DAVID TVILDIANI MEDICAL

UNIVERSITY

BASIC CLINICAL SKILLS LOGBOOK FOR

MD STUDENTS

BASIC AND CLINICAL SCIENCES STAGE

(III-V SEMESTER)

TBILISI
GEORGIA
 DAVID TVILDIANI MEDICAL UNIVERSITY

BASIC CLINICAL SKILLS LOGBOOK FOR

MD STUDENTS

BASIC AND CLINICAL SCIENCES STAGE

(III-V SEMESTER)

Student Name:__________________________________________________
Student ID:__________________________________________________

Study Period: from__________________to___________________

 University confirmation:

Dean: ________________________
(Signature, Stamp)

Date: ___________________________

Page | 2
Structure of Logbook
I. Main Approach

 Problems as starting points for training:

(i) A problem is defined as a complex of complaints, signs and symptoms (e.g. dyspnea) which
may lead a patient to seek medical counsel.
(ii)The Problem-solving goes beyond the classical exercises of establishing a differential
diagnosis (including therapeutic, social, preventive and other interventions)
(iii) Problems are selected if:
- They occur frequently
- Even if the problem is not frequent but rapid and appropriate intervention is required

 Discipline-related objectives
i. The lists are made up of the objectives grouped by medical disciplines and knowledge
and skills needed for management virtual patient and standardized patient cases
(provided by e-PBL, PCD course and Body Interact educational resource)
ii. Subdivision of medical disciplines by narrower medical fields (e.g. Cardiovascular
System Respiratory System etc.) means that trainings were held in relevant course format,
mostly provided through face-to-face simulated environment and/or online resources (see
also "Summary of cases", "Topic list", etc. in logbook).

II. Technical issues

i. Schedule of Courses (filled out by the student)
ii. Each training discipline is organized within the format of: "Topic list", "Learning outcomes",
“Medical Knowledge and Diagnostic Reasoning”, “Clinical Skills”, “Professionalism,
Responsibility and Reliability” and "Summary of Cases" in frames of e-PBL and PCD classes.

III. Assessment see Appendix I, Appendix II

 Appendix I “Descriptors of assessment in PCD sessions”

 Appendix II “Descriptors of assessment in PBL sessions”

Page | 3
Logbook
Schedule of Courses (filled out by the student)

Assignment
CODE Course Name Period
Signature

University confirmation:
Dean________________________
(Signature, stamp)

Page | 4
 MEDICINE
Principles of Clinical Diagnosis with Clinical Assessment

 Musculoskeletal System
 Cardiovascular System
 Respiratory System
 Digestive System and Nutrition
 Urinary System
 Endocrine System

Hospital or Medical Institution where the course was studied:

David Tvildiani Medical University and Affiliated institutions

PBL Courses using virtual patient cases

 Musculoskeletal System
 Hematopoietic System and Infection
 Nervous System and Skin
 Reproductive System
 Cardiovascular System
 Respiratory System
 Digestive System and Nutrition
 Urinary System
 Endocrine System

Hospital or Medical Institution where the course was studied:

David Tvildiani Medical University

University Confirmation: Dean________________________

(Signature, stamp)

Page | 5
Introduction & Musculoskeletal System

The study course content covered during the departmental meetings and PCD classes attended:

DATE TOPIC
Foundations for Clinical Proficiency. Setting the Stage for the Interview.
Approach to the Present Illness. The Rest of the Story.
Advanced Interviewing
Ethics and Professionalism
Beginning the Physical Examination: General Survey, Vital Signs & Pain
Health history, symptoms and signs, red flag signs – joint pain, neck, back
pain; etc. MSK physical examination: Steps for Examining the Joints; Tips for
Successful Examination of the Musculoskeletal System; Assessing the Four
Signs of Inflammation;
General techniques of examination of shoulder; wrist and hands, spine (basic
physical examination techniques)
General techniques of examination of knees, ankle - (basic physical examination
techniques), Recording your findings; Health History: The Skin. The Head. The Eyes.
The Ears. The Nose and Sinuses. The Mouth, Throat and Neck
Health History: The Gastrointestinal Tract and urinary system; Anus, rectum,
prostate; The Genital System – Female; The Genital System – Male.
Health History: The Breasts. The Cardiovascular System, Peripheral Vascular
System, Respiratory system
Behavior and Mental Status

Page | 6
LEARNING OUTCOMES

The course is aimed at the acquisition of program-specified knowledge. After completing the course
students are supposed to: interview patients with musculoskeletal system pathology, collect medical
history, provide physical examination; based on the analysis results of physical examination and
instrumental investigations – identify patient’s problem; discuss preliminary plan of care and
management.

Medical History Taking:

 Cognition of patient’s demands and expectations in respect of the consultation
 Comprehensive history taking: somatic, considering psycho-social factors and all objective and
subjective complaints.
 Task-oriented and hypothesis-based medical history taking
 Genetic history taking.
 History taking on travel-related medical problem
 Occupation environment history taking
 Identificaion of life and health-threatening behavior and life style

Teacher's name and Signature: ___________________________________Date:_______________

Information And Management:

 History taking on psychotropic drug consumption.
 Setting up a clinical task and receiving relevant information from literature data.
 Informing patients and their family about poor diagnosis
 Medical record (Written documentation of patient medical history)
 Advice on diet, physical activity, smoking, alcohol and drug use.
 Pain management, palliative care and terminal stage of life.
 Probable diagnosis outline, raising urgent problems and planning medical management .
 Current algorithms and national Protocols & Guidelines

Teacher's name and Signature: ___________________________________Date:_______________

Page | 7
 Physical Examination
 General state assessment (habitus, stance, symmetry and mobility of the body, nutritional status,
mood and mental status)
 Vital signs assessment (temperature, pulse, arterial blood pressure, heart rate, respiration)
 Skin and mucosa assessment
 Routine activity assessment
 Assessment of attention, concentration, thinking, cognition, affective and psychomotor behavior
 Assessment of alcohol and drug intoxicated individual/patient
 Assessment of peripheral and central arterial pulse, arterial murmur
 Inspection of lymphatic glands/nodes.
 Visual inspection, palpation and auscultation of cervical structures (thyroid gland,carotid ateries
and lymphatic nodes)
 Testing of cranial bones and cervical vertabrae for mobility, sensitivity and stiffness
 Inspection of the chest and testing for sensitivity at palpation and percussion.
 Examination of shoulder girdle
 Examination of pelvic girdle
 Examination of upper extremity joints
 Examination of lower extremity joints
 Examination of spine
 GALS assessment
 Inspection, percussion, palpation, asucultation of chest
 Inspection, auscultation, percussion, palpation of abdomen

Teacher's name and Signature:___________________________________Date:_______________

Additionally, students acquire competencies in performed procedures important for medical

practice:

Procedures

 Arthrocentesis
 Synovial fluid analysis
 Joint/bone X-ray
 Joint ultrasound

Teacher's name and Signature: ___________________________________Date: _______________

Page | 8
 Unified Form for Assessment of Student Performance (PCD)

Student:___________________________________________ Faculty Program:_____________________________________

Course: _____________________ Date: ________________________________

MEDICAL KNOWLEDGE AND DIAGNOSTIC Insufficient Rarely Sometimes Usually Always

REASONING Contact
Knowledge of Pathophysiology and Clinical Topics -
(Demonstrates knowledge of pathophysiology, diagnosis, and
management - Integrates knowledge from a variety of resource)
Diagnostic Reasoning / Differential Diagnosis: (Develops a
comprehensive differential diagnosis; Synthesizes clinical
presentation with understanding of disease

PROFESSIONALISM Insufficient Rarely Sometimes Usually Always

Responsibility and Reliability: Contact
1. Accepts and actively takes on responsibilities
2. Demonstrates industrious work habits
3. Completes tasks carefully and thoroughly
Participation and Initiative:
1. Is motivated and active in patient care and learning
2. Shows interest and takes initiative
Honesty and Integrity
1. Demonstrates trustworthiness
2. Is considered credible
3. Accepts responsibility for own actions and those of colleagues

CLINICAL SKILLS ASSESSMENT (refer to Appendix I for descriptors)

1 2 3 4 5
Communication Skills
Empathy
Interview: Collecting SP history
Interview Technique
Physical Examination
Use of Instruments
Closing/ Summary of the interview
Patient Notes
Student’s Appearance

Teacher's name and Signature: ___________________________________Date: _______________

Page | 9
Please comment on this student’s strengths and weaknesses addressing the following competencies:
Medical Knowledge, Clinical Skills, Interpersonal & Communication Skills, and Professionalism:

YOURE RECOMMENDATION FOR STUDENT’S FINAL GRADE IN THIS COURSE:

FAIL LOW PASS PASS HIGH PASS HONORS

Other (please specify) □________________________________________________________

Teacher's name and Signature: ___________________________________Date: _______________

…………………………………………

Page | 10
 SUMMARY OF CASE (copy the form based on number of practiced cases)
CASE N______________________________________________________________

Name: ___________________________ Age: ______ Sex: _____ Date of Admission: ________

CC:___________________________________________________________________________
HPI_______________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
__________________________________________________________________

Physical Examination:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
__________________________________________________________________

Differential Diagnosis and Workup Plan:

___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
_______________________________________________

Final diagnosis (in case of its presence)

Page | 11
PBL Courses using virtual patient cases

The study course content covered during the departmental meetings and PBL seasons attended:

LEARNING OUTCOMES

MUSCULOSKELETAL (PBL Intended Learning Outcomes)

Period (indicate dates):
Basic and Clinical Sciences
List possible causes for widespread musculoskeletal pain.
Describe the normal physiology of calcium, phosphate and magnesium metabolism.
Describe the normal physiology of vitamin D metabolism.
List major causes of hypercalcaemia.
List the major causes of hypocalcaemia.
Describe the clinical features of osteomalacia.
Explain why certain groups of people are at greater risk of rickets or osteomalacia.
Describe the pathology of rickets and osteomalacia.
Describe investigations and radiographic features to confirm the diagnosis of rickets and
osteomalacia.
Outline strategies for the prevention and treatment of rickets and osteomalacia.
Describe the structure and properties of different types of cartilage.
Describe the structure and movements of the knee and hip joints, including the organisation and functions of the ligaments.
Discuss the main signs, symptoms and pattern of joint involvement in osteoarthritis.
Describe the main pathological features that are associated with osteoarthritis.
Describe the expected findings on x-ray in a patient with osteoarthritis.
Discuss the pharmacological and non-pharmacological treatments of osteoarthritis.
Explain the role of the multidisciplinary team in the management of osteoarthritis.
Discuss the indications for joint replacement surgery for osteoarthritis.
Describe the functional anatomy of the hip joint with emphasis on the factors responsible for
stability and mobility.
Demonstrate an overview of the key functions and structures of the musculoskeletal system.
To describe the term chronic pain and provide an example of a chronic pain syndrome
Patient and Doctor
Perform a competent hip examination.
Carry out a musculoskeletal screening examination (gait, arms, legs and spine GALS) on a
colleague
Community and Population Health
Critically assess social and theoretical assumptions underpinning the concepts of `race' and
ethnicity.
Explore the meaning of institutionalized racism in relation to health care
within the national healthcare system (NHS).
Outline the public health approach to needs assessment.
Understand what influences public health policies and the planning of health
services within the NHS, including priorities for care, government policy and financial constraints.
Appreciate the concepts of need, demand and supply as applied to healthcare'.
Appreciate the concept of rationing in health care and its implications for the
doctor-patient relationship.
To describe how chronic pain syndromes impact on patients' lives
Personal and Professional Development
Critically analyze the ethical principles that support resource allocation decisions.
Discuss the contribution and value of qualitative methodology to research in health care sciences.

Page | 12
 Unified Form for Assessment of Student Performance (PBL)

Student:______________________________________________ Module:_____________________________________

Subject block: _____________________ Date: ________________________________

Preparation For PBL* Contribution For PBL* Attitude to Peers & Tutor*

 
   

*For assessment descriptors refer to Appendix II

Tutors signature:

………………………………………………

Page | 13
Tutors comment on this student’s strengths and weaknesses addressing the following competencies:
Medical Knowledge, Clinical Skills, Interpersonal & Communication Skills, and Professionalism:

YOUR RECOMMENDATION FOR STUDENT’S FINAL GRADE IN THIS COURSE:

FAIL LOW PASS PASS HIGH PASS HONORS

Other (please specify) □________________________________________________________

Tutors signature:

………………………………………………

Page | 14
 SUMMARY OF CASE (copy the form based on number of practiced cases)
CASE N______________________________________________________________

Name: ___________________________ Age: ______ Sex: _____ Date of Admission: ________

CC:___________________________________________________________________________
HPI_______________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
__________________________________________________________________

Physical Examination:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
__________________________________________________________________

Differential Diagnosis and Workup Plan:

___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
_______________________________________________

Final diagnosis (in case of its presence)

Page | 15
Cardiovascular System

The study course content covered during the departmental meetings and PCD classes attended:

DATE TOPIC
Cardiac Chambers, Valves and Circulation.
Events in the Cardiac Cycle. Relation of Heart Sounds to the Chest Wall. The
Conduction System.
Arterial Pulse and Blood Pressure. Jugular Venous Pressure and Pulse.
Chest Pain. Dyspnea. Palpitation. Cyanosis. Pallor. Edema.
The Peripheral Vascular System
Blood Pressure. Jugular Venous Pressure. Carotid Pulse, Peripheral Pulse. The
Heart - Positioning the patient, Inspection, Palpation (PMI), Percussion,
Auscultation
Special Techniques: Maneuvers to Identify Murmurs and Heart Failure -
Valsalva, Handgrip, Squat, leg raise, etc. Techniques of examination of
peripheral vascular system
Table 9-1
Hypertension, Renovascular hypertension, Hypertensive emergency. Heart
Failure, Cor pulmonale, Pulmonary Edema.
Myocardial Infarction and its complications; IHD, Angina Pectoris.
Cardiac Arrhythmias. Heart Block (General Considerations)
Mitral Valve Disease. Aortic Valve Disease. Tricuspid Valve Disease
Athlete’s heart. Sudden Cardiac death in Athlete’s

Page | 16
LEARNING OUTCOMES

The course is aimed at the acquisition of program-specified knowledge. After completing the course
students are supposed to: interview patients with cardiovascular system pathology, collect medical
history, provide physical examination; based on the analysis results of physical examination and
instrumental investigations – identify patient’s problem; discuss preliminary plan of care and
management.

Medical History Taking:

 Cognition of patient’s demands and expectations in respect of the consultation
 Comprehensive history taking: somatic, considering psycho-social factors and all objective and
subjective complaints.
 Task-oriented and hypothesis-based medical history taking
 Genetic history taking.
 History taking on travel-related medical problem
 Occupation environment history taking
 Identificaion of life and health-threatening behavior and life style

Teacher's name and Signature: ___________________________________Date:_______________

Information And Management:

 History taking on psychotropic drug consumption.
 Setting up a clinical task and receiving relevant information from literature data.
 Informing patients and their family about poor diagnosis
 Medical record (Written documentation of patient medical history)
 Advice on diet, physical activity, smoking, alcohol and drug use.
 Pain management, palliative care and terminal stage of life.
 Probable diagnosis outline, raising urgent problems and planning medical management .
 Current algorithms and national Protocols & Guidelines

Teacher's name and Signature: ___________________________________Date:_______________

Page | 17
 Physical Examination
 General state assessment (habitus, stance, symmetry and mobility of the body, nutritional status, mood and
mental status)
 Vital signs assessment (temperature, pulse, arterial blood pressure, heart rate, respiration)
 Skin and mucosa assessment
 Routine activity assessment
 Assessment of alcohol and drug intoxicated individual/patient
 Assessment of peripheral and central arterial pulse, arterial murmur
 Inspection of lymphatic glands/nodes
 Inspection of the chest and testing for sensitivity at palpation and percussion
 Inspection of jugular venous pressure / pulsation
 Inpsection and palpation for edema
 Palpation of the chest
 Palpation of the apex beat of the heart (PMI), central and peripheral pulses
 Auscultation of the heart sounds
 Auscultation for bruits (aorta, renal, carotid)
 Auscultation of the lungs
 Perform special cardiological examination techniques (ex. Valsavla, handgrip, leg-raise)
 General abdominal assessment

Teacher's name and Signature: ___________________________________Date:_______________

Additionally, students acquire competencies in performed procedures important for medical

practice:

Procedures
 Ecg, including 24hour ECG monitoring
 Echocardiography
 Chest x-ray
 Treadmill stress test
 PCI and CABG

Teacher's name and Signature: ___________________________________Date:_______________

Page | 18
 Unified Form for Assessment of Student Performance (PCD)

Student:___________________________________________ Faculty Program:_____________________________________

Course: _____________________ Date: ________________________________

MEDICAL KNOWLEDGE AND DIAGNOSTIC Insufficient Rarely Sometimes Usually Always

REASONING Contact
Knowledge of Pathophysiology and Clinical Topics -
(Demonstrates knowledge of pathophysiology, diagnosis, and
management - Integrates knowledge from a variety of resource)
Diagnostic Reasoning / Differential Diagnosis: (Develops a
comprehensive differential diagnosis; Synthesizes clinical
presentation with understanding of disease

PROFESSIONALISM Insufficient Rarely Sometimes Usually Always

Responsibility and Reliability: Contact
1. Accepts and actively takes on responsibilities
2. Demonstrates industrious work habits
3. Completes tasks carefully and thoroughly
Participation and Initiative:
1. Is motivated and active in patient care and learning
2. Shows interest and takes initiative
Honesty and Integrity
1. Demonstrates trustworthiness
2. Is considered credible
3. Accepts responsibility for own actions and those of colleagues

CLINICAL SKILLS ASSESSMENT (refer to Appendix I for descriptors)

1 2 3 4 5
Communication Skills
Empathy
Interview: Collecting SP history
Interview Technique
Physical Examination
Use of Instruments
Closing/ Summary of the interview
Patient Notes
Student’s Appearance

Teacher's name and Signature: ___________________________________Date:_______________

Page | 19
Please comment on this student’s strengths and weaknesses addressing the following competencies:
Medical Knowledge, Clinical Skills, Interpersonal & Communication Skills, and Professionalism:

YOURE RECOMMENDATION FOR STUDENT’S FINAL GRADE IN THIS COURSE:

FAIL LOW PASS PASS HIGH PASS HONORS

Other (please specify) □________________________________________________________

Teacher's name and Signature: ___________________________________Date:_______________

Page | 20
 SUMMARY OF CASE (copy the form based on number of practiced cases)
CASE N______________________________________________________________

Name: ___________________________ Age: ______ Sex: _____ Date of Admission: ________

CC:_____________________________________________________________________________

HPI_______________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________

Physical Examination:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
____________________________________________________________________________
________________________________________________________________________________

Differential Diagnosis and Workup Plan:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
___________________________________________________

Final diagnosis (in case of its presence)

Page | 21
PBL Courses using virtual patient cases

The study course content covered during the departmental meetings and PBL seasons attended:

LEARNING OUTCOMES

Page | 22
Topics: Cardiovascular (PBL Intended Learning Outcomes)
Period (indicate dates):
Basic and Clinical Sciences
Briefly describe the anatomy of the coronary circulation.
Review the physiology of cardiac conduction, the cardiac cycle and cardiac contractility.
Describe the effect of drugs on cardiac contractility.
Define angina and myocardial infarction.
Explain the origin of the P, QRS and T waves on the ECG and distinguish the alterations
from normal in an ECG of a patient with a myocardial infarction.
Have a basic knowledge of coronary territories on ECG.
Explain the time course and significance of alterations in circulating cardiac markers post
MI.
List classes of drug therapy which relieve cardiac pain and have an understanding of the
pharmacology of these agents.

Describe the difference between anticoagulation, thrombolysis and anti-platelet drugs.

Describe the diagnosis and management of STEMI
List the indications for and contraindications to thrombolysis.
Have a basic understanding of coronary angiography including indications and risks.
Know the indications for Implantable Cardioverter Defibrillators.
Outline the pathogenesis of coronary atherosclerosis and coronary thrombosis.
Outline the pathology of myocardial infarction, describing the effects of acute ischaemia
on cardiac muscle and the time course of healing processes.
Relate the pathology of myocardial infarction to the clinical complications of (a) impaired
cardiac function with left ventricular failure and (b) tachyarrhythmias.
Demonstrate knowledge of the surface anatomy of the heart.
Describe the principles of management of cardiovascular risk
Patient and Doctor
Take a cardiovascular history and perform a cardiovascular examination.
Discuss the management of a patient in primary care after myocardial infarction.
Record a 12 lead ECG on a colleague; check it is technically correct and ready for
interpretation.
Outline relevant content of the cardiovascular history.
Identify and practice appropriate skills to elicit a history from a patient with chest pain and
cardiovascular disease.
Identify relevant content of respiratory history.
Identify and practice appropriate skills to elicit an accurate history from a patient with Page | 23
respiratory disease
 Unified Form for Assessment of Student Performance (PBL)

Student:______________________________________________ Module:_____________________________________

Subject block: _____________________ Date: ________________________________

Preparation For PBL* Contribution For PBL* Attitude to Peers & Tutor*

 
   

*For assessment descriptors refer to Appendix II

Tutors signature:

………………………………………………

Page | 24
Tutors comment on this student’s strengths and weaknesses addressing the following competencies:
Medical Knowledge, Clinical Skills, Interpersonal & Communication Skills, and Professionalism:

YOUR RECOMMENDATION FOR STUDENT’S FINAL GRADE IN THIS COURSE:

FAIL LOW PASS PASS HIGH PASS HONORS

Other (please specify) □________________________________________________________

Tutors signature:

………………………………………………

Page | 25
 SUMMARY OF CASE (copy the form based on number of practiced cases)
CASE N______________________________________________________________

Name: ___________________________ Age: ______ Sex: _____ Date of Admission: ________

CC:___________________________________________________________________________
HPI_______________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
__________________________________________________________________

Physical Examination:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
__________________________________________________________________

Differential Diagnosis and Workup Plan:

___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
_______________________________________________

Final diagnosis (in case of its presence)

Page | 26
Respiratory System

The study course content covered during the departmental meetings and PCD classes attended:

DATE TOPIC
Anatomy and Physiology. Changes with Age.
Cough, Sputum-production. Hemoptysis. Dyspnea. Chest pain. Cyanosis.
Techniques of Examination.
Survey of the Thorax and Respiration.
Examination of the Posterior and Anterior Chest. Inspection. Palpation. Percussion.
Auscultation. Special Maneuvers.
Bronchial Asthma. Acute Bronchitis. Atelectasis.

Pneumonia. Tuberculosis Lung Abscess

Pleural Disorders. Pleurisy. Pneumothorax.

Page | 27
LEARNING OUTCOMES

The course is aimed at the acquisition of program-specified knowledge. After completing the course
students are supposed to: interview patients with Respiratory System pathology, collect medical
history, provide physical examination; based on the analysis results of physical examination and
instrumental investigations – identify patient’s problem; discuss preliminary plan of care and
management.

Medical History Taking:

 Cognition of patient’s demands and expectations in respect of the consultation
 Comprehensive history taking: somatic, considering psycho-social factors and all objective and
subjective complaints.
 Task-oriented and hypothesis-based medical history taking
 Genetic history taking.
 History taking on travel-related medical problem
 Occupation environment history taking
 Identificaion of life and health-threatening behavior and life style

Teacher's name and Signature: ___________________________________Date:_______________

Information And Management:

 History taking on psychotropic drug consumption.
 Setting up a clinical task and receiving relevant information from literature data.
 Informing patients and their family about poor diagnosis
 Medical record (Written documentation of patient medical history)
 Advice on diet, physical activity, smoking, alcohol and drug use.
 Pain management, palliative care and terminal stage of life.
 Probable diagnosis outline, raising urgent problems and planning medical management .
 Current algorithms and national Protocols & Guidelines

Teacher's name and Signature: ___________________________________Date:_______________

Page | 28
 Physical Examination
 General state assessment (habitus, stance, symmetry and mobility of the body, nutritional status, mood and
mental status)
 Vital signs assessment (temperature, pulse, arterial blood pressure, heart rate, respiration)
 Skin and mucosa assessment
 Routine activity assessment
 Assessment of attention, concentration, thinking, cognition, affective and psychomotor behavior
 Assessment of alcohol and drug intoxicated individual/patient
 Assessment of peripheral and central arterial pulse, arterial murmur
 Skin and mucosa assessment
 Inspection and palpation of lymphatic glands/nodes.
 Inspection of the chest and testing for sensitivity at palpation and percussion.
 Assessment of chest excursion and chest area change at breathing.
 Percussion of the lungs.
 Auscultation of the lungs
 Auscultation of the heart
 Inpsection and palpation for edema
 General abdominal assessment

Teacher's name and Signature: ___________________________________Date: _______________

Additionally, students acquire competencies in performed procedures important for medical

practice:

Procedures

 Chest X-ray
 Spirometry
 Chest CT

Teacher's name and Signature: ___________________________________Date: _______________

Page | 29
 Unified Form for Assessment of Student Performance (PCD)

Student:___________________________________________ Faculty Program:_____________________________________

Course: _____________________ Date: ________________________________

MEDICAL KNOWLEDGE AND DIAGNOSTIC Insufficient Rarely Sometimes Usually Always

REASONING Contact
Knowledge of Pathophysiology and Clinical Topics -
(Demonstrates knowledge of pathophysiology, diagnosis, and
management - Integrates knowledge from a variety of resource)
Diagnostic Reasoning / Differential Diagnosis: (Develops a
comprehensive differential diagnosis; Synthesizes clinical
presentation with understanding of disease

PROFESSIONALISM Insufficient Rarely Sometimes Usually Always

Responsibility and Reliability: Contact
1. Accepts and actively takes on responsibilities
2. Demonstrates industrious work habits
3. Completes tasks carefully and thoroughly
Participation and Initiative:
1. Is motivated and active in patient care and learning
2. Shows interest and takes initiative
Honesty and Integrity
1. Demonstrates trustworthiness
2. Is considered credible
3. Accepts responsibility for own actions and those of colleagues

CLINICAL SKILLS ASSESSMENT (refer to Appendix I for descriptors)

1 2 3 4 5
Communication Skills
Empathy
Interview: Collecting SP history
Interview Technique
Physical Examination
Use of Instruments
Closing/ Summary of the interview
Patient Notes
Student’s Appearance

Teacher's name and Signature: ___________________________________Date:_______________

Page | 30
Please comment on this student’s strengths and weaknesses addressing the following competencies:
Medical Knowledge, Clinical Skills, Interpersonal & Communication Skills, and Professionalism:

YOURE RECOMMENDATION FOR STUDENT’S FINAL GRADE IN THIS COURSE:

FAIL LOW PASS PASS HIGH PASS HONORS

Other (please specify) □________________________________________________________

Teacher's name and Signature: ___________________________________Date:_______________

Page | 31
 SUMMARY OF CASE (copy the form based on number of practiced cases)
CASE N______________________________________________________________

Name: ___________________________ Age: ______ Sex: _____ Date of Admission: ________

CC:_____________________________________________________________________________

HPI_______________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________

Physical Examination:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
____________________________________________________________________________
________________________________________________________________________________

Differential Diagnosis and Workup Plan:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
___________________________________________________

Final diagnosis (in case of its presence)

Page | 32
PBL Courses using virtual patient cases

The study course content covered during the departmental meetings and PBL seasons attended:

LEARNING OUTCOMES

Page | 33
Topics: Respiratory (PBL ILOs)
Period (indicate dates):

Basic and Clinical Sciences

Define asthma.

Revise the main accessory muscles of inspiration and of expiration and explain their actions.

Describe the anatomy and histology of normal airways (nose, nasopharynx, oropharynx,
trachea, bronchi & bronchioles).

Describe the pathological changes seen in the airways in asthma.

List the mechanisms that increase airway resistance in asthma and explain how they relate
to the pathological changes of the airways.

Explain what is meant by airway hyper-responsiveness.

Describe the putative roles of mast cells, eosinophils & lymphocytes in an attack of allergic
asthma, and the main mediators they produce.

List the factors (including 2 classes of drugs) which commonly trigger asthma attacks.

Describe the clinical features of nasal problems associated with asthma (rhinitis, polyps).

Outline the immunological mechanisms involved in allergic rhinitis and asthma.

Explain the clinical and physiological measures used to assess the severity of asthma in
adults presenting with an acute attack, namely: pulse rate, respiratory rate, peak flow
measurement and arterial blood gas values.

Describe and explain the abnormalities of arterial blood gases commonly seen in an asthma
attack.

Name a 2 adrenoceptor agonist, and explain how it relieves an asthma attack.

Outline the mechanism by which glucocorticoids treat and prevent attacks of asthma and
allergic rhinitis.

Describe the unwanted effects of glucocorticoid treatment of asthma.

Distinguish between drugs that relieve asthma attacks and those that prevent them. (PBL
T1 & session)

List the main routes by which drugs are given to asthmatic patients (inhaled/nebulized,
oral, intravenous) and outline advantages and disadvantages of each. (PBL T2)

Patient and Doctor

Revise the use of peak flows and spirometry in patients with respiratory disease. Page | 34
 Unified Form for Assessment of Student Performance (PBL)

Student:______________________________________________ Module:_____________________________________

Subject block: _____________________ Date: ________________________________

Preparation For PBL* Contribution For PBL* Attitude to Peers & Tutor*

 
   

*For assessment descriptors refer to Appendix II

Tutors signature:

………………………………………………

Page | 35
Tutors comment on this student’s strengths and weaknesses addressing the following competencies:
Medical Knowledge, Clinical Skills, Interpersonal & Communication Skills, and Professionalism:

YOUR RECOMMENDATION FOR STUDENT’S FINAL GRADE IN THIS COURSE:

FAIL LOW PASS PASS HIGH PASS HONORS

Other (please specify) □________________________________________________________

Tutors signature:

………………………………………………

Page | 36
 SUMMARY OF CASE (copy the form based on number of practiced cases)
CASE N______________________________________________________________

Name: ___________________________ Age: ______ Sex: _____ Date of Admission: ________

CC:___________________________________________________________________________
HPI_______________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
__________________________________________________________________

Physical Examination:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
__________________________________________________________________

Differential Diagnosis and Workup Plan:

___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
_______________________________________________

Final diagnosis (in case of its presence)

Page | 37
Digestive System & Nutrition

The study course content covered during the departmental meetings and PCD classes attended:

DATE TOPIC
Changes with Age. Common Symptoms and Signs. Dysphagia. Heartburn. Abdominal
Pain. Black and Bloody Stools. Constipation. Diarrhea. Nausea. Vomiting.
Techniques of Examination:
Inspection. Auscultation. Percussion, Techniques of Examination. Palpation. Special
Maneuvers.
Investigation of Gastric Juice.
H. Pylori infection, Gastritis. Autoimmune Metaplastic Atrophic Gastritis. Peptic Ulcer
Disease. Peptic Ulcer. Complications of Peptic Ulcer. Neoplasms of the Stomach
Carcinoma of the Esophagus
Cholecystitis. Cholelithiasis and Choledocholithiasis, Cholangitis Acute abdominal pain,
Acute mesenteric Ishemia, Acute perforation, Appendicitis, Hernias of abdominal wall,
Illeus. Intestinal Obstruction, Intra-abdominal Abscesses, Ishemic Colitis.
Fibrosis & Cirrhosis
Portal Hypertension, Portal-systemic Encephalopathy, Varices, Vascular GI lesions
Hepatitis (Acute Viral and Chronic) Hepatitis, Ascites, Spontaneous Bacterial Peritonitis,
Fatty liver, Nonalcoholic Steatohepatitis, Jaundice, Inborn Metabolic Disorders Causing
Hyperbilirubinemia, Systemic Abnormalities in Liver disease, Asymptomatic patient with
Abnormal Laboratory Test results, Postoperative liver dysfunction.

Page | 38
LEARNING OUTCOMES

The course is aimed at the acquisition of program-specified knowledge. After completing the course
students are supposed to: interview patients with Digestive System pathology, collect medical history,
provide physical examination; based on the analysis results of physical examination and instrumental
investigations – identify patient’s problem; discuss preliminary plan of care and management.

Medical History Taking:

 Cognition of patient’s demands and expectations in respect of the consultation
 Comprehensive history taking: somatic, considering psycho-social factors and all objective and
subjective complaints.
 Task-oriented and hypothesis-based medical history taking
 Genetic history taking.
 History taking on travel-related medical problem
 Occupation environment history taking
 Identificaion of life and health-threatening behavior and life style

Teacher's name and Signature: ___________________________________Date:_______________

Information And Management:

 History taking on psychotropic drug consumption.
 Setting up a clinical task and receiving relevant information from literature data.
 Informing patients and their family about poor diagnosis
 Medical record (Written documentation of patient medical history)
 Advice on diet, physical activity, smoking, alcohol and drug use.
 Pain management, palliative care and terminal stage of life.
 Probable diagnosis outline, raising urgent problems and planning medical management .
 Current algorithms and national Protocols & Guidelines

Teacher's name and Signature: ___________________________________Date:_______________

Page | 39
 Physical Examination
 General state assessment (habitus, stance, symmetry and mobility of the body, nutritional status, mood and
mental status)
 Vital signs assessment (temperature, pulse, arterial blood pressure, heart rate, respiration)
 Assessment of alcohol and drug intoxicated individual/patient
 Assessment of peripheral and central arterial pulse, arterial murmur
 Skin and mucosa assessment
 Routine activity assessment
 Inspection and palpation of lymphatic glands/nodes.
 Inspection, palpation, percussion and auscultation of the chest
 Inpsection and palpation for edema
 Inspection of the abdomen
 Auscultation of the abdomen
 Percussion of the abdomen (liver, Traube’s space, urinary bladder)
 Palpation of the abdomen (abominal wall, colon, liver,spleen, aorta, masses)
 Abdominal tension, tenderness, excruciating pain
 Shifting of dulness in the abdomen
 Determination of tenderness (sensitivity) within the kidney projective area
 Performance of special techniques (Murphy’s sign, Obturator sign, rebound tenderness, etc)

Teacher's name and Signature: ___________________________________Date: _______________

Additionally, students acquire competencies in performed procedures important for medical

practice:

Procedures
 Abdominal X-ray
 Abdominal CT
 Abdominal Ultrasound
 Blood analysis (LFTs, HBV, HCV)
 Stool analysis

Teacher's name and Signature: ___________________________________Date:_______________

Page | 40
 Unified Form for Assessment of Student Performance (PCD)

Student:___________________________________________ Faculty Program:_____________________________________

Course: _____________________ Date: ________________________________

MEDICAL KNOWLEDGE AND DIAGNOSTIC Insufficient Rarely Sometimes Usually Always

REASONING Contact
Knowledge of Pathophysiology and Clinical Topics -
(Demonstrates knowledge of pathophysiology, diagnosis, and
management - Integrates knowledge from a variety of resource)
Diagnostic Reasoning / Differential Diagnosis: (Develops a
comprehensive differential diagnosis; Synthesizes clinical
presentation with understanding of disease

PROFESSIONALISM Insufficient Rarely Sometimes Usually Always

Responsibility and Reliability: Contact
1. Accepts and actively takes on responsibilities
2. Demonstrates industrious work habits
3. Completes tasks carefully and thoroughly
Participation and Initiative:
1. Is motivated and active in patient care and learning
2. Shows interest and takes initiative
Honesty and Integrity
1. Demonstrates trustworthiness
2. Is considered credible
3. Accepts responsibility for own actions and those of colleagues

CLINICAL SKILLS ASSESSMENT (refer to Appendix I for descriptors)

1 2 3 4 5
Communication Skills
Empathy
Interview: Collecting SP history
Interview Technique
Physical Examination
Use of Instruments
Closing/ Summary of the interview
Patient Notes
Student’s Appearance

Teacher's name and Signature: ___________________________________Date:_______________

Page | 41
 Please comment on this student’s strengths and weaknesses addressing the following competencies:
Medical Knowledge, Clinical Skills, Interpersonal & Communication Skills, and Professionalism:

YOURE RECOMMENDATION FOR STUDENT’S FINAL GRADE IN THIS COURSE:

FAIL LOW PASS PASS HIGH PASS HONORS

Other (please specify) □________________________________________________________

Teacher's name and Signature: ___________________________________Date:_______________

Page | 42
 SUMMARY OF CASE (copy the form based on number of practiced cases)
CASE N______________________________________________________________

Name: ___________________________ Age: ______ Sex: _____ Date of Admission: ________

CC:_____________________________________________________________________________

HPI_______________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________

Physical Examination:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
____________________________________________________________________________
________________________________________________________________________________

Differential Diagnosis and Workup Plan:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
___________________________________________________

Final diagnosis (in case of its presence)

Page | 43
Topics: Gastrointestinal (PBL ILOs)
Period (indicate dates):
PBL Courses
Basic and Clinical Sciences using virtual
patient cases
Identify common causes of diarrhea, their investigation and management in a young
person. The study
course
Identify on a cadaver and describe the surface anatomy, key anatomical features,
content
anatomical relations, vascular supply, nerve supply, and histological structure the midgut
covered
and hindgut.
during the
Distinguish between retroperitoneal, secondarily retroperitoneal and peritoneal organs. departmental
meetings and
Compare and contrast the functions of the duodenum, jejunum, ileum and large intestines, PBL seasons
pancreas and pancreatico-biliary tree. attended:

LEARNING
Describe the way in which carbohydrates, fats and proteins are absorbed.
OUTCOMES
Explain and describe the signs and symptoms of malabsorption.

Identify clinically important causes of malabsorption and steatorrhea.

Explain how and why malabsorption would alter the full blood count, clotting and
biochemical profile.

Distinguish between Crohn’s disease and ulcerative colitis, giving examples of 3 clinical, 3
macroscopical and 2 microscopical findings which differ between the two diseases.

Define coeliac disease and explain the likely pathogenesis and possible underlying
mechanisms, including the genetic link between HLA loci and coeliac disease.

Describe the common clinical presentations, pathology and management of coeliac disease.

Describe the common clinical presentations, pathology and management of inflammatory

bowel disease.

Describe the complications of coeliac disease and discuss the importance of adherence to a
gluten free diet in minimizing these.

List particular problems associated with childhood coeliac disease.

Outline common gastrointestinal conditions affecting children.

Describe the effect of stimulating the parasympathetic nervous system on the heart, eye,
bladder, GI tract, and lungs.

Identify drugs used to mimic or reduce the actions of the parasympathetic nervous system,
and describe their clinical implications.

Patient and Doctor

Perform a rectal examination, identifying the relevant underlying normal anatomy and
pathology of local organs on a model.
Page | 44
Apply the principles of abdominal examination to examining the acute abdomen
Page | 45
 Unified Form for Assessment of Student Performance (PBL)

Student:______________________________________________ Module:_____________________________________

Subject block: _____________________ Date: ________________________________

Preparation For PBL* Contribution For PBL* Attitude to Peers & Tutor*

 
   

*For assessment descriptors refer to Appendix II

Tutors signature:

………………………………………………

Page | 46
Tutors comment on this student’s strengths and weaknesses addressing the following competencies:
Medical Knowledge, Clinical Skills, Interpersonal & Communication Skills, and Professionalism:

YOUR RECOMMENDATION FOR STUDENT’S FINAL GRADE IN THIS COURSE:

FAIL LOW PASS PASS HIGH PASS HONORS

Other (please specify) □________________________________________________________

Tutors signature:

………………………………………………

Page | 47
 SUMMARY OF CASE (copy the form based on number of practiced cases)
CASE N______________________________________________________________

Name: ___________________________ Age: ______ Sex: _____ Date of Admission: ________

CC:___________________________________________________________________________
HPI_______________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
__________________________________________________________________

Physical Examination:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
__________________________________________________________________

Differential Diagnosis and Workup Plan:

___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
_______________________________________________

Final diagnosis (in case of its presence)

Page | 48
Urinary System

The study course content covered during the departmental meetings and PCD classes attended:

DATE TOPIC
Approach to the Renal Patient. Approach to the Urologic Patient. Imaging Tests.
Procedures. Dysuria. Hematospermia. Isolated Hematuria. Polyuria. Priapism.
Proteinuria. Painless Scrotal Mass. Scrotal Pain. Urinary Frequency.
Urinary Incontinence. Urinary Retention. Neurogenic Bladder. Interstitial Cystitis.

Acute Renal Failure. Chronic Kidney Disease.

Nephritic Syndrome. Nephrotic Syndrome.

Page | 49
LEARNING OUTCOMES

The course is aimed at the acquisition of program-specified knowledge. After completing the course
students are supposed to: interview patients with Urinary System pathology, collect medical history,
provide physical examination; based on the analysis results of physical examination and instrumental
investigations – identify patient’s problem; discuss preliminary plan of care and management.

Medical History Taking:

 Cognition of patient’s demands and expectations in respect of the consultation
 Comprehensive history taking: somatic, considering psycho-social factors and all objective and
subjective complaints.
 Task-oriented and hypothesis-based medical history taking
 Genetic history taking.
 History taking on travel-related medical problem
 Occupation environment history taking
 Identificaion of life and health-threatening behavior and life style

Teacher's name and Signature: ___________________________________Date:_______________

Information And Management:

 History taking on psychotropic drug consumption.
 Setting up a clinical task and receiving relevant information from literature data.
 Informing patients and their family about poor diagnosis
 Medical record (Written documentation of patient medical history)
 Advice on diet, physical activity, smoking, alcohol and drug use.
 Pain management, palliative care and terminal stage of life.
 Probable diagnosis outline, raising urgent problems and planning medical management .
 Current algorithms and national Protocols & Guidelines

Teacher's name and Signature: ___________________________________Date:_______________

Page | 50
 Physical Examination
 General state assessment (habitus, stance, symmetry and mobility of the body, nutritional status, mood and
mental status)
 Vital signs assessment (temperature, pulse, arterial blood pressure, heart rate, respiration)
 Skin and mucosa assessment
 Routine activity assessment
 Assessment of attention, concentration, thinking, cognition, affective and psychomotor behavior
 Assessment of alcohol and drug intoxicated individual/patient
 Assessment of peripheral and central arterial pulse, arterial murmur
 Inspection and palpation of local lymphatic glands/nodes.
 Inspection, percussion, palpation and auscultation of the chest
 Inspection of the abdomen
 Auscultation of the abdomen
 Percussion of the abdomen (liver, Traube’s space, urinary bladder)
 Palpation of the abdomen (abominal wall, colon, liver,spleen, aorta, masses)
 Abdominal tension, tenderness, excruciating pain
 Shifting of dulness in the abdomen
 Determination of tenderness (sensitivity) within the kidney projective area
 Performance of special techniques (Murphy’s sign, Obturator sign, rebound tenderness, etc)

Teacher's name and Signature: ___________________________________Date:_______________

Additionally, students acquire competencies in performed procedures important for medical

practice:

Procedures
 Urinalyis
 Blood analysis (Kidney function tests)
 Abdominal xray
 Abdominal CT
 Urinary ultrasound

Teacher's name and Signature:___________________________________Date:_______________

Page | 51
 Unified Form for Assessment of Student Performance (PCD)

Student:___________________________________________ Faculty Program:_____________________________________

Course: _____________________ Date: ________________________________

MEDICAL KNOWLEDGE AND DIAGNOSTIC Insufficient Rarely Sometimes Usually Always

REASONING Contact
Knowledge of Pathophysiology and Clinical Topics -
(Demonstrates knowledge of pathophysiology, diagnosis, and
management - Integrates knowledge from a variety of resource)
Diagnostic Reasoning / Differential Diagnosis: (Develops a
comprehensive differential diagnosis; Synthesizes clinical
presentation with understanding of disease

PROFESSIONALISM Insufficient Rarely Sometimes Usually Always

Responsibility and Reliability: Contact
1. Accepts and actively takes on responsibilities
2. Demonstrates industrious work habits
3. Completes tasks carefully and thoroughly
Participation and Initiative:
1. Is motivated and active in patient care and learning
2. Shows interest and takes initiative
Honesty and Integrity
1. Demonstrates trustworthiness
2. Is considered credible
3. Accepts responsibility for own actions and those of colleagues

CLINICAL SKILLS ASSESSMENT (refer to Appendix I for descriptors)

1 2 3 4 5
Communication Skills
Empathy
Interview: Collecting SP history
Interview Technique
Physical Examination
Use of Instruments
Closing/ Summary of the interview
Patient Notes
Student’s Appearance

Teacher's name and Signature:___________________________________Date:_______________

Page | 52
Please comment on this student’s strengths and weaknesses addressing the following competencies:
Medical Knowledge, Clinical Skills, Interpersonal & Communication Skills, and Professionalism:

YOURE RECOMMENDATION FOR STUDENT’S FINAL GRADE IN THIS COURSE:

FAIL LOW PASS PASS HIGH PASS HONORS

Other (please specify) □________________________________________________________

Teacher's name and Signature:___________________________________Date:_______________

Page | 53
 SUMMARY OF CASE (copy the form based on number of practiced cases)
CASE N______________________________________________________________

Name: ___________________________ Age: ______ Sex: _____ Date of Admission: ________

CC:_____________________________________________________________________________

HPI_______________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________

Physical Examination:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
____________________________________________________________________________
________________________________________________________________________________

Differential Diagnosis and Workup Plan:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
___________________________________________________

Final diagnosis (in case of its presence)

Page | 54
The study course content covered during the departmental meetings and PBL seasons attended:

Page | 55
Topics: Urinary (PBL Intended Learning Outcomes)
Period (indicate dates): LEARNING
OUTCOMES
Basic and Clinical Sciences

Revise the various body fluid compartments and their composition: intracellular;
extracellular; ionic composition; osmolality and tonicity.

Revise the clinical signs of hypovolemia.

Describe and explain the biological/clinical basis of the classification of acute kidney injury
as ‘pre-renal, renal and post-renal’.

Explain how the classification of pre-renal, renal and post-renal failure determines initial
investigation and management of renal disease.

Identify on a cadaver and describe the key surface anatomy, gross anatomy, relationships,
neurovascular supply, histology and development of the different components of the
urinary system.

Draw a nephron to indicate main histological and transport functions.

Describe the gross and histological structure of the kidney and ureters, relating structure to
function.

Outline the pathological (including cytological and histological findings) process of ‘acute
tubular necrosis”.

Outline the concept of glomerular filtration rate, concept of renal clearance, how GFR is
calculated and clinical importance.

Describe the role of the kidney in acid-base balance in the body.

Discuss the transport of water, ions, glucose and drugs in the kidney.

Give four indications for initiation of artificial renal support.

Explain the principles behind renal replacement therapy and the basis for the choice of
modality of renal replacement therapy.

Describe the nutritional advice which is generally given to patients on dialysis.

Describe how different renal diseases and other comorbid conditions (e.g. hypertension)
affect prognosis in acute renal failure.

Describe and explain the principal laboratory findings that indicate acute kidney injury.

Explain the effects of NSAIDs on the kidney and how these can exacerbate the effects of
volume depletion on kidney function.

Explain how the kidney is involved in the control of fluid balance.

Explain the concept of homeostasis and outline major mechanisms contributing to body
fluid homeostasis.

Describe the radiological modalities used to investigate the urinary tract and their Page | 56
indications.
 Unified Form for Assessment of Student Performance (PBL)

Student:______________________________________________ Module:_____________________________________

Subject block: _____________________ Date: ________________________________

Preparation For PBL* Contribution For PBL* Attitude to Peers & Tutor*

 
   

*For assessment descriptors refer to Appendix II

Tutors signature:

………………………………………………

Page | 57
Tutors comment on this student’s strengths and weaknesses addressing the following competencies:
Medical Knowledge, Clinical Skills, Interpersonal & Communication Skills, and Professionalism:

YOUR RECOMMENDATION FOR STUDENT’S FINAL GRADE IN THIS COURSE:

FAIL LOW PASS PASS HIGH PASS HONORS

Other (please specify) □________________________________________________________

Tutors signature:

………………………………………………

Page | 58
 SUMMARY OF CASE (copy the form based on number of practiced cases)
CASE N______________________________________________________________

Name: ___________________________ Age: ______ Sex: _____ Date of Admission: ________

CC:_____________________________________________________________________________

HPI_______________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________

Physical Examination:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
____________________________________________________________________________
________________________________________________________________________________

Differential Diagnosis and Workup Plan:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
___________________________________________________

Final diagnosis (in case of its presence)

Page | 59
Endocrine System

The study course content covered during the departmental meetings and PCD classes attended:

DATE TOPIC
Hypothalamus-pituitary Relationships.
Anterior Lobe Disorders.
Thyroid Hormones, Hyperthyroidism.
Hypothyroidism. Thyroiditis. Euthyroid Goiter.
Diabetes Mellitus. Symptoms and Signs, Diagnosis. Diabetic Ketoacidosis. Nonketotic
hyperglycemic Hyperosmolar Coma. Hypoglycemia. Glucagon.
Polyglandular Deficiency Syndromes

Page | 60
LEARNING OUTCOMES

The course is aimed at the acquisition of program-specified knowledge. After completing the course
students are supposed to: interview patients with Endocrine System pathology, collect medical
history, provide physical examination; based on the analysis results of physical examination and
instrumental investigations – identify patient’s problem; discuss preliminary plan of care and
management.

Medical History Taking:

 Cognition of patient’s demands and expectations in respect of the consultation
 Comprehensive history taking: somatic, considering psycho-social factors and all objective and
subjective complaints.
 Task-oriented and hypothesis-based medical history taking
 Genetic history taking.
 History taking on travel-related medical problem
 Occupation environment history taking
 Identificaion of life and health-threatening behavior and life style

Teacher's name and Signature: ___________________________________Date:_______________

Information And Management:

 History taking on psychotropic drug consumption.
 Setting up a clinical task and receiving relevant information from literature data.
 Informing patients and their family about poor diagnosis
 Medical record (Written documentation of patient medical history)
 Advice on diet, physical activity, smoking, alcohol and drug use.
 Pain management, palliative care and terminal stage of life.
 Probable diagnosis outline, raising urgent problems and planning medical management .
 Current algorithms and national Protocols & Guidelines

Teacher's name and Signature: ___________________________________Date:_______________

Page | 61
 Physical Examination
 General state assessment (habitus, stance, symmetry and mobility of the body, nutritional status, mood and
mental status)
 Vital signs assessment (temperature, pulse, arterial blood pressure, heart rate, respiration)
 Skin and mucosa assessment
 Routine activity assessment
 Assessment of attention, concentration, thinking, cognition, affective and psychomotor behavior
 Assessment of alcohol and drug intoxicated individual/patient
 Assessment of peripheral and central arterial pulse, arterial murmur
 Inspection and palpation of regional lymphatic glands/nodes.
 Visual inspection, palpation and auscultation of cervical structures (thyroid gland,carotid ateries and
lymphatic nodes)
 GALS assessment
 Inspection, percussion, palpation, asucultation of the chest
 Inspection, auscultation, percussion, palpation of the abdomen

Teacher's name and Signature: ___________________________________Date:_______________

Additionally, students acquire competencies in performed procedures important for medical

practice:

Procedures

 Thyroid ultrasound
 Endocrinological blood tests

Teacher's name and Signature: ___________________________________Date: _______________

Page | 62
 Unified Form for Assessment of Student Performance (PCD)

Student:___________________________________________ Faculty Program:_____________________________________

Course: _____________________ Date: ________________________________

MEDICAL KNOWLEDGE AND DIAGNOSTIC Insufficient Rarely Sometimes Usually Always

REASONING Contact
Knowledge of Pathophysiology and Clinical Topics -
(Demonstrates knowledge of pathophysiology, diagnosis, and
management - Integrates knowledge from a variety of resource)
Diagnostic Reasoning / Differential Diagnosis: (Develops a
comprehensive differential diagnosis; Synthesizes clinical
presentation with understanding of disease

PROFESSIONALISM Insufficient Rarely Sometimes Usually Always

Responsibility and Reliability: Contact
1. Accepts and actively takes on responsibilities
2. Demonstrates industrious work habits
3. Completes tasks carefully and thoroughly
Participation and Initiative:
1. Is motivated and active in patient care and learning
2. Shows interest and takes initiative
Honesty and Integrity
1. Demonstrates trustworthiness
2. Is considered credible
3. Accepts responsibility for own actions and those of colleagues

CLINICAL SKILLS ASSESSMENT (refer to Appendix I for descriptors)

1 2 3 4 5
Communication Skills
Empathy
Interview: Collecting SP history
Interview Technique
Physical Examination
Use of Instruments
Closing/ Summary of the interview
Patient Notes
Student’s Appearance

Teacher's name and Signature: ___________________________________Date: _______________

Page | 63
Please comment on this student’s strengths and weaknesses addressing the following competencies:
Medical Knowledge, Clinical Skills, Interpersonal & Communication Skills, and Professionalism:

YOURE RECOMMENDATION FOR STUDENT’S FINAL GRADE IN THIS COURSE:

FAIL LOW PASS PASS HIGH PASS HONORS

Other (please specify) □________________________________________________________

Teacher's name and Signature: ___________________________________Date: _______________

Page | 64
 SUMMARY OF CASE (copy the form based on number of practiced cases)
CASE N______________________________________________________________

Name: ___________________________ Age: ______ Sex: _____ Date of Admission: ________

CC:_____________________________________________________________________________

HPI_______________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________

Physical Examination:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
____________________________________________________________________________
________________________________________________________________________________

Differential Diagnosis and Workup Plan:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
___________________________________________________

Final diagnosis (in case of its presence)

Page | 65
PBL Courses using virtual patient cases

The study course content covered during the departmental meetings and PBL seasons attended:

LEARNING OUTCOMES
Topics: Endocrine (PBL Intended Learning Outcomes)
Period (indicate dates):

Basic and Clinical Sciences

Define diabetes and its diagnostic criteria, and briefly differentiate between the different types.

Describe the pathways and major controls in normal individuals on: glucose uptake into muscle cells and adipocytes;
glycogen synthesis, glycogenolysis, glycolysis and gluconeogenesis in liver cells; fatty acid synthesis and oxidation in
liver cells; triacylglycerol storage and mobilization in adipose tissue; protein synthesis and breakdown

Explain what is meant by 'ketone bodies' and outline the pathway for their production.

Identify and explain the major abnormalities in the control of intermediary metabolism in insulin-dependent diabetes
which result in elevated circulating glucose, loss of proteins and ketoacidosis.

Explain the importance of maintaining blood glucose.

Identify the source and mechanism of action of insulin and glucagon.

Identify the buffer system in the blood.

Describe in general terms the responses of the lung and kidney to metabolic acidosis. Describe the consequences
(osmotic diuresis and reduced blood volume) of plasma glucose concentration exceeding the renal threshold.

Explain why it is important to maintain Na+ and K+ levels in plasma during treatment of diabetic ketoacidosis.

Describe the pathogenesis and pathology of micro and macrovascular disease in diabetes.

Describe the monitoring and management of a patient with Type1 and Type 2 diabetes.

Present a general overview of the endocrine system, including classification, synthesis, secretion,
mechanism of action and control of hormones and hormone receptors.

Outline the anatomy and histology of the hypothalamic-pituitary axis and explain its relation to optic
chiasma.

Outline neurosecretion and explain how hypothalamic hormones act on the anterior pituitary gland.

List the hormones of the anterior pituitary gland and outline their function.

Describe the mechanisms and the physiological effects of hormone deficiency and excess.

Describe the metabolic consequences of obesity and the complications that can arise from this.

Patient and Doctor

Identify and practice appropriate skills to elicit an accurate history from a patient with a disorder of the

Page | 66
endocrine system.
Practice giving information about diabetes in a clinical setting.
Calculate the Body Mass Index of a colleague and explain its significance.
Calculate the waist / hip ratio of a colleague and explain its significance.
Accurately test simulated urine samples using standard dipsticks.
Measure their own blood glucose with a standard glucometer.
Recognize and be familiar with a U100 syringe and needle device.
Demonstrate an awareness of problems associated with diabetic feet.
Interview and perform and diabetic check on a patient.
Community and Population Health
Explain the aims of diabetic care in General Practice.
Describe how your patient a) monitors their glucose and b) administers their insulin.
Consider the need for a total package of care approach in the treatment of people with diabetes.
Define the main design features of experimental studies including clinical trials.
Explain the value of randomized clinical trials in informing the management and prevention of diabetes.
Personal and Professional Development
Discuss the importance of inter-professional care in good clinical outcomes and on-going support for
patients with diabetes.
For metabolic pathways, the students should be able to: Describe the major functions of each pathway. Recognize the
major ways by which the rate of the pathway is controlled by (a) regulation of enzyme activity, and (b) regulatory
molecules such as hormones and metabolites

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 Unified Form for Assessment of Student Performance (PBL)

Student:______________________________________________ Module:_____________________________________

Subject block: _____________________ Date: ________________________________

Preparation For PBL* Contribution For PBL* Attitude to Peers & Tutor*

 
   

*For assessment descriptors refer to Appendix II

Tutors signature:

………………………………………………

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Tutors comment on this student’s strengths and weaknesses addressing the following competencies:
Medical Knowledge, Clinical Skills, Interpersonal & Communication Skills, and Professionalism:

YOUR RECOMMENDATION FOR STUDENT’S FINAL GRADE IN THIS COURSE:

FAIL LOW PASS PASS HIGH PASS HONORS

Other (please specify) □________________________________________________________

Tutors signature:

………………………………………………

Page | 69
 SUMMARY OF CASE (copy the form based on number of practiced cases)
CASE N______________________________________________________________

Name: ___________________________ Age: ______ Sex: _____ Date of Admission: ________

CC:_____________________________________________________________________________

HPI_______________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________

Physical Examination:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
____________________________________________________________________________
________________________________________________________________________________

Differential Diagnosis and Workup Plan:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
___________________________________________________

Final diagnosis (in case of its presence)

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 Hematopoietic System
PBL Courses using virtual patient cases

The study course content covered during the departmental meetings and PBL seasons attended:

LEARNING OUTCOMES
Topics: Hematopoietic (PBL Intended Learning Outcomes)
Period (indicate dates):
Basic and Clinical Sciences
Describe the anatomy of the liver and its relevant circulatory systems
Describe standard panel of liver function tests and the reason for performing the tests and interpretation of
tests
Describe the histology of the normal liver lobule and relate this to specific functions.
Describe the synthesis, composition and excretion of bile.
Describe how the liver detoxifies.
Describe the metabolism of bilirubin.
Discuss the ways in which viral hepatitis is diagnosed.
List viruses that cause human disease.
Describe the structure of hepatitis B and C viruses.
Describe how viruses evade the immune response and cause chronic infection
With reference to hepatitis B describe how virus vaccines are designed.
Compare the routes of transmission and risk factors of hepatitis A, B, D, C and E viruses
Describe the long-term complications of chronic hepatitis B or C infection
List the drug treatments available for hepatitis B and C infection.
Discuss the role of vaccination in prevention of hepatitis B infection worldwide.
Describe the precautions a health care professional should take to avoid exposure to blood borne viruses and
the steps they should take immediately after exposure
Describe different receptor types and how these receptors are coupled to cellular events. Identify how these
signaling events are molecular targets for drug action.
Patient and Doctor
Outline the principles and skills for giving information to patients
Obtain a sample of venous blood using safe phlebotomy technique.
Safely perform the steps required to obtain a blood sample from a manikin.
Practice clinical skills opportunistically in a GP surgery.
Describe the range and types of infections presenting in a GP urgent surgery.
Community and Population Health

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Discuss the lifestyle advice which should be given to patients with active viral hepatitis
Compare the global impact of hepatitis B with hepatitis C.
Personal and Professional Development
Identify the role of the Occupational Health department in healthcare organizations
Describe the responsibilities of healthcare employees in protecting their own health and that of colleagues and
patients

Page | 72
 Unified Form for Assessment of Student Performance (PBL)

Student:______________________________________________ Module:_____________________________________

Subject block: _____________________ Date: ________________________________

Preparation For PBL* Contribution For PBL* Attitude to Peers & Tutor*

 
   

*For assessment descriptors refer to Appendix II

Tutors signature:

………………………………………………

Page | 73
Tutors comment on this student’s strengths and weaknesses addressing the following competencies:
Medical Knowledge, Clinical Skills, Interpersonal & Communication Skills, and Professionalism:

YOUR RECOMMENDATION FOR STUDENT’S FINAL GRADE IN THIS COURSE:

FAIL LOW PASS PASS HIGH PASS HONORS

Other (please specify) □________________________________________________________

Tutors signature:

………………………………………………

Page | 74
 SUMMARY OF CASE (copy the form based on number of practiced cases)
CASE N______________________________________________________________

Name: ___________________________ Age: ______ Sex: _____ Date of Admission: ________

CC:_____________________________________________________________________________

HPI_______________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________

Physical Examination:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
____________________________________________________________________________
________________________________________________________________________________

Differential Diagnosis and Workup Plan:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
___________________________________________________

Final diagnosis (in case of its presence)

Page | 75
 Nervous System
PBL Courses using virtual patient cases

The study course content covered during the departmental meetings and PBL seasons attended:

LEARNING OUTCOMES
Topics: Nervous (PBL Intended Learning Outcomes)
Period (indicate dates):
Basic and Clinical Sciences
Describe the classification, signs and symptoms of anxiety disorders.
Outline the prevalence and etiology of anxiety disorders.
Outline the main approaches to the treatment of anxiety disorders
Have a broad understanding of types of memory and what factors can affect recall in a clinical context
Understand how we learn, and the application of learning theory in clinical practice
Describe the changes in cognition that are considered a part of normal ageing.
List the major causes and basic pathology of the main dementias.
Outline features which distinguish dementia from delirium (chronic vs acute confessional states and describe the major
symptoms of both.
Describe the functional localization in the brain for the main higher cognitive functions and give examples of bedside tests that
can be used to evaluate higher cognitive functions.
Describe a systematic approach for evaluating language skills in adults at the bedside.
Discuss medical strategies available to help symptoms or slow disease progression in dementias.
Patient and Doctor
Outline the principles and skills for giving information to patients
Obtain a sample of venous blood using safe phlebotomy technique.
Safely perform the steps required to obtain a blood sample from a manikin.
Practice clinical skills opportunistically in a GP surgery.
Describe the range and types of infections presenting in a GP urgent surgery.
Community and Population Health
Discuss the lifestyle advice which should be given to patients with active viral hepatitis
Compare the global impact of hepatitis B with hepatitis C.
Personal and Professional Development
Identify the role of the Occupational Health department in healthcare organizations
Describe the responsibilities of healthcare employees in protecting their own health and that of colleagues and patients

Page | 76
 Unified Form for Assessment of Student Performance (PBL)

Student:______________________________________________ Module:_____________________________________

Subject block: _____________________ Date: ________________________________

Preparation For PBL* Contribution For PBL* Attitude to Peers & Tutor*

 
   

*For assessment descriptors refer to Appendix II

Tutors signature:

………………………………………………

Page | 77
Tutors comment on this student’s strengths and weaknesses addressing the following competencies:
Medical Knowledge, Clinical Skills, Interpersonal & Communication Skills, and Professionalism:

YOUR RECOMMENDATION FOR STUDENT’S FINAL GRADE IN THIS COURSE:

FAIL LOW PASS PASS HIGH PASS HONORS

Other (please specify) □________________________________________________________

Tutors signature:

………………………………………………

Page | 78
 SUMMARY OF CASE (copy the form based on number of practiced cases)
CASE N______________________________________________________________

Name: ___________________________ Age: ______ Sex: _____ Date of Admission: ________

CC:_____________________________________________________________________________

HPI_______________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________________

Physical Examination:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
____________________________________________________________________________
________________________________________________________________________________

Differential Diagnosis and Workup Plan:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
___________________________________________________

Final diagnosis (in case of its presence)

Page | 79
Appendix I - “Descriptors of assessment in PCD sessions”

CLINICAL
SKILLS 1 2 3 4 5

Communication Shows poor eye Greets and introduces self to Greets and introduces self to the SP,
Skills contact, doesn't greet the SP, but shows poor eye has good eye contact with the SP: Is
and/or introduces self contact, is partially patient patient oriented
to the SP, isn't patient
oriented
oriented
Empathy Doesn't show Uses element(s) of empathy Shows and expresses empathy towards
empathy towards the (only verbally) SP
SP
Interview: Incompletely collects Collects patients history Collects history sequentially; During
Collecting SP patient history unsequentialy; collects interview uses all of the main and
history information of main subcomponents
components and superficially
subcomponents
Interview Asks patients several Uses: open ended questions,
Technique questions Uses closed ended questions paraphrases, transitions; asks one
simultaneously and question at a time; talks in a language
interrupts them comprehensible for the patient

Physical Performs physical Physical examination is done

Examination Asks patients several examination incompletely; thoroughly, sequentially, and in
questions Uses only several correct locations with respect to the
simultaneously and components of physical organ system
interrupts them examination; Auscultation
points are imprecise; chaotic
examinations
Use of Doesn't use Incorrectly uses instruments Uses instruments correctly
Instruments instruments
Closing/ Incompletely summarizes in Thoroughly summarizes in nonmedical
Summary of the Doesn't summarize nonmedical language language the key information: CC,
interview the key information at differential diagnosis, clinical and
the end of the laboratory tests and their purpose,
interview recommendations; Asks the patient at
the end of interview if they have any
questions
Patient Notes Doesn’t write patient Writes patient note, misses Writes patient note completely,
note some key and relevant includes key and relevant details from
details from History, Physical History, Physical Examination, lists
Examination; misses keys Differentials and workup plans (in case
Differentials and workup needed)
plans (in case needed)
Student’s Student's appearance, Student's appearance and Student's appearance, clothing and
Appearance clothing and personal clothing is acceptable; personal hygiene is agreeable
hygiene is improper Personal hygiene is improper

Page | 80
Page | 81
 Appendix II - “Descriptors of assessment in PBL sessions”
A B
Preparation Always well prepared, has
for PBL material well organized and
has in depth knowledge
and critical approach to
information. Has used a
broad range of sources.
Has a deep understanding
of topic under discussion.
Contribution Always contributes to the
to PBL group discussion
constructively, and
spontaneously. Doesn’t
dominate discussion.
Listens well.
Attitude to Always polite, encouraging,
peers and listens, supportive, non-
tutor judgmental, respectful of
other people even if s/he
disagrees with
contributions, non-
aggressive in questioning.
Good at identifying conflict
and getting the group to
resolve it.
Usually well prepared. Has
material well organized and
has learnt material. Has
searched beyond boundaries
of the subject as defined by
lecture material, and is
knowledgeable. Has used a
broad range of sources. Has
a good understanding of topic
under discussion.
Usually contributes to the
group discussion
constructively, and
spontaneously. Doesn’t
dominate discussion.
Polite, encouraging, listens,
supportive, non-judgmental,
respectful of other people
even if s/he disagrees with
contributions, non-aggressive
in questioning. Good at
identifying conflict and getting
the group to resolve it.
C D
Usually minimally Regularly poorly prepared
prepared for PBL. Has for PBL. Brings sparse
used a minimal range of material of low quality or
sources from lecture none at all. Inadequate or
notes and basic level absent understanding of
internet sites or texts. topics
Has some understanding
of topic under discussion
but not at required depth
Variable contribution to Rarely contributes to the
the group discussion; PBL process. Alternatively
can be silent or quiet; or dominates the group
can constructively and interaction.
spontaneously
contribute. Occasionally
dominates the
discussion.
Occasionally one or Frequently one or more of
more of dominating, dominating, judgmental,
judgmental, aggressive, aggressive, disrespectful,
disrespectful, critical, critical, sarcastic in
sarcastic in manner, or manner, or doesn’t listen to
doesn’t listen to peers. peers. Initiates or catalyzes
Initiates or catalyzes group conflict
group conflict
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