Department of Internal

Medicine

Course: Medicine (1); 20212022

Course Code: MED34301

COURSE

PORTFOLIO

WEEK: ① ② ③ ④ ⑤ ⑥ ⑦ ⑧

Ali Awadh

Student s name:
Alahmari

Student s group: H

Instructions:

1. This portfolio should be completed based on your own work (Do not use medical records).

2. This portfolio should be completed and submitted weekly to the clinical advisor.

Internal Medicine-1 (MED34301), 2019-2020 Course Portfolio

Introduction:

Portfolios are well known and used in medical education where they have numerous

advantages to the learner, the teacher and the educational program as well. Their use to enhance

learning is based on the notion of collection of evidence that learning has taken place (1). When

they are properly designed and utilized, they promote student learning, help in their assessment

and enhance their professional growth (2). They promote student learning from the individual cases

reported in it and improve their writing skills (3). In addition, they enhance their clinical skills (e.g.

history taking and physical examination) that they require for patient management and care (4).

They also help distribute study time evenly throughout the course and not only towards its end

(5). Reflection and feedback are two essential characteristics of portfolios that empower learners

with lifelong learning skills such as self-assessment, goal setting and self-regulation (6).

Learning outcomes:

The following learning outcomes are expected to be demonstrated by the student based on

their work in this portfolio (also align with course learning outcomes):

1. Take history from patients in the appropriate format of history taking.

2. Conduct physical examination in a systematic and organized way.

3. Interpret clinical data (symptoms and signs) to reach a likely diagnosis.

4. Outline the differential diagnosis considering the clinical data

5 . Request the appropriate diagnostic procedures to reach the diagnosis

6 . Outline the management (by interpreting the diagnosis and prescribe the necessary

treatment) in view of other differential diagnoses.

7. Reflect critically on learning experiences to generate learning and lessons to improve future

performance (desired outcome).

General instructions:

You are expected to complete this portfolio based on your individual effort with patients (i.e.

not using neither medical records nor depending on you colleagues work) and submit it weekly to

your clinical supervisor to receive feedback on your performance that you should utilize to

improve your following portfolio exercises. You are also encouraged to seek feedback and

discuss your performance with your supervisors to maximize you benefit from your work. You

are also advised to refer back to the notes in your portfolio regularly and whenever needed

throughout the module in order to enhance your learning and improve your performance

towards the final course assessment. Please keep your work in this portfolio and do not include

data that may uncover persons or breach their confidentiality (e.g. do not include names). Please

be informed that plagiarism (copying others work as your own) is a form of academic dishonesty

and should be avoided.

Internal Medicine-1 (MED34301), 2019-2020 Course Portfolio

1. ELECTIVE CASES:

A. From the patients scenarios that you have seen this week, choose THREE

elective cases and complete the following:

Three differential
No. Age and sex Provisional diagnosis

diagnoses

Tuberculosis plueritis
Tuberculosis
42 years old

i
1. male Asthma
plueritis NSTEMI

GERD

2.

3.

B. Choose ONE of the above cases and complete the following: (tick: ①,②,③)

Analysis of ONE of the TWO signs in the

The chief complaint(s)

chief complaints physical examination

Dry cough
Chronic dry cough since Dulness on right lung

2013
on percussion

Shortness of breath Aggregated with spicy

food and exercise and Decreased sounds of

relived by rest and the right lung during

ventoline inspiration

C. Compare and contrast the possibility (likelihood) of the provisional diagnosis

with other differential diagnoses (for the case in B):

Clinical findings supporting the diagnosis

Provisional diagnosis

1- thoracentesis shows exudative type

Tuberculosis plueritis and highly infiltration of lymphocytes.

2- x-ray shows right plueral effusion

NSTEMI

3- right lung dulness

4- Decreased sounds of the right lung

during inspiration

Internal Medicine-1 (MED34301), 2019-2020 Course Portfolio

2. EMERGENCY CASES:

A. Choose TWO cases that you have seen this week in the emergency or bedside

department and complete the following:

Provisional\working KEY finding(s) in the

No. diagnosis Chief complaint(s) physical examination

1.

2.

B. Compare and contrast the possibility (likelihood) of the provisional diagnosis

for one of the above cases (tick: ①, ②):

Clinical findings supporting the

Provisional diagnosis

diagnosis

3. PROCEDURES:

Choose ONE of the procedures that you have attended this week and complete

the following:

Name the procedure

What is the indication

What are the precautions

1.

Mention TWO expected complications 2.

Internal Medicine-1 (MED34301), 2019-2020 Course Portfolio

4. LONG CASE

Please write down a complete clinical record (history and physical examination) of a

case of your preference (use your handwriting):

i. History:

A. Personal information:

Age:42 Years/months Gender: Male

Occupation: Building guard

Nationality: Indian Marital status: Married Children: 2

Maddam came to clinic complaining of chronic dry cough since 2013

and shortness of breath that aggregates with spicy food, exercise, dust,
and relived by the ventilator and rest, now days the severity of the cough
has been decreased, he went to indian hospital 6 years ago complaining
of the same problem and treated by fexodine and ventilator otherwise
there is no chronic illnesses, his family also had no chronic illness,
maddam works in alafjah neighborhood and there are a lot of excavation
works there, he is none smoker, none alcoholic, and he didn’t have sex
without protection, there are no fever, weight loss, chest pain, abdominal
pain, lung percussion and lung auscultation performed and there is right
lung dulness and decreased inspiration sound on the right lung, on x-ray
the are right plural effusion, thoracentesis pleural fluid analysis has
performed and it shows exudative type and highly infiltration of
lymphocytes, he is treating now with ventolin and isoniazid.

B. Chief complaint(s): Dry cough

C. History of presenting illness:

Chronic dry cough from 2013

aggregate with spicy food and dust

inhalation and rested by ventilator

and the severity of cough now days

has been decreased

D. Systemic inquiry:

CNS:

____________________________________________________________________
None

____________________________________________________________________

CVS:

_______________________________________________________________________________

None
_______________________________________________________________________________

Respiratory:

_______________________________________________________________________________

Shortness of breath and dry cough

_______________________________________________________________________________

GIT:

_______________________________________________________________________________

None
_______________________________________________________________________________

Genitourinary:

_______________________________________________________________________________

None
_______________________________________________________________________________

Musculoskeletal:

_______________________________________________________________________________

None
_______________________________________________________________________________

E. Past medical history:

_______________________________________________________________________________

Chronic dry cough 6 years ago treated by ventilator + fexodine

_______________________________________________________________________________

F. Family history:

Negative

G. Social history:
None smoker, alcoholic, sex without protection, he

works in a place with dusty whether

H. Drug history: _

Fexodine + ventilator in

2015

ii. Physical examination:

A. General examination:

General condition, appearance and orientation:

Vitals: PR: 87 bpm BP:110/76 mmhg RR:21 per min Temp: 37.5 c

B. Examination of the involved system (local examination):

No scars and no distention on inspection

No masses on palpation

Right lung dulness on percussion

Decreased sound of the right lung during inspiration on auscultation

Internal Medicine -1 (MED 34301), 2019-2020 Course Portfolio

C. Examination of relevant other systems:

None

D. Complementary examination:

I would like to do tuberculin test or IGRA test but it's not available, on chest

x-ray there is inferolateral right pleural effusion and exudative type with

high infiltration of lymphocytes on thoracentesis

E. Additional notes:

F. What is the most likely diagnosis: Dormant infection of tuberculosis

pleuritis

G. What is the Differential diagnosis:

asthma, and gastroesophageal reflux disease, alone

or in combination

H. Compare and contrast the most likely diagnosis with the differential diagnoses:

i. Clinical finding(s) in favor of the diagnosis:

The results of the x-ray in addition to

the results of percussion and

auscultation

ii. Clinical finding(s) against the diagnosis:

7
Internal Medicine -1 (MED 34301), 2019-2020 Course Portfolio

5. REFLECTION:
Reflect on your learning experiences this week (whether in hospitals or in the
University campus):
A. What has gone well with your learning activities\efforts?

B. What has gone unwell with your learning activities\efforts?

C. What specific aspect(s) of your work in this logbook you need feedback on?

D. Formulate a plan (learning goals) for the coming week(s) based on self
evaluation of your learning experiences in this week:

Student’s signature:

8
Internal Medicine -1 (MED 34301), 2019-2020 Course Portfolio

6. CLINICAL ADVISOR S FEEDBACK (this section is for teachers):

Please provide the student with clear and specific feedback on his work above:
A. Areas of strength in the student s work:

B. Areas of weakness in the student s work:

C. Your advice for the student to improve his performance in the future:

D. Your response to the student request of feedback in point (C) of section (5):

E. Please give the student any exercise (based on his work above) that seems
important to consolidate knowledge or provide an evidence of what the
student may have learned this week (e.g. reading of a book section,
assignment, questions, etc.):

Teacher’s name: Teacher’s signature:

_

9
Internal Medicine -1 (MED 34301), 2019-2020 Course Portfolio

7. FOLLOW UP EXERCISES:
Please respond to any exercise(s) that given by your teacher here:

N.B: You mat attach additional papers if needed. Date & signature:

10
Internal Medicine -1 (MED 34301), 2019-2020 Course Portfolio

Marking
criteria
Your work will be given a mark out of ten. All marks will be averaged at the end of the course to give
rise eventually to 5 marks which represents (5%) of the final assessment. Your work will be marked
based on the following criteria:
Criteri Description Grade
a Cases submitted are essential
Essentialness and variation and cover a wide range and\or
of the cases important aspects of the course ① ② ③
objectives.
Data submitted is correct from
Clinical point of view, well
Correctness of the
written and indicate that ① ② ③
clinical information
genuine learning has likely
ensued.
Handwriting is punctual with no
Punctual and or few spelling mistakes and
scientific handwriting follow the guidelines of ① ②
scientific writing.
The Student responds to the
Response to exercises given by Exercises given by the teacher
the teacher promptly and in a good way ① ②
that helps his learning.
Total mark ………… /10

Interpretation of the mark: you may interpret your performance as follows:

0: portfolio not submitted. 1-4: below average. 5-6: average. 7-8: good. 9-10: excellent.
References:
1. Fida N. Shamim M. Portfolios in Saudi medical colleges, Why and how? Saudi Med J
2016;37(3):245-248.
2. Simpson JG. et al. The Scottish doctor--learning outcomes for the medical undergraduate
in Scotland: a foundation for competent and reflective practitioners, Medical Teacher,
2002;24(2):136-143.
3. Watters D, et al. Requirements for Trainee Logbooks. ANZ Journal of Surgery,
2006;76:181–184.
4. Shahi R, et al. Clinical participation of medical students in three contemporary training
models. Medical Education, 2015;49: 1219–1228.
5. Carless, D, et al. (2011). Developing sustainable feedback practices. Studies in Higher
Education, 2011;36(4): 395-407.
6. Alotaibi F. Implementing portfolio in postgraduate general practice training Benefits and
recommendations. Saudi Med J, 2012;33(10): 1053-1058