Syllabus
Name of the course/
module
Authors of the
syllabus/authors
(lecturer, lecturers, course
executives)
Faculty, department
Name of the program
Semester
Status of the course
(elective/compulsory)
Language of the course
ECTS
Aim of the course
Program prerequisits
Formatting of the course
Learning outcomes,
competences(general and
field specific)
Principles of Physical Examination
Physical Diagnostics-1
Clinical Skills -2
Imeda Qurtsikidze , MD
Imeda1971@gmail.com mob: 599884408
Mgvdeladze Giorgi MD , PhD student
giorgi.mgvdeladze@atsu.edu.ge 555 69 98 45
Consultations: Tuesday, 15 hr.
Faculty of Medicine/ Department of clinical medicine
One-circle Medical Educational Program ,,Medical Doctor”
V Semester
Compulsory (C)
English
Credits to be achieved – 9 credits. Total: 225hours
- Contact hours – 80 hrs; Lecture - 15, Practical – 60, Passing midterm and fin
exams - 5hrs;
- Hours for Independent Work – 145 hrs.
The aim of the course is to provide students with the knowledge of interviewing pa
with the problems of respiratory and cardiovascular systems (inspection, palp
percussion and auscultation), teaching instrumental and laboratory methods, interp
test results, training for respiratory and cardiovascular diseases, understandin
elements of medical ethics and deontology, developing clinical thinking; to teac
student: classification of the basic concepts and definitions of emergency situa
Emergency first aid, safety, also how to conduct fundamental procedure
cardiorespiratory systems and principles of cardiopulmonary resuscitation.
Body Systems-1, 2,3,4,5,6,7
Professional aspects 2
15Lecture/ 60Practical
Knowledge and Understanding
The student
- Describes the basic features of the patient's examination scheme and histo
illness, assembly of anamnesis, symptoms of physical and instrum
examination, laboratory methods and pathological conditions;
- Classifies the major clinical symptoms of the diseases, causes and mechanis
main pathological processes of the respiratory and cardiovascular system.
- Represents Emergency Management System in the medical sector and ensur
functionality of the scheme;
- Demonstrates the knowledge of emergency medical aid, its principles
methods.
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Skills
A student is able to:
- Make survey independently of the thematic patient and take a history;
- Identify major complaints and feelings;
- perform examination using the senses of sight (inspection);
- External examination of the patient - in the presence of the teacher st
performs palpation, percussion and auscultation;
- Providing explanations and advices to an emergency patient;
- Recognition and evaluation of an emergency medical condition;
- First aid in the organization and implementation of the lesion.
- Have an ability to connect received basic knowledge with practical skills and a
it for improved illness management of future patients

Responsibility and Autonomy

- Consistently plan his/her own learning process;
- applying the gained knowledge in the profession;
- Protect patient privacy according to the medical ethics.
- Respect existing traditional values of the field; Make some contributi
developing these values according to his\her own beliefs.

Field Competences
1. Carry out a consultation with a patient
- take a history
- carry out physical examination
- make clinical judgments and decisions
- provide explanation and advice
- provide reassurance and support
2.Assess clinical presentations, order investigations, make differential diagnoses, and
negotiate a management plan
- recognize and assess the severity of clinical presentations
- order appropriate investigations and interpret the results
- make differential diagnoses
- negotiate an appropriate management plan with patients and careers
- take care of a terminal patient and his family members
- manage the chronic disease
3.Providing first aid in emergency medical situations (First aid and resuscitation
measures)
- Identifying and assessing the emergency medical conditions (DRSABCD
- Treatment of emergency medical conditions
- Providing with first aid; age peculiarities;
- Conducting the basic life maintaining and cardiopulmonary resuscitation
activities in compliance with the guidelines.
- Conducting the activities for enhance lifetime maintenance in accordanc
with the guidelines.
5. Conducting Practical Procedures
Vital Signs: Pulse, respiration, temperature
- Measure Blood pressure
- Oxygen delivery,
- Patient Transportation and Treatment

2
 - Electrocardiography
- Interpretation
- Performing Respiratory Function Test
6. Communicate effectively in a medical context
- Communicate with patient
- Communicate with colleagues
- Communicatein breaking bad news
- Communicate with patient’s relatives
- Communicate with disabled peoples
- Communication in seeking informed consent
- Written communication (Including the medical records)
- Communicate in dealing with aggression
- Communicate with those who require an interpreter
- Communicate with law enforcement agencies and mass media
- Effective communication with any person regardless of his/her social, cultur
religious and ethnic background
7. The use of Ethic and Legal Principles in Medical Practice
- Keep confidentiality
- The use of Ethical principles and analytical skills in treatment process
- Get the informed consent and make an appropriate record
- Issuing death certificate
- Requiring autopsy (in compliance with the Georgian Legislation)
- Apply Georgian and international legislation during treatment
- Conducting medical
10.Use information and information technology effectively in a medical context
- Keep accurate and complete clinical records
- Use computers in medical practice
- Access specific information sources;
- Store and retrieve information
- Keep personal records (portfolio)
12. Implementation of health promoting events, engage with public healthcare issue
efficient performance within the healthcare system
 Conducting the treatment that minimizes the risk of damage to the patient.
- Implement measures for the prevention of infection spread
- Understanding ones’ own health problems and evaluating ones’ own health
regard to professional responsibilities;
- Participation in health promotion events both on individual and population-
level
13. Professionalism
ability to recognize limits and ask for help
- ability to workautonomously when necessary
- ability to solve problems
- ability to make decisions
- ability to work in a multidisciplinary team
- ability to communicate with experts in other disciplines
- ability to lead others
Competences

Knowledge and understanding skills Responsibility a

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 Autonomy

X X X

Learning / Teaching methods - Verbal teaching method

and activities - Demonstration of study materials
- Presentation
- Explanation methods
- Discussion/debate
- Case study

Assessment system and Student's credit can be obtained in the educational program only after the attainm
criteria learning outcomes planned according syllabus, which is reflected in the credit syst
one of the positive evaluations.
Student assessment contribution is made by:
a)Interim (intermediate) assessments, which includes the student's daily aca
activity (examination, testing, presentation, essay), activity on tutorial, practical
assessment and a mid-term exam. Interim assessment may also include
components.
b)Final exam
The final assessments are made on the basis of summarizing the evaluatio
intermediate and the final exam.
- The student has the right to take the final exam, if his/her minimum compe
is 18 points and the number of missed contact hours does not exceed 50%.
- Minimum margin of assessment received by the student on the final exam
points.
Evaluation System includes:
A. Five Forms of Positive Assessment:
(A) Excellent – 91% and more from maximum evaluation
(B) very good – 81-90% from maximum evaluation
(C) good – 71-80% from maximum evaluation
(D) satisfactory – 61-70% from maximum evaluation
(E) sufficient – 51-60% from maximum evaluation
B. Two Forms of Negative Assessment:
(FX) (Administrative Fail in Course for Grade/could not pass)– A student gets 41
from maximum evaluation which means that s/he is required to work more for p
the exam, and that s/he is entitled to take a makeup exam only once through per
study
(F) (Academic Fail) – A student gets 40% and less from maximum evaluation w
means that the work done by him/her is not sufficient and s/he has to retake the cou

According to educational component of educational program, in case of adoption of

a makeup exam will be appointed no less than 5 calendar days after the conclusion
the final exam results.
- The number of points received in the makeup final exam, is not added to the
assessment received by the student.
- According to the assessment 0-50 points received from the makeup final exam, in
final evaluation of the educational component, the student will be evaluated the
score.
Midterm and final exams take place in exam center of ATSU
Learning course maximum evaluation equals 100 points.
A student’s final grade is obtained as a result of summing the midterm evaluation e

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 per semester and final exam evaluation results.
The sum of the course assessment breaks down as follows:
The sum of the course assessment (100 points) breaks down as follows:

 Activities (Ongoing evaluation) - 18 points

The student is evaluated 6 times, one evaluation 3 points,
3 point - The student is well prepared, the answer is perfect and exhausting.
2 point - The student is well prepared, the answer is perfect and exhausting.
1 point - The answer is short, the answer is substantially wrong.
0 point - The student is unprepared and his answer is absolutely wrong ation criteria

 Examination skills -Total 6 points

Student demonstrate following clinical skills, which is assisted with max. 1point
each skill assisted by one point.
1point - collecting anamnesis
1point- inspection
1point - palpation
1point -percussion
1 point - auscultation
1points - assessment of ECG

 Case health history - maximal 6 points, is conducted 3times a semester,

with 2 points:
2 points - the case history is written according the scheme, data are collected wi
mistakes, investigation plan is formed correctly.
1- point - case history is not following the stated form, anamnesis fails some impo
data, investigation plan is not formed correctly.
 Midterm exam – 30 points, administered in written form (30 MCQ test
correct answer 1 point.
 Final exam is combined, maximum score - 40 points and include a
assignment and a - OSCE
Test assignment is conducted at the examination center - 20 points and includ
closed-ended questions, each correct answer is assessed with 0.25 points.
OSCE - 20 points. Is held at the Faculty of Medicine at the stations of the Clinical
Laboratory.

Activities 18%
Examination skills 6%
Case health history 6%
Midterm exam 30 %
Final exam 40%
Total 100%

Note: Student assessment is based on the following principles: feasibility, relia

validity and transparency. Papers will not be corrected if academic dishone
identified: plagiarism, self-plagiarism, counterfeiting (The ATSU Code for Acad
Integrity.
Core literature: Bates' Guide to Physical Examination and History-Taking –
Edition Eleventh, North American Edition

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Additional literature
Topics of the lecture, practical classes/laboratory work/working group, literature
Anthony F.T. Brown- Emergency Medicine. 6e. 2012
Essential Procedures for Emergency, Urgent, and Primary Care Settings, S
edition, 2016
Auscultation Skills Breath & Heart Sounds, Fifth Edition; Jessica Shank Co
© 2014 by Lippincott Williams & Wilkins, a Wolters Kluwer business.
1. Textbook of Physical Diagnosis: History and Examination With STUDENT
CONSULT Online Access, 7e (Textbook of Physical Diagnosis (Swartz)) 7th
Edition by Mark H. Swartz MD FACP (Author)
2. History and Physical Examination, 10th Edition (Current Clinical Strategies)
Edition by Paul D. Chan (Author), Peter J.Winkle (Author)
3. Textbook of Adult Emergency Medicine. Edited by: Peter Cameron. 3e, 2009
Course description:
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Week № Type of
Topics
the class

An overview of physical examination and history taking

The health history: structure and purposes. The comprehensive adult health history. The
Lect.-1 h physical examination: approach and overview. Recording findings.
1
Pract.- 4 h
 Clinical skills 2 -Bases of emergency medicine. Demonstration of practical skills.

Interviewing and the health history

 The approach to the interview. The sequence of the interview. The techniques of
skilled interviewing. Adapting interviewing techniques to specific situations. Special
Lect.-1 h aspects of interviewing. Interviewing patients of different ages. Ethical considerations.
2
Pract.- 4 h. Demonstration the patient interviewing video.

 Clinical Skills 2- Basic principles and techniques for the protection of the population
in emergency situations.
Clinical reasoning, assessment and plan
 The process of clinical reasoning the case of Mrs. N: assessment and plan. Organizing
Lect.-1 h the patient record. Clinical assessment.
3
Pract.- 4 h 
 Clinical Skills 2 - First Aid "first aid alphabet" _ ABC - airway, breathing, circulation;
Damaged in a safe location
Beginning the Physical Examination: General Survey and Vital Signs.
 Health promotion. Techniques of examination. Adjusting Lighting and the
Lect.-1 h Environment. The General Survey. Blood pressure, heart rate, respiratory rate and
4 rhythm, the temperature. Clinical Case Discussion based on CBL (Case Based Learning)
Pract.- 4 h
method. Clinical case on interpretation and assessment of Vital Signs.

 Clinical Skills 2 -Auscultation, Heart sounds
The Thorax and Lungs. Anatomy and physiology. Health history. Common symptoms of
respiratory diseases.
Lect.-1 h  Examination of the Posterior and anterior Chest. Inspection, palpation. Demonstration
5
Pract.- 4 h of video. Examination of patients.

 Clinical Skills 2 -Auscultation, Heart sounds

Percussion and auscultation of the chest.
 Breath sounds (lung sounds). Adventitious sounds. Transmitted voice sounds. Clinical
assessment of pulmonary function. Using a Manikin for the lung auscultation and
training in listening of lung sounds. Demonstration of video. Clinical Case Discussion
Lect.-1 h
6 based on CBL (Case Based Learning) method. Clinical case on Differential Diagnosis of
Pract.- 4 h
Lung diseases patient.

 Clinical Skills 2 - ECG-taking and recording technique

7 Lect.-1 h The Cardiovascular System. Anatomy and physiology.
Pract.- 4 h  The Cardiovascular System. Anatomy and physiology. Arterial pulses and blood
pressure. Jugular venous pressure (JVP). Jugular venous pulsations.

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  Clinical Skills 2 -Heart- Exercise Stress Testing
8 Midterm 2 h
Common symptoms of heart diseases. Inspection and palpation of the heart.
Lect.-1 h
9  Assessing the jugular venous pressure (JVP).
Pract.- 4 h
 Clinical Skills 2 -Spirometry – technique
Auscultation of heart sounds and murmurs.
 The auscultator areas. Listening of heart sounds and murmurs audio materials and
Lect.-1 h training on the patients. Using a Manikin for the cardiac auscultation and training in
10
Pract.- 4 h listening of heart sounds and murmurs.

 Clinical Skills 2 -Pulse measurement, Blood pressure measurement

Clinical Case Discussion based on CBL (Case Based Learning) method. Clinical cases on
Lect.-1 h Interpretation and differential diagnosis of Heart diseases.
11
Pract.- 4 h
 Clinical Skills 2 -Oximetry
The skin, hair, nails.
 The skin anatomy and physiology. Changes with Aging. Health promotion. Common
symptoms of skin diseases. Techniques of examination. Skin Lesions. Recording of
Lect.-1 h
12 physical examination-the skin. Demonstration of video – the skin, hair and nails
Pract.- 4 h examination.

 Clinical Skills 2 -Oxygen therapy

The Head and Neck. Important areas of examination of the eyes.
 Anatomy and physiology of the eyes. Common symptoms. Visual acuity, visual fields,
Lect.-1 h conjunctiva and sclera, cornea, lens, pupils, extra ocular movements, fundi.
13
Pract.- 4 h Demonstration video of examination of eyes. Examination of patients.

 Clinical Skills 2 - Cardiopulmonary resuscitation

Anatomy and physiology of the ears. Examination of ears. Demonstration of video.
 Techniques of examination of ears. Common symptoms of ear diseases. Examination of
Lect.-1 h
auditory acuity on patients.
14 Pract.- 4 h

 Clinical Skills 2 -Chest drain

The Nose and Paranasal Sinuses. The Mouth and Pharynx. Demonstration of video.
 Examination of the nose, paranasal sinuses, the mouth and pharynx. The Neck. Lymph
Lect.-1 h
15 Nodes. The Trachea and the Thyroid Gland.Examination of patients.
Pract.- 4 h

 Clinical Skills 2- Tracheostomy- technique

Special techniques and instrumental methods of heart assessment.
Lect.-1 h  Electrocardiography. Analysis and interpretation of normal ECG.
16 Pract.- 4 h
 Clinical Skills 2 - Tracheal Intubation -technique
17-18 Final exam 3 h

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Author of the syllabus: I. Qurtsikidze, G.Mgvdeladze Date ----- 2021