anesthetic management of renal failure

Hospital Practice[11Hrs.]

Interactive Lecture and Discussion

Introduction to anesthesia for Hepato-biliary surgery [1:30 Hrs.]
Physiology
Effect of different drugs on hepatic function and effect of liver on
metabolism of the different drugs
o Anatomy of the
Week 9 PBL [4Hrs.] hepato-billiary
system
 Topic to be identified

Hospital Practice[11Hrs.]

Pathophysiology and investigation modalities of Hepatobiliary surgery

disorders [5:30hr]

Hepatitis
Liver cirosis
Hepatomegally
Week10 Acute cholecystisis
Choletiastasis
Jaundice
Pancreatitis

Hospital Practice[11Hrs.]

201
 Required Reading
Week Learning Activity
(Assignment)
Perioperative Anesthetic management of hepato-biliary surgery
[4:30Hrs]
Exploration
Bypass
Cholecystectomy
Chodedocystectomy
Week11 Laparoscopic Cholecystectomy
Group discussion on [1Hrs]
Laparoscopic Cholecystectomy

Hospital Practice[11Hrs.]

Video on [0.5Hrs]
Laparoscopic surgery

PBL [4Hrs.]

 Topic to be identified
Week12
Seminar presentation on [1Hrs]

Anesthetic management of obstructive jaundice

Hospital Practice[11Hrs.]

Interactive Lecture and Discussion

Introduction to anesthesia for endocrine surgery [3Hrs.]
Physiology of thyroid, parathyroid, suprarenal gland
Effect of different drugs on endocrine function
Pathophysiology and investigation modalities of endocrine disorder [2:30hr
Week13
Hyperthyroidism
Hypothyroidism

Hospital Practice[11Hrs.]

202
 Required Reading
Week Learning Activity
(Assignment)
Pathophysiology and investigation modalities of endocrine disorder [3:30 hrs]

Hypo/hyperparathyroidism
Hypo/hyperaldostronism
Peochromocytoma
Conn’s disease
Week14 Seminar presentation on [1Hrs]
Anesthetic management toxic goiter

Group discussion on [1Hrs]

Laparoscopic Cholecystectomy

Hospital Practice[11Hrs.]

Perioperative Anesthetic management of common endocrine surgery

[5:30HRs]
Thyroidectomy
Tymoctomy
Week15 Resection of adrenal tumor
Parathyroidectomy
Mastectomy

Hospital Practice[11Hrs.]
Interactive Lecture and Discussion
Introduction to anesthesia for thoracic emergency surgery [ 1:30Hrs]
Anatomy
Physiology
Pharmacologic consideration of thoracic emergency

Week16 PBL [4Hrs.]

 Topic to be identified

Hospital Practice[11Hrs.]

Pathophysiology and investigation modalities of thoracic emergency [4hr]

Week17 Pneumothorax
Hemothorax
Pulmonary contusion

203
 Required Reading
Week Learning Activity
(Assignment)
Cardiac contusions
Group discussion on [ 1:30 Hrs]
Common investigation for thoracic emergency sugary
Anesthetic management of thoracic emergency
Common postoperative complications associated with thoracic
emergency procedure

Hospital Practice[11Hrs.]
Perioperative Anesthetic management of thoracic emergency surgery [3HR]

Tracheobronchial disruptions
Esophageal injury
Diaphragmatic injury
Pulmonary contusion
Seminar presentation on [1Hrs]
o Anesthtetic
Week18 Anesthetic consideration of thoracic emergency patients
management for
Demonstration [30 minute]
cardiac emergencies
Double lumen tube insertion

Video [ 1Hr]
Respiratory tract
Double lumen tube insertion
Chest x- ray and ECG interpretation
Hospital Practice[11Hrs.]
Interactive Lecture and Discussion
Introduction to anesthesia for oncologic surgery [1:30Hrs.]
Physiology
Pharmacology

PBL [4Hrs.]

 Topic to be identified
Week19
Hospital Practice[11Hrs.]

Pathophysiology and investigation modalities of different oncologic disorder

[2hr]

Breast cancer
Colonic cancer
Gastric cancer

204
 Required Reading
Week Learning Activity
(Assignment)
Thyroid cancer

Perioperative Anesthetic management of common oncologic procedure

[3.HRs]
Effect of chemo/radiotherapy on different body system
Breast cancer
Colonic cancer
Gastric cancer
Week20 Thyroid cancer

Group discussion on [30 minute ]

Preoperative anesthetic consideration for oncologic surgery

Hospital Practice[10Hrs.]

205
Measurement of Health and Disease

Module Title: Measurement of Health and Disease

Module Code: SPHM-4212
Module ECTS: 4 ECTS

Module Description: This module is designed to equip learners with the knowledge, skills and
attitude needed to measure disease and other health conditions in the community for public health
action. This Module will be addressed through Interactive lecture, Seminar presentations and
supervised feedbacks in real community setup.

Module Objective

At the end of this module, learners will be able to apply public health methods for the measurement
of health and disease at population level.

Module Competencies
The core professional competencies where this practice Module aimed at achieving are:
1. Apply epidemiological studies
2. Apply the steps of an outbreak investigation for measure of morbidity and mortality
3. Apply basic biostatistics concepts, tools and methods
4. Apply the techniques of data analysis
Learning outcome

 Explain the notion of health from scientific and layman perspective

 Describe the history, evolution and functions of public health and its relevance to the
practice of Anesthesia
 Apply epidemiological approach to disease causation with emphasis on infectious diseases
 Apply levels of prevention regarding avoidance and control at different levels
 Apply the different types of epidemiologic studies
 Calculate and interpret measures of morbidity and mortality including from existing data
sources
 Apply different methods of data collection in the community
 Apply basic biostatistics concepts, tools and methods

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  Describe criteria for establishing and evaluating screening programs and factors that affect
validity and reliability of screening tests
 Describe the processes, uses, and evaluation of public health surveillance
 Apply the steps of an outbreak investigation and management
 Discuss epidemiology of diseases of public health significance in Ethiopia and locally
 Demonstrate clear, sensitive and effective communication skills in interactions with
individuals, families, communities, PHCU staff, local health department staff, peers and faculty
 Suggest health promotion and disease prevention methods for major public health problems
 Demonstrate professional values and behavior in interaction with individuals, families and
communities consistent with the future role of a physician
 Demonstrate key public health values, attitudes and behaviors such as commitment to equity
and social justice, recognition of the importance of the health of the community as well as the
individual, and respect for diversity, self-determination, empowerment, and community
participation
 Analyze community practice experience and perform practice-based improvement activities
using a systematic methodology
 Search, collect, organize and interpret health and health-related information from different
sources
Prerequisite: Determinants of Health
Duration: 19 weeks
Teaching-Learning Methods
 Interactive lecture and discussion
 Small group learning activities: assignment, exercise, case study
 Individual reading
 PHCU/Community-based learning and study trip: home visit, discussion with individuals
and families to identify and solve problems, observation, PHCU visit, Zonal and District
Health Department Visit, field visit, and targeted literature review based on community
experience
 Student presentation
 Reflective portfolio and mentoring

Prerequisite: None

207
Teaching-Learning Methods

 Small group discussion

 Role play
 Case study
 Portfolio
 Video show
 Demonstration
 Individual studies.

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board
 Posters
 LCD Projector
 White board, marker
 Laptop and Videotapes

Methods of Assessment
Formative assessment
18. Exercise and assignment
19. Portfolio
20. Student presentation
Summative assessment
21. quiz 5%
22. Reflective portfolio /community visit (15 %)
23. Test 20
24. Assignment and/or student presentation (15 %)
25. Class participation 5%
26. Final Written exam (40 %)

208
Module Policy
 Attendance: It is compulsory to attend both SDL and community practice on time and every
time. If students are going to miss more than 20% of days during this semester, they will not
be allowed to final assessment and next semester unless otherwise proven by evidence per
legislation requirement.
 Assignments: Students must complete Module assignments and work based assessments on
time. Uncompleted work-based assessments and assignments will result in Incomplete (I)
grade submissions to registrar. Further consecutive procedures will be handled in line with
institutional senate legislation.

Reference Books
1. Fletcher. Principles of Epidemiology
2. Charles H Hennekens and Julie E Buring. Epidemiology in Medicine
3. Rothman, Kenneth J.; Greenland, Sander; Lash, Timothy L. Modern epidemiology. 3rd
edition. 2008
4. David G. Kleinbaum, Kevin M. Sullivan. A pocket guide to epidemiology. 2007
5. Yemane Berhane, Damen Hailemariam and Helmut Kloos. Epidemiology and ecology
of health and disease in Ethiopia. 2006
6. Daniel. Biostatistics: a foundation for analysis in health sciences.
7. Pagano. Principles of Biostatistics
8. Colton. Statistics in Medicine
9. Bland. An introduction to Medical Statistics.
 Teaching –learning materials
 AV aids (LCD and computer, writing board and marker or chalk)
 Handouts of lecture materials
 Logbooks for entry of community experience

209
 Module Schedule

Week Contents
Week 1 Introduction to public health
Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Introduction to epidemiology (3 hrs.)
 Types of study design
o Descriptive epidemiology
- Descriptive variables
- Nature of descriptive study
Methods of standardization of rates
Community practice (4 hrs.)

Week 2 Measurements of morbidity and mortality

 Measure of morbidity
 Measures of mortality
 Examples of rates in our country
Source of data in epidemiology
 Census
 Vital statistics
 Health service records
 Morbidity and mortality surveys
Community practice (4 hrs.)
Week 3 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
o Analytic epidemiology (5 hrs.)
Cross-sectional &longitudinal survey
o Case control studies
o Analysis &interpretation
o Cohort study
o Analysis &interpretation

Community practice (4 hrs.)

Week 4 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
o Interventional studies
 Types of intervention studies (2 hrs)
 Analysis &interpretation
 Analysis of epidemiological studies (3 hrs.)
o Role of bias, types of bias
o Validity &reliability
o Predictive value s
o Control of bias, the nature of confounders
Community practice (4 hrs.)
Week 5 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
 Measure of association (5 hrs.)
- Relative risk
- Attributable risk
- Odds Ratio
- Attributable risk percent

210
 - Population Attributable Rate or Risk
Community practice (4 hrs.)
Week 6 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
 Definition &reliability
Validity of screening test
 Sensitivity, specificity
Community practice (4 hrs.)
Week 7 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Epidemiological aspects of communicable disease
 Chain of disease transmission
 Methods of controlling communicable disease
 Epidemics and it’s control
 Epidemiological surveillance
 Major epidemics in Ethiopia and it/s control
Community practice (4 hrs.)
Week 8 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
 Screening in disease control
o Natural history of diseases (communicable and non-communicable)
o Contagious disease
o chain of transmission
o Time course of disease
Community practice (4 hrs.)
Week 9 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Investigation of epidemic (5 hrs)
o Levels of disease occurrence
o Types of epidemics
o Steps in epidemic investigation
o Implementing preventive & control measures
o Surveillance
Community practice (4 hrs.)
Week 10  Measurements of Health (5 hrs)
Classroom based Teaching (lecture, + seminars + group discussion) [4 hrs.]
o Fractions used in describing disease frequency
o Prevalence
o Incidence
o Comparing disease occurrence
o Epidemiology of diseases of public health significance in Ethiopia
o Death rates, morbidity and disability measures
Community practice (4 hrs.)
Week 11 Introduction to biostatistics
Classroom based Teaching (lecture, + seminars + group discussion) [4 hrs.]
Introduction to statistics
• Definitions
• Importance in health sciences
Community practice (4 hrs.)

211
Week 12 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Descriptive statistics
• Scales of measurement
• Collection and organization of data
• Presentation of data
• Measures of central tendency and dispersion
Community practice (4 hrs.)
Week 13 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
 Measures of Relative standing
 Inter Quartile Range
 Data and distributions
Community practice (4 hrs.)
Week 14 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Probability theory and probability distribution
 Definition
 Rules
 Binomial distribution
 Normal distribution
Community practice (4 hrs.)
Week 15 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Sampling theory
 Sampling
 Sampling distribution
 Sampling variability of proportions
 Comparing two proportions ling variability of means
Community practice (4 hrs.)
Week 16 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Statistical Estimation theory
 Point estimation
 Interval estimation
 Sample size determination
Community practice (4 hrs.)
Week 17 Statistical testing
 Common tests of statistical significance
(Z – test, T – test and chi – square test)
 Steps in statistical testing
Community practice (4 hrs.)
Week 18 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Measures of association
 Association between categorical variables
 Regression and correlation including statistical software applications
 Interpretation of published article
Community practice (4 hrs.)
Week 19 Exam

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Regional Anesthesia and Pain Management Module

Module Name: Regional Anesthesia and Pain Management Module

Module Code… AnstM-4221

Module: - 10 ECTS

Module Duration: 20 Weeks

Module Description: This module is designed for post basic BSc anesthesia students to enable them
competent in the provision of compassionate, respectful and caring management of Regional
Anesthesia and pain for both inpatient and outpatient settings in most patient groups and
circumstances. They will be equipped to become an effective member of a multi-professionalism
regional Anesthesia and pain medicine services with in-depth understanding of the importance of
managing pain in a timely manner. Moreover, they will have the basic competency of assessment and
management of Regional Anesthesia, chronic and cancer pain. Finally, graduates will be aware of the
need for multi-professional input and embrace this in the management of Regional anesthesia, chronic
and cancer pain. This module will be addressed through interactive classroom lecture & Seminar
presentations, Skill Development Lab (SDL) demonstration & supervised feedbacks in simulated
environment, hospital or pain clinic attachment or pain round.

Module Objective

At the end of this module, students will be able to provide Regional Anesthesia and acute surgical,
non-surgical and basic chronic pain management in both inpatient and outpatient settings in
compassionate, respectful and caring manner.

Module Competency:

 Provide Regional Anesthesia management

 Provide pain management

 Describe the purpose of the anesthetic record

 Define the different types of regional anesthesia
 Identify the distinctive features of regional anesthesia from GA

213
 Describe clinically relevant anatomy for performing regional anesthesia
 Describe pain pathways and dermatomes
 Explain pharmacology of local anesthetics for regional anesthesia
 Identify ways to improve the intensity and duration of local anesthetic agents
 Describe the concerns of anticoagulation in performing regional anesthesia
 Perform preoperative evaluation
 Prepare relevant equipment and drugs for regional anesthesia
 Identify indication & contraindication of regional anesthesia
 Identify optimum position for specific regional anesthesia
 Monitor patients with regional anesthesia intraoperatively
 Perform spinal block
 Perform upper extremity axillary and digital blocks
 Perform lower extremity blocks (ankle blocks),
 Manage patients who already had epidurals
 Perform caudal anesthesia
 Perform different peripheral nerve blocks using the loss of resistance technique
 Prevent the complication of regional anesthesia
 Identify the complications of regional block
 Manage complications of regional blocks
 Manage post-operative complications of regional blocks
 Describe discharge criteria from PACU
 Monitor patients with regional anesthesia postoperatively
 Manage pain effectively in different settings using national and WHO guideline
 Discuss anatomy and physiology of pain including nociceptive, visceral and neuropathic
pain.
 Discuss different classification of pain.
 Describe drugs used to manage pain and their pharmacology
 Describe the assessment methods of pain and management of surgical and non-surgical
pain.
 Describe a basic understanding of acute and chronic pain in adults.
 Explain the importance of the psychosocial aspects of pain.

214
  Describe the organization and objectives of an acute pain service.
 Describe the requirement for the multidisciplinary management of chronic pain.
 Explain the role of social services, rehabilitation and other support services.
 Demonstrate the assessment and perioperative management of pain in opioid dependent
patient.
 Demonstrate the ability to assess and manage acute pain for special groups to include
children, infants, elderly, cognitive impaired, those with communication difficulties, the
unconscious and critically ill patients.
 Demonstrate the ability to undertake a significant role in a pain management services.
 Demonstrate the importance of regular on-going monitoring of pain management/follow
up.
 Demonstrate the ability to assess and manage pain in compassionate, respectful and caring
manner.
 Appreciate the importance of multidisciplinary approach in the management of pain

Prerequisite: None
Teaching-Learning Methods

 Interactive lecture and discussion

 Small group discussion
 Role play
 Case study
 Bedside teaching
 Portfolio
 Clinical simulation
 Video show
 Demonstration (at skills lab and Basic Sciences lab)
 Guided clinical practice
 PBL cases
 Inter-professional learning experience in the clinics, and community practice
 Seminar Presentations

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board
 Posters
 Anatomic models

215
  LCD Projector
 White board, marker
 Laptop and Videotapes

Methods of Assessment
 Formative
o Drills, essay exams, quizzes, and practical test (direct observation of skills)
o Structured feedback report
o Oral exam
o Logbook
o Portfolio
o And other assessment methods
 Summative
o Progressive/ Continuous assessment:
o Objectively Structured Clinical Examination (OSCE)
o Structured Oral Examination
 Percentage allocation:
Content area Hour load Self S %
Emphasis
Regional anesthesia 80 45.5%
Pain management 96 54.5%
Total Hrs. 176 100%

Module Policy
 Attendance: It is compulsory to attend both SDL and Hospital clinical practice on time and
every time. If students are going to miss more than one class/ hospital attachment days during
this semester, they will not be allowed to final assessment and next semester unless otherwise
proven by evidence per legislation requirement.
 Assignments: Students must complete module assignments and work based assessments on
time. Uncompleted work-based assessments and assignments will result in Incomplete (I)
grade submissions to registrar. Further consecutive procedures will be handled in line with
institutional senate legislation.

216
 Module Schedule
Duration: 20 Weeks (Hospital Practice will be Parallel to Classroom-based teaching) - Lecture: 64
hrs; Skill Lab: 28hrs; Hospital Practice : 128 hrs ;PBL :12 HRs

Required Reading
Week Learning Activity
(Assignment)
Reading Assignment
Overview of the Module, Interactive Lecture and Discussion [4 Hrs.] on:

Module Overview

 Structure and design

 Education strategies
 Core competencies
 Teaching and learning methods
 Assessment methods
Lecture and Discussion on
– Definition of Pain
Week 1
– Anatomy and Physiology of pain [Surgical stress response, Pain Processing
(Pain pathway), Physiologic effects of pain]
– Classification and types of of Pain

Video Demonstration on

 Pain pathway
Hospital Clinical Practice [7Hrs.]: Supervised and guided practice on

Observation of patient-staff encounter at PACU, wards and role of anesthetists in

different setup/ units work as team in acute pain management services
Reading Assignment
on:
Interactive Lecture and Discussion on [2Hrs.]

 assessment and management of acute surgical and non-surgical pain
 assessment and perioperative management of pain in opioid dependent patient

Small group discussion & presentation [2Hr.] on:

o Objective assessment of acute pain [e.g., analgesia nociception index-ANI,

Week 2 composite algorithms measures combining autonomic responses with indicators of
brain activity(EEG &Entropy)]

Hospital Clinical Practice [7Hrs.]:

217
 Required Reading
Week Learning Activity
(Assignment)
Supervised and Guided Hospital Clinical Practice including acute pain round
(surgical and non-surgical unit)

 Assessment and monitoring of acute surgical and non-surgical pain and side
effects of medication.
 Assessment of pain in opioid dependent patient.
 Effective Communication skill with patients, relatives and care givers including
advantages, disadvantages and side effects of pain management.

Interactive Lecture and Discussion [2Hrs.]

 Application of Pain assessment scales and WHO analgesic ladder
 chronic pain in adults

Simulation/role playing [2 Hr.] on

 Assessment of pain

Clinical Skill Development Lab [1 Hr.]

Application of Pain assessment scales

Hospital Practice/ Visit [7hrs] Assignment and home

Supervised and Guided Hospital Clinical Practice including acute pain round studies on equipment
Week 3 on: utilized on airway
management (6 Hrs.)
– Assessment and monitoring of acute surgical and non-surgical pain and side effects
of medication.
– Assessment of pain in opioid dependent patient.
 Effective Communication skill with patients, relatives and care givers including
advantages, disadvantages and side effects of pain management
– Start to complete the module workplace assessment tools: DOP, PCE, ACAT,
Case reports, MSF

Whole Group Session [2Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in the
presence of their instructors and coordinators including the department head.

Interactive Lecture and Discussion [4 Hrs.]

Week 4  psychosocial aspects of pain
 use of opioids in the management of chronic non-malignant pain

218
 Required Reading
Week Learning Activity
(Assignment)

Clinical Skill Development Lab [4 Hrs.]

– Application of WHO analgesic ladder and the principle of multimodal analgesia

Hospital Practice/ Visit [7 Hrs.]

Supervised and Guided Hospital Clinical Practice including acute pain round
(surgical and non-surgical unit)

– Undertake a significant role in acute pain management services.

– Safe use of equipment used to manage pain including equipment used for PCA and
epidurals.
– Assess [structured Hx, PE and interpretation of investigations] and carry out basic
management of chronic pain in adults
 Continue to complete the module workplace assessment tools: DOP, PCE, ACAT,
Case reports, MSF

PBL [4Hrs.]

Hospital Practice/ Visit [7 Hrs.]

Supervised and Guided Hospital Clinical Practice including acute pain round

 Undertake a significant role in acute pain management services.

Week 5
 Assess [to include thorough structured history taking, physical examination and
interpretation of investigations] chronic pain in adults.
 Monitoring of pain management/follow up in a regular on-going basis
 Appropriate continuity of care and communications occurs in the management of
pain.
 Exercise teamwork in the multi-professional management of pain.
 Continue to complete the module workplace assessment tools: DOP, PCE, ACAT,
Case reports, MSF
Interactive Lecture and Discussion on [2 Hr.]

 Organization and objectives of pain management services

 role of social services, rehabilitation and other support services in pain management
Seminar [2Hr.]

Week 6 - chronic pain syndrome

Hospital Practice/ Visit [ 7 Hrs.]

219
 Required Reading
Week Learning Activity
(Assignment)
Supervised and Guided Hospital Practice including acute pain round (surgical
and non-surgical unit)

– Undertake a significant role in acute pain management services.

– Safe use of equipment used to manage pain including equipment used for PCA and
epidurals.
– Assess [structured Hx, PE and interpretation of investigations] and carry out basic
management of chronic pain in adults
– Visit oncology center
– Assess [structured Hx, PE and interpretation of investigations] cancer pain patients.
 Continue to complete the module workplace assessment tools: DOP, PCE, ACAT,
Case reports, MSF

Interactive Lecture and Discussion [4 Hrs.]

 Multidisciplinary management of chronic pain
 Interventional pain management [overview of invasive procedures such as lumbar
epidural steroid injection (LESI), Selective nerve root blocks (SNRB), facet joint
injections, neuro augmentation, vertebroplasty, , kyphoplastyetc

Hospital Practice/ Visit [7 Hrs.]

Supervised and Guided Hospital Practice including acute pain round (surgical
and non-surgical unit)

– Assess and manage pain in compassionate, respectful and caring manner.

Week 7 – Undertake a significant role in acute pain management services.
– Assess [structured Hx, PE and interpretation of investigations] and carry out basic
management of chronic pain in adults
– Assess [structured Hx, PE and interpretation of investigations] and carry out basic
management of cancer pain patients.
– Recognize and manage neuropathic pain.
 Continue to complete the module workplace assessment tools: DOP, PCE, ACAT,
Case reports, MSF

Whole Group Session [2 Hrs.]

– Students will discuss on the progress of their clinical learning process in the
presence of their instructors and coordinators including the department head.


Interactive Lecture and Discussion [4 Hrs.]

– Options for perioperative pain management.
Week 8
– Opoid analgesics
– NSAID

220
 Required Reading
Week Learning Activity
(Assignment)

Hospital Practice/ Visit [7 Hrs.]

Supervised and Guided Hospital Practice including acute pain round (surgical
and non-surgical unit) [4Hrs.]:

– Assess and manage pain in compassionate, respectful and caring manner.

– Become an effective member of a multi-professional pain medicine services
 Continue to complete the module workplace assessment tools: DOP, PCE, ACAT,
Case reports, MSF

PBL [4Hr.]

Hospital Practice/ Visit [7 Hrs.]

Supervised and Guided Hospital Practice including acute pain round (surgical
and non-surgical unit)
Week 9
– Assess and manage pain in compassionate, respectful and caring manner.
– Undertake a significant role in acute pain management services.
– Assess [structured Hx, PE and interpretation of investigations] and carry out basic
management of chronic pain in adults
– Assess [structured Hx, PE and interpretation of investigations] and carry out basic
management of cancer pain patients.
– Continue to complete the module workplace assessment tools: DOP, PCE, ACAT,
Case reports, MSF.

Interactive Lecture and Discussion [4hr]

Regional anesthesia
 Lecture on types/classifications of regional anesthesia
 General principles and equipments for General anesthesia
 Group discussion on regional vs general anesthesia
Week 10

Hospital Practice/ Visit [7 Hrs.]

 Observation and guided practice: emergency department, surgical ward and OPD
 Observe commonly practicing regional anesthesia in OR
 Practicing patient preparation for regional Anesthesia
 Prepare equipments for General anesthesia
 Observe and apply aseptic techniques in Regional Anesthesia

221
 Required Reading
Week Learning Activity
(Assignment)

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in the
presence of their instructors and coordinators including the department head.

Interactive Lecture and Discussion [4 Hrs.]

Regional anesthesia
 Lecture presentation on relevant anatomy( Head, Neck, Spine, Upper extremity,
Trunk, & lower extremity)
 Seminar presentation on pain pathways

Week 11 Hospital Practice/ Visit [7 Hrs.]

 Observe commonly practicing regional anesthesia in OR
 Practicing patient preparation for regional Anesthesia
 Prepare equipment’s for General anesthesia
 Observe and apply aseptic techniques in Regional Anesthesia

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in the
presence of their instructors and coordinators including the department head.

Interactive Lecture and Discussion [4 Hrs.]

Regional anesthesia
 Lecture on pharmacology of local anesthetics
 Lecture on additives and adjuvant for Local Anesthesia
 Group discussion on improving the intensity and duration of local anesthetics
 Group discussion on bleeding disorders and anticoagulant treatment with RA

Clinical Skill Development Lab [4 Hrs.]

Week 12  Demonstration on positioning related to specific blocks (2 Hrs)

Hospital Practice/ Visit [7Hrs.]

 Observation and guided practice: emergency department, surgical ward and OPD
 Observe the application and usage of local anesthetics
 Observe the application and usage of additives and adjuvant for Local Anesthesia

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in the
presence of their instructors and coordinators including the department head.

222
 Required Reading
Week Learning Activity
(Assignment)

Interactive Lecture and Discussion [4 Hrs.]

Regional anesthesia
 lecture presentation on Indications and contraindications for Regional
Anesthesia
 Lecture on factors affecting the effectiveness of regional of regional Anesthesia
 Patient preparation for regional Anesthesia
 Group discussion on monitoring patients during regional anesthesia

Clinical Skill Development Lab [4 Hrs.]

Week 13  SDL demonstration on monitoring patients during regional anesthesia

Hospital Practice/ Visit [7 Hrs.]

 Observation and guided practice: emergency department, surgical ward and OPD
 Observe and prepare Patients for regional Anesthesia
 Use and apply monitoring devises and monitor patients during regional
anesthesia

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in the
presence of their instructors and coordinators including the department head.

Interactive Lecture and Discussion [4 Hrs.]

Regional anesthesia
 Lecture presentation on Neuroaxial blocks( spinal and epidural anesthesia)

Clinical Skill Development Lab [7 Hrs.]

 SDL Demonstration on equipment preparation for Neuroaxial blocks
 SDL Demonstration on spinal l anesthesia
Week 14  SDL demonstration on epidural anesthesia

Hospital Practice/ Visit [7Hrs.]

 Observe on equipment preparation for Neuroaxial blocks
 Observe on spinal l anesthesia Techniques
 Observe on epidural anesthesia
 Prepare necessary equipments for Neuroaxial blocks.
 Perform Spinal and Epidural Anesthesia

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in the
presence of their instructors and coordinators including the department head.

223
 Required Reading
Week Learning Activity
(Assignment)

Interactive Lecture and Discussion [4 Hrs.]

Regional anesthesia
 Lecture presentation on upper extremity blocks ( Brachial plexus block Axillary,wrist
and digital blocks)
 Lecture presentation on loss of resistance blocks (TAP block, Rectus sheaths
block…)

Clinical Skill Development Lab [4 Hrs.]

 SDL demonstration on patient preparation for Upper extremity blocks
 SDL demonstration on upper extremity and lower extremity blocks Video show on
upper extremity block
 SDL demonstration on loss of resistance blocks Video show on upper extremity
Week 15 block (TAP block ,Rectus Sheaths block…)

Hospital Practice/ Visit [7 Hrs.]

 Clinical observation on upper extremity blocks ( Brachial plexus block Axillary,
wrist and digital blocks)
 Clinical observation on loss of resistance blocks (TAP block, Rectus sheaths
block…)
 Perform upper extremity blocks ( Brachial plexus block Axillary, wrist and digital
blocks)
 Perform loss of resistance blocks (TAP block, Rectus sheaths block…)

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in the
presence of their instructors and coordinators including the department head.

Interactive Lecture and Discussion [4Hrs.]

Regional anesthesia
 Lecture presentation on Lower extremity blocks
 Lecture presentation on performance of caudal

Clinical Skill Development Lab [4 Hrs.]

Week 16  SDL demonstration on patient preparation for Lower extremity blocks
 SDL demonstration on Lower extremity blocks Video show on upper extremity
block
 SDL demonstration on Caudal blocks Video show on upper extremity block

Hospital Practice/ Visit [ 7Hrs.]

 Clinical observation on Lower extremity blocks
 Clinical observation on performance of caudal

224
 Required Reading
Week Learning Activity
(Assignment)
 Perform Lower extremity blocks
 Perform caudal Analgesia
 Perform upper extremity blocks ( Brachial plexus block Axillary, wrist and digital
blocks)
 Perform loss of resistance blocks (TAP block, Rectus sheaths block…)

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in the
presence of their instructors and coordinators including the department head.

Interactive Lecture and Discussion [4 Hrs.]

Regional anesthesia 3 Hr.)
 Complications Of regional anesthesia
 Case study on identifying complications related to regional anesthesia (1 Hr)
 Group discussion on identifying complications related to regional anesthesia (1
Hr.)
 Group discussion on prevention and managing complications related to regional
Week anesthesia (1 Hr)
17
Hospital Practice/ Visit [7 Hrs.]
 Identify the Complications Of regional anesthesia
 Practice prevention and managing complications related to regional anesthesia (1
Hr)

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in the
presence of their instructors and coordinators including the department head.

Interactive Lecture and Discussion [4 Hrs.]

Regional anesthesia
 Seminar presentation on postoperative complications of regional blocks
 Seminar presentations on discharge from PACU
 Seminar on PACU monitoring of regional anesthesia patients
Week 18
Hospital Practice/ Visit [7Hrs.]
 Observation and guided practice: emergency department, surgical ward and OPD
 Practice on postoperative complications of regional blocks
 Apply the discharge criteria from PACU
 Apply the principles of PACU monitoring of regional anesthesia patients

Whole Group Session [2 Hrs.]

225
 Required Reading
Week Learning Activity
(Assignment)
 Students will discuss on the progress of the week’s teaching learning process in the
presence of their instructors and coordinators including the department head.

PBL [4Hr.]

Hospital Practice/ Visit [7 Hrs.]

 Observation and guided practice: emergency department, surgical ward and OPD
Week 19  Practice on postoperative complications of regional blocks
 Apply the discharge criteria from PACU
- Apply the principles of PACU monitoring of regional anesthesia patients

Whole Group Session [2 Hrs.]

Students will discuss on the progress of the week’s teaching learning process in the
presence of their instructors and coordinators including the department head.
Examination Week
- OSCE
- Oral
Week 20
MCQ

226
Obstetric and Gynecological Anesthesia

Module Title: Obstetric and gynecological anesthesia

Module Code: AnstM-4231
Module ECTS: 10 ECTS
Module Duration: 16 Weeks
Module Description: This module is designed for anesthesia students to create a learning
opportunity to enable graduate students in delivering safe anesthesia for pregnant mothers; women
with common gynecologic problem and pregnant women with non-obstetric surgery. It also deals with
resuscitation of the newborn and mothers as a whole. This Module will be addressed through
Interactive lecture, Seminar presentations, Skill Development Lab (SDL) demonstration and
supervised feedbacks in simulated environment and real hospital setting.
Module Competency
 Provide comprehensive peri-operative anesthetic care for obstetric and gynecologic patients
undergoing surgery/ anesthesia

Module Objective
 By the end of this module, students will be able to provide safe anesthesia and analgesia for
patients undergoing obstetrics and gynecologic surgery for a variety of indications
Learning Outcomes:
To meet the above module objective the student will be expected to:

 Describe maternal anatomic, physiologic and pharmacological changes with its anesthesia
implication during pregnancy
 Describe utero- placental and fetal circulation
 Explain anesthetic risk in obstetric patient
 Explain factors affecting placental drug transfer and fetal exposure to anesthetic drugs
 Perform pre-operative evaluation for obstetrics and clients
 Identify fluid and electrolyte management in pregnant patients
 Describe techniques used in labor analgesia
 Describe anesthetic considerations for high risk parturient undergoing obstetrics surgery
 Provide General anesthesia for elective or emergency caesarean section
 Provide Neuraxial anesthesia for elective and emergency Cesarean section

227
  Administer anesthesia for pregnant woman undergoing non-obstetric surgery
 Plan and Manage difficult Airway in obstetrics
 Perform pre-operative evaluation for gynecological clients
 Identify and optimize patients presenting for pelvic gynecologic surgery (DVT, neuropathy)
 Manage anesthesia for common gynecologic surgeries/ procedures
 Perform gynecological laparoscopic procedures
 Perform obstetric CPR
 Provide resuscitation for a newborn

Prerequisite: None

Teaching-Learning Methods

 Interactive lecture and discussion

 Small group discussion
 Video show
 Case study
 Demonstration (at skills lab and Basic Sciences lab)
 Seminar
 Guided clinical practice

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board
 Posters
 Anatomic models
 LCD Projector
 White board, marker
 Laptop and Videotapes

Methods of Assessment

228
  Formative
 Direct Observed practice (DOP)
 Practical clinical examination (PCE)
 Structured feedback report
 Assignments and essay
 Logbook
 Seminars & presentations
 Summative
 Summative
o Final written exam
o Progressive/ Continuous assessment:
o Objectively Structured Clinical Examination (OSCE)
o Structured Oral Examination
- Final written exam - 30%
- Practical summative assessment (70%)
 2 Direct Observed Procedures (DOP) - 10%
 2 Case Base Discussions (CBD) - 10%
 4 Practical Clinical Evaluations - 20%
 Objectively Structured Clinical Examination (OSCE) - 20%
 Structured Oral Examination - 10%
Possible Summative assessment areas for:

Direct Observed Procedure (DOP)

 Perform neuraxial block on obstetrics patients

 Perform rapid sequence induction
 Perform regional block for labor analgesia
 Intubation of a difficult airway
 Performing Rapid Sequence Induction (RSI)

Possible Summative assessment areas for:

Practical Clinical Evaluations
 Preoperative evaluation for obstetrics patients

229
  Anesthesia management for cesarean section patients with diagnosis of eclampsia
 Intrauterine resuscitation for mothers coming for cesarean section with fetal distress
 Anesthetic management of laparoscopic gynecology
 Intraoperative anesthetic management of gynecologic surgical patients
 Sequential management of complications of spinal anesthesia
 Sequential management of newborn resuscitation

Possible Summative assessment areas for:

Objectively Structured Clinical Examination (OSCE)

 Performing Lumbar Puncture under sterile technique & administer SA

 Preparation and titration of different resuscitation drugs
 Resuscitation of neonates (apply necessary techniques)
 Difficult airway management
 Difficult Airway Management with Boogie
 Difficult Airway Management with Intubating Laryngeal Mask Airway (ILMA)
 Anesthetic management of high-risk pregnancy (Preeclampsia, Fetal distress, Ectopic
pregnancy, Ruptured uterus, Placenta previa….)
 Hemodynamic optimization and anesthetic management in obstetrics patients

Module Policy
 Attendance: It is compulsory to attend both SDL and Hospital clinical practice on time and
every time. Students should 100% attend the hospital practice. If they are going to miss more
than three classes/ hospital attachment days during this semester, they will not be allowed to
final assessment and next semester unless otherwise proven by evidence per legislation
requirement.
 Assignments: Students must complete module assignments and work-based assessments on
time. Uncompleted work-based assessments and assignments will result in Incomplete (I)
grade submissions to registrar. Further consecutive procedures will be handled in line with
institutional senate legislation.

Reference Books

230
1. Curtis Baysinger: Practical approach to obstetric anesthesia (2nd edition); 2016
2. Alpesh ahdhi: Principles of critical care in obstetrics volume II; Spinger 2016
3. Vicki Clark: oxford textbook of obstetric anesthesia; oxford 2016
4. Harold Ellis: Anatomy for Anesthetists (8th edition). Blackwell Science Ltd, 2004.
5. Paul G Barash: Handbook of Clinical Anesthesia (6th edition). Lippincott Williams & Wilkins
publications, Inc., 2009.
6. Paul G Barash: Clinical Anesthesia (8th edition). Lippincott Williams & Wilkins publications,
Inc., 2017.
7. Ronald D. Miller: Millers Anesthesia (8th edition). Churchill Livingstone publication, An
Imprint of Elsevier, 2015.
8. G. Edward Morgan: Clinical Anesthesiology (5th edition). Mcgraw-Hill Companies, Inc.,
2013
9. Ronald D. Miller: Basics of Anesthesia (7th edition). Saunders, an imprint of Elsevier Inc.
2011.
10. Fleisher: Anesthesia and Uncommon Diseases, (5th edition). Elsevier Saunders Inc., 2005
11. James C. Duke: Duke’s Anesthesia Secretes (5th edition). Saunders, an imprint of Elsevier
Inc.2016.
12. Timothy E. Miller: Anesthetic Care for Abdominal Surgery. Elsevier Saunders Inc., 2015.

231
 Module Schedule
Duration: 16weeks (Hospital Practice will be Parallel to Classroom-based teaching) Lecture
64(24.80%), Skill lab 14(5.43%), PBL 12(4.65%), Self-study 30(11.63%) and Hospital practice
138(53.49%)

Required Reading
Week Learning Activity
(Assignment)
Interactive lecture [4HR] Reading Assignment on:
 Physiological change
Physiological changes of pregnant mother with [3HR] of
 Airway
 Respiratory
 Cardiovascular
 GI
 Hematologic
 Renal and liver
 CNS
Seminar presentation on [1HR]
Week 1
 IV induction agents
 Inhalational
 Opioids
 Muscle relaxants
 Adjuvants

Hospital practice [9 Hrs.]

 Hospital based practice on physiological and pharmacological changes

on obstetrics patients

Interactive lecture [4HR]

 Fetal circulation [1HR]

 Uteroplacental blood flow [1HR]
 On factors affecting placental drug transfer and fetal exposure to
anesthesia drugs [1HR]

Seminar presentation of [1HR] Pregnant mother with

Week 2  Amniotic fluid embolism and pulmonary edema in obstetrics, Coronary Artery disease and
anesthesia for obstetric interventions Myocardial infarction

Hospital practice [9 Hrs.]

 Hospital practice on airway examination for obstetrics and
gynecology patients
 Hospital practice on regional anesthesia for obstetrics and
gynecology patients

232
 Required Reading
Week Learning Activity
(Assignment)
 Hospital practice on preoperative evaluation for obstetrics and
gynecology patients
Interactive lecture [4HR]

 Preoperative evaluation in obstetric patients [1/2HR]

 Valvular heart disease [1/2HR]
 Congestive heart failure [1HR]
 Ischemic heart disease [1HR]

Group discussion for [1HR]  HIV in pregnant

 Prevention of fetal exposure to anesthesia drugs mothers and
Hospital practice [9 Hrs.] anesthesia
 Hospital based practice on preoperative evaluation for obstetric and
gynecological patients
Week 3  Hospital based practice on preoperative evaluation for obstetric and
gynecological patients
Skill Development Lab (SDL) [2HR]
 Fluid resuscitation of patient in shock.
Interactive lecture [4HR]

 Diabetes mellitus during pregnancy and its management [1/2HR]

 Hypertension [1/2HR]
 Anemia and Smoking [1/2HR]
 Obesity [1/2HR]
 Fluid and electrolyte management in obstetric patients Introduction
to labor analgesia [1HR]

Group discussion [1HR]

Week 4  Types of labor analgesia with advantages and disadvantages for each  Epidural anesthesia
Skill Development Lab (SDL) [2HR]

 Administration of drugs and methods for labor analgesia

Hospital practice [9 Hrs.]

 Hospital based practice on labor analgesia
 Hospital based practice on preoperative evaluation for obstetric and
gynecological patients
 Hospital based practice on preoperative evaluation for obstetric and
gynecological patients

233
 Required Reading
Week Learning Activity
(Assignment)
Interactive lecture for [4HR]

Anesthesia consideration for

 Preeclampsia
 Eclampsia
 Placenta Previa
 Abruptio placenta

Small group discussions [1HR] Appencitis in pregnant

Week 5
mother
 How to resuscitate a patient with severe bleeding

Hospital practice [9 Hrs.]

 On administering anesthesia for high risk parturient
 Hospital based practice on labor analgesia
 Hospital based practice on preoperative evaluation for obstetric and
gynecological patients
 Hospital based practice on preoperative evaluation for obstetric and
gynecological patients
Interactive lecture of [4HR]

 Uterine rupture
 Uterine atony
 Uterine inversion/laceration
 Retained fetal tissue/placenta
 Substance abuse
 Tobacco abuse
 Alcohol
 Opioids
 Marijuana  Diagnosis and
 Cocaine management of aspiration
 Amphetamines Pneumonitis
Week 6 Discussion of [1/2HR]

 Rapid sequence induction for obstetrics patients

Video show of [¼ HR]

 How and why to apply cricoid pressure

Skill Development Lab (SDL) demonstration [2HR]

 Selection and administration of drugs for GA

234
 Required Reading
Week Learning Activity
(Assignment)
Hospital practice [9 Hrs.]
 Hospital based general anesthesia for patients coming for Caesarian
section
 Hospital based practice on labor analgesia
 Hospital based practice on preoperative evaluation for obstetric and
gynecological patients

Interactive lecture of [4HR]

 Neuraxial anesthesia for C/S [2HR]

Small group discussion of [1HR]

 Complications of Neuraxial anesthesia for C/S patients

Video-show [1/2HR]

 How to do spinal anesthesia

Week 7 Small group discussion [1/2HR] Preterm delivery

 On management of complications of GA

Hospital practice [9 Hrs.]

 Hospital based general anesthesia for patients coming for Caesarian

section
 Hospital based practice on labor analgesia
 Hospital based practice on preoperative evaluation for obstetric and
gynecological patients

Interactive lecture of [4HR]

 Newborn resuscitation [2HR]

Group discussion [1HR]

 Case on neonatal discussion

Week 8 Video show Neonatal adaptation at birth

 Neonatal resuscitation [1/2HR]
Skill Development Lab (SDL) [2HR]

 Neonatal resuscitation [2HR]

Hospital practice [9 Hrs.]

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 Required Reading
Week Learning Activity
(Assignment)
 Hospital based general anesthesia for patients coming for Caesarian
section
 Hospital based practice on labor analgesia
 Hospital based practice on preoperative evaluation for obstetric and
gynecological patients

PBL [4HR]

Hospital practice [9 Hrs.]

 Performing anesthesia for parturient coming for non-obstetric

surgery
Week 9 Uterotonic agents
 Hospital based general anesthesia for patients coming for Caesarian
section
 Hospital based practice on labor analgesia
 Hospital based practice on preoperative evaluation for obstetric and
gynecological patients

Interactive lecture [4HR]

 How to administer safe anesthesia for parturient coming for non

-obstetric surgery [2HR]

Seminar [1HR]

 Cardiopulmonary resuscitation for obstetrics parturient

Group Discussion [1HR]

 Techniques of anesthesia for parturient coming for non -

obstetric surgery
Week 10
Skill Development Lab (SDL) [2HR]

 Management of the complications of spinal anesthesia

Hospital practice [9 Hrs.]

 Hospital based practice on obstetric difficult airway
 Hospital based general anesthesia for patients coming for
Caesarian section
 Hospital based practice on labor analgesia
 Hospital based practice on preoperative evaluation for obstetric
and gynecological patients

236
 Required Reading
Week Learning Activity
(Assignment)
Interactive lecture [4HR]

 Difficult airway management in obstetrics surgery [1 1/2HR]

 Preop evaluation in gynecological surgery [1HR]

Small group discussion [1HR]

 Optimization and preparation of patients for gynecological surgery

Video show [1/2HR]

Week 11  Management of difficult airway on obstetrics patients

Skill Development Lab (SDL) [2HR]

 Performing airway evaluation for obstetrics patients

Hospital practice [9 Hrs.]

 Performing preoperative evaluation on gynecological surgery

 Hospital based practice with a patient coming for gynecological
procedures
 Hospital based practice for neonatal resuscitation

PBL [4HR]

Hospital practice [9 Hrs.]

 Anesthesia Management of common gynecological surgeries
Week 12
 Performing preoperative evaluation on gynecological surgery
 Hospital based practice with a patient coming for gynecological
procedures

237
 Required Reading
Week Learning Activity
(Assignment)
Interactive lecture [4HR]

 Optimizing patients presenting for pelvic gynecologic surgery [1HR]

 Common gynecological surgeries [1 1/2HR]

Small group discussion [1HR]

o Anemia
o DVT
Week 13 o Neuropathy
o Methastized malignancy

Group Discussion [1/2HR]

 Anesthesia consideration for common gynecological surgeries

Hospital practice [10 Hrs.]

 Anesthesia Management of common gynecological surgeries

Interactive lecture [4HR]

 Complications and management of gynecological surgeries

[11/2HR]
 Anesthesia for gynecological laparoscopic surgery [11/2HR]

Small group discussion [1HR]

Week 14  Choice of anesthesia for laparoscopic surgery

Skill Development Lab (SDL) demonstration of 2hr on

 Management of complications of gynecological surgeries

Hospital practice [10 Hrs.]

 Anesthesia Management of gynecologic laparoscopic surgery

 Anesthesia Management of common gynecological surgeries
PBL [4HR]

Hospital practice [10 Hrs.]

Week 15  Anesthesia Management of gynecologic laparoscopic surgery Maternal mortality

 Anesthesia Management of common gynecological surgeries

Week 16 Exam week

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Anesthesia for Coexisting diseases

Module Title: Anesthesia for patients with coexisting diseases and Psychiatric Illness
Module Code: AnstM-4241
Module ECTS: 7 ECTS
Module Duration: 20 Weeks

Module Description: This module is designed for fourth year BSc Anesthesia students to create a
learning opportunity on Anesthesia for patients with coexisting diseases and psychiatric illness
practices that enable students to provide anesthesia for coexisting diseases and psychiatric illness. This
Module will be addressed through Interactive lecture, Seminar presentations, group discussion, role
play and reflective portfolio supervised feedbacks in real hospital setting.

Module Objective
At the end of this module, students will be able to provide safe anesthesia for patients with
coexisting diseases and psychiatric illness.

Module Competencies

 Provide Anesthesia for patients with coexisting diseases.

 Anesthesia for Psychiatric patients and electroconvulsive therapy.

Learning Outcomes
In order to achieve core competencies, students at the end of this Module will be able to:
 Optimize cardiac patients present for non-cardiac surgery
 Provide anesthesia for cardiac patients present for non-cardiac surgery
 Perform post anesthesia care for cardiac patients present for non-cardiac surgery
 Perform perioperative anesthesia management for hypertensive patients
 Optimize diabetic patient’s medical condition for anesthesia and surgery
 Provide safeanesthesia for diabetic patients.
 Perform preoperative anesthetic evaluation for patients with neuromuscular disorders(Guillian
Barre syndrome, malignant hyperthermia, muscle dystrophy and myasthenia gravis)
 Provide safe anesthesia for neuromuscular disorders (Guillian Barre syndrome, malignant
hyperthermia, muscle dystrophy and myasthenia gravis).

239
  Describe perioperative anesthetic management of patients with Parkinson’s disease
 Provide safe anesthesia for patients with Parkinson’s disease
 Assess and optimize patients with obstructive and/or restrictive lung disease for anesthesia
and surgery
 Provide anesthesia for obstructive and/or restrictive lung disease.
 Discuss anesthetic management for patients on anti-retroviral therapy
 Provide safe anesthesia for patients with HIV
 Apply perioperative anesthesia care for patients with HIV
 Explain anesthetic consideration for obese patients present for non-bariatric surgery
 Provide safe anesthesia for obese patients present for non-bariatric surgery
 Evaluate patients infected by malaria perioperatively
 Provide safe anesthesia for patients malaria
 Define mental health
 Identify common mental disorder
 Explain common Anxiety disorders
 Describe Alcohol and other substance related disorders
 Define Personality disorders
 Describe Causes, Clinical feature and Treatment of Delirium and Dementia
 List commonly used antidepressants and anesthetic implication
 Explain anesthesia for schizophrenia, clinical features, DDx and its treatment
 Describe Mood disorder and its type
 Define seizure
 Explain the pathophysiology and type of seizure
 Describe seizure and anesthetic implication
 Provide safe anaesthesia for psychiatric patient.
 Provide safe anesthesia for electroconvulsive therapy

Prerequisite: None

Teaching-Learning Methods

 Interactive lecture and discussion

240
  Small group discussion
 Role play
 Case study
 Portfolio
 Guided clinical practice
 Seminar Presentations

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board
 Posters
 LCD Projector
 White board, marker
 Laptop

Methods of Assessment
 Formative
o Practical test (DOP,PCE,CBD,)
o MCQ
o Oral exam
o Logbook
o Portfolio
o And other assessment methods
 Summative
o Progressive/ Continuous assessment:
o Structured Oral Examination
 Percentage allocation:

Module Policy

241
  Attendance: It is compulsory to attend both SDL and Hospital clinical practice on time and
every time. If students are going to miss more than three classes/ hospital attachment days
during this semester, they will not be allowed to final assessment and next semester unless
otherwise proven by evidence per legislation requirement.
 Assignments: Students must complete module assignments and work based assessments on
time. Uncompleted work-based assessments and assignments will result in Incomplete (I)
grade submissions to registrar. Further consecutive procedures will be handled in line with
institutional senate legislation.

Reference Books

1, Anesthesia and co-existing disease (7th edition). Robert L.Hines Churchill, Katherine
E.Marschall,2018
2. Harold Ellis: Anatomy for Anaesthetists (8th edition). Blackwell Science Ltd, 2004.
3. Paul G Barash: Handbook of Clinical Anesthesia (8th edition). Lippincott Williams &
Wilkins publications, Inc., 2018.
4. Ronald D. Miller: Millers Anesthesia (7th edition). Churchill Livingstone publication, An
Imprint of Elsevier, 2009
5. Alan R Aitkenhead: Textbook of Anaesthesia (6th edition). Churchill Livingstone publication,
AnImprint of Elsevier, 2001.
6. Morgan and Mikhil’s Clinical Anesthesiology (5th edition). McGraw-Hill educations, Inc., 2013
7. Ronald D. Miller: Basics of Anesthesia (8th edition). Saunders, an imprint of Elsevier Inc. 2011.
8. Fleisher: Anesthesia and Uncommon Diseases, (5th edition). Elsevier Saunders Inc., 2005
9. James C. Duke: Duke’s Anesthesia Secretes (5th edition). Saunders, an imprint of
ElsevierInc.2016.
10. Timothy E. Miller: Anesthetic Care for Abdominal Surgery. Elsevier Saunders Inc., 2015.133
11. Tim Smith: Fundamentals of Anaesthesia (3rd edition). Cambridge University Press, 2009.
12. Fun-Sun F: Yao: Yao and Artusio's Anesthesiology: Problem-Oriented Patient Management
(6thedition). Lippincott Williams & Wilkins publications, Inc., 2010.
13. Richard A. Jaffe: Anesthesiologist's Manual of Surgical Procedures (5th edition). Lippincott
Williams & Wilkins publications, Inc., 2009.

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 Module Schedule
Duration: 20 Weeks (Hospital Practice will be Parallel to Classroom-based teaching)

Lecture: 72 hrs; Skill Lab : 4 hrs; Hospital Practice : 76 hrs ;PBL :4 HRs

Required Reading
Week Learning Activity
(Assignment)
Reading Assignment
Interactive Lecture [3 1/2 Hrs.] on:
Week  Cardiac anatomy and physiology Perioperative
1  Common cardiac diseases (CHF, IHD, MI) management of
Group discussion [30min] cardiovascular
 Pathophysiology of Valvular heart disease drugs

Hospital Clinical practice [4Hrs.]

 Anesthetic management of patients with cardiac disease

Interactive Lecture[4hr]
Week
2  Preoperative evaluation & preparation for stenotic valvular heart disease
 Types of hypertension:
 different class of anti-hypertensive agents used for treatment of
hypertension:
Group discussion
 preoperative evaluation & preparation for regurgitant VHD

Hospital Clinical practice [4 Hrs.]

 Anesthetic management of patients with cardiac disease

Interactive Lecture
 Anatomy, Physiology Endocrine Gland pathophysiology
pancreas
Week Group discussion
3  pathophysiology of hypertension

Hospital Clinical practice [4 Hrs.]

 Anesthetic management of hypertensive patient

Interactive Lecture[2hrs] Reading Assignment

 Anesthetic Implications of DM on:
 Evaluation of diabetic patient
Week
Seminar presentation[2hrs] Oral anti diabetic agents
4
 Interpret lab investigations of a patient with DM

243
 Required Reading
Week Learning Activity
(Assignment)
Hospital Clinical practice [4 Hrs.]
 Anesthetic management for diabetic patients

Interactive Lecture[1hr]
 Safe intraoperative anesthetic consideration for DM
Group discussion[1hr]
 Identify intraoperative complication in a Patient with DM
 Safe and effective postoperative complications management plan in a
Patient with DM.
Week Reflective Portfolio [2hrs]
5  Postoperative management of DM patient
Hospital Clinical practice [4 Hrs.]
 Anesthetic management for diabetic patients
Interactive lecture[2hrs]
 pathophysiology of GBS,MHT,MDs and MG
Seminar presentation[2hrs]
 Clinical presentation of neuromuscular disorders (GBS, MHT, MDS, MG)
Week
6
Hospital Clinical practice [4 Hrs.]
 Anesthetic management for diabetic patients

Seminar presentation [4hrs]

 Clinical presentation of neuromuscular disorders (GBS, MHT, MDS, MG)
 preoperative assessment for patients with neuromuscular disorders (GBS,
Week MHT, MDS, MG)
7
Hospital Clinical practice [4Hrs.]
 Anesthetic management of patient with neuromuscular Disease

Interactive lecture [31/2]

 Pre-Op Optimization for Patient with neuromuscular Disease:
 Intraoperative anesthetic consideration for patients with neuromuscular
disorders:
Week
Group discussion[30min]
8
 Pre-Op Optimization for Patient with neuromuscular Disease:
Hospital Clinical practice [4 Hrs.]
 Anesthetic management of patient with neuromuscular Disease

244
 Required Reading
Week Learning Activity
(Assignment)
Interactive lecture [3hrs]
 post-operative management for patients with GBS
 Evaluation of patients with neuromuscular disorders Reading Assignment
Group discussion[1hrs] on:
Week  Intraoperative anesthetic consideration for patients with neuromuscular Management of
9 disorder anesthesia for multiple
 Postoperative anesthetic care for patients with neuromuscular disorder sclerosis
Hospital Clinical practice [4Hrs.]
 Anesthetic management of patient with neuromuscular Disease

PBL

Hospital Clinical practice [4 Hrs.]

Week
 Anesthetic management of patient with obstructive and restrictive
10
pulmonary disease
Seminar presentation [4hrs]
 Pathophysiology of obstructive and restrictive pulmonary disease
 Clinical presentation of obstructive and restrictive Pulmonary disease
 Anesthetic consideration for asthmatic patient
Week
 Anesthetic consideration for patient with COPD
11
Hospital Clinical practice [4Hrs.]
 Anesthetic management of patient with obstructive and restrictive
pulmonary disease
Interactive lecture [2hr]
 Anesthetics consideration for a patient with HIV /AIDS [1hr]
 Anesthetic drug interaction with ART drugs [1hr]
Group discussion [1 hr]
 Anesthetic consideration for patients with extrinsic restrictive lung disease
Week  Anesthetic consideration for patients with intrinsic restrictive lung disease
12 Reflective portfolio[1hr]

 Intraoperative management of Asthma and/or COPD

Hospital Clinical practice [4 Hrs.]
 Anesthetic management of patient with obstructive and restrictive
pulmonary disease
Interactive lecture [4hrs] Reading Assignment
Week
 Anesthetic considerations for a patient with Malaria on:
13
 Anesthetics management for a patient with Parkinson Diseases Infection control

245
 Required Reading
Week Learning Activity
(Assignment)
Hospital Clinical practice [4 Hrs.]
 Anesthetic management of patient for patients with ART
Seminar presentation
Interactive lecture[3hrs]
 Concepts of obesity
 Peri-operative anesthetic consideration for obese patients
Week
14 Reflective portfolio [1hrs]
 Intraoperative management of obesity
Hospital Clinical practice [4 Hrs.]
 Anesthetic management of patient for patients with ART

Interactive lecture[ 3hrs]

 Definition of mental health
 Common psychiatric disorders: psychoses, bipolar disorders, depressive
disorders,
Reading Assignment
 Common causes of mental disorder on:
Week  Signs and symptoms (psychopathology) ,of mental illness Preoperative screening
15 Group discussion on [1hrs] test of patients with
 Anesthetic consideration for patients with OSA OSA
 Delayed awakening
Hospital Clinical practice [4 Hrs.]
 Anesthetic management for obese patients

Week Interactive lecture on [4 Hrs.]

16
Common anxiety disorders:

 Panic disorder
 Phobias
 Specific phobia and Social phobia
 Obsessive compulsive disorder (OCD)
 Post-traumatic stress disorder (PTSD)
 Generalized anxiety disorder (GAD)
 Alcohol and other substance related disorder such asabuse, dependence and
class of substances of abuse
Hospital Clinical practice [4Hrs.]
Optimize patients coming for surgery with psychiatric disease.
Provide postoperative Anesthetic care for psychiatric patients

Week Interactive Lecture and Seminar on [4 Hrs.]

17  Definition of personality disorder

246
 Required Reading
Week Learning Activity
(Assignment)
 Personality disorder, clinical feature and treatment
 Definition, Causes, Clinical feature and Treatment of Delirium and
Dementia
 Anesthesia and psychiatric drugs: antidepressants, anxiolytics,
antipsychotics, mood stabilizers,
Seminar on
 Antidepressants and anesthetic implication
Hospital Clinical practice [4Hrs.]
 Optimize patients coming for surgery with psychiatric disease.
 Provide safe anesthesia for electroconvulsive therapy

Interactive Lecture [4 Hrs.]

Week  Anesthesia for patients with schizophrenia and its clinical features DDx
18 and treatment.
 Bipolar disorder, depressive disorders, anxiety disorders, substance related
disorders
 Definition of seizure disorders Reading Assignment
 Pathophysiology of seizure disorders on:
 Types of seizures disorders Postpartum depression
 Differential diagnosis
 Treatment of seizure disorders

Hospital clinical Practice [4Hrs.]

 Identify drug interaction b/n anti-psychotic drugs and anesthetics.
 Provide safe anesthesia for electroconvulsive therapy
Interactive Lecture on [4 Hrs.]
 Seizure and anesthesia(50mins)
 History taking technique in psychiatry patient(150min)
 Techniques of Mental state examination(40mins)

Week
Skill lab [4 Hrs.]
19
 Techniques of Mental state examination(2hr)
 Techniques of Mental state examination(2hrs)
 Final exam

Hospital Clinical Practice [4 Hrs.]

 Provide postoperative Anesthetic care for psychiatric patients
 Provide safe anesthesia for electroconvulsive therapy
Week Exam week - Written (MCQ,ORAL exam)
20

247
Health Promotion and Disease Prevention

Module Title: Health promotion, education and disease prevention module

Module Code: SPHM-4252
Module ECTS: 4 ECTS
Module Duration: 19 Weeks (Clinical Practice parallel to classroom based teaching)

Module Description: This Module is designed for BSc in anesthesia students to create a learning
opportunity on health promotion, health communication, sexual and reproductive health right and
principles of nutrition and communicable disease to enable Anesthesia students and to apply the
principles in a culturally sensitive manner. This module also introduces basic concepts, principles of
teaching, learning, assessment, and teaching methods. It provides the concept of curriculum
development & implementation. This Module will be addressed through Interactive lecture, Seminar
presentations and supervised feedbacks in simulated environment and real community setup.

Module Objective
At the end of this module, students will be able to provide health counseling and health education in
a professional manner in a teaching and learning process.

Module Competencies
The core professional competencies where this practice Module aimed at achieving are:
1. Plan, conduct and evaluate Health education in different health settings
2. Apply Health communication to enhance health and prevent diseases
3. Apply Health promotion principles
4. Apply human rights principle, sexual and reproductive health and their effects on health of
individuals
5. Apply the principles of Nutrition and health
6. Apply basic principles of communicable disease control
7. Utilize various instructional and assessment methods
8. Apply concepts of curriculum development, implementation and evaluation.
9. Utilize various instructional media and methods and assessment in teaching learning process

Learning Outcomes
In order to achieve core competencies, students at the end of this Module will be able to:

248
  Identify communication /counseling techniques to enhance health/disease prevention
 Demonstrate appropriate communication and listening skills across all domains of
competency
 Plan, conduct and evaluate Health education in different health settings
 Apply Health communication to enhance health and prevent diseases
 Apply Health promotion principles
 Apply human rights principle, sexual and reproductive health and their effects on health of
individuals
 Apply the principles of Nutrition and health
 Apply basic principles of communicable disease control
 Describe the general principles and concept of education, teaching, and learning (K)
 Discuss the characteristics of a good teacher(k)
 Apply different teaching methods (S)
 Describe instructional objectives (K)
 Develop instructional objectives (S)
 Identify the components of lesson plan (K)
 Develop a lesson plan (S)
 Describe various assessment methods of knowledge, skill and attitude (K).
 Describe the principles of curriculum development and implementation (K)
 Describe the curriculum change and evaluations (k, S)
Prerequisite: None

Teaching-Learning Methods
 Small group discussion
 Role play and Case study
 Portfolio
 Video show
 Demonstration
 Individual studies
 Projects and personal reflection activities
 Seminar Presentations on:

249
 o Sexual and reproductive health rights
o Assessment of common nutritional problems

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board
 Posters
 LCD Projector, Laptop and Videotapes
 White board, marker

Methods of Assessment
 Formative assessment
o Exercise and assignment
o Logbook and portfolio
o Student presentation
 Summative assessment
o Final Written exam (40 %)
o quiz 5%
o Reflective portfolio /community visit (15 %)
o Class participation 5%
o Test 20%
o Assignment and/or student presentation (15 %)

Module Policy
Attendance: It is compulsory to attend a class on time and every time. If you are going to miss
more than three classes during the term, you should not take this course.
Assignments: you must do your assignment on time. No late assignment will be accepted.
Tests/Quizzes: you will have short quizzes and tests almost every week. If you miss the class or,
are late to class, you will miss the quiz or test. No makeup tests or Quizzes will be given. You are
expected to observe the rules and the regulations of the University as well.

250
Reference Books
1. Carl Fertman and Diane Allensworth. Health promotion programs: from theory to practice.
2010
2. Lawrence Green, Marshall Kreuter. Health program planning: an educational and ecological
approach. Volumes 1-2. 2005
3. Jackie Green, Tones. Health promotion: planning and strategies. 2010.
4. Mark Edberg. Essentials of health behavior: social and behavioral theory in public health.
2007
5. Richard D. Semba and Martin W. Bloem. Nutrition and health in developing countries.
Human Press. 2008
6. Goeffrey P Webb. Nutrition. A health promotion approach. 3rd edition.
7. Michael J. Gibney , Prof. Susan A. Lanham , Aedin Cassidy , Hester H. Vorster.
Introduction to human nutrition. 2nd edition. 2009
8. Denis M Medeiros, Robert E.C. Wildman . Advanced human nutrition. 2nd edition. 2011
9. Judith E. Brown. Nutrition through the life cycle. 4th edition. 2010.
10. Rosalind S. Gibson. Principles of nutritional assessment. 2nd edition. 2005
11. Michael Gibney, HESTER H VORSTER. Clinical nutrition. 2005
12. Berhane Y, Haile Mariam D, Kloos H. The epidemiology and ecology of health and disease in
Ethiopia. Addis Ababa; Shama Books, 2006.
13. FMOH. National reproductive health strategy
14. FMOH. National nutrition strategy
15. Salem, R.M., Bernstein, J., Sullivan, T.M., and Lande, R. “Communication for Better Health,”
Population Reports, Series J, No. 56. Baltimore, INFO Project, Johns Hopkins Bloomberg
School of Public Health, January 2008.Available online:
http://www.populationreports.org/j56/
16. Salem, R.M., Bernstein, J., and Sullivan, T.M. “Tools for Behavior Change Communication.”
INFO Reports, No. 16. Baltimore, INFO Project, Johns Hopkins Bloomberg School of Public
Health, January 2008. Available online at: http://www.infoforhealth.org/inforeports/
17. de Fossard, E., and Lande, R.“Entertainment-Education for Better Health,” INFO Reports,
No. 17. Baltimore, INFO Project, Johns Hopkins Bloomberg School of Public Health,
January 2008. Available online at: http://www.infoforhealth.org/inforeports/

251
18. IOM (Institute of Medicine).Promoting Cardiovascular Health in the Developing World: A Critical
Challenge to Achieve Global Health. Washington DC: The National Academies Press.2010
19. Lancet series on maternal and child nutrition
20. Lancet series on maternal health
21. Lancet series on newborn health
22. Lancet series on child health
23. Lancet series on reproductive health
24. Guilbert JJ. (1998). Educational Handbook for Health Professionals, WHO, Jeneva.
25. Matiru, B., G. Schlette, R. (1995). Teach Your Best. A handbook, for University
26. Lecturers, Geramn, DeutcheStifung for Internationale, Entwicklung, (DSE)
27. Davis, B.G. (2009). Tools for Teaching. 2nd Edition, San Francisco: Jossey Bass.
28. Berhane G., Asrat D. (2005). The Principles and Methods of Teaching for Health

252
 Module Schedule

Week Contents
Week 1 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]

Introduction to health education

 Health education in PHC
 Health education in Ethiopia
 Basic principles of health education
 Aims of health education
 Contribution of social sciences to health promotion
Principle of e d u c a t i o n , teaching and learning (2hrs.)
 Philosophical and historical aspects of Anesthesia practice and education
 The meaning and scope of education
Self-study (2hrs.)
Week 2 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]

Health education in different settings

 Methods and materials for health education
 Adult learning theories
 Peer education
 Patient education
 School health education
 Prison health education
 Evaluate health education
Principle of e d u c a t i o n , teaching and learning cont. (2hrs.)
 Types of education
 Teaching and learning principles
 Functions of education
 Aims of education
Self-study (2hrs.)

Week 3 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]

Health communication

 Concepts and principles of health communication

 Communication model and process
 Individual and group communication strategies
 Effective communication skills
 Barriers of communication
Principle of e d u c a t i o n , teaching and learning cont. (2hrs.)
 Purpose of teaching

253
  Teaching approaches
 Characteristics of a good teacher
Self-study (2hrs.)
Week 4 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Health promotion principles
 Health perspectives and choice of strategies to address health issues
 Models and theories of health promotion
 Principles of advocacy
Instructional objective (2hrs)
 Definition
 Specific objective
 General objectives
 Intermediate objectives
Self-study (2hrs.)
Week 5 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
 Principles of social marketing
 Principles of social/community mobilization
 Community diagnosis
Instructional objective cont.…(2hrs)
 Criteria used for writing
 Domains of objectives/Blooms taxonomy
- Cognitive domain
- Psycho motor domain
- Affective domain
Self-study (2hrs.)
Week 6 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Reproductive and maternal health
o History, concepts, definitions, components of RH
o History and development of MCH/RH in Ethiopia
Methods in teaching and learning process (2hrs.)
 Interactive Lecture method
 The Demonstration method
 Brain storm
 Project methods
 Role play
Self-study (2hrs.)
Week 7 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Family planning
 Origins and Rationale of Family Planning
 Family Planning methods
 Counseling in Family Planning

254
  Family Planning Delivery Strategies
 Fertility Trends and Contraceptive Use
 Trends in Contraceptive Use in Ethiopia
 Reasons for Not Using Contraceptive
Methods in teaching and learning process (2hrs.)
 Various types of discussion methods
 Jigsaw methods
 Field trip
 Questioning
 Hot set teaching ……..
Self-study (2hrs.)
Week 8 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Maternal and child health
o Safe Motherhood
o Essential Services for Safe Motherhood
o Magnitude of maternal health problems
o Causes of Maternal Mortality and Morbidity
o Risk Factors for Maternal Health
o Maternal Health interventions; ANC, Delivery, PNC, Essential Newborn Care
o Maternal Nutrition
Methods in teaching and learning process cont...(2hrs.)
- Definitions of instructional media/aids
- Importance of instructional media/aids
- Types of instructional media/aids
- Characteristics of instructional media/aids
Self-study (2hrs.)
Week 9 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Adolescent and youth reproductive health HIV/AIDS
 Characteristics of the Adolescence Period
 Major adolescent SRH problems
 Reproductive Health Risks and consequences for adolescents
 Reproductive health services for Adolescents
 Youth friendly RH services
 HIV/AIDS Epidemiology, prevention strategies,
 policies
 Epidemiology of MTCT of HIV
 Modes of Transmission of HIV
Prepare lesson plan (2)
 Definition of a lesson plan
 Values of a lesson plan
 Essential components of a lesson plan
 Development of a lesson plan

255
 Self-study (2hrs.)
Week 10 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Sexual Health and STIs
o Classification of STIs
o Assessing STI Risk
o Syndromic Management and counseling of STIs
o Prevention and control of STIs
Unwanted pregnancy and Abortion
o Unwanted pregnancy and abortion
o Legal status of abortion
o Incidence and prevalence
Assessments/evaluation (2)

 Types of assessment:
 Grading system
 Principles of assessment development
- MCQ
- Matching
Self-study (2hrs.)
Week 11 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Introduction to Human Nutrition
- Definition, origin & development of Nutrition
- Significance of Nutrition in general
Nutrients: Macro-nutriments, micronutrients & water
- Chemical and physical properties and classification
- Food sources, digestion, absorption, metabolism & utilization (function)
- Assessment
- Deficiency & toxicity
- Treatment & prevention of deficiency
- Recommended intake & dietary recommendations
- Energy balance, obesity & associated health problems
Assessments/evaluation cont...(2)

- Short answer
- True/false
- Essay
- Advantage/ disadvantage of each assessment methods
Self-study (2hrs.)

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Week 12 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Nutritional Requirement
 Definitions & concepts of nutrient reference levels
 Developing nutrient reference levels
 Applications of nutrient reference levels
 Nutritional requirement during critical periods
 Nutrient-based vs. food-based dietary guidelines
Nutritional deficiency states
o Protein-energy malnutrition
o Iodine deficiency disorders
o Vitamin A deficiency disease
o Nutritional anemia
o Zinc deficiency
Concepts of Curriculum development and implementations (2hrs)
 Definition of curriculum development
 Types of curriculum
 Structure of curriculum/components
Self-study (2hrs.)
Week 13 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Nutritional Assessment
 Anthropometry
 Dietary assessment
 Clinical assessment
 Laboratory assessment
 Indirect methods of nutritional assessment
Nutritional Surveillance
 Food & nutrition security
 Definition, objectives, and types of nutrition surveillance
 Basic steps in carrying out nutritional surveillance
 Indicators for nutrition monitoring and sources of data
 Early warning signs
Concepts of Curriculum development and implementations cont...(2hrs)
 Topology of curriculum change
 Resistance to change
 Principles of curriculum development and implementation
Self-study (2hrs.)

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Week 14 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Food safety and quality
 Food borne diseases (food infection & intoxication/poisoning)
 Methods of food preservation
 Food additives and preservatives & health implications
Nutrition Intervention
 Overview of direct nutrition interventions & other interventions with close/immediate
impact on nutrition
 The National Nutrition Strategy
 The National Guideline of Infant & Young Child Feeding
 The National Guideline for Control & Prevention of Micronutrient Deficiencies
 Essential Nutrition Actions
Concepts of Curriculum development and implementations cont...(2hrs)
 Models of curriculum developments and implementations.
 Models of curriculum evaluation
Self-study (2hrs.)
Week 15 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Introduction to communicable diseases
Definition of common terms (important terms)
Communicable disease/ (infectious disease)
Specific feature of communicable disease
Classification of communicable disease
Chain of disease transmission (diseases transmission dynamics)
Self-study (2hrs.)
Week 16 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
 Determinants of disease and defense mechanism of hosts
 Factor determine the degree of infectivity, Pathogenicity and virulence
 Source of infection
 Carriers and Infected individuals
 Host parasite interactions (measuring of infectiousness)
 Spectrum of infectious disease/ gradient of infection/
 Natural history of disease
Self-study (2hrs.)
Week 17 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
Major epidemic disease in Ethiopia Disease that transmitted by
contaminated water, food, and others
 Typhoid fever, Bacillary dysentery, Amoebic dysentery, Giardiasis, Cholera, Poliomyelitis,
Infectious hepatitis, Ascariasis, Enterobiasis, Hookworm, Strongloidiasis, Trichuriasis,
Tapeworm, Schistosomiasis, Gina worm
Self-study (2hrs.)

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Week 18 Classroom based Teaching (lecture, + seminars + group discussion) [5 hrs.]
 Disease that transmitted by inhalation
 Diseases that transmitted by vector
 Prevention and control of food borne diseases
 prevention and control of zoonotic disease
Self-study (2hrs.)
Week 19 Exam

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Community-Based Training Program (CBTP) Syllabus

Module Title: Community-Based Training Program (CBTP) I

Module Code: SPHM-4262

Prerequisites:

Phase I or CBTP 1: SPH I –II

Phase II or CBTP 2: SPH I –III

Phase III or CBTP 3: SPH I –IV

Phase V or CBTP 4: SPH I –V

Attachment Duration: 4 weeks in each phase

Introduction to Community Based Training Program Attachment: As higher learning

institutions host various intellectual disciplines and undertake many researches in different aspects of
social life, they pose all the capacity to bring a significant impact on the development of the
community.

Community based Education (CBE) is a means of achieving educational relevance to community

needs and consequently of implementing a community-oriented education program .It consists of
learning activity which uses the community extensively as a learning environment and involves
students, teachers, community and all other stakeholders in the community throughout the
educational experience. It follows a problem solving approach that starts with the identification of
community problem, setting of objectives and plan of action to implementation and monitoring and
evaluating progress. The program is of obvious benefit to both the students and the community. The
activity of the students in the community is neither peripheral nor casual experience. It is integral part
of the whole educational process which is evidenced by the total weight given to the program in the
form of credit hours (20% of the curriculum) and as requirement for graduation.

The community-based education (CBE) deploys three basic approaches, as strategies; to address the
community needs by producing socially accountable citizens. These are: Community Based Training
Program (CBTP), Team Training Program (TTP) and Students Research Program (SRP).

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Community Based Training Program (CBTP) is an integrated program which runs in phases from first
year to graduation at the end of each academic year along with in built regular follow up program. The
student learning activities in this program is to be phased, spiral in nature and problem solving in
approach. Each phase has a well-planned and defined educational objectives and goals. The students
undergoes through well-defined performance phases consisting of data collection, community
diagnosis, planning, implementation and evaluation. These phases should, however, be viewed as
continuum of activities in which the student is supposed to spend some time in each phase depending
on his competence and the needs of the community concerned.

Attachment Description: Through the process of this training, students acquire the ability to plan,
implement and evaluate health program. In addition students develop analytical thinking in
interpretation of data, report writing and presentation and also the aptitude to work as a team. Thus
this program benefits both the students and the community and contributes to the community
development which is the final goal of education.

The CBTP attachment is intended to enable medical students to develop competencies in assessing
and analyzing community health problems. Students will also develop relevant competencies with the
Medical expertise, Scholar, Collaborator, Communicator, Manager, Health Advocate and Professional.
The CBTP module is basically divided in to three phases. Accordingly the students are expected to go
for CBTP attachment at the end of each academic year for about four weeks’ period during the
undergraduate medical education program.

General Purpose of CBTP attachments:

 Define the demographic, socio-economic, political and environmental aspects of a given

community (determinants of health status).
 Make community diagnosis and draw health action plan which would enable students to
suggest appropriate intervention measures according to the different levels of prevention
(primary, secondary and tertiary)
 Organize health intervention programs utilizing the concept, components and strategies of
primary health care (PHC).
 Plan and conduct problem oriented and community based research.

Module Design

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Attachment Objectives

At the end of this module, the medical student will be able to conduct community diagnosis, identify
priority community health problems and their social determinants to initiate action for change.

Supporting Objectives

As a Medical Expert

 Conduct demographic and health survey to identify common causes of mortality and
morbidity and their determinants in the target community
 Analyze determinants of major health problems
 Prioritize community health problems for intervention planning
 Analyze community practice experience and perform practice-based improvement activities
using a systematic methodology
 Demonstrate a habit of self-reflection, responsiveness to feedback and an on-going
development of new skills, knowledge and attitude
 Apply search, collect, organize and interpret health and health-related information from
different sources
As a communicator

 Communicate effectively results of the assessment to initiate action by communities and local
stakeholders in the spirit of self-reliance
 Demonstrate clear, sensitive and effective communication skills in interacting with
individuals, families, communities, PHCU staff, local health office, peers and faculty

As a Collaborator

 Demonstrate professional values and behavior in interaction with individuals, families and
communities consistent with the future role of a physician
 Demonstrate key public health values, attitudes and behaviors such as commitment to equity
and social justice, recognition of the importance of the health of the community as well as the
individual, and respect for diversity, self-determination, empowerment, and community
participation

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  Show respect for peers and other healthcare professionals and the ability to foster a positive
collaborative relationship with them
As a Manager

 Develop their leadership skills

 Design and organize elements of health care delivery
 Set priorities and manage time to balance practice and personal life
 Promote occupational health as physicians for sustainable practice

As a Health Advocate

 Work with patients and their families to address the determinants of health that affect them
and their access to needed health services or resources and to increase their opportunities to
adopt healthy behaviors
 Incorporate determinants of health disease prevention, health promotion, and health
surveillance into interactions with individual patients
 Lead a healthy life style to be role models to promote population health
 Work with a community or population to identify the determinants of health that affect them
 Participate in a process to improve determinants of health in the community or population
they serve

Scholar

 Develop, implement, monitor, and revise a personal learning plan to enhance professional
practice
 Identify opportunities for learning and improvement by regularly assessing their performance
 Engage in collaborative learning to continuously improve personal practice and contribute to
collective improvements in practice
 Recognize the power of role-modeling and the impact of the hidden curriculum on learners
 Promote a safe learning environment
 Ensure patient safety is maintained when learners are involved
 Collaboratively identify the learning needs of others and prioritize learning outcomes
 Provide effective feedback to enhance learning and performance

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  Use assessment and evaluation tools and practices that are relevant to the teaching and learning
context
 Recognize knowledge gaps in public health and other professional encounters and generate
focused questions that can address them
 Identify scholarly sources that shed light on a given professional question
 Interpret study findings, including a discussion
 Determine the validity and risk of bias in a wide range of scholarly sources
 Describe study results in both quantitative and qualitative terms
 Demonstrate an understanding of the scientific principles of research and scholarly inquiry
and the role of research evidence in contemporary health care
 Identify ethical principles for research and incorporate them into obtaining informed consent,
considering potential harms and benefits, and considering vulnerable populations
 Contribute to the work of a research program
 Pose questions amenable to scholarly investigation and select appropriate methods to address
them
 Summarize and communicate to professional and lay audiences, including patients and their
families, the findings of relevant research and scholarly inquiry

As a Professional

 Integrate other intrinsic roles into their learning and practice of public health
 Exhibit appropriate professional behaviors and relationships in all aspects of practice,
reflecting honesty, integrity, commitment, compassion, respect, altruism, respect for diversity,
and maintenance of confidentiality
 Demonstrate a commitment to excellence in all aspects of learning
 Recognize and respond to ethical issues in practice
 Exhibit professional behaviors in the use of technology enabled communication
 Demonstrate accountability to patients, society, and the profession
 Recognize the professional and ethical codes, standards of practice, and laws governing
practice

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  Recognize and respond to unprofessional and unethical behaviors in physicians and other
colleagues in the health care professions
 Participate in peer assessment and standard-setting
 Exhibit self-awareness and effectively manage influences on personal well-being and
professional performance
 Promote a culture that recognizes, supports, and responds effectively to colleagues in need

Strategies of CBTP

During each phase, students as a group are assigned to urban, semi-urban or rural community. The
same group of students will be assigned in a given community every year to understand the
fundamentals of that community life at the grass-root level. Students during their study and work in
the communities use the primary health care strategies: community involvement, intersectorial
collaboration and appropriate health technologies to meet their objectives.

The approaches employed for conducting CBTP include mapping, numbering and zoning of the
catchments area, data collection by house-to-house visits and from relevant bodies as well as center-
based data collection. With the growing number of students, the data collection may not cover every
house and a suitable sampling technique shall be used when appropriate. The students then analyze
the collected data, write reports and present the activities for each phase. When appropriate,
interventions for health-related problems detected are made. Subsequently, regular follow-up work is
done by the students in their respective communities.

Module Codes and duration of CBTP by phase of training

Phase of training Module Code Duration in Remark

weeks

Year II- Phase I SPH- 402/3 4 First phase

Year III- Phase II SPH- 402/4 4 Second phase
Year IV, Phase III SPH- 402/5 4 Third phase
Year V, Phase IV SPH- 402/6 4 Fourth phase

Prerequisites of each phase of CBTP Module:

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In order to strengthen the link between theoretical knowledge and practical field experience the
theoretical class lectures and the practical training in the CBTP are complementary. Thus students are
expected to take prerequisite modules before each phase. The modules offered at every stage of the
training are shown below.

Phases Prerequisites for each phase of the

Module

Phase I Medical psychology, sociology, and

anthropology, Introduction to Public
Health , Environmental health,

Biostatistics and Epidemiology

Phase II Health Education, Health policy and

management, Nutrition , Reproductive
Phase III Health and
Pediatrics & Research Methodology
child health

Internal medicine

Gynecology & obstetric

Surgery

Phase IV All the required courses of preclinical and

clinical including SPH I- V
Epidemiology

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 Attachment Schedule

Phases of Community attachment Activities

CBTP
Phase 1 Community diagnosis (20 days)
 Orientation --------- 1 day
 Developing a structured format and Instrument for interview-------2 days
 Data collection –--- 7 days
 Data cleaning and analysis and report writing ------------6 days
 Rehearsal- --------------2 days
 Presentation/Symposium- --------1 day
 Contingency---- 1 day
Phase 2 Development of Action Plan and Implement health intervention (20 days)
 Orientation --------- 1 day
 Developing a structured format and Instrument for interview ------2 days
 Data collection for up-dating ---------- 3 days
 Data cleaning and analysis and report writing-------------3 days
 Develop action plan----------2 days
 Present, discuss and review findings and action plan-------1 day
 Implement health intervention--------------8 days
Phase 3 Continuation of health interventions (20 days)
 Orientation --------- 1 day
 Developing a structured format and Instrument for interview ------2 days
 Data collection for up-dating ---------- 3 days
 Data cleaning and analysis and report writing-------------3 days
 Modify action plan----------2 days
 Present, discuss and review findings and action plan-------1 day
 Continue implementing health intervention-------------8 days
Phase 4 Monitoring and Evaluation of the community diagnosis and intervention (20 days)
 Evaluate the learning experience and service provided to the community-----19 days
 Presentation and Exam -----------1day

Organization of Student Groups

A group composed of 20-25 students is assigned in a Kebele. Although there is close support to
students from supervisors, health service institutions and the communities, students are expected to
explore situations by themselves and to share their experiences with each other. In order to foster this,
student grouping is done with the following considerations:
i) Level of student motivation: - those students who are better motivated to the CBTP are identified
and assigned to each group.

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ii) Academic performance: - In the grouping of students, due consideration is paid to the academic
achievements of each student.
iii) Work experience: - If there are students with some sort of work experience in health or related
field they are distributed equally among the groups.
iv) Language skills: - Those students who are capable of speaking the local language will be identified
and distributed uniformly in each group to facilitate communication.
Each team will have a leader, reporter and logistic personnel as selected by the team members.

Job Description of CBE Coordinators

1. He/she will be appointed by the faculty academic commission

2. He/she is accountable to the faculty dean on the following issues:

The academic activities of CBE:

 The annual operational plan and activity report

 Compiling and submitting the students grades
 Assignment and supervision of supervisors
 Stationary materials
 Accept students’ grade claim, clear and decide with the supervisors

3. He/she is accountable to the central CBE office on the following issues:

Submission and utilization of annual budget:

 Monitoring quality of training

 As member of standing committee
 Intervention and perdiem budget
 Transport and scarce resources

Project development and proposal

4. He/she is a member of the academic commission

5. He/she is a member of the CBE standing committee

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 6. Plan the annual CBTP and SRP budget and activities of the faculty

7. The budget will be presented to the university by CBE and the allocated money will be
controlled by central CBE office

8. The faculty CBE the allocated budget for the faculty academic activities

9. Provide the list of supervisors and days on supervision to the central CBE office for perdiem
payment

10. Organize the overall faculty CBE activities (CBTP & SRP)

 Provide orientation to staffs and students at each phase of CBTP

 Assign students to selected communities
 Support and monitor the intervention activities and the students

11. Monitor and evaluate the faculty CBE activities

12. He/she requests the necessary materials from the faculty

13. At the end of each rotation he/she receives the activity and evaluation reports from students
& supervisors

14. Evaluate and compile the students’ CBTP/SRP grade and notify to the central CBE office:

15. Co-ordinate resource and logistic support for implementation of activities

16. Requests transport and scarce equipment from the central CBE office

17. With the approval of the faculty dean assign supervisors

18. In collaboration with the CBE office select kebeles for the CBTP

19. Revise and update the curriculum, which should be approved by the central

CBE and faculty:

20. Compiles, and submits the annual operational and activity report to the central CBE office.

Job Description of Supervisory Team Members

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Students’ supervision is a process where by supervisors assist students during their attachments and
help them learn from the process as well. The composition of supervisory team is multidisciplinary
and is based on phase objectives including speciality from behavioural and social sciences, public
health, laboratory technology, nurses, environmental health, basic medical sciences and clinical
medicine. It is believed that the team could contribute to the success of the programme when acting
together in union than as an individual expert. Here is shown the specific tasks of supervisory team
members throughout CBTP attachment.

1. Based on specific objective of the training programme, team members provide guidance and support
to students.
2. Organize and coordinate students group in the practical implementation of community diagnosis
(Selection of appropriate study design, population/target, measurement etc).
3. Generate a conducive educational atmosphere through discussion on application of concepts and
principles of community-based education.
4. Guide students in developing survey instruments
5. Guide students in application of statistical methods in data collection, analysis, interpretation &
presentation.
6. Assist students to measure factors that affect community health status through data collected from
field, laboratory or clinical investigations.
7. Guide students how to perform zoning, numbering and mapping of a specific community.
8. Assist students in understanding the status of the environment as related to health in the specific
community.
9. Guide and support students in application of parasitological survey, specimen handling,
identification of parasite and recording.
10. Assist students to deeply understand the culture, believes, taboos of the community related to
health.

11. Assist students on scientific report writing.

12. Evaluate students’ activity and performance and submit the report at the end of the training
programme to the supervisory team leader.

Job Description of Supervisory Team Leader

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The supervisory team leader is directly accountable to the office of faculty CBE. He/She has the
following responsibilities:

A. Plans, directs, coordinates and monitors overall activities of his/her team.

B. Confirms that the fieldwork is started on time according to the schedule and facilitates the work
of his/her team.
C. Schedules appropriate time for supervisory team members.
D. Organizes regular supervisory team member’s meeting to discuss performance and problems.
E. Receives and compiles report from each supervisory team members, students group leader and
submit to the office of faculty CBE.
F. Makes sure that students receive proper supervision, guidance and consultation from supervisory
team members.
Job description of student team leader, reporter and logistic personnel
Team leader- Is responsible for organizing the team, taking student attendance and represent
students when there is a need.
Logistics- is responsible for requesting and obtaining necessary material like stationeries,
instruments, tools etc.
Reporter - is responsible for compiling and presenting the activities at the end of the phase
Supportive Staff and Materials
Supportive Staff
The program has non – technical staff that takes care of the administrative affairs of the CBTP under
the direct responsibility of the co-coordinator.
 Secretary typist
 Office boy/girl
Materials
The requirements are:
1. Expendable items
 Stationary
 Laboratory reagents
 Fuel for transport
 Demonstration materials
2. Non – expendable items
 Typing machine

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  Xerox Machine
 Duplicating machine
 Audio – Visuals
 Over – head projector
 Slide projector
 Film projector
 Camera with photo processing equipment
 Video camera with play back screen (TV)
 Calculators – ordinary and scientific
 Weighting scale – adult and baby scales
 Office furniture for co-coordinator and supportive staff
 Statistical current publications on Ethiopia
 Vehicle

Evaluation System
Evaluation of the students’ performance

The evaluation scheme has the following major categories.

i. Written examination: - is conducted for each phase of the CBTP courses. The examination
accounts for 20% of the students` final grade.
ii. Symposium evaluation: - this refers to the presentations and defense for each CBTP course and
accounts for 30%.
iii. Activity evaluation by the supervisors
This includes evaluations of the students by their respective supervisors during both the fieldwork as
well as report writing. The evaluation is made as per the format provided and it accounts for 40% of
the students’ final grade (see Annex- B1 for the format).

iv. Peer evaluations among the students themselves

This scheme provides opportunity for the students to evaluate each other for their participation in the
CBTP courses. The evaluation is made as per the format provided and it accounts for 10% of the
students’ final grade (see Annex-B2 for the format).

Evaluation of the Program

The need for an inbuilt evaluating mechanism assessing the effectiveness and efficiency of the CBTP
is obvious. Students, supervisors, health institutions and community leaders evaluate the program at

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the end of each phase of CBTP. This is done by filling the evaluation format provided by the Faculty’s
CBE office. The evaluation made is further processed and the whole feedback is then used for future
improvement of the programs. The evaluation of this program has two components.
A. Short term evaluation

This is done continuously every year. Its main objectives are:

A.1. To determine the degree to which specific objectives laid down for each year are attended.

A.2. To assess the practicability of general principles and strategies such as problem oriented teaching,
integration of service and training, community involvement and intersectoral collaboration

A.3. To identify major problems encountered during operation of the program regarding planning and
organization in order to take appropriate remedial actions in the subsequent years.

A.4. To assess the level of student motivation in the program.

B. Long term evaluation

This evaluation is done at the end of attachment of group of students in a specific community. Its
objectives are:

B.1. To assess the behavioral and attitudinal changes the program was able to bring about on the
students.

B.2. To determine the impact of the program on the health status of the community included under
this program.

Academic Rules and Regulations

The rules and regulations pertaining to the community Based Training program (CBTP) are
summarized as follows. Violations of the rules and any misconduct by a student will result in
disciplinary actions being taken by the faculty’s CBE office as per the regulations stated. Moreover,
any implicit or explicit implications of the rules and regulations are also enforceable by the office.

1. The course of community Based Training program one (CBTP phase I) is a prerequisite course
to the CBTP phase II. Accordingly a student is not allowed to register and take the second
phase before he/she completes the first one.

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2. A student who joins medical school by transfer cases from other Universities should take the
courses in the sequence stated above and any inconveniencies arising from the transfer is born
by the student. E.g. a student may be delayed for one year to complete the CBTP modules.
3. Any misconduct by the student during data collection or report writing will result in the
student earning a grade of “F” in the course and repeating it. Examples include insulting and
quarrelling with the community members, kebele or Woreda officials, supervisors and any kind
of unnecessary behaviors
4. A student who scores grades “D” or “F” in any one of the CBTP courses is subject to
repeating the course.
The supervisor assigned to closely follow and give guidelines to the students during the CBTP
activities should avail himself or herself for the whole duration and should always be ready to help the
students. Failure to supervise will be communicated to the respective office and appropriate measures
will be taken.
Main Activities in each phase of the CBTP

A period of four weeks is exclusively allotted to the program at the end of each academic year. This
four weeks period is further scheduled in respective phases as follows:
Phase I Year II

At the end of this phase the student should be able to:

1. Do house numbering zoning and mapping

2. Determine the socio-demographic characteristics and means of communication of the community
3. Determine basic vital statistics indicators
4. Determine community resources and their distribution
5. Collect, analyze and interpret health and health related data
6. Identify, prioritize, plan, organize and implement intervention measures for some common
problem of the community
7. Use communication skills to effect necessary health related behavioral changes to solve
community health problems
Phase II year III

1. Collect and update data, analyze, interpret and draw inferences.

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2. Use appropriate techniques to assess health status of a community: health interview survey, health
service record review, nutritional survey such as anthropometric measurements and parasitological
survey with simple laboratory tests using appropriate sampling techniques: simple random sampling,
3. Determine the sanitary level of the given community: waste disposal, water supply system, housing
condition, and food sanitation and vector control

4. Identify, prioritize, plan, organize and implement intervention measures for some of the common
health problem in the community
5. Organize and guide the use of appropriate technology for
5.1 Safe and adequate water supply

5.2 Proper liquid and solid waste disposal

5.3 Proper food preparation and preservation

5.4 Insect and rodent control

6. Teach & demonstrate balanced diet for the family.

Phase III year IV

1. Further apply his/her knowledge and skill through the implementation of the various programs.
2. Identify and manage the common preventable antenatal and postnatal problems.
3. Organize and carry out immunization programs.
4. Conduct schools health services including health appraisal and detection of defects.
5. Perform surveillance and containment activities (case-finding, early treatment, quarantine and
isolation chemoprophylaxis)
6. Make appropriate preventive measures in population groups exposed to occupational hazards
through accident prevention, protection from possible pollutants and toxicants.
Phase IV year V

1. Measure the quantitative effect of changes due to health procedures introduced into the
community.
2. Evaluate the learning experience and service provided to the community
3. Write a comprehensive final report

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Teaching-Learning Methods
 Community survey
 Literature review
 Student presentation and discussion
 Portfolio
 PPRE
Teaching-Learning Materials

 Logbooks for entry of community experience

 Stationeries for community survey
 Computer, statistical software and internet
 Equipment and tool for conducting health assessment
Assessment Methods
Formative assessment
 Logbook and portfolio
 Global rating midway during the attachment
Summative assessment
 Community survey, action plan and presentation (40 %)
 Written Exam (20%)
 Global rating or 360 degree evaluation (15 %)
 Reflective portfolio (10 %)
 Personal research and reflection exercise (15 %)
References

1. Fletcher. Principles of Epidemiology

2. Charles H Hennekens and Julie E Buring. Epidemiology in Medicine
3. Rothman, Kenneth J.; Greenland, Sander; Lash, Timothy L.Modern epidemiology. 3rd edition.
2008
4. David G. KleinbaumKevin M. Sullivan. A pocket guide to epidemiology. 2007
5. Daniel. Biostatistics: a foundation for analysis in health sciences.
6. Pagano. Principles of Biostatistics
7. Colton. Statistics in Medicine

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8. Bland. An introduction to Medical Statistics.
9. YemaneBerhane, DamenHailemariam and HelmuKloos. Epidemiology and ecology of Health
and Disease in Ethiopia. 2006
10. EPHTI. Ecology. Lecture note series for health science students. 2007
11. White, P. Bio psychosocial medicine: An integrated approach to understanding illness.
2005 Oxford University Press.
12. Frankel, R. M., Quill, T. E., & McDaniel, S. H. Biopsychosocial approach: Past, present,
future. 2003. University of Rochester Press.
13. Singer, M. & Baer, H. A. Introducing medical anthropology: A discipline in action (2nd
ed.) 2011. Rowman Littlefield
14. Bernice A. Pescosolido, Jack K. Martin, Jane D. McLeod, Anne Rogers (Editors). Handbook of
the Sociology of Health, Illness, and Healing. A Blueprint for the 21st Century. 2011
15. Bird, C. E., Conrad, P., Fremont, A. M., &Timmermans, S. Handbook of medical sociology
(6th ed.) 2010. Vanderbilt University.
16. Sobo, E. J. &Loustaunau, M. Cultural context of health, illness, and medicine (2nd ed.)
2010. Greenwood
17. David French et al. Health psychology (2nded.) 2010. Blackwell Publishing
18. Susan Ayers, Richard de Visser. Psychology of medicine. 2011
19. WHO. Closing the gap in a generation: health equitythrough action on the social determinants
of health: final report of the commission on social determinants of health. 2008.
20. Robert H Friis. Essentials of environmental health (2nd edition). The essential public health
series. 2012.
21. Kathryn Hilgenkamp. Environmental Health: Ecological Perspectives. 2006
22. Herman Koren and Michael Bisesi.Handbook of environmental health. 2002
23. MakonnenAsefa. Department of community health in perspective, Jimma Institute of Health
Sciences, Jimma, 1996
24. Manual Community Based Training Program: Part I, Department of community health in
perspective, Jimma Institute of Health Sciences, Jimma, July1987
25. MakonnenAsefa. Community Based Education: The experience of Jimma University in
Ethiopia, Ethiop.J.Health Dev. Volume 14, Special Issue, 2000

277
Year III modules

1. Trauma, burn and Orthopedic Anesthesia

2. Emergency and Critical Care
3. Geriatrics Anesthesia
4. Neonatal and Pediatrics Anesthesia
5. Research Methods and EBM
6. ENT, Maxillofacial, Ophthalmic & Day Anesthesia
7. Remote Anesthesia
8. Leadership and Management
9. Neurosurgery Anesthesia
10. Comprehensive Examination
11. Research Project
12. TTP

278
Anesthesia for Trauma, Burn and Orthopedic Surgeries:

Module Title: Anesthesia for Trauma, Burn and Orthopedic Surgeries:

Module Code: AnstM-5271
Module ECTS: 6 ECTS
Module Duration: 20 Weeks

Module Description: This module is designed for Anesthesia students to equip with adequate
knowledge, skill, and attitude on effective anesthetic management of patients coming for trauma, burn,
and orthopedic Surgeries

This Module will be addressed through Interactive lecture, Seminar presentations, Skill Development
Lab (SDL) demonstration and supervised feedbacks in simulated environment and real hospital
setting.

Module Objective

At the end of this module, students will be able to provide effective anesthetic management of patients
coming for trauma, burn, and orthopedic Surgeries in professional manner.

Module Competencies
 Provide anesthesia for Trauma and burn patient
 Provide anesthesia for orthopedic surgery

Learning Outcomes
In order to achieve core competencies, students at the end of this Module will be able to:
 Describe concepts of trauma care
 Describe the epidemiology of trauma
 Identify and prioritize trauma patients
 Assess multiple trauma patients
 Describe pathophysiology of trauma
 Identify clinical manifestation of shock
 Describe types of shock and their management
 Identify and manage life threatening conditions of trauma, & shock

279
  Massive Transfusion Protocols in Trauma Care
 Perform PRIMARY SURVEY including pediatrics and obstetrics
 Perform SECONDARY SURVEY including pediatrics, and obstetrics
 Perform TERTIARY SURVEY including pediatrics and obstetrics
 Manage anesthesia for Head and Spinal cord trauma surgeries
 Provide anesthesia for chest, abdominal and extremity trauma
 Administer safe anesthesia for pregnant mother with trauma
 Describe concepts and epidemiology of orthopedic surgeries
 Manage anesthesia for different orthopedic surgeries
 Identify complications related to orthopedic surgery (VTE)
 Describe the epidemiology of burn injury
 Classify and identify the implication of burn based on the degree, size and site of injury
 Describe the pathophysiology of burn, and burn shock
 Demonstrate fluid management for burned patients
 Provide anesthesia for burn patients

Prerequisite: None

Teaching-Learning Methods

 Interactive lecture and discussion

 Small group discussion
 Role play
 Case study
 Bedside teaching
 Portfolio
 Clinical simulation
 Video show
 Demonstration (at skills lab and Basic Sciences lab)
 Guided clinical practice
 PBL cases
 Inter-professional learning experience in the clinics, and community practice

280
  Seminar Presentations

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board
 Posters
 Anatomic models
 LCD Projector
 White board, marker
 Laptop and Videotapes

Methods of Assessment
 Formative
o Drills, essay exams, quizzes, and practical test (direct observation of skills)
o Structured feedback report
o Oral exam
o Logbook
o Portfolio
o And other assessment methods
 Summative
o Progressive/ Continuous assessment (DOP, CBD, PCE): - 20%
o Objectively Structured Clinical Examination (OSCE) – 10%
o Structured Oral Examination – 20%
o Final written exam – 50%

Module Policy
 Attendance: It is compulsory to attend both SDL and Hospital clinical practice on time and
every time. If students are going to miss more than three classes/ hospital attachment days
during this semester, they will not allowed to seat on final assessment and next semester unless
otherwise proven by evidence per legislation requirement.

281
  Assignments: Students must complete module assignments and work based assessments on
time. Uncompleted work-based assessments and assignments will result in Incomplete (I)
grade submissions to registrar. Further consecutive procedures will be handled in line with
institutional senate legislation.

Reference Books
1. Harold Ellis: Anatomy for Anaesthetists (8th edition). Blackwell Science Ltd, 2004.
2. Paul G Barash: Handbook of Clinical Anesthesia (8th edition). Lippincott Williams &
Wilkins publications, Inc., 2016.
3. Paul G Barash: Clinical Anesthesia (5th edition). Lippincott Williams & Wilkins
publications, Inc.,
2006.
4. Ronald D. Miller: Millers Anesthesia (8th edition). Churchill Livingstone publication, An
157 Imprint of Elsevier, 2009. 158
5. Robert K Stoelting: Stoelting’s anesthesia and co-existing disease (5th edition). Churchill
Livingstone, an Imprint of Elsevier, 2002.
6. Alan R Aitkenhead: Textbook of Anaesthesia (6th edition). Churchill Livingstone
publication, An Imprint of Elsevier, 2001.
7. G. Edward Morgan: Clinical Anesthesiology (5th edition). McGraw-Hill Companies, Inc.,
2006
8. Ronald D. Miller: Basics of Anesthesia (6th edition). Saunders, an imprint of Elsevier Inc.
2011.
9. Fleisher: Anesthesia and Uncommon Diseases, (5th edition). Elsevier Saunders Inc., 2005
10. James C. Duke: Duke’s Anesthesia Secretes (5th edition). Saunders, an imprint of Elsevier
Inc. 2016.
11. Timothy E. Miller: Anesthetic Care for Abdominal Surgery. Elsevier Saunders Inc., 2015.
12. Tim Smith: Fundamentals of Anaesthesia (3rd edition). Cambridge University Press, 2009.
13. Fun-Sun F: Yao: Yao and Artusio's Anesthesiology: Problem-Oriented Patient Management
(6th edition). Lippincott Williams & Wilkins publications, Inc., 2010.
14. Richard A. Jaffe: Anesthesiologist's Manual of Surgical Procedures (5th edition). Lippincott
Williams & Wilkins publications, Inc., 2009.

282
15. David E. Longnecker: Anesthesiology (1st edition). The McGraw-Hill Companies, Inc.,
2008.
16. Ronald D. Miller: Basics of Anesthesia (6th edition). Elsevier Saunders Inc., 2011.
17. Stoelting, Robert K: Pharmacology and Physiology in Anesthetic Practice (2nd edition).
Lippincott
Williams & Wilkins publications, Inc., 2006.
18. Philip L. Liu: Principles and procedures in anesthesiology (4th Edition). Lippincott Williams
and Wilkins publications, Inc., 1992.

283
 Module schedule: lecture 45 hrs. PBL 6hrs. Self-study – 17 hrs. Practice 102 hrs.

Required Reading
Week Learning Activity
(Assignment)
Reading Assignment
Interactive Lecture and Discussion [2.5 Hrs.] on:
Introduction to trauma  Trauma in
 Concepts of trauma care and trauma scoring Ethiopia and
 Epidemiology of trauma Africa
 Initial assessment and triage of traumatized patient
 Mechanisms of trauma injury

Hospital Clinical Practice (emergency department, operation theatre)

[6 Hrs.]
Week 1 Supervised and guided practice on:
 Assessment and immediate management of trauma patient
 Stabilize C-spine, Secure airway, Establish IV access
 Resuscitation based on BTLS, ATLS
 Log roll
 Patient triage
 Team work in resuscitation of patient with multiple trauma

Week 2
Interactive lecture 2.5 hrs.
Initial assessment and management principles (ATLS)
 Primary survey
 Secondary survey
 Tertiary survey

Hospital Clinical Practice (emergency department, operation theatre)

[6 Hrs.]
Supervised and guided practice on:
 Assessment and immediate management of trauma patient
 Stabilize C-spine, Secure airway, Establish IV access
 Resuscitation based on BTLS, ATLS
 Log roll
 Patient triage
 Team work in resuscitation of patient with multiple trauma

284
 Required Reading
Week Learning Activity
(Assignment)
Reading Assignment
Interactive Lecture and Discussion [2.5 Hrs.] on:
 Resuscitation of trauma patient  Mechanism of
 Massive transfusion protocol coagulopathy in
trauma
Clinical Skill Development Lab [1Hrs.]
 Thrombo-
Week 3 elastograph
Demonstration on establishment of Intra-Osseous vascular access for
TEG
resuscitations

Hospital Clinical Practice (emergency department, operation theatre)

[6Hrs.]
Supervised and guided practice on:
 Assessment and immediate management of trauma patient
 Stabilize C-spine, Secure airway, Establish IV access
 Resuscitation based on BTLS, ATLS
 Pre-anesthetic evaluation of trauma patient
 Optimization of trauma patient for surgery

Interactive Lecture and Discussion [2.5 Hrs.]

 Damage control surgery
 Anesthetic induction and maintenance

Hospital Clinical Practice (emergency department, operation theatre)

[6 Hrs.]
Supervised and guided practice on administrating anesthesia for patient
undergoing surgical intervention for trauma Reading Assignment
 Pre-anesthetic evaluation and preparation on:
Week 4  Unstable cervical spine and airway management  Glass Coma
 Preparation of anesthesia management plan for trauma surgery Scale (GCS)
 Anesthesia induction and airway management
 Perform intra-operative monitoring for patient
 Manage Intra-operative of complications associated with trauma
surgery
Start to complete weakly module summative assessments:
 Direct Observed Practice (DOP)
 Practical Clinical Evaluation (PCE)
 Case Based Discussion (CBD)

285
 Required Reading
Week Learning Activity
(Assignment)

Interactive Lecture and Discussion [2.5 Hrs.]

 Traumatic brain injury

Hospital Clinical Practice (emergency department, operation theatre)

[6 Hrs.]
Supervised and guided practice on administrating anesthesia for patient Reading Assignment
undergoing surgical intervention for trauma on:
 Pre-anesthetic evaluation and preparation of head injury patient  Indications for
 Unstable cervical spine and airway management Intra-cranial
 Preparation of anesthesia management plan for emergency pressure
Week 5 craniotomy monitoring
 Anesthesia induction and airway management for emergency  Barbiturate
craniotomy coma
 Perform intra-operative monitoring for trauma surgery  Investigative
 Manage Intra-operative of complications associated with modalities for
emergency craniotomy brain injury
 Provide post-operative management for emergency craniotomy

Start to complete weakly module summative assessments:

 Direct Observed Practice (DOP)
 Practical Clinical Evaluation (PCE)
 Case Based Discussion (CBD)

Interactive Lecture and Discussion [2.5 Hrs.]

 Spinal cord injury

Hospital Clinical Practice (emergency department, operation theatre)

Reading Assignment
[6 Hrs.]
on:
Supervised and guided practice on administrating anesthesia for patient
Week 6  Assessment of total
undergoing surgical intervention for trauma
burn area (rule of
 Pre-anesthetic evaluation and preparation of patient with Spinal
nine)
cord injury
 Unstable cervical spine and airway management
 Preparation of anesthesia management plan for surgical patient
with Spinal cord injury
 Anesthesia induction and airway management for surgical
patient with Spinal cord injury

286
 Required Reading
Week Learning Activity
(Assignment)
 Perform intra-operative monitoring for surgical patient with
Spinal cord injury
 Manage Intra-operative of complications associated with trauma
surgery
 Provide post-operative management for trauma patient
Start to complete weakly module summative assessments:
 Direct Observed Practice (DOP)
 Practical Clinical Evaluation (PCE)
 Case Based Discussion (CBD)

Hospital Clinical Practice (Emergency Department, Burn Unit, Operation

Theatre)

[6 Hrs.]
Supervised and guided practice on administrating anesthesia for patient
undergoing surgical intervention for trauma and/or burn
 Pre-anesthetic evaluation and preparation of patient with burn
injury
 Unstable cervical spine and airway management
 Preparation of anesthesia management plan for surgical patient Reading Assignment
with burn on:
 Anesthesia induction and airway management for surgical  Carbon mono-
patient with burn oxide poisoning
Week 7
 Perform intra-operative monitoring for surgical patient with
burn
 Manage Intra-operative of complications associated with trauma
surgery
 Provide post-operative management for trauma patient
Start to complete weakly module summative assessments:
 Direct Observed Practice (DOP)
 Practical Clinical Evaluation (PCE)
 Case Based Discussion (CBD)

Interactive Lecture and Discussion [2.5 Hrs.]

Anesthesia for specific organ injury Reading Assignment
Week 8 on:
 Chest trauma
Tension pneumothorax
 Cardiac injury
 Abdominal trauma

287
 Required Reading
Week Learning Activity
(Assignment)

Hospital Clinical Practice (Emergency Department, Burn Unit, Operation

Theatre)

[6 Hrs.]
Supervised and guided practice on administrating anesthesia for patient
undergoing surgical intervention for trauma and/or burn
 Pre-anesthetic evaluation and preparation of patient with trauma
 Unstable cervical spine and airway management
 Preparation of anesthesia management plan for surgical patient
with trauma and/or burn
 Anesthesia induction and airway management for surgical
patient with trauma and/or burn
 Perform intra-operative monitoring for surgical patient with
trauma and/or burn
 Manage Intra-operative of complications associated with trauma
and/or burn surgery
 Provide post-operative management for trauma and/or patient
Start to complete weakly module summative assessments:
 Direct Observed Practice (DOP)
 Practical Clinical Evaluation (PCE)
 Case Based Discussion (CBD)
Problem Based learning (PBL) – 3hrs.

Hospital Clinical Practice (Emergency Department, Burn Unit, Operation

Theatre)

[6 Hrs.]
Supervised and guided practice on administrating anesthesia for patient
undergoing surgical intervention for trauma and/or burn
 Pre-anesthetic evaluation and preparation of patient with
trauma
Week 9  Unstable cervical spine and airway management
 Preparation of anesthesia management plan for surgical patient
with trauma and/or burn
 Anesthesia induction and airway management for surgical
patient with trauma and/or burn
 Perform intra-operative monitoring for surgical patient with
trauma and/or burn
 Manage Intra-operative of complications associated with
trauma and/or burn surgery
 Provide post-operative management for trauma and/or patient

288
 Required Reading
Week Learning Activity
(Assignment)

Interactive lecture – 2.5 hrs.

 Orthopedic trauma
 Pediatric trauma
 Obstetric trauma

Hospital Clinical Practice (Emergency Department, Burn Unit, Operation

Theatre)

[6 Hrs.]
Supervised and guided practice on administrating anesthesia for patient
undergoing surgical intervention for trauma and/or burn
 Pre-anesthetic evaluation and preparation of patient with
trauma
Week 10  Unstable cervical spine and airway management
 Preparation of anesthesia management plan for surgical patient
with trauma and/or burn
 Anesthesia induction and airway management for surgical
patient with trauma and/or burn
 Perform intra-operative monitoring for surgical patient with
trauma and/or burn
 Manage Intra-operative of complications associated with
trauma and/or burn surgery
 Provide post-operative management for trauma and/or patient
Start to complete weakly module summative assessments:
 Direct Observed Practice (DOP)
 Practical Clinical Evaluation (PCE)
 Case Based Discussion (CBD)

Interactive Lecture and Discussion [2.5 Hrs.]

Anesthesia for orthopedic surgery:
 Peri-operative anesthetic considerations in orthopedic surgery
(bone cement, tourniquet, fat embolism syndrome, deep venous
thrombosis and thromboembolism)

Week 11
Hospital Clinical Practice (Burn Unit, Operation Theatre)

[6 Hrs.]
Supervised and guided practice on administrating anesthesia for patient
undergoing surgical intervention for trauma and/or burn
 Pre-anesthetic evaluation and preparation of patient with trauma
 Unstable cervical spine and airway management

289
 Required Reading
Week Learning Activity
(Assignment)
 Preparation of anesthesia management plan for surgical patient
with trauma and/or burn
 Anesthesia induction and airway management for surgical
patient with trauma and/or burn
 Perform intra-operative monitoring for surgical patient with
trauma and/or burn
 Manage Intra-operative of complications associated with trauma
and/or burn surgery
 Provide post-operative management for trauma and/or burn
patient
Start to complete weakly module summative assessments:
 Direct Observed Practice (DOP)
 Practical Clinical Evaluation (PCE)
 Case Based Discussion (CBD) – 3hrs.

Interactive Lecture and Discussion [2.5 Hrs.]

Anesthesia for Burn patient
 Definition
 Relevant Anatomy and physiology of skin
 Types of burn (based on degree & Cause)

Hospital Clinical Practice (Emergency Department, Burn Unit, Operation

Theatre)

[6 Hrs.]
Supervised and guided practice on administrating anesthesia for patient Reading Assignment
undergoing surgical intervention for trauma and/or burn on:
Week 12
 Pre-anesthetic evaluation and preparation of patient with trauma  bone cement
 Unstable cervical spine and airway management syndrome
 Preparation of anesthesia management plan for surgical patient
with trauma and/or burn
 Anesthesia induction and airway management for surgical
patient with trauma and/or burn
 Perform intra-operative monitoring for surgical patient with
trauma and/or burn
 Manage Intra-operative of complications associated with trauma
and/or burn surgery
 Provide post-operative management for trauma and/or burn
patient

290
 Required Reading
Week Learning Activity
(Assignment)
Start to complete weakly module summative assessments:
 Direct Observed Practice (DOP)
 Practical Clinical Evaluation (PCE)
 Case Based Discussion (CBD)

Interactive lecture 2.5 hrs.

 Resuscitation and management burn
 Complications associated with burn
 Surgical interventions of burn

Hospital Clinical Practice (Emergency Department, Operation Theatre)

[6 Hrs.]
Supervised and guided practice on administrating anesthesia for patient
undergoing surgical intervention for orthopedic surgery
 Pre-anesthetic evaluation and preparation of patient for
orthopedic surgery
 Preparation of anesthesia management plan for orthopedic Reading Assignment
surgery on:
Week 13
 Anesthesia induction and airway management for orthopedic  Pneumatic
surgery tourniquet
 Perform intra-operative monitoring for orthopedic surgical
patient
 Manage Intra-operative of complications associated with
orthopedic surgery
 Provide post-operative management for orthopedic surgical
patient
Start to complete weakly module summative assessments:
 Direct Observed Practice (DOP)
 Practical Clinical Evaluation (PCE)
 Case Based Discussion (CBD)

Problem based learning (PBL)

Hospital Clinical Practice (Emergency Department, Operation Theatre)

Reading Assignment
Week 14 [6 Hrs.] on:
Supervised and guided practice on administrating anesthesia for patient
undergoing surgical intervention for orthopedic surgery
 Pre-anesthetic evaluation and preparation of patient for
orthopedic surgery

291
 Required Reading
Week Learning Activity
(Assignment)
 Preparation of anesthesia management plan for orthopedic
surgery
 Anesthesia induction and airway management for orthopedic
surgery
 Perform intra-operative monitoring for orthopedic surgical
patient
 Manage Intra-operative of complications associated with
orthopedic surgery
 Provide post-operative management for orthopedic surgical
patient
Start to complete weakly module summative assessments:
 Direct Observed Practice (DOP)
 Practical Clinical Evaluation (PCE)
 Case Based Discussion (CBD)

Interactive Lecture and Discussion [2.5 Hrs.]

Anesthesia for hip surgery
 Fracture of the hip
 Pre-anesthetic consideration for hip surgery
 Intra-operation management for hip surgery
 Post-operative management

Hospital Clinical Practice (Emergency Department, Operation Theatre)

Reading Assignment
[6 Hrs.] on:
Supervised and guided practice on administrating anesthesia for patient  Closed
Week 15 undergoing surgical intervention for orthopedic surgery reduction
 Pre-anesthetic evaluation and preparation of patient for of hip dislocation
orthopedic surgery  Hip
 Preparation of anesthesia management plan for Arthroscopy
orthopedic surgery
 Anesthesia induction and airway management for
orthopedic surgery
 Perform intra-operative monitoring for orthopedic
surgical patient
 Manage Intra-operative of complications associated with
orthopedic surgery
 Provide post-operative management for orthopedic
surgical patient

292
 Required Reading
Week Learning Activity
(Assignment)
Start to complete weakly module summative assessments:
 Direct Observed Practice (DOP)
 Practical Clinical Evaluation (PCE)
 Case Based Discussion (CBD)
Interactive lecture 2.5 hrs.
 Total hip Arthroplasty
 Pre-anesthetic consideration
 Intra-operation management
 Post-operative management

Hospital Clinical Practice (Emergency Department, Operation Theatre)

[6 Hrs.]
Supervised and guided practice on administrating anesthesia for patient
undergoing surgical intervention for orthopedic surgery
Week 16  Pre-anesthetic evaluation and preparation of patient for
orthopedic surgery
 Preparation of anesthesia management plan for
orthopedic surgery
 Anesthesia induction and airway management for
orthopedic surgery
 Perform intra-operative monitoring for orthopedic
surgical patient
 Manage Intra-operative of complications associated with
orthopedic surgery
 Provide post-operative management for orthopedic
surgical patient
Interactive lecture 2.5 hrs.
Anesthesia for knee surgery
 Knee arthroplasty
 Pre-operative considerations
 Intra-operative and post-operative management
 Total knee replacement
Week 17  Pre-operative considerations
 Intra-operative and post-operative management

Hospital Clinical Practice (Emergency Department, Operation Theatre)

[6 Hrs.]
Supervised and guided practice on administrating anesthesia for patient
undergoing surgical intervention for orthopedic surgery

293
 Required Reading
Week Learning Activity
(Assignment)
 Pre-anesthetic evaluation and preparation of patient for
orthopedic surgery
 Preparation of anesthesia management plan for
orthopedic surgery
 Anesthesia induction and airway management for
orthopedic surgery
 Perform intra-operative monitoring for orthopedic
surgical patient
 Manage Intra-operative of complications associated with
orthopedic surgery
 Provide post-operative management for orthopedic
surgical patient
Start to complete weakly module summative assessments:
 Direct Observed Practice (DOP)
 Practical Clinical Evaluation (PCE)
 Case Based Discussion (CBD)

Seminar Presentation on Upper extremity surgery [2.5 hrs.]

Seminar presentation on upper extremity surgery
 Shoulder surgery
 Upper extremity surgery

Hospital Clinical Practice (Emergency Department, Operation Theatre)

[6 Hrs.]
Supervised and guided practice on administrating anesthesia for patient
undergoing surgical intervention for orthopedic surgery Reading Assignment
 Pre-anesthetic evaluation and preparation of patient for on:
orthopedic surgery  Surgery of upper
Week 18  Preparation of anesthesia management plan for orthopedic extremity
surgery  Analgesia for
 Anesthesia induction and airway management for orthopedic shoulder surgery
surgery
 Perform intra-operative monitoring for orthopedic surgical patient
 Manage Intra-operative of complications associated with
orthopedic surgery
 Provide post-operative management for orthopedic surgical
patient
Start to complete weakly module summative assessments:
 Direct Observed Practice (DOP)
 Practical Clinical Evaluation (PCE)
 Case Based Discussion (CBD)

294
 Required Reading
Week Learning Activity
(Assignment)
 Analgesia techniques for Upper extremity surgery
Interactive lecture 2.5 hrs.
 Congenital orthopedic disorders

Hospital Clinical Practice (Emergency Department, Operation Theatre)

[6 Hrs.]
Supervised and guided practice on administrating anesthesia for patient
undergoing surgical intervention for orthopedic surgery
 Pre-anesthetic evaluation and preparation of patient for Complete work place
Week 19 orthopedic surgery based assessment tools
 Preparation of anesthesia management plan for orthopedic (CBD, PCE, DOP)
surgery
 Anesthesia induction and airway management for orthopedic
surgery
 Perform intra-operative monitoring for orthopedic surgical patient
 Manage Intra-operative of complications associated with
orthopedic surgery
 Provide post-operative management for orthopedic surgical
patient
Final Examination week
Week 20

295
Critical care
Module Title: Critical care
Module Code: AnstM-5281
Module ECTS: 6 ECTS
Module Duration: 19 Weeks
Module Description:

This Critical Care module is designed to prepare anesthesia students to participate in recognition of critically ill
patients presenting with various pathologies in the intensive care unit. Moreover, this module will emphasize
on optimization and resuscitation of critically ill patients. This Module will be addressed through Interactive
lecture, Seminar presentations, Skill Development Lab (SDL) demonstration and supervised feedbacks in
simulated environment and real hospital setting.

Module Objective
At the end of this module, students will be able to participate in the management of critical ill patients in the
intensive care unit.

Module Competencies
 Participate in the management of critical care illness
 Provide basic and advanced cardiac life support in the ICU

Learning Outcomes
In order to achieve core competencies, students at the end of this Module will be able to:

 Recognize organization, structuring and staffing of ICU

 Identify admission criteria’s for critically ill patients
 Recognize critically ill patient / the use of early warning signs
 Apply the principle of FASTHUG (feeding, analgesia, sedation, thrombo-embolism prophylaxis,
position (head up), ulcer prevention, glycemic control) in the critical care unit
 Identify and manage patients with respiratory failure
 Identify patients with respiratory failure that requires mechanical ventilation like:
o Pulmonary edema
o ARDS
o Asthma
o COPD
 Apply the principles of oxygen therapy for critically ill patients

296
  Apply invasive and non-invasive modes to support ventilation
 Evaluate patients for ventilator associated complications
 Apply the principles of weaning to relieve patients from mechanical ventilators
 Provide respiratory care for patients with tracheostomy and endotracheal tube insitu
 Identify and participate in the management of patients with cardiac failure
 Identify and participate in the management of patients requiring inotropic support in the ICU
 Identify and participate in the management of patients with hepatic & renal failure
 Identify and participate in the management of patients sepsis
 Identify and participate in the management of patients with neurological impairment
 Identify critically ill patients with electrolyte and acid-base imbalances
 Participate in the management of critically ill patients with fluid, electrolyte and acid-base imbalances
 Identify causes of cardiorespiratory arrest
 Handle ethical concerns related to management of critically ill patients
 Identify and treat reversible causes of cardiac arrest
 Provide BLS for adult critical ill patients
 Provide ACLS for adult critically ill patients
 Provide post resuscitation care for patients after cardiac arrest
 Identify and treat peri-arrest arrhythmias

Prerequisite: None

Teaching-Learning Methods

 Interactive lecture and discussion

 Small group discussion
 Role play
 Case study
 Bedside teaching
 Portfolio
 Clinical simulation
 Video show
 Demonstration (at skills lab and Basic Sciences lab)
 Guided clinical practice
 PBL cases
 Inter-professional learning experience in the clinics, and community practice

297
  Seminar Presentations

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board
 Posters
 Anatomic models
 LCD Projector
 White board, marker
 Laptop and Videotapes
 Manikin, Triage Boxes: Disposable gloves, I/V Fluids: Ringers/ Saline, Venipuncture
equipment/ IV Cannula/ Intra osseous needles, Dressing bandages/ Scissors, Catheters,
nasogastric tubes, Drugs which are likely needed, Standard, Documentation charts and patient
folders with a unique number, each folder should include a triage admission card, lab & X-ray
request form. 


Methods of Assessment
 Formative
o Drills, essay exams, quizzes, and practical test (direct observation of skills)
o Structured feedback report
o Logbook
o Portfolio
o DOP, PCE, CBD
o And other assessment methods
 Summative
o Progressive/ Continuous assessment: - 20%
o Objectively Structured Clinical Examination (OSCE) – 10%
o Structured Oral Examination – 20%
o Final written exam – 50%

Possible Summative assessment areas for:

 Direct Observed Procedure (DOP)

- NGT insertion for ICU feeding

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 - Neurologic examination

- Provide daily respiratory care for ICU patients

- Apply principles of weaning from respiratory support

- Apply advanced airway management modalities during life threatening airway obstructions

- Apply synchronized chest compression and ventilation for patients with cardiac arrest

- Deliver shock for patients with shockable cardiac arrest rhythm

 Case Base Discussion (CBD)

- Principles of FAST-HUG in daily patient care
- Assess metabolic and renal function including acid – base physiology, serum, urine,
electrolytes and other investigation modalities
- Utilize different ventilator setting for patients different with comorbidities
- Provide daily respiratory care for ICU patients
- Apply principles of weaning from respiratory support
- Use results of invasive monitoring modalities to optimize patients in circulatory crisis
- Provide post-resuscitation care
- Manage patients with status asthmatics
- Treat patients with Status epileptics
- Manage patients with tetanus
- Manage critically ill patients with fluid & electrolyte imbalance
- Manage patients with aspiration pneumonitis
 Practical Clinical Evaluation (PCE)
- Apply comprehensive patient evaluation & consultation for ICU patients
- Assess pain using different modalities
- Manage pain in ICU
- Apply different non-invasive monitors and interpret invasive monitoring data for critically
ill patient
- Mange patients with respiratory failure including artificial ventilation
- Utilize different ventilator setting for patients different with comorbidities
- Provide daily respiratory care for ICU patients
- Evaluate and manage patients for ventilator associated complications
- Assess and Manage critically patients with ABCDE approach
- Apply advanced airway management modalities during life threatening airway obstructions
- Identify and treat peri-arrest arrhythmias
- Treat reversible causes of cardiac arrest
- Manage patients with shock (cardiogenic, neurogenic, and anaphylactic)
 Objectively Structured Clinical Examination (OSCE)
- Interpretation of basic CXR
- Interpretation of basic 12 Lead ECG
- Setting and checking mechanical ventilator
- Assessment of critically ill patient (ABC)

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 - Perform Cricothyrotomy
- Basic Life Support (BLS)
- Perform Advanced Cardiac Life Support (ACLS)
- Provide Continuous Positive Airway Pressure (CPAP) administration
- Sedation score
- Perform Neurological examination
- Defibrillation
- Troubleshoot mechanical ventilator alarms
- Manage reversible causes of cardiac arrest
- CVP and Arterial pressure monitoring & interpretations

Module Policy
 Attendance: It is compulsory to attend both SDL and Hospital clinical practice on time and every
time. If students are going to miss more than three classes/ hospital attachment days during this
semester, they will not be allowed to final assessment and next semester unless otherwise proven by
evidence per legislation requirement.
 Assignments: Students must complete module assignments and work based assessments on time.
Uncompleted work-based assessments and assignments will result in Incomplete (I) grade submissions
to registrar. Further consecutive procedures will be handled in line with institutional senate legislation.
Reference Books
1. Miller’s anaesthesia volume 1 and 2, 8th Edition. Ronald D. Miller.
2. Understanding Anesthesia Equipment, Jerry A. Dorsch, Fifth Edition
3. Clinical anaesthesia, 6th Edition. Paul G. Barash.
4. Anaesthesia and co-existing disease, 6th Edition. Robert K. Stoelting
5. Clinical anesthesiology, 5th Edition. G. Edward Morga
6. The Primary Trauma Care Foundation | www.primarytraumacare.org
7. Halls, Schmdit, and Woods Principles of Critical Care Fourth Edition.

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 Module schedule (Lecture = 45 hrs. Lab/ practical =102. And self-study = 17 hrs. PBL = 6 hrs.

Date/ Learning activities Required

week reading(assignments)
Week 1 Interactive lecture 2.5 hrs. Self-study – 3 hrs.
 The roles of critical care units
 Different types of critical care units Surgical patients requiring
 Admission and discharge policy ICU input
 Common causes of admission to critical care units
 The approach to management of critically ill patients
 Recognition of patients requiring intensive input pre-, intra- or
post-operatively

Hospital practice 6 hrs. Select a specific case for

 Observe emergency OPD and ICU setting progress report and
 Observe/ assist in patient position, record keeping and airway protection submission on the final week
 Observe/give tracheostomy care in the ICU of attachment
 Demonstrate different ways of oxygen therapy
 Observe /administer oxygen to critically ill patients
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical team
 Providing general critical care
 Providing system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator support in a
simulated environment
 Assist in weaning of patients from ventilator support

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Week 2 Interactive lecture 2.5 hrs Self-study – 3 hrs.
 Criteria for admission and discharge to and from ICU
Pathophysiology of VTE, GI
 FAST HUG (Feeding, Analgesia, Sedation, position, Ulcer
ulcer and glucose imbalance in
prophylaxis, Glucose control in ICU)
ICU patients
 Nutritional support in ICU
Hospital practice 6 hrs
 Observe emergency OPD and ICU setting
 Observe/ assist in patient position, record keeping and airway
protection Continue to document
 Observe/give tracheostomy care in the ICU progress of selected patient
 Demonstrate different ways of oxygen therapy case
 Observe /administer oxygen to critically ill patients
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical
team
 Providing general critical care
 Providing system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator
support in a simulated environment
 Assist in weaning of patients from ventilator support

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Week 03 Interactive lecture 2.5 hrs. Self-study – 3 hrs.
Respiratory failure
 Definition, causes, pathophysiology, types, clinical features, prediction Restrictive and obstructive
of risky patients and their management lung disease
Hospital practice 6hrs
 Observe emergency OPD and ICU setting
 Observe/ assist in patient position, record keeping and airway
protection
 Observe/give tracheostomy care in the ICU Continue to document
 Demonstrate different ways of oxygen therapy progress of selected patient
 Observe /administer oxygen to critically ill patients case
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical team
 Providing general critical care
 Providing system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator support in a
simulated environment
 Assist in weaning of patients from ventilator support

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Week 04 Interactive lecture 2.5 hrs Self-study – 3 hrs.
Pulmonary edema
 Definition, causes, pathophysiology, types, clinical features, Lung volumes and capacities
prediction of risky patients and their management
Hospital practice 6 hrs
 Observe emergency OPD and ICU setting
 Observe/ assist in patient position, record keeping and airway
protection Continue to document
 Observe/give tracheostomy care in the ICU progress of selected patient
 Demonstrate different ways of oxygen therapy case - review/refer to
 Observe /administer oxygen to critically ill patients literature and books to follow
weather treatment is being
 Assist/Administering appropriate analgesia
given as per the standard
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical team
 Providing general critical care
 Providing system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator support in a
simulated environment
 Assist in weaning of patients from ventilator support

304
Week 5 Interactive lecture 2.5 hrs
ARDS
 Definition, causes, pathophysiology, types, clinical features,
prediction of risky patients and their management
Hospital practice 6 hrs
 Observe emergency OPD and ICU setting
 Observe/ assist in patient position, record keeping and airway
protection
 Observe/give tracheostomy care in the ICU
 Demonstrate different ways of oxygen therapy
 Observe /administer oxygen to critically ill patients
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical team
 Providing general critical care
 Providing system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator support in a
simulated environment
 Assist in weaning of patients from ventilator support

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Week 06 Interactive lecture 2.5 hrs. Self – study – 3 hrs.
Asthma
COPD
 Definition, causes, pathophysiology, types, clinical features,
prediction of risky patients and their management
Hospital practice 6 hrs Continue to document
 Observe emergency OPD and ICU setting progress of selected patient
 Observe/ assist in patient position, record keeping and airway case - review/refer to
protection literature and books to follow
 Observe/give tracheostomy care in the ICU weather treatment is being
 Demonstrate different ways of oxygen therapy given as per the standard
 Observe /administer oxygen to critically ill patients
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical team
 Providing general critical care
 Providing system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
Week 07  Demonstrate
Interactive lecture 2.5different
hrs ways of weaning from a ventilator support in a Self-study – 3 hrs.
simulatedtherapy
 Oxygen environment
Assist inand
 Types weaning
purposeof patients from
of oxygen ventilator
delivery support
devices in HDU & ICU Lung Spirometry

306
 Hospital practice 6 hrs
 Observe emergency OPD and ICU setting
 Observe/ assist in patient position, record keeping and airway
protection
 Observe/give tracheostomy care in the ICU
 Demonstrate different ways of oxygen therapy
 Observe /administer oxygen to critically ill patients
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical team
 Providing general critical care
 Providing system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator support in a
simulated environment
 Assist in weaning of patients from ventilator support
Week 08 Interactive Lecture 2.5 hrs. Self-study – 3 hrs.
Mechanical ventilation
Physiology of breathing
 Definition
 Purpose of mechanical ventilation
 Indications for mechanical ventilation
 Types of mechanical ventilation
 Modes of mechanical ventilation

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 Hospital practice 6 hrs. Continue to document
 Observe emergency OPD and ICU setting progress of selected patient
 Observe/ assist in patient position, record keeping and airway case - review/refer to
protection literature and books to follow
 Observe/give tracheostomy care in the ICU weather treatment is being
given as per the standard
 Demonstrate different ways of oxygen therapy
 Observe /administer oxygen to critically ill patients
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical team
 Providing general critical care
 Assist in provision of system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator support in a
simulated environment
 Assist in weaning of patients from ventilator support

Week 09 Problem based learning (PBL) – 3hrs

Interactive lecture 2.5 hrs.

Mechanical ventilation cont…
 Setting mechanical ventilator
 Complications of MV
 Troubleshooting mechanical ventilator alarms
 Weaning from mechanical ventilator

308
 Hospital practice 6 hrs.
 Observe emergency OPD and ICU setting
 Observe/ assist in patient position, record keeping and airway
protection
 Observe/give tracheostomy care in the ICU
 Demonstrate different ways of oxygen therapy
 Observe /administer oxygen to critically ill patients
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical team
 Providing general critical care
 Assist in provision of system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator support in a
simulated environment
 Assist in weaning of patients from ventilator support

Week 10 Interactive lecture 2.5 hrs. Self-study – 3 hrs.

Non-invasive ventilation
 Indication for NIV Types of sleeping masks
 Patient selection for NIV
 Care of tracheostomy and ETT in the ICU

309
Hospital practice 6 hrs. Continue to document
 Observe emergency OPD and ICU setting progress of selected patient
 Observe/ assist in patient position, record keeping and airway case - review/refer to
protection literature and books to follow
 Observe/give tracheostomy care in the ICU weather treatment is being
given as per the standard
 Demonstrate different ways of oxygen therapy
 Observe /administer oxygen to critically ill patients
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical team
 Providing general critical care
 Assist in provision of system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator support in a
simulated environment
 Assist in weaning of patients from ventilator support

310
Week 11 Interactive lecture 2.5 hrs. Self-study – 3 hrs.
Cardiac failure (CHF)
 Definition, causes, pathophysiology, types, clinical features, Hypertensive crisis in ICU
prediction of risky patients and their management
 Inotropic support for patients with shock
Hospital practice 6 hrs. Continue to document
 Observe emergency OPD and ICU setting progress of selected patient
 Observe/ assist in patient position, record keeping and airway case - review/refer to
protection literature and books to follow
 Observe/give tracheostomy care in the ICU weather treatment is being
 Demonstrate different ways of oxygen therapy given as per the standard
 Observe /administer oxygen to critically ill patients
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical team
 Providing general critical care
 Assist in provision of system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator support in a
simulated environment
 Assist in weaning of patients from ventilator support

311
Week 12 Interactive lecture 2.5 hrs. Self-study – 3 hrs.
Renal and Liver failure
Liver cirrhosis
 Definition, causes, pathophysiology, types, clinical
features, prediction of risky patients and their Continue to document
management progress of selected patient
Hospital practice 6 hrs. case - review/refer to
 Observe emergency OPD and ICU setting literature and books to follow
 Observe/ assist in patient position, record keeping and airway weather treatment is being
protection given as per the standard
 Observe/give tracheostomy care in the ICU
 Demonstrate different ways of oxygen therapy
 Observe /administer oxygen to critically ill patients
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical
team
 Providing general critical care
 Assist in provision of system specific critical care
 Demonstrate setting of mechanical ventilatory settings Self-study – 3 hrs.
Week 13 Interactive lectures 2.5 hrs. different alarms of mechanical ventilator in ICU
 Troubleshoot
Sepsis and ShockApply non-invasive ventilatory modalities for patients
 Definition,
Demonstrate causes, pathophysiology,
different ways of weaningtypes,
fromclinical
a ventilator Continue to document
features, prediction of risky patients
support in a simulated environment and their progress of selected patient
 management
Assist in weaning of patients from ventilator support case - review/refer to
 Surviving sepsis campaign literature and books to follow
Hospital practice 6 hrs. weather treatment is being
 Observe emergency OPD and ICU setting given as per the standard
 Observe/ assist in patient position, record keeping and airway
protection
 Observe/give tracheostomy care in the ICU
 Demonstrate different ways of oxygen therapy
 Observe /administer oxygen to critically ill patients
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical
team
 Providing general critical care
 Assist in provision of system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms 312of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator
support in a simulated environment
Week 14 Interactive lecture 2.5 hrs Self-study – 3 hrs.
Stroke
Delirium Epilepsy & epileptic seizure

 Definition, causes, pathophysiology, types, clinical

features, prediction of risky patients and their
management
Continue to document
 Assessment of GCS in ICU patients
progress of selected patient
Hospital practice 6 hrs.
case - review/refer to
 Observe emergency OPD and ICU setting
literature and books to follow
 Observe/ assist in patient position, record keeping and airway weather treatment is being
protection given as per the standard
 Observe/give tracheostomy care in the ICU
 Demonstrate different ways of oxygen therapy
 Observe /administer oxygen to critically ill patients
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical
team
 Providing general critical care
 Assist in provision of system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator
support in a simulated environment
 Assist in weaning of patients from ventilator support

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Week 15 Interactive lecture 2.5 hrs. Self-study – 3 hrs.
Fluid, electrolyte and acid—base imbalance in ICU
 Input output in ICU patients Less common electrolyte
 Common electrolyte disturbances and their management imbalances in ICU
 Simple acid – base imbalances and their management
Hospital practice 6 hrs.
 Observe emergency OPD and ICU setting
 Observe/ assist in patient position, record keeping and airway
protection
 Observe/give tracheostomy care in the ICU Continue to document
 Demonstrate different ways of oxygen therapy progress of selected patient
 Observe /administer oxygen to critically ill patients case - review/refer to
 Assist/Administering appropriate analgesia literature and books to follow
 Keeping adequate & regular record weather treatment is being
given as per the standard
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical
team
 Providing general critical care
 Assist in provision of system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator
support in a simulated environment
 Assist in weaning of patients from ventilator support

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Week 16 Interactive lecture 2.5 hrs. Self-study – 3hrs.
Resuscitation
 Causes of cardio-respiratory arrest Pediatric ACLS
 BLS for adults
 ACLS for adults
 Defibrillation during cardiac arrest
 Post resuscitation care
Hospital practice 6 hrs. Finalize progress report of
selected case
 Observe emergency OPD and ICU setting
 Observe/ assist in patient position, record keeping and airway
protection
 Observe/give tracheostomy care in the ICU
 Demonstrate different ways of oxygen therapy
 Observe /administer oxygen to critically ill patients
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical
team
 Providing general critical care
 Assist in provision of system specific critical care
 Demonstrate
Interactive lecture 2.5 hrs. setting of mechanical ventilatory settings
 ACLS  forTroubleshoot
adults different alarms of mechanical ventilator in ICU
 Applyduring
 Defibrillation non-invasive
cardiac ventilatory
arrest modalities for patients
 Postresuscitation
Demonstratecaredifferent ways of weaning from a ventilator
Hospital practice 6 hrs.in a simulated environment
support
 Observe emergency
Assist in weaning of OPD andfrom
patients ICUventilator
setting support
 Observe/ assist in patient position, record keeping and airway
protection
 Observe/give tracheostomy care in the ICU
 Demonstrate different ways of oxygen therapy
 Observe /administer oxygen to critically ill patients
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical
team
 Providing general critical care
 Assist in provision of system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
315
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator
support in a simulated environment
 Assist in weaning of patients from ventilator support
Week 17 Problem based learning (PBL) – 3 hrs.

Week 18 Interactive lecture 2.5 hrs. Self-study – 3 hrs.

Peri-arrest arrhythmias
 Common types of peri-arrest arrhythmias Less frequent arrhythmias and
 Management approach of peri-arrest arrhythmias their management
 Synchronized cardioversion
Hospital practice 6 hrs.
 Observe emergency OPD and ICU setting
 Observe/ assist in patient position, record keeping and airway
protection
 Observe/give tracheostomy care in the ICU
 Demonstrate different ways of oxygen therapy
Submit progress report to the
 Observe /administer oxygen to critically ill patients
department
 Assist/Administering appropriate analgesia
 Keeping adequate & regular record
 Providing appropriate post-operative instructions
 Following-up patients post-operatively in ICU
 Communicating effectively with the patient, family and surgical
team
 Providing general critical care
 Assist in provision of system specific critical care
 Demonstrate setting of mechanical ventilatory settings
 Troubleshoot different alarms of mechanical ventilator in ICU
 Apply non-invasive ventilatory modalities for patients
 Demonstrate different ways of weaning from a ventilator
support in a simulated environment
 Assist in weaning of patients from ventilator support

Week 19 Exam week

316
Geriatrics Anesthesia

Module Title: Geriatrics Anesthesia

Module Code: AnstM-5291
Module ECTS: 5 ECTS
Module Duration: 20 Weeks
Module Description: This module is designed to train BSc degree in anesthesia students with deep
knowledge, skills & attitude on effective anesthesia management of geriatrics patients. This Module
will be addressed through Interactive lecture, Seminar presentations, Skill Development Lab (SDL)
demonstration and supervised feedbacks in simulated environment and real hospital setting.

Module Objective
At the end of this module, students will be able to provide anesthesia for geriatrics patient in
professional manner

Module Competencies

Provide anesthesia for geriatrics patients

Learning Outcomes
In order to achieve core competencies, students at the end of this Module will be able to:
 Discuss anatomic & physiological change related with aging
 Discuss pharmacokinetic and pharmacodynamics changes of drugs on geriatrics patient
 Discuss special aspects of geriatrics pharmacology
 List the major contents of anesthesia related history taking of geriatrics patients
 Perform comprehensive pre-operative history taking & interpret the charts of the patient
 Request relevant investigation of geriatrics patient work up
 Interpret relevant investigation of geriatrics patient work up
 Optimize geriatrics patient before surgery
 Manage intra operatively for geriatrics patient
 Explain special challenges of anesthetic managements of geriatrics patients
 Lists the contents of frailty criteria to assess vulnerability of geriatrics patients
 List post-operative complication of geriatrics patients
 Manage post-operative complication of geriatrics patients

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  provide post-operative care for geriatrics patients
 Discuss the commonest co morbid disease related with aging
 Perform physical examination for geriatrics patients
 Explain the contents of the informed consent & left the decision for patient’s ,families or
care givers
 Discuss the psychosocial aspects of geriatrics patient
 Describe causes, Clinical feature and Treatment of Delirium and Dementia
 Prerequisite: None

Teaching-Learning Methods

 Interactive lecture and discussion

 Small group discussion
 Role play
 Case study
 Bedside teaching
 Portfolio
 Clinical simulation
 Video show
 Demonstration (at skills lab and Basic Sciences lab)
 Guided clinical practice
 PBL cases
 Inter-professional learning experience in the clinics, and community practice
 Seminar Presentations

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board
 Posters
 Anatomic models

318
  LCD Projector
 White board, marker
 Laptop and Videotapes

Methods of Assessment
 Formative
o Drills, essay exams, quizzes, and practical test (direct observation of skills)
o Structured feedback report
o Oral exam
o Logbook
o Portfolio
o And other assessment methods
 Summative
o Progressive/ Continuous assessment: practical and theoretical; 20%
o Comprehensive written exam;30%
o Objectively Structured Clinical Examination (OSCE) ;10%
o Structured Oral Examination ;10%
o Case based discussion ;10%
o Assignment;10%
o Practical clinical examination;10%
Total practical +theoretical=100%

Module Policy
 Attendance: It is compulsory to attend both SDL and Hospital clinical practice on time and
every time. If students are going to miss classes/ hospital attachment during the semester, they
will not be allowed to final assessment and next semester unless otherwise proven by evidence
per legislation requirement.
 Assignments: Students must complete module assignments and work based assessments on
time. Uncompleted work-based assessments and assignments will result in Incomplete (I) grade
submissions to registrar. Further consecutive procedures will be handled in line with institutional
senate legislation.

319
Reference Books
33. Barash, Paul G.; Cullen, Bruce F.; Stoelting, Robert K Clinical Anesthesia, 8th Edition.
2017 ,USA
34. Miller’s Anesthesia, 8th ed by Ronald D. Miller, 2010 ,2015 ;USA
35. Lucille Bartholomeusz and Jean Lees, Safe anesthesia –third edition, 2014
36. Ronald D Miller and Manuel C Pardo, JrBasics of anesthesia, Sixth edition, 2015
37. G. Edward Morgan, Jr., Maged S. Mikhail, Michael J. Murray, Clinical Anesthesiology, 5th
Edition,
38. WHO Guidelines for Safe surgery:2009
39. K.G .Allman, Iain H. Wilson) Oxford hand book of anesthesia 2nd ed. 2011 Dr. K. Rupp
Dr. J. Holzki Dr. T. Fischer Dr. C. Keller Pediatrics Anesthesia ,Drager medical, 5th edition
2016
40. Roberto L.Hines,Kathrine.EStoelting’s: Anesthesia & co-existing disease 5th edition

320
 Module Schedule (lecture hours = 30hrs, PBL=10hrs, skill Lab. =8hrs, self study=16hrs,
hospital clinical practice=80hrs, total hrs= 144hrs)
Duration: 20 Weeks (Hospital Practice will be Parallel to Classroom-based teaching)
Required Reading
Week Learning Activity
(Assignment)
Reading Assignment
Interactive Lecture and Discussion [1Hrs.] on:
Overview of the Module [1Hrs.]  Mechanisms and
 Structure and design Anatomic change
 Education strategies of different
 Core competencies organs with aging
 Teaching and learning methods
 Assessment methods
Introduction to Anatomic changes with aging [1 Hr.]
 Mechanisms of aging
 Anatomic change of different organs
Week
1
Hospital Practice/ Visit [2 Hrs.]
 Tour of the hospital and introduction to staff

Visiting geriatrics patients with in the hospital

Facility [2 Hrs.]

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including the
department head.
Reading Assignment
Interactive Lecture and Discussion [1 Hrs.] on:
 Cardiovascular systems & Respiratory systems physiological - physiologic changes
Week change with aging of CNS, hepatic &
2 renal change
Group discussions &presentation [1 Hrs.]
 physiologic changes of CNS, hepatic & renal change

Hospital Practice/ Visit [4 Hrs.]

 Observation of geriatrics patient in different ward
 Observation of geriatric patient interaction with staff & other clients

321
 Required Reading
Week Learning Activity
(Assignment)

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.

Interactive Lecture and Discussion [2 Hrs.]

 Pre-operative history taking

 Components of history taking
 Purpose of pre-operative geriatrics patient assessment

Skill lab practice on [2 Hrs.]

 Pre-operative history taking

Components of history taking

Week
3
Hospital Practice/ Visit [4 Hrs.]
 Observation of patient-anesthetist encounter at pre-operative clinic and
the role of anesthetist in the units
 Talking to the anesthetist

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.

Interactive Lecture and Discussion [1 Hrs.]

 Continuation of pre-operative history taking( CVS,RS,CNS) geriatric

assessment.

Week Student’srole plays on history taking at skill lab [1 Hrs.]

4

Hospital Practice/ Visit [4 Hrs.]

 Remind how to take history with instructors at pre-operative clinic

 Practice history taking form real patient at pre-operative clinic

322
 Required Reading
Week Learning Activity
(Assignment)

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.

Interactive lecturer on physical examination of geriatrics patient [2 Hrs.]

 Specific air way examination

Clinical Skill Development Lab [1 Hrs.]

 Audio video presentation on physical examination

Week Hospital Practice/ Visit [4 Hrs.]

5  Performing physical examination on real patient

Whole Group Session [2Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.

 Interactive Lecture on pertinent investigation modalities and Discussion

[1 Hrs.]
 Group discussion on specific patient’s investigations [1 Hrs.]

Hospital Practice/ Visit [4 Hrs.]

 Order specific investigation for geriatrics patient
Week  Discuss on the investigation results of the patients
6
Whole Group Session [2 Hrs.]
 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.

Seminar presentation on geriatrics patient optimization (2 Hrs.)

Week
7 Hospital Practice/ Visit [4 Hrs.]
 Observe specific adjuvant drug that is used for patient optimization

323
 Required Reading
Week Learning Activity
(Assignment)

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.

Interactive Lecture on intra operative geriatrics management [2 Hrs.]

 The special consideration of induction drug for geriatric

 Special care when using neuromuscular drug

Week Hospital Practice/ Visit [4 Hrs.]

8  Observations when patient comes to Operation Theater& make
complete perioperative documentation.

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.
Group discussion [2 Hrs.]
 Group discussion on intraoperative complicating while managing
geriatrics patient
 Respiratory system complicating /Cardiovascular system complication

Hospital Practice/ Visit [4Hrs.]

 Manage geriatrics patient who came for surgery
Week
 Anesthesia record documentation
9
 Anesthesia machine check up
 Preparing drug for GA & for spinal anesthesia

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.

Interactive Lecture and Discussion on special challenges while managing

[2 Hrs.]
Week
10  airway management challenges in the geriatrics
 Challenge of position for spinal anesthesia
 Challenges of I.V cannulation
 Spinal vs. general anesthesia

324
 Required Reading
Week Learning Activity
(Assignment)

Skill lab practice on airway management challenges in the geriatrics, Challenge

of position for spinal anesthesia [2 Hrs.]

Hospital Practice/ Visit [4 Hrs.]

 Prepare air way management equipment’s
 Anesthesia machine check up
 Checkup monitoring equipment &set alarms calibration
 Intubate the patient if it is general anesthesia
 Confirm intubation
 Perform lumbar puncture if is spinal anesthesia
 Monitor vital sign

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.

Group discussion on Frailty criteria to assess geriatrics patients

vulnerability to disability [2 Hrs.]

Classify geriatrics patients vulnerability to disability during and after stress based
on Frailty criteria

Hospital Practice/ Visit [4Hrs.]

 Prepare air way management equipment’s
 Anesthesia machine check up
Week  Checkup monitoring equipment &set alarms calibration
11
 Intubate the patient if it is general anesthesia
 Confirm intubation
 Perform lumbar puncture if is spinal anesthesia
 Monitor vital sign

Whole Group Session [2

Hrs.]
 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.

325
 Required Reading
Week Learning Activity
(Assignment)
 PBL [2 Hrs.]

Hospital Practice/ Visit [8 Hrs.]

 Prepare air way management equipment’s
 Anesthesia machine check up
 Checkup monitoring equipment &set alarms calibration
Week  Intubate the patient if it is general anesthesia
12  Confirm intubation
 Perform lumbar puncture if is spinal anesthesia
 Manage post-operative pain
 Monitor vital sign

Whole Group Session [2Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.

PBL[2 Hrs.]

Hospital Practice/ Visit [4Hrs.]

 Prepare air way management equipment’s
 Anesthesia machine check up
 Checkup monitoring equipment &set alarms calibration
Week  Intubate the patient if it is general anesthesia
13  Confirm intubation
 Perform lumbar puncture if is spinal anesthesia
 Manage post-operative pain
 Monitor vital sign

Whole Group Session [1 Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.
Week
Group discussion &presentation on geriatrics age related comorbidity [2
14
Hrs.]

326
 Required Reading
Week Learning Activity
(Assignment)

 dementia
 Parkinson’s disease
 delirium
 causes, Clinical feature and Treatment of Delirium and
Dementia

Hospital Practice/ Visit [4Hrs.]

 pertinent history taking form the geriatrics patient
 performing pertinent physical examination
 pre-operative geriatrics patient optimization
 taking informed consent from patient itself ,from family or care givers
 manage intra operative accordingly
 post-operative pain managemen
 Apply infection prevention principles
 Apply protective materials while instrument processing
 Sharp handling, waste disposal management
 Personnel protective equipment
 Hand hygiene
 Observe/ Assist CPR (if any)

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.
o PBL [2 Hrs.]

Hospital Practice/ Visit [4Hrs.]

 pertinent history taking form the geriatrics patient
 performing pertinent physical examination
 pre-operative geriatrics patient optimization
 taking informed consent from patient itself ,from family or care givers
Week  manage intra operative accordingly
15  post-operative pain management
 Apply infection prevention principles
 Apply protective materials while instrument processing
 Sharp handling, waste disposal management
 Personnel protective equipment
 Hand hygiene Observe/ Assist CPR (if any)

Whole Group Session [1 Hrs.]

327
 Required Reading
Week Learning Activity
(Assignment)
 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.

PBL [2Hrs.]

Hospital Practice/ Visit [4Hrs.]

 pertinent history taking form the geriatrics patient

 performing pertinent physical examination
 pre-operative geriatrics patient optimization
 taking informed consent from patient itself ,from family or care givers
 manage intra operative accordingly
 post-operative pain management
 Apply infection prevention principles
Week  Apply protective materials while instrument processing
16  Sharp handling, waste disposal management
 Personnel protective equipment
 Hand hygiene
 Observe/ Assist CPR (if any)
Skill lab practice on Apply infection prevention principles Hand hygiene,
Observe/ Assist CPR (if any) [2 Hrs.]

Group Discussion& Presentation on special geartrics patient care in

respecting CRC manner [2 Hrs.]
- What is CRC?
- Components of CRC

Hospital Practice/ Visit [4Hrs.]

 pertinent history taking form the geriatrics patient
Week  performing pertinent physical examination
17  pre-operative geriatrics patient optimization
 taking informed consent from patient itself ,from family or care givers
 manage intra operative accordingly
 post-operative pain management
 Apply infection prevention principles
 Apply protective materials while instrument processing
 Sharp handling, waste disposal management
 Personnel protective equipment

328
 Required Reading
Week Learning Activity
(Assignment)
 Hand hygiene
 Therapeutic communication
 Observe/ Assist CPR (if any)

Whole Group Session [1 Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.

 PBL [2 Hrs.]

Hospital Practice/ Visit [2 Hrs.]

 pertinent history taking form the geriatrics patient
 performing pertinent physical examination
 pre-operative geriatrics patient optimization
 taking informed consent from patient itself ,from family or care givers
 manage intra operative accordingly
 post-operative pain management
Week  Apply infection prevention principles
18  Apply protective materials while instrument processing
 Sharp handling, waste disposal management
 Personnel protective equipment
 Hand hygiene
 Therapeutic communication
 Observe/ Assist CPR (if any)

Whole Group Session [1 Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.

 Group discussion on ways of Effective Communication with patients,

patient’s family or care givers by applying CRC manner [2 Hrs.]

Week
19

Clinical Skill Development Lab [2 Hrs.]

 Demonstration using models on: CPR, Provide basic life support, ABC,
Suctioning, oxygenation

329
 Required Reading
Week Learning Activity
(Assignment)
 Respiratory emergencies, different types of positioning used during
artificial respiration, artificial respiration and safety measures during
swimming and boating cardio pulmonary resuscitation(CPR)

Hospital Practice/ Visit [4Hrs.]

 pertinent history taking form the geriatrics patient
 performing pertinent physical examination
 pre-operative geriatrics patient optimization
 taking informed consent from patient itself ,from family or care givers
 manage intra operative accordingly
 post-operative pain management
 Apply infection prevention principles
 Apply protective materials while instrument processing
 Sharp handling, waste disposal management
 Personnel protective equipment
 Hand hygiene
 Therapeutic communication
 Observe/ Assist CPR (if any

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning
process in the presence of their instructors and coordinators including
the department head.

Week Examination Week

20

330
Anesthesia for Neonatal and Pediatrics surgeries

Module Title: Anesthesia for Neonatal and Pediatrics surgeries

Module Code: AnstM-5301
Module ECTS: 9 ECTS
Module Duration: 19 Weeks

• Module Description: This module is designed to enable third year anesthesia students in delivering
safe anesthesia for pediatric age group and neonate by considering the basic principles of pediatrics
Anesthesia, in relation to physiologic, anatomic and pharmacologic differences. This module also
deals with anesthetic management for specific surgical procedures in pediatrics and its special
considerations and pediatrics basic and advanced cardiac life support (pediatrics resuscitation).

 Module Objective: By the end of this module, students will be able to provide safe anesthesia and
analgesia for life threating neonatal emergency and pediatric patients undergoing general surgery for
a variety of indications.

 Module Competencies
Provide Anesthesia for Pediatrics and Life threathing Neonatal Emergency.

Learning Outcomes
In order to achieve core competencies, students at the end of this Module will be able to:
 Define pediatrics and pediatrics anesthesia
 Describe principles of pediatrics Anesthesia
 Elaborate anatomical change of pediatrics patients when compare to adult patients
 Elaborate physiological differences of pediatrics patients when compare to adult
patients
 Explain psychological consideration of pediatrics patient
 Recognize varied individual needs of hospitalized children.
 Establish Communication with children and their care givers and consultation
 Explain pharmacological consideration of pediatrics patient.
 Describe neonatal Physiology of and Transition period and fetal circulation

331
 Describe Thermoregulation mechanism of pediatrics patients
 explain the adverse effects of starvation and hypoglycemia in neonates and children
 Formulate Fluid and electrolyte management of neonate and pediatrics patients.
 Perform preoperative evaluation for pediatric patients
 Describe about premedication in pediatrics
 Prepare relevant equipment and drugs for pediatrics anesthesia
 Identify pediatrics patients who are at risk of aspiration and techniques to avoid it.
 Identify investigation modalities with the existing diagnosis
 Prepare patient for anesthesia
 Formulate induction and management options for pediatric patients
 Perform endotracheal intubation for pediatric patients
 Monitor pediatrics patients intraoperatively
 Manage Problems occurring during perioperative anesthesia for pediatrics
 Demonstrate Neonatal and pediatrics IV access(intraosseous cannulation )
 Monitor fluid and electrolyte status of pediatrics patients
 Formulate extubation criteria
 Manage intraoperative complication of pediatrics patients
 Describe the anesthetics management for neonatal congenital heart diseases
 Discuss the Anesthetics management for neonatal Neurosurgeries( Hydrocephalus and
Meningomyelocele)
 Discuss the perioperative Anesthetic consideration for Neonatal Hypertrophic Pyloric
Stenosis(Olive Tumour)
 Discuss the perioperative Anesthetic consideration for neonatal Tracheoesophageal
Fistula and esophageal Atresia
 Discuss the perioperative Anesthetic consideration for neonatal Anal
atresia.(Imperforated Anus)
 Discuss the perioperative Anesthetic consideration for neonatal Abdominal wall
defects (Gastroschisis & Omphalocele)
 Discuss the perioperative Anesthetic consideration for neonatal Congenital
Diaphragmatic Hernia

332
  Discuss the Anesthetics management for a child with cleft Lip and palate repair
 Discuss the perioperative Anesthetic consideration for a child with croup and acute
Respiratory infection (Acute Laryngotarcheobronchitis, Epiglotitis)
 Discuss Anesthetic management of child with common cold & child with murmur.
 Discuss the perioperative Anesthetic consideration for Foreign Body Aspiration
removal (Bronchoscopy)
 Manage postoperative complication of Anesthesia for pediatrics age group.
 Describe discharge criteria for pediatric patients from PACU.
 Monitor pediatrics patients postoperatively.
 Formulate postoperative pain management option for pediatric patients.
 Perform Pediatrics Basic and advanced cardiac life support

Teaching-Learning Methods

 Interactive lecture and discussion

 Small group discussion
 Role play
 Bedside teaching
 Video show
 Demonstration (at skills lab and Basic Sciences lab)
 Guided clinical practice
 Inter-professional learning experience in the clinics, and community practice
 Seminar Presentations

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board
 Posters
 Anatomic models

333
  LCD Projector
 White board, marker
 Laptop and Videotapes

Methods of Assessment
 Formative
o Drills, essay exams, quizzes, and practical test (direct observation of skills)
o Structured feedback report
o Oral exam
o Logbook
o Portfolio
o And other assessment methods
 Summative
o Progressive/ Continuous assessment:
- 5 Direct Observed Procedures (DOP) - 20%
- 5 Case Base Discussions (CBD) - 20%
- 10 Practical Clinical Evaluations - 20%
Objectively Structured Clinical Examination (OSCE) - 30%
Structured Oral Examination - 10%
o Possible summative assessment areas for:
 Direct Observed Procedure (DOP)
- Preoperative evaluation for pediatric patients
- Preparation of drugs for pediatrics patient
- Selection and preparation of equipment for pediatrics anesthesia
- Investigation modalities with the existing diagnosis
- Prepare patient for anesthesia
- Induction and management options for pediatric patients
- Endotracheal intubation for pediatric patients
- Monitor pediatrics patients intraoperatively
- Monitor fluid and electrolyte status of pediatrics patients
- Extubation criteria

334
 - Manage intraoperative complication of pediatrics patients
- Monitor pediatrics patients in PACU
 Case base discussion (CBD)
- Recognize needs of hospitalized children
- pharmacological consideration of pediatrics patient
- Neonatal Physiology of and Transition period and fetal circulation
- Explain the adverse effects of starvation and hypoglycemia in neonates and
children
- pediatrics patients and risk of aspiration and techniques to avoid it .
- Formulate induction and management options for pediatric patients
- Perform endotracheal intubation for pediatric patients
- Manage Problems occurring during perioperative anesthesia for pediatrics
- Formulate extubation criteria
- Manage intraoperative complication of pediatrics patients
- Anesthetics management for neonatal congenital heart diseases
- Anesthetics management for neonatal Neurosurgeries( Hydrocephalus and
Meningomyelocele
- Perioperative Anesthetic consideration for Neonatal Hypertrophic Pyloric Stenosis
(Olive Tumour).
- perioperative Anesthetic considerationfor neonatal Anal atresia.(Imperforated
Anus)
- perioperative Anesthetic consideration for Pediatrics Tonsillectomy &
Adenoidectomy
- Anesthetics management for a child with cleft Lip and palate repair
- perioperative Anesthetic consideration for a child with patient with croup and
acute
- Anesthetic management of child with common cold & child with murmur
- perioperative Anesthetic consideration for a child with epiglottitites
- Perioperative Anesthetic consideration for Foreign Body Aspiration
removal
- postoperative complication of Anesthesia for pediatrics age group

335
 - Discharge criteria for pediatric patients from PACU
- Monitor pediatrics patients postoperatively
- Formulate postoperative pain management option for pediatric
patients
 Practical Clinical Evaluation (PCE)
– preoperative evaluation for pediatric patients
– induction and management options for pediatric patients
– Endotracheal intubation for pediatric patients
– Pediatrics patients intraoperatively.
– Demonstrate Neonatal and pediatrics IV access
– Monitor fluid and electrolyte status of pediatrics patients
– Formulate extubation criteria
– anesthetics management for neonatal congenital heart diseases
– Anesthetics management for neonatal Neurosurgeries(
Hydrocephalus and Meningomyelocele
– Perioperative Anesthetic consideration for Neonatal Hypertrophic
Pyloric Stenosis(Olive Tumour)
– Perioperative Anesthetic consideration for neonatal
Tracheoesophageal Fistula.and esophageal atresia
– Perioperative Anesthetic considerationfor neonatal Anal
atresia.(Imperforated Anus)
– Perioperative Anesthetic consideration for neonatal Congenital
Diaphragmatic Hernia

 Objectively Structured Clinical Examination (OSCE)

- Preoperative evaluation for pediatric patients
- Preparation of drugs for pediatrics patient
- Selection and preparation of equipment for pediatrics anesthesia
- Investigation modalities with the existing diagnosis
- Prepare patient for anesthesia

336
 - Induction and management options for pediatric patients
- Endotracheal intubation for pediatric patients
- Monitor pediatrics patients intraoperatively
- Monitor fluid and electrolyte status of pediatrics patients
- Extubation for pediatrics anesthesia
- Perform Pediatrics Basic and advanced cardiac life support

Module Policy
 Attendance: It is compulsory to attend Interactive lecture class, SDL and Hospital clinical
practice on time and every time. If students are going to miss more than three classes/ hospital
attachment days during this semester, they will not be allowed to final assessment and next
semester unless otherwise proven by evidence per the Universities legislation requirement.

 Assignments: Students must complete module assignments and work based assessments on
time. Uncompleted work-based assessments and assignments will result in Incomplete (I)
grade submissions to registrar. Further consecutive procedures will be handled in line with
institutional senate legislation.

Reference Books
41. Barash, Paul G.; Cullen, Bruce F.; Stoelting, Robert K Clinical Anesthesia, 8th Edition.
2017 ,USA
42. Miller’s Anesthesia, 8th ed by Ronald D. Miller, 2010 ,2015 ;USA
43. Rebecca Jacob, Understanding Pediatrics Anesthesia 2nd ed ,2014,India
44. Lucille Bartholomeusz and Jean Lees, Safe anesthesia –third edition, 2014
45. Ronald D Miller and Manuel C Pardo, Jr Basics of anesthesia, Sixth edition, 2015
46. G. Edward Morgan, Jr., Maged S. Mikhail, Michael J. Murray, Clinical Anesthesiology, 5th
Edition,
47. WHO Guidelines for Safe surgery:2009
48. K.G .Allman, Iain H. Wilson) Oxford hand book of anesthesia 2nd ed. 2011
49. Dr. K. Rupp Dr. J. Holzki Dr. T. Fischer Dr. C. Keller Pediatrics Anesthesia ,Drager medical,
5th edition 2016

337
 Module Schedule
Duration: 16 Weeks (Hospital Practice will be Parallel to Classroom-based teaching)
Lecture: 68 hrs; Skill Lab: 10.5 hrs; Hospital Practice: 144 Hrs; PBL: 8 hrs
Required
Week Learning Activity Reading
(Assignment)
Reading
Interactive Lecture and Discussion [4 Hr.] Assignment
Overview of the Module [2 Hr.] on:
 Structure and design
 Education strategies
 Core competencies
 Teaching and learning methods
 Assessment methods
Define pediatrics and pediatrics anesthesia [2 Hr.]
 Introduction to Pediatrics Anesthesia [30min]
 Fetal circulation and physiological Adaptation[30 min]
Week 1

Clinical Skill Development Lab [30 mint.]

 Video show on Fetal circulation

Hospital Practice/ Visit [8Hr.]

 Observe the environment and practice of pediatrics ORT
 Observe the Utility room for Anesthesia equipments and drug store
 Create Familiarity with the staffs in hospitals
 Observation of patient- Anesthetist encounter at OPDs /ward and role of
Anesthetists in different setup/ units
 Observe on pediatrics and neonatal Anesthesia at preanesthetics room

Whole Group Session [2 Hrs.]

Students will discuss on the progress of the week’s teaching learning process in the
presence of their instructors and coordinators including the department head.
Reading
Interactive Lecture and Discussion [ 2Hrs.] Assignment
 Neonatal Physiology and Transition period on:

338
 Required
Week Learning Activity Reading
(Assignment)

Seminar presentation [2 hr.]

 Physiologic, differences of children and adults [30mint]
 pharmacological consideration of pediatrics patient [30 mint]
 Thermoregulation mechanisms of pediatrics age group [30 mint]

Hospital Practice/ Visit [8Hr.]

 Observe the environment and practice of ORT
Week 2  Observe the Utility room for Anesthesia equipments and drug store
 Create Familiarity with the staffs in hospitals
 Observation of patient- Anesthetist encounter at OPDs /ward and role of
Anesthetists in different setup/ units
 Observe and practice Fluid and electrolyte management of neonate and
pediatrics patients
 Hospital based clinical practice on premedication for pediatrics

Whole Group Session [1 Hr.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department
head.

Interactive Lecture and Discussion [1Hr]

 Anatomic differences of children and adults and the anesthetics implication
Role Play [1 hr ]
 Communication with and their care givers and consultation

Seminar presentation [1hr]

 Adverse effects of starvation and hypoglycemia in neonates and children 60’

Week 3 Group work activity [1Hr.]

 Psychological consideration of pediatrics patient 30
 Individual needs of hospitalized children 60

Clinical Skill Development Lab [30minute.]

Video demonstration on communication30’

Hospital Practice/ Visit [8Hr.]

339
 Required
Week Learning Activity Reading
(Assignment)
 Practice Communication skills with and their care givers and consultation
 Observe the environment and practice of ORT
 Observe the Utility room for Anesthesia equipments and drug store
 Create Familiarity with the staffs in hospitals
 Observation of patient- Anesthetist encounter at OPDs /ward and role of
Anesthetists in different setup/ units
 Observe and practice Fluid and electrolyte management of neonate and
pediatrics patients
 Hospital based clinical practice on premedication for pediatrics

Whole Group Session [2 Hrs.]

Students will discuss on the progress of the week’s teaching learning process in the presence of
their instructors and coordinators including the department head.

Interactive Lecture and Discussion [2Hrs.]

 Pharmacologic differences of children and adults.
 Premedication in pediatrics.
 Identification of investigation modalities with the existing diagnosis.

Group work activity [2Hr]

 Group work then presentation with gallery walk methods on Identification of
Week 4
pediatrics patients who are at risk of aspiration and techniques to avoid it.[1]

Clinical Skill Development Lab [2 Hrs.]

 Role play on preoperative evaluation for pediatric patients
 Demonstrate on Preparation of relevant equipment and drugs for pediatrics
anesthesia
 Demonstrate on selection and preparation of drugs for induction and maintainace

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 Required
Week Learning Activity Reading
(Assignment)

Hospital Practice/ Visit [8Hrs.]

 Observation of patient- Anesthetist encounter at OPDs /ward and role of
Anesthetists in different setup/ units
 Clinical practice on Preparation of relevant Anesthetics equipment and drugs for
pediatrics anesthesia
 Discussing/Talking to the Anesthetists
 Hospital based clinical practice on Identification of investigation modalities with
the existing diagnosis
 Hospital based clinical practice on selection and preparation of drugs for
induction and maintainace

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department head.

Interactive Lecture and Discussion [4 Hr.]

 Formulate induction and management options for pediatric patients.
 Prepare patient for anesthesia
 Endotracheal intubation for pediatric patients

Clinical Skill Development Lab [2 Hrs.]

 Role play on Preparation of pediatrics patient for anesthesia ( 30’)
 Demonstration in skill lab on endotracheal intubation for pediatric patients(30’)
 Video show on endotracheal intubation for pediatric patients (30’)
 Demonstration in skill lab on Monitor pediatrics patients intraoperatively (30’)
Week 5

Hospital Practice/ Visit [8 Hrs.]

 Hospital based clinical practice on Preparation of pediatrics patient for anesthesia
 hospital based clinical practice endotracheal intubation for pediatric patients
 hospital based clinical practice
 Observation and guided practice on communicating with clients
 Observation and guided practice: ORT and preanesthetics clinic

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department head.

341
 Required
Week Learning Activity Reading
(Assignment)

Interactive Lecture and Discussion [2 Hr.]

 Monitor pediatrics patients intraoperatively
 Management of Problems occurring during perioperative anesthesia for pediatrics

Group work activity /Seminar presentation/ [2 Hrs.]

 Group assignment and presentation with jigsaw method methods on Monitor fluid
and electrolyte status of pediatrics patients .
 Group assignment and presentation with jigsaw method on intraoperative
complication of pediatrics patients.

Clinical Skill Development Lab [1 1/2 Hrs.]

 Demonstration on Problems occurring during perioperative anesthesia for
pediatrics
Week 6

Hospital Practice/ Visit [8 Hrs.]

 Observe and practice on management of intraoperative complication of pediatrics
patients.
 Observation and guided practice: operation theater
 Observation of patient-Anesthetists encounter

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department head.

Interactive Lecture and Discussion [2Hrs.]

Anesthetics and neonatal congenital Malformations
 Neonatal and pediatrics IV access(Intraosseous cannulation )
 extubation criteria
Group Activity /Seminar/[2]
Week 7  Working in group and presentation with jigsaw method on anesthetics
management for neonatal congenital heart diseases

Clinical Skill Development Lab [1 1/2 Hrs.]

 Demonstrate Neonatal and pediatrics IV access(intraosseous cannulation )
 Video show

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 Required
Week Learning Activity Reading
(Assignment)
 Demonstration in skill lab on extubation criteria-

Hospital Practice/ Visit [8 Hrs.]

 Observe and practice on perioperative monitor fluid and electrolyte status of
pediatrics patients.
 Observe and practice clinical practice on extubation criteria
 Observe and practice on post-operative Anesthetics management for congenital
Anomalies
 Observation and guided practice: in Operation room

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department head.

Interactive Lecture and Discussion [3 Hrs.]

 Introduction to congenital Anomalies
 Classification of Congenital Anomalies
 Cause and risk factors for congenital Anomalies

Group work Activity [1 Hr.]

 Work in group and present with jigsaw method on Anesthetics management for
neonatal Neurosurgeries(60’)

Hospital Practice/ Visit [8 Hrs.]

 Observe and practice on Preoperative anesthetics consideration for a child with
congenital heart diseases
Week 8  Observe and practice on Intraoperative anesthetics consideration for a child with
congenital heart diseases
 Observe and practice on Postoperative anesthetics consideration for a child with
congenital heart diseases
 Observe and practice on Preoperative anesthetics consideration for a child with
Hydrocephalus and spinal bifida
 Observe and practice on Intraoperative anesthetics consideration for a child with
Hydrocephalus and spinal bifida
 Observe and practice on Postoperative anesthetics consideration for a child with
Hydrocephalus and spinal bifida.
 Observe and practice on Observation of documentation, admission and discharge
of patient process

Whole Group Session [2 Hrs.]

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 Required
Week Learning Activity Reading
(Assignment)
 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department head.

Interactive Lecture and Discussion [4Hrs.]

Anesthetics management for neonatal with congenital heart disease
o Cause, risk factor and classification of congenital heart diseases.
o Pathophysiology of congenital heart diseases.
o Preoperative anesthetics consideration for a child with congenital heart diseases
o Intraoperative anesthetics consideration for a child with congenital heart diseases
o Postoperative anesthetics consideration for a child with congenital heart diseases

Hospital Practice/ Visit [8Hrs.]

 Observe and practice on Preoperative anesthetics consideration for a child with
Week 9 congenital heart diseases
 Observe and practice on Intraoperative anesthetics consideration for a child with
congenital heart diseases
 Observe and practice on Postoperative anesthetics consideration for a child with
congenital heart diseases
 Observe and practice on Preoperative anesthetics consideration for a child with
Hydrocephalus and spinal bifida
 Observe and practice on Intraoperative anesthetics consideration for a child with
Hydrocephalus and spinal bifida
 Observe and practice on Postoperative anesthetics consideration for a child with
Hydrocephalus and spinal bifida.
 Observe and practice on Observation of documentation, admission and discharge
of patient process

Interactive Lecture and Discussion [3 Hrs.]

 Anesthetics management for neonatal Neurosurgeries
o Cause, risk factor and classification of Hydrocephalus and spinal bifida
o Pathophysiology of Hydrocephalus and spinal bifida
o Preoperative anesthetics consideration for a child with Hydrocephalus and spinal
Week bifida
10 o Intraoperative anesthetics consideration for a child with Hydrocephalus and spinal
bifida
 Postoperative anesthetics consideration for a child with Hydrocephalus and spinal
bifida.

Group work Activity [1Hrs.]

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 Required
Week Learning Activity Reading
(Assignment)
 Group work and presentation with jigsaw method on perioperative Anesthetic
consideration of Tracheoesophageal Fistula.and esophageal Atresia (60’)

Hospital Practice/ Visit [8 Hrs.]

 Observe and practice on Preoperative anesthetics consideration for a child with
Hydrocephalus and spinal bifida
 Observe and practice on Intraoperative anesthetics consideration for a child with
Hydrocephalus and spinal bifida
 Observe and practice on Postoperative anesthetics consideration for a child with
Hydrocephalus and spinal bifida.
 Observe and practice on Observation of documentation, admission and discharge
of patient process

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department head.

Problem based learning [4 Hrs.]

Hospital Practice/ Visit [8 Hrs.]

 Observe and practice on Preoperative anesthetics consideration for a child with
IHPS
Week
 Observe and practice on Intraoperative anesthetics consideration for a child with
11
IHPS
 Observe and practice on Postoperative anesthetics consideration for a child with
IHPS
 Observe and practice on Observation of documentation, admission and discharge
of patient process

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department head.
Week
12 Interactive Lecture and Discussion [3 Hrs.]

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 Required
Week Learning Activity Reading
(Assignment)
 Anesthetic Management for Infantile Hypertrophic Pyloric Stenosis
(IHPS)[11/2]
 Introduction to for Neonatal IHPS
 Cause and risk factors for IHPS
 Pathophysiology for Neonatal IHPS
 Perioeprative Anesthestic management for IHPS
 Anesthetic Management for neonatal Tracheoesophageal Fistula(TEF)and
esophageal Atresia(EA) [11/2hr ]
 Introduction to for Neonatal TEF&EA
 Cause risk factors and Classification of for TEF&EA
 Pathophysiology for Neonatal TEF&EA
 Perioeprative Anesthestic management for TEF&EA

Group work activity (1Hr.)

 Group assignment and presentation with jigsaw method on perioperative Anesthetic
consideration for Abdominal wall defects(30’)
 Group assignment and presentation with jigsaw method on perioperative Anesthetic
consideration for Congenital Diaphragmatic Hernia (60’)

Hospital Practice/ Visit [8 Hrs.]

 Observe and practice on Preoperative anesthetics consideration for a child with
TEF&EA
 Observe and practice on Intraoperative anesthetics consideration for a child with
TEF&EA
 Observe and practice on Postoperative anesthetics consideration for a child with
TEF&EA.
 Observe and practice on Observation of documentation, admission and discharge
of patient process

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department head.

346
 Required
Week Learning Activity Reading
(Assignment)

Interactive Lecture and Discussion [3 Hrs.]

 Perioperative Anesthetic consideration Anal atresia.(Imperforated Anus)
 perioperative Anesthetic consideration for Abdominal wall defects
 perioperative Anesthetic consideration for Congenital Diaphragmatic Hernia

Group work Activity [1 Hr.]

 Group assignment and presentation with jigsaw method on Anesthetics
management for cleft Lip and palate repair[30’]
 Group assignment and presentation with jigsaw method on perioperative
Anesthetic consideration for croup and acute[30’]
Week
13
Hospital Practice/ Visit [8 Hrs.]
 Perioperative Anesthetic consideration Anal atresia.(Imperforated Anus)’30’
 perioperative Anesthetic consideration for Abdominal wall defects60’
 perioperative Anesthetic consideration for Congenital Diaphragmatic Hernia60’
 Observation and guided practice: emergency department, surgical ward and
OPD

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department head.

Interactive Lecture and Discussion [ 3 Hr.]

- Anesthetics management for cleft Lip and palate repair[1 hr]
- perioperative Anesthetic consideration for croup and acute emergency surgeries
Week (acute laryngotracheobronchitis and epiglottitis)[ 1hrs]
14
Group work activity(1)
 assignment and presentation with jigsaw method on Anesthetic management of
child with common cold & child with murmur (60’)

347
 Required
Week Learning Activity Reading
(Assignment)

Hospital Practice/ Visit [8Hrs.]

 Anesthetics management for cleft Lip and palate repair45’
 perioperative Anesthetic consideration for croup and acute emergency surgeries
45’
 Observation and guided practice: emergency department, surgical ward and OPD
 Observe and practice on perioperative Anesthetic consideration for epiglottise

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department head.

Interactive Lecture and Discussion [3Hrs.]

 Anesthetic management of child with common cold & child with murmur
 perioperative Anesthetic consideration for epiglottise
 Anesthetic consideration Foreign Body Aspiration removal(Bronchoscopy)

Seminar presentation[1hrs]
 Seminar presentation on postoperative complication of Anesthesia for pediatrics
age group
 Seminar presentation on discharge criteria for pediatric patients from PACU

Week
Clinical Skill Development Lab [30minute]
15
Demonstration in skill lab on Monitor pediatrics patients postoperatively (30)

Hospital Practice/ Visit [8 Hrs.]

 Observe and practice on Anesthetic management of child with common cold &
child with murmur
 Observe and practice on Anesthetic consideration Foreign Body Aspiration
removal(Bronchoscopy)

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department head.

348
 Required
Week Learning Activity Reading
(Assignment)

Interactive Lecture and Discussion [4Hrs.]

 Monitor pediatrics patients postoperatively
 postoperative pain management option for pediatric patients

Clinical Skill Development Lab [1 Hr.]

 Demonstration in skill lab on monitoring pediatrics patients postoperatively.
Week  postoperative pain management option for pediatric patients postoperative pain
16 management option for pediatric patients

Hospital Practice/ Visit [8 Hrs.]

 Practice /Perform Monitoring of pediatrics patients postoperatively
 Practice on postoperative pain management option for pediatric patients

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department head.

Problem base Learning [4Hrs.]

Week
Hospital Practice/ Visit [8 Hrs.]
17
Whole Group Session [2 Hrs.]
 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department head.

Interactive Lecture and Discussion [4Hrs.]

Pediatrics Resuscitation
 What is Cardiac arrest in children?
Week  Causes of cardiac arrest in children
18  Principals and qualities in the management of cardiac arrest in children
 Pediatrics Basic and advanced cardiac life support

Clinical Skill Development Lab [1 Hr.]

 Demonstration on pediatrics Basic and advanced cardiac life support in skill lab y.

349
 Required
Week Learning Activity Reading
(Assignment)
 Video show on Pediatrics Basic and advanced cardiac life support.

Hospital Practice/ Visit [8 Hrs.]

 Observe and practice Pediatrics Basic and advanced cardiac life support
 Observation and guided practice: emergency department and surgical wards and
OPD.
 Observation and guided practice: emergency department and surgical wards and
OPD

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching learning process in
the presence of their instructors and coordinators including the department head.

Exam week

 OSCE
Week
19  Oral exam

 Written (MCQ)

350
Research Methodology

Module Title: Research Methodology

Module Code: SPHM-5312

Module ECTS: 5 ECTS
Module Duration: 20 Weeks

Module Description: This Module is designed for anesthesia students to scientific inquiry, critical
appraisal of literature and evidence, and research process. The student will acquire basic fundamental
knowledge and skills to ethically conduct research in Anesthesia and application of common statistical
packages to appreciate the importance of research in professional Anesthesia. This Module will be
addressed through Interactive lecture, Seminar presentations, Skill Development in computer Lab
(SDL) demonstration and supervised feedbacks in computer skill lab

Module Objective
At the end of this module, students will be able to undertake operational researches in a
professional manner.

Module Competencies
The core professional competencies where this practice Module aimed at achieving are:
1. Apply basic principles of research method
2. Critically appraise scientific literatures, select, and summarize findings
3. Develop a research proposal following the steps of the research process
4. Conduct basic and operational scientific research to solve community problem
5. Utilize updated evidences in providing Anesthesia care

Learning Outcomes
In order to achieve core competencies, students at the end of this Module will be able to:
 Discuss Elements of research project
 Conduct Literature review
 Demonstrate effective research writing and presentation skills
 Collect data and apply common statistical package for data processing, analysis
 Write research report

351
  Apply ethical principles relating to research
 Apply evidences based Anaesthesia care

Prerequisite: None

Teaching-Learning Methods
 Interactive lecture
 Exercises and assignments
 Proposal development
 Computer lab practice (Statistical software programs such as Epi Info and SPSS

Teaching-Learning Materials
 Text books
 Reference manual
 Writing board
 LCD Projector
 White board, marker
 Laptop

Methods of Assessment
Formative assessment
 Exercises and assignments
 progressive proposal assessment
Summative assessment
 Critical appraisal of literature (20 %)
 Developing a research proposal (30 %)
 Written exam (50 %)
 Possible Summative assessment areas for:
o Document of Critical appraisal of literature
o Document of Proposal
 Practical lab Evaluation (PLE)
o Compile document of Critical appraisal of literature
o Compile computer statical package

352
Module Policy
 Attendance: It is compulsory to attend SDL (computer lab) practice on time and every time.
If students are going to miss more than three classes/ computer lab practice days during this
semester, they will not be allowed to final assessment and next semester unless otherwise
proven by evidence per legislation requirement.
 Assignments: Students must complete Module assignments and work based assessments on
time. Uncompleted work-based assessments and assignments will result in Incomplete (I)
grade submissions to registrar. Further consecutive procedures will be handled in line with
institutional senate legislation.

Reference Books
1. Getu Degu and Tegbar Yigzaw. Research Methodology: Lecture Note for Health Science
Students. Ethiopian Public Health Training Initiative. 2006
2. Nigel Bruce, Danniel Pope and Debbi Stanistreet: Quantitative methods for health research.
A practical interactive guide to epidemiology and statistics
3. Denise F. polit, Chery Tatano Beck. Nursing research principle and methods 3rd edition 2003
4. Evidence based Anesthesia care Chhay Sveng CheaAth February 2015
5. Health research methodology: A Guide for Training in Research Methods, WHO Second
Edition.2001
6. Varkevisser C, Pathmanathan I. and Brownlee A. Designing and Conducting Health Systems
Research Projects (Volumes 1 and 2). Amsterdam: KIT Publishers, WHO/IDRC, 2003.
7. Proposal Writing For Health and Health-Related Research (Training Module 1). Addis
Ababa, Ethiopia: The Health Department of the Ethiopian Science and Technology
Commission in collaboration with The Ethiopian Public Health Association and Regional
State Health Bureaus, June, 2005
8. Assefa M, Tessema F. Supplementary Readings for Research undertaking. Jimma, 2000:77.
9. Assefa M. Manual for undertaking research: the participatory approach learning by doing.
Jimma: 2003:92

353
 Module schedule
Duration: 20 Weeks (Classroom-based teaching)

Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture and Discussion [5 Hrs.]
Week 1 Overview of the Module [1 Hrs.]
 Structure and design
 Education strategies
 Core competencies
 Teaching and learning methods
 Assessment methods

Introduction to research [3 Hrs.]

 Definition of research
 Rationale for research
 Types of research
 Features of health system research
 The research process format
 Identify and prioritize research topic
Week 2 Interactive Lecture and Discussion [4 hrs.]
 Problem statement
 Literature review
 Conceptual frameworks
Week 3  Research hypothesis/questions
 Formulation of research objectives
 Citation and Referencing styles
Skill Development Lab [16 hrs.]
 Basic computer skill for application of research
week 4, 5, 6  research software’s Endnote application
and 7  Review a literature
Interactive Lecture and Discussion [4 hrs.]
Week 8 Research Methodology

354
 Required Reading
Week Learning Activity
(Assignment)
 Qualitative and quantitative studies design
o Descriptive studies
o Analytic studies design
 Source population and study population
 Sample size and sampling methods
 Variables
 Validity and Reliability of measurements of tools
 Data collection techniques
Skill Development Lab [4 Hrs.]
 Basic computer skill for the application of research
Week 9
 Research software’s Endnote application
 Review a literature
Interactive Lecture and Discussion [4 hrs.]
Week 10  Plan for data collection and organization
 Plan for data processing and analysis
Interactive lecture and discussion [2hrs.]
 Plan for data processing and analysis (continue)
 Pre-testing the methodology
Week 11 Ethical considerations (3 Hrs)
 Plagiarism
 Ethical concerns pertaining study subjects
 Ethical issues in selected health researches
Interactive Lecture and Discussion [4 hrs.]
Ethical principles
 Confidentiality
 Autonomy
Week 12
 Veracity
 Beneficence
 Non-malfeasance
 Justice

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 Required Reading
Week Learning Activity
(Assignment)
 Informed consent

Interactive Lecture and Discussion [4 hrs.]

Week 13  Work Plan
 Budget Plan
Week 14,15 Skill Development Lab [12 hrs.]
and 16  Methods of data processing and analysis (Epi Info, SPSS ) endnote
Interactive Lecture and Discussion [4 hrs.]
 The concepts of scientific evidence and evidence-based practice
o Definition of evidence-based practice (EBP)
Week 17 o Components of evidence-based practice (EBP)
o Steps of evidence-based practice (EBP)
 Application of evidence to practice
o Critical appraisal of literature and utilization of evidence
Skill Development [15 hrs.]
Day 18-19  Students develop a research proposal
 Finalizing and reviewing the research proposal

Week 20 Final Examination Week

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ENT, Maxillofacial, Ophthalmic and Day Case Anesthesia

Module Title: ENT, Maxillofacial, Ophthalmic and Day Case Anesthesia

Module Code: AnstM-5321
Module ECTS: 9 ECTS
Module Duration: 14 Weeks

Module Description: This module is designed for anesthesia students to create a learning
opportunity on ENT, maxillofacial, ophthalmic& day case surgical procedures that enable students to
equip with the necessary knowledge skill and attitude on anesthesia management to all age groups and
also manage the complications associated with it. This Module will be addressed through Interactive
lecture, Seminar presentations, Skill Development Lab (SDL) demonstration and supervised
feedbacks in simulated environment and real hospital setting.

Module Objective
At the end of this module, students will be able to provide Anesthesia for various types of ENT,
maxillofacial, ophthalmic& day case surgery.

Module Competencies
 Provide anesthesia for ENT surgical patients in compassionate respectful and caring manner.
 Provide anesthesia for maxillofacial surgical patients in compassionate respectful and caring
manner.
 Provide Anesthesia for Ophthalmic surgical patients in compassionate respectful and caring
manner.
 Provide Anesthesia for day case surgical patients in compassionate respectful and caring
manner.

Learning Outcomes
In order to achieve core competencies, students at the end of this Module will be able to:
 Discuss Anatomy and physiology of the Ear, Nose and Throat.
 Explain coagulation status of ENT patient
 Describe Leo fort classification and its implication to anesthesia management
 Describe the concerns of nitrous oxide and other gas during ear surgery
 Discuss postoperative complication of ENT and maxillofacial surgery and anesthesia

357
 Discuss Ludwig angina
 Describe the equipment used and technique of jet ventilation
 Discuss laser surgery anesthesia and biological effect of laser surgery.
 Perform preoperative evaluation (exploring OSA, congenital anomalies) for ENT patient
 Perform airway assessment for ENT surgical patients in respectful and compassionate manner
 Order and interpret appropriate investigation for ENT and maxillofacial procedures
 Prepare different airway equipment and drugs for ENT and maxillofacial surgery and anesthesia
 Perform nasal intubation
 Perform awake intubation
 Manage failed airway using alternative technique
 Discuss techniques of anesthesia for various types of throat surgical procedures
 Provide anesthesia for various types of throat surgical procedures
 Provide anesthesia for various types of pediatric airway emergency surgical patients
 Provide anesthesia for various types of ear canal and tympanic membrane disorder
 Practice closed monitoring in sheared airway during ENT and maxillofacial surgery
 Manage postoperative complication of ENT and maxillofacial surgeries
 Discuss anatomy and physiology of the eye
 Discuss IOP and OCR and its effect to our anesthetic management
 Describe the challenges of open eye injury and full stomach in anesthetic management
 Describe the effects of ophthalmic drugs on anesthesia management
 Assess and optimize Ophthalmic surgical patients in compassionate respectful and caring
manner
 Order and interpret appropriate investigation for ophthalmic patients
 Perform regional anesthesia (retrobulbar, peribulbar) block for various type of eye procedure
 Manage anesthesia for various types of Ophthalmic surgical patients
 Describe the principles of Anesthesia for day case surgery
 Describe basic consideration for day case anesthesia service
 Describe basic consideration for office-based anesthesia and procedure outside operating room
 Describe the pharmacologic and non-pharmacologic optimization strategies of day case surgical
patients
 Assess and optimize Day-care surgical patients in compassionate respectful and caring manner

358
 Order and interpret appropriate diagnosing investigation for day case anesthesia and surgery
 Manage of anesthesia for various types of Day-care surgery
 Manage pain using multimodal analgesia technique for day case surgical patients
 Provide post-anesthetic care for Day care surgical patients
 Describe and apply discharging criteria for day case anesthesia
 Apply infection prevention principles and patient safety.
 Produce accurate and complete documentation

Prerequisite: None

Teaching-Learning Methods

 Interactive lecture and discussion

 Small group discussion
 Role play
 Case study
 Bedside teaching
 Portfolio
 Clinical simulation
 Video show
 Demonstration (at skills lab and Basic Sciences lab)
 Guided clinical practice
 PBL cases
 Inter-professional learning experience in the clinics, and community practice
 Seminar Presentations

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board
 Posters
 Anatomic models

359
  LCD Projector
 White board, marker
 Laptop and Videotapes

Methods of Assessment
 Formative
o Drills, essay exams, quizzes, and practical test (direct observation of skills)
o Structured feedback report
o Logbook
o Portfolio
o And other assessment methods
 Summative
o Final written exam
o Progressive/ Continuous assessment:
o Objectively Structured Clinical Examination (OSCE)
o Structured Oral Examination
- Final written exam - 30%
- Practical summative assessment (70%)
 4 Direct Observed Procedures (DOP) - 15%
 4 Case Base Discussions (CBD) - 10%
 4 Practical Clinical Evaluations - 15%
 Objectively Structured Clinical Examination (OSCE) - 20%
 Structured Oral Examination - 10%
 Possible Summative assessment areas for:
o Direct Observed Procedure (DOP)
 Prepare different airway equipment and drugs for ENT and maxillofacial surgery and
anesthesia
 Provide anesthesia for various types of pediatric airway emergency (foreign body
aspiration, epiglottises, broncos copy and vocal cord disorder) surgical patients
 Perform regional anesthesia (retrobulbar, peribulbar) block for various type of eye
procedure

360
  Manage anesthesia for Ophthalmic surgical patients (with emphasis in intraocular
pressure (glaucoma), oculo cardiac reflex, anesthetic implications of ophthalmic
drugs)
 Provide post-anesthetic care for Ophthalmic surgical patients
 Manage of anesthesia for Day-care surgery
 Manage pain using multimodal analgesia technique for day case surgical patients
 Provide post-anesthetic care for Day care surgical patients
 Describe and apply discharging criteria for day case anesthesia
 Assess and optimize Day-care surgical patients in compassionate respectful and
caring manner
 Apply infection prevention principles and patient safety.
 Possible Summative assessment areas for:
o Case Based Discussion (CBD)
 Postoperative complication of ENT and maxillofacial surgery and anesthesia
 Blind nasal intubation
 Failed airway using alternative technique
 Anesthesia Management for tonsillectomy (OSA) patients
 Anesthesia for ear canal and tympanic membrane disorder
 Postoperative complication of ENT and maxillofacial surgeries
 Anesthesia management of patient with day care surgery
 Possible Summative assessment areas for:
o Objectively Structured Clinical Examinations (OSCE)
 Preoperative evaluation for tonsillectomy patients
 Investigation for ENT and maxillofacial procedures
 Difficult airway equipment for ENT surgery and anesthesia
 Difficult airway equipment for maxillofacial surgery and anesthesia
 Nasal & awake intubation
 Failed airway using alternative technique
 Airway evaluation for ophthalmic patients
 Regional block for ophthalmic patients
 Percentage allocation:

361
Module Policy
 Attendance: It is compulsory to attend class Lecture, SDL and clinical practice 100%,
unless the students have justifiable evidence for their absence. If the students miss
Lecture and clinical practice without justifiable evidence they will not sit for exam and
forced to repeat the course.
 Assignments: Students must complete module assignments and work-based assessments
(DOP, PCE & CBD) on time. Uncompleted work-based assessments and assignments will
result in Incomplete (I) grade submissions to registrar. Further consecutive procedures will be
handled in line with institutional senate legislation.

Reference Books
1. Ronald D. Miller: Millers Anesthesia (7th edition). Churchill Livingstone publication, An
Imprint of Elsevier, 2009
2. Robert K Stoelting: Stoelting’s anesthesia and co-existing disease (5th edition). Churchill
Livingstone, an Imprint of Elsevier, 2002.
3. Philip L. Liu: Principles and procedures in anesthesiology (4th Edition). Lippincott Williams
and Wilkins publications, Inc., 1992.
4. Ronald D. Miller: Basics of Anesthesia (6th edition). Elsevier Saunders Inc., 2011.
5. G. Edward Morgan clinical anesthesiology 4th edition.
6. Lucille Bartholomeus Safe anesthesia 3rd edition
7. Pathophysiology review hurt,
8. Alan R Aitkenhead: Textbook of Anaesthesia (6th edition). Churchill Livingstone
publication, An Imprint of Elsevier, 2001
9. Guyton’s physiology, 15th edition
10. Harold Ellis: Anatomy for Anaesthetists (8th edition). Blackwell Science Ltd, 2004

362
 Module Schedule
Duration: 14 Weeks (Hospital Practice will be Parallel to Classroom-based teaching) (Lecture hrs.
65 (26.16%), skill lab 14.5(5.84%), PBL 8(3.22%), self-study 29(11.67%) and hospital practice
132(53.11%)

Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture [5Hr.] Reading Assignment on:
 Overview of the Module [1/2Hr.]  Anatomy, physiology
 Introduction about the course [1/2HR] and innervations of the
 Introduction to anesthesia for ENT surgical patients [1/2HR] Ear, nose and throat
 Preoperative evaluation for tonsillectomy patients [1/2HR]
 Anesthesia management for tonsillectomy (OSA and tonsillitis) [2
1/2HR]
Group discussion [1/2Hrs.]

 Anesthesia management for OSA patients

Week 1
Clinical Skill Development Lab [1:30Hr.]
 Demonstration of ENT anatomy

Hospital Practice/ Visit [10 Hrs.]

 Assessment and optimization of ENT patients
 Applying infection prevention principles and patient safety for
ENT patients
 Perform endotracheal intubation for ENT (adeno-tonsillectomy
patients) under direct supervision

Whole Group Session [2Hrs.]

 Students will discuss on the progress of the week’s teaching
learning process in the presence of their instructors and
coordinators including the department head.
Reading Assignment on:
Interactive Lecture [5 Hrs.]  definition,
 Managements of post-tonsillectomy complications [1HR] classification cause
 Coagulation disorder of ENT patient [1/2HR] and medical
 Preoperative evaluation for Ear Surgery patients [11/2HR] management of
 Anesthesia management for Ear surgery [1HR] patient with
Group discussion using [1/2HR] coagulation disorder

 Investigation modalities for tonsillectomy patients

363
 Required Reading
Week Learning Activity
(Assignment)

Video show in Skill Development Lab [1/2 Hr.]

o On anatomy of ENT

Clinical Skill Development Lab [1 Hrs.]

o Role play on preoperative assessment of ENT patient
o Role play compassionate and respectful care

Hospital Practice/ Visit [10 Hrs.]

 Order and interpret appropriate investigation for ENT
 Manage nasal intubation
 Manage failed airway using alternative technique
Week 2  Hospital guided practice on tonsillectomy patients
 Perform preoperative evaluation for ear and nose surgery patients

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching
learning process in the presence of their instructors and
coordinators including the department head.

Interactive Lecture [5 Hrs.]

 Anesthesia management of ear surgery [1HR]
 Anesthesia management of nose surgery [1HR]
 Postoperative complication of ear and nose surgery [2HR]
 Introduction to maxillofacial surgery [1HR]

Clinical Skill Development Lab [2 Hrs.]

 Demonstration on anatomic model on air way examination
 Role play on air way examination

Hospital Practice/ Visit [10 Hrs.]

 Manage anesthesia for various types of throat (adino-tonsilar
hypertrophy patients
Week 3
 Manage anesthesia for different kinds of ear and nasal surgery

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching
learning process in the presence of their instructors and
coordinators including the department head.

364
 Required Reading
Week Learning Activity
(Assignment)

Interactive Lecture [5 Hrs.]

 Pathophysiology of Ludwig angina [1HR]
 Airway assessment for patients presented with Ludwig angina
[1HR]

Seminar presentation [1 1/2 Hrs.]

 Common postoperative complications of ENT

Group Discussion [1 1/2 Hrs.]

 Procedures Concerns of Nitrous oxide and other gas for ENT
(ear) surgery
Type, classification and
Week 4 Clinical Skill Development Lab [2Hrs.] medical management of
 Difficult airway management (fiberoptic intubation) maxillofacial fracture patients

Hospital Practice/ Visit [10 Hrs.]

 Perform airway assessment for maxillofacial patients
 Prepare patients for maxillofacial surgery
 Perform nasal intubation for maxillofacial surgical patients
 Perform anesthesia for maxillofacial surgical patients

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching
learning process in the presence of their instructors and
coordinators including the department head.

Interactive Lecture [5 Hrs.]

 Anesthesia management of patients with Ludwig angina [1HR]
 Lefort classification [1/2HR] Reading assignment: on
 Techniques of awake fiberoptic intubation [1 1/2HR] definition, cause and medical
management of adino
Group discussion [1HR] tonsillar hypertrophy,
Week 5 pediatric
 Difficult Airway management (case on Ludwig angina) obstructive sleep apnea
Seminar presentation syndrome and adino
 Awake fiberoptic intubation [1HR] tonsilectomy) patients

Clinical Skill Development Lab [2 Hr.]

 Demonstration on nasal& awake intubation for maxillofacial
patient

365
 Required Reading
Week Learning Activity
(Assignment)

Hospital Practice/ Visit [10 Hrs.]

 Manage anesthesia for different kinds of maxillofacial surgical
patients
 Manage postoperative complications of maxillofacial surgical
patients

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching
learning process in the presence of their instructors and
coordinators including the department head.

Interactive Lecture and Discussion [5 Hr.]

 laser surgery anesthesia and biological effect of laser surgery (1hr)
o PBL (4hrs)

Hospital Practice/ Visit [10 Hrs.]

 Manage anesthesia for different kinds of maxillofacial surgical
patients
 Manage postoperative complications of maxillofacial surgical
Week 6 patients

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching
learning process in the presence of their instructors and
coordinators including the department head.

Interactive Lecture [5 Hrs.]

o Jet ventilation [1/2Hrs.]
Seminar presentation [1 1/2Hrs.]
 Postoperative complications of maxillofacial surgery’s

Clinical Skill Development Lab [2 Hrs.]

Week 7  Demonstration of Jet ventilation on anatomical model

Hospital Practice/ Visit [10 Hrs.]

 Manage anesthesia for different kinds of maxillofacial surgical
patients
 Manage postoperative complications of maxillofacial surgical
patients

366
 Required Reading
Week Learning Activity
(Assignment)

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching
learning process in the presence of their instructors and
coordinators including the department head.

Interactive Lecture [5 Hrs.]

 Introduction to ophthalmic anesthesia [1HR]
 Revision on ocular anatomy and physiology [2HR]
 Effect of anesthesia and adjuvants drugs on IOP [2HR]

Clinical Skill Development Lab [2 Hrs.]

 Role play on Assess and optimize ophthalmic surgical patients
Week 8
Hospital Practice/ Visit [10 Hrs.]
 Hospital based anesthesia practice on ENT patients
 Hospital based anesthesia practice on maxillofacial patients

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching
learning process in the presence of their instructors and
coordinators including the department head.

Interactive Lecture and Discussion [5Hrs.]

 Oculo cardiac reflex (OCR) and anesthesia [2HR]
 Preoperative evaluation for ophthalmic surgical patients [2HR]

Seminar presentation [1HR]

 Anesthetic challenges of ophthalmic procedures

Week 9 Hospital Practice/ Visit [10 Hrs.]

 Preparation on different airway equipment and drugs for
ophthalmic surgery and anesthesia
 Hospital based practice on ophthalmic procedures

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching
learning process in the presence of their instructors and
coordinators including the department head.

367
 Required Reading
Week Learning Activity
(Assignment)

Interactive Lecture [5 Hrs.]

 Regional anesthesia for ophthalmic surgical patients [2 Hrs.]
 IOP and OCR, Factors affecting IOP and postoperative ocular
complications [1 Hrs.]
 Challenges of open eye injury and full stomach in anesthetic
management including anesthesia for Ophthalmic surgical
patients (General anesthesia, Sedation technique) [2 Hrs.]

Clinical Skill Development Lab [2 Hrs.]

 Demonstration on anatomic model on air way examination for
Reading assignment on
anesthesia ophthalmic procedures
infection prevention
Week 10  Anatomical charts and atlas
principles and hand washing
o Computer assisted simulations and video shows
procedures
Hospital practice on [10 Hrs.]

 Guided practice Regional anesthesia (retrobulbar peribulbar)

block for various type of eye procedure
 Hospital based anesthesia practice on ophthalmic procedures

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching
learning process in the presence of their instructors and
coordinators including the department head.

Seminar
 Postoperative anesthetic complication of ophthalmic procedures
[1HR]
PBL [4HR]

Clinical Skill Development Lab [2 Hrs.]

Role play on air way examination for ophthalmic patient
Week 11
Hospital Practice/ Visit [10 Hrs.]
 Guided practice: post-anesthetic care for Ophthalmic surgical
patients
 Guided practice Regional anesthesia (retrobulbar peribulbar)
block for various type of eye procedure
 Hospital based anesthesia practice on ophthalmic procedures

Whole Group Session [2 Hrs.]

368
 Required Reading
Week Learning Activity
(Assignment)
 Students will discuss on the progress of the week’s teaching
learning process in the presence of their instructors and
coordinators including the department head.

Interactive lecture [5 Hrs.]

 Introduction to anesthesia for day case surgery [1/2HR]
 Basic consideration for day case anesthesia service [1 1/2HR]
 Preoperative evaluation for day care patients [1HR]
Group discussion [2HR]
 Anesthetic challenges of day care surgical patients [2HR]

Hospital Practice/ Visit [11 Hrs.]

Week 12
 Hospital based anesthesia practice on day care patients
 Observation and guided practice: Ordering and interpreting
appropriate diagnosing investigation for day case anesthesia and
surgery

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching
learning process in the presence of their instructors and
coordinators including the department head.

Interactive Lecture and Discussion [5 Hrs.]

 Anesthesia management for day care surgical patients [1 1/2Hrs.]
 Pharmacologic and non-pharmacologic optimization strategies
[1Hrs.]
 Postoperative complication of day care surgery [1Hrs.]
 Discharging criteria for day care anesthesia [1/2Hrs.]
Seminar [1 Hrs.]

 Anesthetic challenges of day care surgery [1 Hrs.]

Week 13

Hospital Practice/ Visit [12 Hrs.]

 Observation and guided practice on management of pain using
multimodal analgesia technique for day case surgical patients

Whole Group Session [2 Hrs.]

 Students will discuss on the progress of the week’s teaching
learning process in the presence of their instructors and
coordinators including the department head.
Week 14 EXAM WEEK

369
Remote anesthesia

Module Title: Remote anesthesia

Module Code: AnstM-5331
Module ECTS: 3 ECTS
Module Duration: 14 Weeks

Module Description: This module is designed for third year BSc anesthesia students to create a
learning opportunity ondifferent procedural sedation practices that enable students to apply basic
principles of procedural sedation. This Module will be addressed through Interactive lecture, Seminar
presentations/discussion, Skill Development Lab (SDL) demonstration and supervised feedbacks in
simulated environment and real hospital setting.

Module Objective
At the end of this module, students will be able to provide procedural sedation techniques for
different procedures

Module Competencies
 Perform pre-procedural risk assessment for procedural sedation
 Select a conducive environment for procedural sedation
 Use and interpret monitoring findings during procedural sedation
 Select the appropriate drugs for procedural sedation
 Prepare all the equipment used for procedural sedation
 Provide procedural sedation

Learning Outcomes
In order to achieve core competencies, students at the end of this Module will be able to:
 Define procedural sedation and those patients whom require minimal or moderate sedation
is indicated for
 Identify what equipment, staffing and venue is required before proceeding with the
procedural sedation
 Determine if the benefits of using a sedation agent(s) outweighs the risks

370
  Assess risks for procedural sedation
 Perform patient evaluation for those whom require procedural sedation
 Identify the resources and documentation required for a procedural sedation
 Demonstrate how to interpret key life threatening from the monitoring and how to respond
during procedural sedation
 Plan, prepare and Safely administer oral, intravenous/and intramuscular and inhaled sedation
agents
 Demonstrate basic and advanced airway management
 Demonstrate how to avoid and respond to adverse events of procedural sedation
 Apply those procedural sedation guidelines/sedation scales appropriately
 Safely administration of accredited listed sedation agents
 Consider the discharge criteria is met, provided other medical factors permit
 Work in a collaborative way with the other team members

Prerequisite: None

Teaching-Learning Methods

 Interactive lecture and discussion

 Small group discussion
 Role play
 Case study
 Bedside teaching
 Portfolio
 Clinical simulation
 Demonstration (at skills lab and Basic Sciences lab)
 Guided clinical practice
 PBL cases
 Inter-professional learning experience in the clinics, and community practice
 Seminar Presentations/discussion

Teaching-Learning Materials
 Learning guides and checklists

371
  Text books
 Reference manual
 Writing board
 Posters
 Anatomic models
 LCD Projector
 White board, marker
 Laptop and Videotapes

Methods of Assessment
 Formative
o MCQ, PCE, DOP
o Structured feedback report
o Oral exam
o Logbook
o Portfolio
o And other assessment methods
 Summative
o Progressive/ Continuous assessment:
o Objectively Structured Clinical Examination (OSCE)
o Structured Oral Examination

Content area Theory/ Hospital Skill PBL Self- % Emphasis

Lecture practice lab study
Hr. Hr.
Remote Anesthesia 17 42 5 8 10 100%

372
Module Policy
 Attendance: It is compulsory to attend both SDL and Hospital clinical practice on time and
every time. If students are going to miss more than three classes/ hospital attachment days
during this semester, they will not be allowed to final assessment and next semester unless
otherwise proven by evidence per legislation requirement.
 Assignments: Students must complete module assignments and work-based assessments on
time. Uncompleted work-based assessments and assignments will result in Incomplete (I)
grade submissions to registrar. Further consecutive procedures will be handled in line with
institutional senate legislation.

Reference Books
1. Miller’s anaesthesia volume 1 and 2, 8th Edition. Ronald D. Miller.
2. Understanding Anesthesia Equipment, Jerry A. Dorsch, Fifth Edition
3. Clinical anaesthesia, 6th Edition. Paul G. Barash.
4. Anaesthesia and co-existing disease, 6th Edition. Robert K. Stoelting
5. Clinical anesthesiology, 5th Edition. G. Edward Morgan

373
 Module Schedule
Duration: 20 Weeks (Hospital Practice will be Parallel to Classroom-based teaching)
Required Reading
Week Learning Activity
(Assignment)
Interactive Lecture definition and indication of procedural sedation [2 Hrs.] Reading
 Urinary Catheterization Assignment on:
 Lumbar puncture 
 Radiography suite (CT, MRI and interventional radiology)
 Joint aspiration
 Sexual assault examinations
 Eye examinations
 biopsy
 Vascular access

Hospital Practice/ Visit [3 Hrs.]

Week 1
 Assess risks for procedural sedation:
 Significant risk of delayed of gastric emptying or vomiting
 Significant respiratory disease
 Significant cardiovascular impairment
 Abnormal conscious status/risk of raised ICP
 Immunosuppression
 Significant liver disease/liver failure
 Acute systemic infection
 Perform patient evaluation for those whom require procedural sedation
Reading
Week 2 Interactive Lecture definition and indication of procedural sedation [1 Hrs.] Assignment on:
 Burn dressings 
 Extensive wound care
 Elective cardioversion
 ECT
 Extracorporal shock wave lithotripsy (ESWL)
 Dental surgery
Discussion on staffing, venue, equipment own safety for procedural
sedation 1 hour

Hospital Practice/ Visit [3 Hrs.]

 Assess risks for procedural sedation
 Perform patient evaluation for those whom require procedural sedation
 Identify the resources and documentation required for a procedural
sedation
 Demonstrate how to interpret key life threatening from the monitoring
and how to respond during procedural sedation

374
 Required Reading
Week Learning Activity
(Assignment)
 Plan, prepare and Safely administer oral, intravenous/and intramuscular
and inhaled sedation agents
 Demonstrate basic and advanced airway management
 Demonstrate how to avoid and respond to adverse events of procedural
sedation
 Apply those procedural sedation guidelines/sedation scales appropriately
 Safely administration of accredited listed sedation agents

PBL [2Hrs.]

Hospital Practice/ Visit [3 Hrs.]

 Assess risks for procedural sedation
 Perform patient evaluation for those whom require procedural sedation
 Identify the resources and documentation required for a procedural
Week 3 sedation
 Demonstrate how to interpret key life threatening from the monitoring
and how to respond during procedural sedation
 Plan, prepare and Safely administer oral, intravenous/and intramuscular
and inhaled sedation agents
 Demonstrate basic and advanced airway management
 Demonstrate how to avoid and respond to adverse events of procedural
sedation
 Apply those procedural sedation guidelines/sedation scales appropriately
 Safely administration of accredited listed sedation agents
Case studies on patient risk assessment for procedural sedation (2 Hr.)
 Assess risks for procedural sedation:
 Significant risk of delayed of gastric emptying or vomiting
 Significant respiratory disease
 Significant cardiovascular impairment
 Abnormal conscious status/risk of raised ICP
Week 4  Immunosuppression
 Significant liver disease/liver failure
 Acute systemic infection
 Perform patient evaluation for those whom require procedural sedation

Hospital Practice/ Visit [3 Hrs.]

 Assess risks for procedural sedation
 Perform patient evaluation for those whom require procedural sedation

375
 Required Reading
Week Learning Activity
(Assignment)
 Identify the resources and documentation required for a procedural
sedation
 Demonstrate how to interpret key life threatening from the monitoring
and how to respond during procedural sedation
 Plan, prepare and Safely administer oral, intravenous/and intramuscular
and inhaled sedation agents
 Demonstrate basic and advanced airway management
 Demonstrate how to avoid and respond to adverse events of procedural
sedation
 Apply those procedural sedation guidelines/sedation scales appropriately
 Safely administration of accredited listed sedation agents
 Consider the discharge criteria is met, provided other medical factors
permit
 Work in a collaborative way with the other team members
Discussion on advantages and disadvantages of procedural sedation (30
minutes)
Interactive lecture on procedural sedation guideline and sedation scales
(1Hr. and 30minutes.)

Hospital Practice/ Visit [3 Hrs.]

 Assess risks for procedural sedation
 Perform patient evaluation for those whom require procedural sedation
 Identify the resources and documentation required for a procedural
sedation
 Demonstrate how to interpret key life threatening from the monitoring
Week 5 and how to respond during procedural sedation
 Plan, prepare and Safely administer oral, intravenous/and intramuscular
and inhaled sedation agents
 Demonstrate basic and advanced airway management
 Demonstrate how to avoid and respond to adverse events of procedural
sedation
 Apply those procedural sedation guidelines/sedation scales appropriately
 Safely administration of accredited listed sedation agents
 Consider the discharge criteria is met, provided other medical factors
permit
 Work in a collaborative way with the other team members
Skill lab demonstration during assessment on pre-procedural risk
assessment (1 Hr.)
 Assess risks for procedural sedation:
 Significant risk of delayed of gastric emptying or vomiting

376
 Required Reading
Week Learning Activity
(Assignment)
Week 6  Significant respiratory disease
 Significant cardiovascular impairment
 Abnormal conscious status/risk of raised ICP
 Immunosuppression
 Significant liver disease/liver failure
 Acute systemic infection
 Perform patient evaluation for those whom require procedural sedation

 Skill lab demonstration on identifying and preparing

resources/equipment and drugs 1hour

Hospital Practice/ Visit [3 Hrs.]

 Assess risks for procedural sedation
 Perform patient evaluation for those whom require procedural sedation
 Identify the resources and documentation required for a procedural
sedation
 Demonstrate how to interpret key life threatening from the monitoring
and how to respond during procedural sedation
 Plan, prepare and Safely administer oral, intravenous/and intramuscular
and inhaled sedation agents
 Demonstrate basic and advanced airway management
 Demonstrate how to avoid and respond to adverse events of procedural
sedation
 Apply those procedural sedation guidelines/sedation scales appropriately
 Safely administration of accredited listed sedation agents
 Consider the discharge criteria is met, provided other medical factors
permit
 Work in a collaborative way with the other team members
Discussion on staffing, venue, equipment own safety for procedural
sedation (1 Hr.)
Skill lab on Posters of monitoring findings demonstration (1 Hr.)

Hospital Practice/ Visit [3 Hrs.]

Week 7  Assess risks for procedural sedation
 Perform patient evaluation for those whom require procedural sedation
 Identify the resources and documentation required for a procedural
sedation
 Demonstrate how to interpret key life threatening from the monitoring
and how to respond during procedural sedation

377
 Required Reading
Week Learning Activity
(Assignment)
 Plan, prepare and Safely administer oral, intravenous/and intramuscular
and inhaled sedation agents
 Demonstrate basic and advanced airway management
 Demonstrate how to avoid and respond to adverse events of procedural
sedation
 Apply those procedural sedation guidelines/sedation scales appropriately
 Safely administration of accredited listed sedation agents
 Consider the discharge criteria is met, provided other medical factors
permit
 Work in a collaborative way with the other team members
PBL (2 Hrs.)

Hospital Practice/ Visit [3 Hrs.]

 Assess risks for procedural sedation
 Perform patient evaluation for those whom require procedural sedation
 Identify the resources and documentation required for a procedural
sedation
 Demonstrate how to interpret key life threatening from the monitoring
and how to respond during procedural sedation
Week 8
 Plan, prepare and Safely administer oral, intravenous/and intramuscular
and inhaled sedation agents
 Demonstrate basic and advanced airway management
 Demonstrate how to avoid and respond to adverse events of procedural
sedation
 Apply those procedural sedation guidelines/sedation scales appropriately
 Safely administration of accredited listed sedation agents
 Consider the discharge criteria is met, provided other medical factors
permit
 Work in a collaborative way with the other team members
Case studies on planning and preparing the drugs for procedural sedation (2
Hr.)

Hospital Practice/ Visit [3 Hrs.]

Week 9
 Assess risks for procedural sedation
 Perform patient evaluation for those whom require procedural sedation
 Identify the resources and documentation required for a procedural
sedation
 Demonstrate how to interpret key life threatening from the monitoring
and how to respond during procedural sedation

378
 Required Reading
Week Learning Activity
(Assignment)
 Plan, prepare and Safely administer oral, intravenous/and intramuscular
and inhaled sedation agents
 Demonstrate basic and advanced airway management
 Demonstrate how to avoid and respond to adverse events of procedural
sedation
 Apply those procedural sedation guidelines/sedation scales appropriately
 Safely administration of accredited listed sedation agents
 Consider the discharge criteria is met, provided other medical factors
permit
 Work in a collaborative way with the other team members
Skill lab demonstration on basic and advanced airway management (2
Hrs.).

Hospital Practice/ Visit [3 Hrs.]

 Assess risks for procedural sedation
 Perform patient evaluation for those whom require procedural sedation
 Identify the resources and documentation required for a procedural
sedation
 Demonstrate how to interpret key life threatening from the monitoring
Week 10 and how to respond during procedural sedation
 Plan, prepare and Safely administer oral, intravenous/and intramuscular
and inhaled sedation agents
 Demonstrate basic and advanced airway management
 Demonstrate how to avoid and respond to adverse events of procedural
sedation
 Apply those procedural sedation guidelines/sedation scales appropriately
 Safely administration of accredited listed sedation agents
 Consider the discharge criteria is met, provided other medical factors
permit
 Work in a collaborative way with the other team members
PBL (2 Hrs.)

Hospital Practice/ Visit [3 Hrs.]

Week 11
 Assess risks for procedural sedation
 Perform patient evaluation for those whom require procedural sedation
 Identify the resources and documentation required for a procedural
sedation

379
 Required Reading
Week Learning Activity
(Assignment)
 Demonstrate how to interpret key life threatening from the monitoring
and how to respond during procedural sedation
 Plan, prepare and Safely administer oral, intravenous/and intramuscular
and inhaled sedation agents
 Demonstrate basic and advanced airway management
 Demonstrate how to avoid and respond to adverse events of procedural
sedation
 Apply those procedural sedation guidelines/sedation scales appropriately
 Safely administration of accredited listed sedation agents
 Consider the discharge criteria is met, provided other medical factors
permit
 Work in a collaborative way with the other team members
Discussion on adverse events of procedural sedation (1 Hr.)
Interactive Lecture on procedural sedation guideline and sedation scales (1
Hr.)
PBL 2 Hr

Hospital Practice/ Visit [3 Hrs.]

 Assess risks for procedural sedation
 Perform patient evaluation for those whom require procedural sedation
 Identify the resources and documentation required for a procedural
sedation
 Demonstrate how to interpret key life threatening from the monitoring
Week 12 and how to respond during procedural sedation
 Plan, prepare and Safely administer oral, intravenous/and intramuscular
and inhaled sedation agents
 Demonstrate basic and advanced airway management
 Demonstrate how to avoid and respond to adverse events of procedural
sedation
 Apply those procedural sedation guidelines/sedation scales appropriately
 Safely administration of accredited listed sedation agents
 Consider the discharge criteria is met, provided other medical factors
permit
 Work in a collaborative way with the other team members
Interactive Lecture on pharmacology of sedative drugs (2 Hrs.)
Week 13

380
 Required Reading
Week Learning Activity
(Assignment)

Hospital Practice/ Visit [3 Hrs.]

 Assess risks for procedural sedation
 Perform patient evaluation for those whom require procedural sedation
 Identify the resources and documentation required for a procedural
sedation
 Demonstrate how to interpret key life threatening from the monitoring
and how to respond during procedural sedation
 Plan, prepare and Safely administer oral, intravenous/and intramuscular
and inhaled sedation agents
 Demonstrate basic and advanced airway management
 Demonstrate how to avoid and respond to adverse events of procedural
sedation
 Apply those procedural sedation guidelines/sedation scales appropriately
 Safely administration of accredited listed sedation agents
 Consider the discharge criteria is met, provided other medical factors
permit
 Work in a collaborative way with the other team members
Week 14 Examination week

381
Leadership and management

Module Code: SPHM-5342

Module ECTS: 4 ECTS
Module Duration: 20 Weeks

Module Description: This Module is designed for anesthesia students to equip with the knowledge,
skill and attitude needed to apply the principles of health policy, management and leadership in a
culturally sensitive manner with full participation of the community and other stakeholders. This
Module includes health service management, health economics and health informatics and will be
addressed through interactive lecture, Seminar presentations in class room teaching and structured
feedbacks in various health sectors and real community setup.

Module Objective
At the end of this module, students will be able to apply principles and methods of management and
leadership for effective and efficient management of the Ethiopian healthcare system.

Module Competencies
The core professional competencies where this practice Module aimed at achieving are:
10. Analyze the concept of development and organization of the health system
11. Apply the concept of management and leadership in the health sector
12. Ensure adequate health services coverage, utilization and quality
13. Apply the principles of health informatics in Anesthesia practice

Learning Outcomes
In order to achieve core competencies, students at the end of this Module will be able to:
 Describe the Ethiopian health system including historical development, organization,
structure, approaches, policy, strategy, regulations and programs
 Apply principles and functions of management as well as leadership in the health sector
 Apply the principles of economics in the health sector including issues of equity and financing
 Describe the principles and components of the national health management information
system
 Analyze the concepts of health care coverage, utilization and quality with focus in the
Ethiopian health system

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  Demonstrate skills for effective communication with individuals, families, communities,
health sector staff, local leadership and development partners with sensitivity to personal and
cultural factors for the promotion of health and prevention of diseases
 Demonstrate professional values and behavior in interaction with individuals, families and
communities
 Demonstrate key public health values, attitudes and behaviors such as commitment to equity
and social justice, recognition of the importance of the health of the community as well as the
individual, and respect for diversity, self-determination, empowerment, and community
participation
 Show respect for peers and other healthcare professionals and the ability to foster a positive
collaborative relationship with them
 Demonstrate a habit of self-reflection, responsiveness to feedback and an on-going
development of new skills, knowledge and attitude
 Search, collect, organize and interpret health and health-related information from different
sources
 Use information and communication technology to assist in health promotion and disease
prevention measures for individuals and families

Prerequisite: none
Duration: 19 weeks
Teaching-Learning Methods
 Interactive lecture and discussion
 Small group learning activities: assignment, exercise, case study, game, role play
 Individual reading
 PHCU/Community-based learning and study trip: home visit, discussion with individuals and
families to identify and solve problems, observation, PHCU visit, Zonal and District Health
Department Visit, field visit, and targeted literature review based on community experience
 Student presentation
 Reflective portfolio and mentoring
Teaching-Learning Materials
 AV aids (LCD and computer or Overhead projector and transparencies, writing board and
marker or chalk)

383
  Handouts of lecture materials
 Logbooks for entry of community experience
References (textbooks and articles)
1. Management Sciences for Health (MSH). Managers who lead. MSH, 2005.
2. Wagstaff A, Van Doorslaer E. Equity in the finance and delivery of health care. 1995.
3. Shaw RP, Griffin CC. Financing health care in Sub-Saharan Africa through user fees and
insurance. The World Bank, 1995.
3. Drumond MF, Stoddart CL, Torrance GW. Methods for the economic evaluation of health
care programs. 1993: 39 - 54.
4. Jira C. Health planning for health science students. Carter Center; 2003.
5. Jira C, Feleke A, Mitike G. Health services management for health science students. Carter
Center; 2003.
6. Berhane Y, Haile Mariam D, Kloos H. The epidemiology and ecology of health and disease in
Ethiopia. Addis Ababa; Shama Books, 2006.
7. Haile Mariam D. Exploring Alternatives for Financing Health Care In Ethiopia: An
Introductory Review Article.Ethiop J Health Dev2001;15(3):153-163.
8. Pankhurst R. An introduction to medical history of Ethiopia, with a postscript by Asrat
Woldeyes. Trenton, New Jersey; 1990.
9. Walt G, Vaughan P. An Introduction to the Primary Health Care Approach in Developing
Countries: A Review with Selected Annotated References. Ross Institute of Tropical Hygiene:
London School of Hygiene and Tropical Medicine; 1981.

Assessment Methods
Formative assessment
27. Exercise and assignment
28. Logbook and portfolio/community visit
29. Student presentation
30. Global rating of community experience midway during the module
Summative assessment
31. Reflective portfolio /community visit (10 %)
32. Quiz = 10%

384
 33. Test=15
34. Assignment and student presentation (15%)
35. Final Written exam (50%)

Module policy
Attendance: It is compulsory to attend a class on time and every time. If students are going to miss
more than three classes during the term, he/she should not take this Module.
Assignments: the student must do their assignment on time. No late assignment will be accepted.
Tests/Quizzes: There will be short quizzes and tests almost every week. If a student misses the class
or, are late to class, he/she will miss the quiz or test. No makeup tests or Quizzes will be given. The
students are expected to observe the rules and the regulations of the University as well.

385
 Module Schedule
Week Contents Teaching/Learning
Activities
Week 1 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]

Introduction to the module (2hrs)

Introduction to health policy and management
 Definitions, principles and concepts of management, leadership and
governance theories of change
Primary health care or community visit (2 hrs.)

Introduction to the community and assignment of individual homes in their

respective team
Week 2 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]

 Management and environment Types, skills and roles of managers

Main functions of management
 Policies, strategies and programs during various periods
 Concepts and applications of leadership in the health sector

Primary health care or community visit (2hrs.)

 Community engagement and assignment of individual homes in their

respective team
Week 3 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]

Functions of Management
o Health management with focus to the Ethiopian health system (planning
and organizing)

Primary health care or community visit (2hrs.)

o Community engagement and assignment of individual homes in their

respective team
Week 4 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]

Functions of Management continued

Health management with focus to the Ethiopian health system

(Implementation)

Primary health care or community visit (2hrs.)

Community engagement and assignment of individual homes in their

respective team

386
Week Contents Teaching/Learning
Activities
Week 5 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]

Functions of Management continued

Health management with focus to the Ethiopian health system

(Monitoring and Evaluation)

Primary health care or community visit (2hrs.)

Community engagement and assignment of individual homes in their

respective team

Week 6 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]

o Approaches in organization and delivery during various periods (modern

health services, basic health services, PHC, SWAP); Initiatives in health
development (including SDGs, PASDEP)

Primary health care or community visit (2hrs.)

o Community engagement and assignment of individual homes in their

respective team
Week 7 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]

o Three tier of health system

Primary health care or community visit (2hrs.)

Community engagement and assignment of individual homes in their

respective team

Week 8 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]

o Three tier of health system continued

Primary health care or community visit (2hrs.)

o Community engagement and assignment of individual homes in their

respective team
Week 9 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]

o Concepts and applications of leadership in the health sector (Managing a

health team)
Primary health care or community visit (2hrs.)

o Community engagement and assignment of individual homes in their

respective team

387
Week Contents Teaching/Learning
Activities
Week 10 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]
Management of finance, HRH, time and material resources (Managing
resources)
 Health management with focus to the Ethiopian health system (planning,
organizing implementation, monitoring and evaluation)
 The concept of coverage and patterns of health care utilization (including
organization and use of the referral system
Primary health care or community visit (2hrs.)

 Community engagement and assignment of individual homes in their

respective team
Week 11 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]
 Quality of health care
 Management of finance, Management of change, Drug HRH, time, space
and material resources
Primary health care or community visit (2hrs.)

 Community engagement and assignment of individual homes in their

respective team
Week 12 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]
o Introduction to health economics
Definition, concepts, principles of health economics
o Application of economics to the health sector
o Demand and supply in the health sector
Primary health care or community visit (2hrs.)

o Community engagement and assignment of individual homes in their

respective team
Week 13 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]
o Issues of equity in the health sector
o Methods of economic evaluation and costing of health care programs
o Principles and types of healthcare financing
o Healthcare financing in Ethiopia

Primary health care or community visit (2hrs.)

o Community engagement and assignment of individual homes in their

respective team
Week 14 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]
 Introduction to computer
 Data representation and number system

388
Week Contents Teaching/Learning
Activities
Computer lab [2 Hrs.]

Identify the types of computer

Observe and identify the components of computer
Distinguish inputs with output devices
Observe the processing devices
Week 15 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]
 Health informatics terminologies Information management
 Introduction to telemedicine and tele-education
 Health Information Systems Overview

Computer lab [2 Hrs.]

 Practice on Microsoft word

 Practice on Microsoft excel, Formula, table, graph
 Demonstrate GUI (graphical user interface)
Week 16 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]
 Routine health information System
 Clinical Information System EMR
 Patient Monitoring Systems CDSS

Computer lab [2 Hrs.]

 Demonstrate CMD
 Demonstrate Utility software
 Demonstrate basic types of application software
Week 17 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]
 Information retrieval & EBM
 Information and computer ethics

Computer lab [2 Hrs.]

 Computer network overview

 Types of computer network
Week 18 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]
o Introduction to HIS
o Types of HIS
o Building blocks of HIS
o Principles and components of HMIS

Computer lab [2 Hrs.]

389
Week Contents Teaching/Learning
Activities
 Overview on the internet Web
 Tools and service on the internet
Week 19 Classroom based Teaching (lecture, + seminars + group discussion) [4hrs.]
o Ethical and legal issues in HMIS
o Application of IT in the analysis and management of health systems
o Ethiopian HMIS

Computer lab [2 Hrs.]

Purposes of the internet Browsers component

Operating system installation
Week 20 Exam week

390
Neurosurgery Anesthesia module

Module Title: Neurosurgery Anesthesia module

Module Code: AnstM-5351
Module ECTS: 7 ECTS
Module Duration: 14 Weeks

– Module Description: This module is designed for post basic anesthesia students. Students are
expected to describe the application of anatomy, physiology and the anesthetic techniques in
Neuro-surgery. The learner should also demonstrate skills needed to manage emergency neuro-
surgery cases. This Module will be addressed through Interactive lecture, Seminar presentations,
Skill Development Lab (SDL) demonstration, supervised feedbacks in simulated environment
and real hospital setting. The learners are also expected to demonstrate effective communication
with patients in order to relive anxiety and other specialty in order to manage neurosurgical
patients.
Module Objective
At the end of this module, students should be
Able to Provide Anesthesia for Neurosurgery

Module Competencies
Provide Anesthesia for Neurosurgery

Learning Outcomes
In order to achieve core competencies, students at the end of this Module will be able to:
 Describe Applied neuro- anatomy and physiology
 Discuss regulation of cerebral blood flow
 Explain intracranial pressure
 Explain Effect of Anesthetic Agents on Cerebral Physiology
 Explain adjuvant Pharmacology relevant to neuro-anesthesia
 Identify cerebral protection method
 Discuss Clinical investigation and monitoring in neuro anesthesia
 Participate Preoperative assessment of neuro surgery patient
 Describe Positioning and its effect in neuro- surgery

391
  Explain Management of intracranial hypertension
 Participate in anesthesia consideration for supratentorial and posterior fossa surgery
 participate anesthesia consideration for pituitary and Epilepsy surgery
 Discuss anesthesia consideration Surgery of spine and spinal cord
 Explain awake craniotomy
 Participate management of pediatric emergency neuro surgery
 Participate Management of Anesthesia for emergency neurosurgical procedure
 Provide post-operative Anesthetic care for neuro surgery
 Communicate with patients in order to relive anxiety, interdisciplinary communication in
order to manage patients and Perform appropriately under stressful situation.

Prerequisite: None

Teaching-Learning Methods

 Interactive lecture and discussion

 Small group discussion
 Case study
 Bedside teaching
 Video show
 Demonstration (at skills lab and Basic Sciences lab)
 Guided clinical practice
 PBL cases
 Inter-professional learning experience in the clinics, and community practice
 Seminar Presentations
 Hospital based practice
.

Teaching-Learning Materials
 Learning guides and checklists
 Text books
 Reference manual
 Writing board

392
  Posters
 Anatomic models
 LCD Projector
 White board, marker
 Laptop and Videotapes

Methods of Assessment
 Formative
o essay exams, quizzes, and practical test (direct observation of skills)
o Structured feedback report
o Oral exam
o Logbook
o And other assessment methods
 Summative
o Progressive/ Continuous assessment (10%):
o MCQ (50%)
o Structured Oral Examination (10%)
o Practical clinical evaluation (PCE)(10%)
o Case based discussion (CBD)(10%)
o Directly observed procedure (DOP (10%)
 Percentage allocation:
Content area Theory/ Hospital PBL Self- % Emphasis
Lecture practice study
Hr. Hr.
Anesthesia for Neuro- 49 117 8 19 100%
surgery

Module Policy
 Attendance: It is compulsory to attend student in class, SDL and 100 %Hospital clinical
practices on time and every time. If students are going to miss more than three classes/ one

393
 hospital attachment days during this semester, they will not be allowed to final assessment and
next year unless otherwise proven by evidence per legislation requirement.
 Assignments: Students must complete module assignments and work based assessments on
time. Uncompleted work-based assessments and assignments will result in Incomplete (I)
grade submissions to registrar. Further consecutive procedures will be handled in line with
institutional senate legislation.

Reference Books
1. G.edward morgan, clinical Anesthesiolgy, 5th Edition (MCGRAW-Hill companies,Inc,2013

2. PaulG Barsh, clinical anaesthesia (8th edition).Lippincot willams and Wilkins publications, inc, 2017
3. Rolland D miller, millers anaesthesia (8th edition),Churchill Livingston publication and,an imprint
of elisever,2015
4. Hemanshu prabhakar .Essentials of Neuroanesthesia,2017
5. Hemanshu prabhakar. Complication of Neuroanesthesia, 2016
6.David chambers,christophers Huang and Gareth Matthews .Basic physiology for anesthetist,2015
7. PaulG Barsh.Hand book of clinical anesthesia(6th edtion),2009

394
 Module Schedule
Duration: 20 Weeks (Hospital Practice will be Parallel to Classroom-based teaching)
Required
Week Learning Activity Reading
(Assignment)
Overview of the Module [1Hrs.] Reading
 Structure and design Assignment
 Education strategies on:
 Core competencies 
 Teaching and learning methods
 Assessment methods

Interactive lecture neuro anatomy(1hour)

 Review important anatomical structure of brain

 Frontal surface of brain
Week  Lateral surface of brain
1  Medial surface of the brain
 Cerebral lobes

Group discussion and presentation brain stem structure (1hr)

Interactive neurophysiology(1hr)

CEREBRAL METABOLISM

Cerebral oxygen consumption

Assessment

 MCQ

Hospital based practice(9hr)

Interactive neurophysiology(1hr)

CEREBRAL PERFUSION PRESSURE

CEREBRAL BLOOD FLOW ( CBF )

Week Assessment
2
 MCQ

Group discussion and presentation Cerebral fluid dynamics and physiology

(1hr)

395
 Required
Week Learning Activity Reading
(Assignment)
Interactive Lecture Regulation of cerebral blood flow(1hr)

 Cerebral auto regulation

 cerebral perfusion pressure
 Intrinsic factors controlling CBF

seminar on extrinsic factor that affect cerebral regulation(1hr)

 respiratory gas tension
 temperature
 viscosity
 CMRO2 ( regional CBF )
 ANESTHETIC DRUGS

Hospital based practice(9hr)

Seminar Presentation on intracranial pressure (1hr)

o Definition of ICP
o ICP range in each age group
o Factor that increase ICP

Interactive Lecture effect of anesthetic agents on cerebral physiology (2hour)

 Inhalational anesthetic agent

 Intravenous anesthetic agent

Thiopental

Propofol
Week
Ketamine
3
Etomidat

Neuro muscular blocking agent

Group discussion and presentation on

Benzodiazpines ,opioids, Anticholinergic and

cholinergic (1hr)

Hospital based practice(9hr)

396
 Required
Week Learning Activity Reading
(Assignment)
Interactive Lecture adjuvant pharmacology relevant to neuro-surgery (1hr)

 vasopressors
 vasodilators
 diuretics
 Corticosteroids.
 Anticonvulsants
 Fluid management

Group discussion and presentation osmotic therapy(30minute)

Assessment

o Practical clinical evaluation (PCE)

o Directly observed procedure

MCQ

Interactive Lecture cerebral protection (1hr)

 drug
Week
 hyperventilation
4
 hypothermia
 hypotension

Seminar presentation induced hypotension(30minute)

Interactive Lecture clinical investigation and monitoring in neuro anesthesia(1hr)

clinical investigation

CBC, Electrolyte ,ECG ,Blood glucose, CT scan ,MRI

Monitoring

 Standard monitoring
 Central venous access
 Monitoring visual evoked potentials
 direct intraarterial pressure monitoring and bladder catheterization
 Trans esophageal echocardiography

Hospital based practice(9hr)

PBL [2 Hrs.]

397
 Required
Week Learning Activity Reading
(Assignment)
Week Case study investigation on patient for neuro –surgery(1hr)
5
Interactive Lecture preoperative assessment of neuro surgery patient(1hr)

 History and physical examination

 Investigation
 Preoperative order Informed consent

Demonstrate history taking and physical examination Neuro surgery patient(2hr)

ASSESSMENT

 PCE,CBD

Hospital based practice(8hr)

PBL(2hr)

Group discussion Presentation positioning and its effect on neuro surgery(1hr)

 Principle of positioning
 Surgical approach of craniotomies
 positioning: supine, prone, sitting
 effect of positioning on neuro -surgery and consideration
Week
6 Video on neurosurgery patient positioning(1hr)

ASSESSMENT

PCE,CBD

Hospital based practice(9hr)

interactive Lecture management of intracranial hypertension(1hr)

 Clinical indicator of increase ICP

Week  Factor aggravate intracranial hypertension
7  Treatment of Intracranial Hypertension
 Tight brain checklist

Case study on Intracranial hypertension(1hr)

398
 Required
Week Learning Activity Reading
(Assignment)
Interactive lecturer anesthesia for supra-tentorial (2hr )

 Classification
 Patho physiology and clinical relation
 Intra operative management
 Premedication
 Induction
 Maintenance
 Emergence

Assessment

 PCE,CBD,DOP

Hospital based practice(9hr)

Group discussion Presentation intra-operative air embolism(1hr)

Interactive Lecture posterior fossa surgery(2hour)

 Clinical presentation
 Preoperative preparation patient for posterior fossa surgery
 Special consideration posterior fossa surgery
 Postoperative management

Case study surgery on posterior fossa(Brain stem injury) surgery(1 Hr)

Interactive lecturer anesthesia consideration pituitary surgery(1hour)
Week
8  Approach of pituitary surgery
 Anesthetic management
 complication

Assessment

MCQ,PCE,CBD

Hospital based practice(9hr)

399
 Required
Week Learning Activity Reading
(Assignment)
Case study diabetes insipidus (1hr)

Seminar presentation anesthesia consideration awake craniotomy(1hour)

 Indication of awake craniotomy

 Drug selection
 premedication
 Induction
 Maintenance
Week
9 Interactive Lecturer neuro emergency(2hour)

 General principle of head injury and anesthesia

 GCS assessment
 Subdural hematoma
ASSESMENT
 MCQ,PCE,CBD,DOP

Hospital based practice(9 hr)

Interactive lecture anesthesia consideration surgery on spine and spinal cord
(2hour)

 Common spine disorder

 Types of spine surgery
 Positioning for spine surgery
 Anesthetic management

Group discussion and Presentation type of monitoring surgery on spine and

spinal cord(1hr)
Week
 Motor evoked potential
10
 Somato-sensory evoked potential
 Visual evoked potential

Interactive Lecturer management anesthesia for emergency neurosurgical

procedure(1hour)

 Epidural hematoma
ASSESMENT
 MCQ,PCE,CBD

Hospital based practice(9 hr)

400
 Required
Week Learning Activity Reading
(Assignment)
Week PBL(2hr)
11
Interactive Lecturer management anesthesia for emergency neurosurgical
procedure(1hour)

 Subdural hematoma
ASSESSMENT

MCQ,,CBD

Case study management of head injury (1hr)

ASSESSMENT

PCE,CBD,D0P

Hospital based practice(8 hr)

Mechanisms of neuro protection (1hour)

Group discussion indication of mechanical ventilator for neurosurgery

patient(1hr)
Reading
ASSESSMENT
assignment
Week
MCQ,PCE,CBD Anesthesia
12
for stereo-
static surgery
PBL(2hr)

Hospital based practice(5hr)

Anesthesia for Intracranial Aneurysms & Arteriovenous Malformations (4hr)

Interactive lecture on
Week Criteria for
Cerebral aneurism
13 Brain death
Ischemic stroke

Hospital based practice(9hr)

Week
Examination Week
14

401
Team Training Program

Attachment Title: Team training program (TTP)

Module Code: AnstM-5382
Module ECTS: 4 ECTS
Module Duration: 4 Week (block)

Attachment Description: This TTP attachment is intended to provide medical interns experiential
learning opportunities while providing primary health care services by teaming up with other health
professionals. This supervised practice covers both clinical and public health tasks.

Attachment Objective
At the end of this attachment the medical intern will be able to provide essential clinical and public
health services in primary health care setting in the context of effective teamwork with other healthcare
students.

Supporting Objectives
 Diagnose and manage patients at the primary health care unit level in an ethical and efficient
manner (KSA4)
 Diagnose and manage common infectious diseases and nutritional deficiencies (KSA4)
 Recognize immediate life-threatening conditions, institute appropriate first-line treatment and
arrange referral for those who require higher level of care (KSA4)
 Provide basic and comprehensive emergency obstetric care available at PHCU level (KSA4)
 Provide continued care for patients with common chronic health conditions (KSA4)
 Identify and refer patients who require higher level of care (KSA4)
 Provide comprehensive reproductive health/maternal and child health services (KSA4)
 Perform minor surgical and obstetric procedures (S4)
 Perform and interpret basic laboratory tests (S4)
 Identify priority community health problems and hazards and their determinants (K4)
 Design and implement effective and feasible health promotion and disease prevention
interventions (KSA4)
 Design and implement health education sessions on priority health issues (KSA4)
 Interact with other healthcare professionals through effective teamwork (SA4)

402
  Lead and manage healthcare team and health services at PHCU level (KSA4)
 Mobilize community partnerships and action to identify and solve community health problems
(KSA4)
 Evaluate effectiveness, efficiency, accessibility, equitability, and quality of health services (K4)
 Communicate effectively with individuals, families, communities, PHCU staff, local health
department staff, peers and faculty (S4)
 Interact with individuals and families with sensitivity to personal and cultural factors (SA4)
 Advise individuals and families to promote health and prevent illness (KS4)
 Demonstrate professional values and behavior in interaction with individuals, families and
communities consistent with the future role of a physician (A4)
 Demonstrate key public health values, attitudes and behaviors such as commitment to equity
and social justice, recognition of the importance of the health of the community as well as the
individual, and respect for diversity, self-determination, empowerment, and community
participation (A4)
 Show respect for peers and other healthcare students and professionals and the ability to foster
a positive collaborative relationship with them (A3)
 Analyze community practice experience and perform practice-based improvement activities
using a systematic methodology (K4)
 Use information technology to manage information, access online medical information, and
support one’s own education (K4)
 Demonstrate a habit of self-reflection, responsiveness to feedback and an on-going
development of new skills, knowledge and attitude (A3)
 Search, collect, organize and interpret health and health-related information from different
sources (KS4)
 Use information and communication technology to assist in health promotion and disease
prevention measures for individuals and families (K3)
Duration: 8 weeks
Pre-requisite: Clerkship II and III
Teaching-Learning Methods
 Community survey
 Mini-project
 Supervised clinical practice
 Supervised community practice

403
  Portfolio
 PRRE
Teaching-Learning Materials
 David Sprigings, John B. Chambers. Acute medicine: a practical guide to the management of
medical emergencies / – 4th edition.
 Ferri. Ferri's Clinical Advisor, 1st edition. 2009
 Dan L Long (et al.) Harrison’s principles of medicine. 18th edition. 2012
 Goldman. Cecil Medicine. 23rd edition. 2007
 Bailey and Love’s Short Practice of Surgery. 25th ed. [edited by] Norman J Williams,
Christopher J.K. Bulstrode, P Ronnan O’Connell. 2008
 Courtney M. Townsend Jr. [et al.]. Sabiston textbook of surgery: the biological basis of modern
surgical practice. —19th ed. 2012
 Schwartz, Principles of Surgery. 9th edition.2010
 WHO. District hospital essential surgical skills manual.
 Eddleston, Michael; Davidson, Robert; Brent, Andrew; Wilkinson, Robert. Oxford Handbook
of Tropical Medicine, 3rd Edition. 2008
 Hillard, Paula J. Adams. 5-Minute Obstetrics & Gynecology Consult. The 1st Edition. 2008
 Current Diagnosis & Treatment Obstetrics & Gynecology, Tenth Edition. 2007
 Nelson Text book of Pediatrics, 19th edition
 Nelson essentials of pediatrics. 6th edition
 Jira C, Feleke A, Mitike G. Health services management for health science students. Carter
Center; 2003.
 Berhane Y, Haile Mariam D, Kloos H. The epidemiology and ecology of health and disease in
Ethiopia. Addis Ababa; Shama Books, 2006.
 Rothman. Modern epidemiology
 Daniel: Biostatistics: A foundation for analysis in health sciences.
 Pagano: Principles of Biostatistics
 Management Sciences for Health (MSH). Managers who lead. MSH, 2005.
 Walt G, Vaughan P. An Introduction to the Primary Health Care Approach in Developing
Countries: A Review with Selected Annotated References. Ross Institute of Tropical Hygiene:
London School of Hygiene and Tropical Medicine.
1981.http://books.google.com.et/books/about/An_Introduction_to_the_Primary_Health_
Ca.html?id=qkaIAAAACAAJ
 Carl Fertman and Diane Allensworth. Health promotion programs: from theory to practice.
2010
 Lawrence Green, Marshall Kreuter. Health program planning: an educational and ecological
approach. Volumes 1-2. 2005
 Jackie Green, Keith Tones. Health promotion: planning and strategies. 2010
 Mark Edberg. Essentials of health behavior: social and behavioral theory in public health. 2007
 Richard D. Semba and Martin W. Bloem. Nutrition and health in developing countries.
Human Press. 2008
 Goeffrey P Webb. Nutrition. A health promotion approach. 3rd edition.
 Rosalind S. Gibson. Principles of nutritional assessment. 2nd edition. 2005
 Robert H Friis. Essentials of environmental health (2nd edition). The essential public health
series. 2012.
 Kathryn Hilgenkamp. Environmental Health: Ecological Perspectives. 2006

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  Herman Koren and Michael Bisesi. Handbook of environmental health. 2002
AV aids (LCD and computer or Overhead projector and transparencies, writing board and marker
or chalk)
Computers with internet and data analysis software
Logbooks for entry of community experience
Stationeries for community survey
Drugs, equipment, tools and materials for clinical and public health interventions
Assessment Methods
Formative assessment
 Logbook and portfolio
 Global rating midway during TTP
 Weekly activity report and Seminar
Summative assessment
 360-degree evaluation (20 %)
 Global rating (20 %)
 Reflective portfolio (15 %)
 PRRE2 (15 %)
 Community diagnosis (15 %)
 Mini-project (15 %)

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Attachment Schedule
Week Activity
Week 1 Discussion with local administration, health office, PHCU staff and community representatives about
attachment objectives and roles and responsibilities of all parties
Community diagnosis: survey, analysis of results, action plan and presentation and discussion
Week Plan and implement PHCU and local health office activities in coordination with them
2-3
Clinical service at OPD, clinic, wards and outreach sites throughout the week including duty
Public health interventions: Health education, school health, prison health, EPI, epidemic
investigation and management, primary health care evaluation including clinical services,
environmental health activities (inspection of water sources, food hygiene in public restaurants,
public sanitation facilities, waste disposal, health facilities supervision, workplace safety), mini-
project to solve priority community health problems
 Home visit on Fridays for half day
 Weekly activity report and seminar on Friday afternoons
Week 4 Evaluate effectiveness and efficiency of the service rendered and the community learning experience
Overall reporting and discussion

Typical Weekly Schedule of Week 2-7

Monday Tuesday Wednesday Thursday Friday
AM Group I: Clinic Group I: Clinical Group I: Public Group I: Public Home visit
service at PHCUs service at PHCUs health interventions health interventions
including duty including duty

Group II: Clinical Group II: Clinical

Group II: Public Group II: Public service at PHCUs service at PHCUs
health interventions health interventions including duty including duty
PM Group I: Clinic Group I: Clinic Group I: Public Group I: Public Weekly activity
service at PHCUs service at PHCUs health interventions health interventions report
including duty including duty
Seminar
Group II: Clinical Group II: Clinical
Group II: Public Group II: Public service at PHCUs service at PHCUs
health interventions health interventions including duty including duty

NB.
 Depending on the number of interns and size of facilities, 2-4 interns will be assigned for
duty at OPD and wards during evening hours and in the weekends.
 Seminar topics will be selected through discussion between interns and faculty based on
national and local relevance
 Outreach and public health interventions will be coordinated with plans of the district and
PHCUs

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Student Research project/paper

Module Title: Student research project

Module Code: AnstM-5371
ECTS: 6 ECTS
Duration: 16 weeks (parallel)
Module Description: The module is intended to prepare learners to design and conduct
operational research specific to anesthesia specialty and other health related problems for the
evidence based practice.
Module Objective
At the end of this module, the student will be able to design and conduct an operational research
specific to anesthesia specialty and other health related problems for the evidence based practice.
Supporting Objectives
• Select a priority research problem (S2)
• Conduct literature review
• Develop a research proposal (S5)
• Collect data according the research protocol (S5)
• Analyze data with appropriate statistics (S4)
• Interpret the findings (S3)
• Write a scientific research report (S5)
• Disseminate research findings
Teaching-Learning Methods: Supervised research and Portfolio
Teaching-Learning Materials
 Getu Degu and Tegbar Yigzaw. Research Methodology: Lecture Note for Health
Science Students. Ethiopian Public Health Training Initiative. 2006.
 Corlien M. Varkevisser, Indra Pathmanathan, and Ann Brownlee. Designing and
Conducting Health
 Systems Research Projects: Volume 1 (Proposal Development and Fieldwork).
KIT/IDRC. 2003
 Corlien M. Varkevisser, Indra Pathmanathan, and Ann Brownlee. Designing and
Conducting Health
 Systems Research Projects: Volume 2. KIT/IDRC. 2003

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  Henryk Dancygier: Clinical epidemiology. How to do clinical practice research
 Margaret L. Brandeau: Operations research and health care. Handbook of methods and
applications
 Nigel Bruce, Danniel Pope and Debbi Stanistreet: Quantitative methods for health
research. A practical
 interactive guide to epidemiology and statistics
 Ann Bowling: Research methods in health. Investigating health and health service.
 AV aids (LCD and computer or Overhead projector and transparencies, writing board
and marker or chalk)
 Computers with data analysis software and internet access
 Handouts of lecture materials
Assessment Methods
Formative assessment
 Portfolio
 Progressive assessment
Summative assessment
 Developing a research protocol like Questioner development, pre-testing, consent, secure
ethical approval, secure budget and logistics, data collector enumeration, agreement format,
attendance format and training, communication network of focal person (20 %)
 Final research report (50 %)
 Oral presentation of research finding (30 %)
Module Schedule

Week 1-3 Protocol Development

Week 4-9 Data collection
Week 10-15 Analysis and Write-up
Week 16-17 Preparation for oral presentation
Week 18 Oral presentation

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Annex 01:- Assessment tools

Direct observed procedure (DOP)

409
Practical clinical evaluation (PCE)

410
411
Case based discussion (CBD)

412
End

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