Syllabus

Course Introduction to Clinical Diagnostics II - Physical Diagnosis and Clinical Skills

Program MD Program
Faculty Medicine
Study cycle One-Cycle Educational Program
Semester V
Lecturer Liana Rigvava - Invited Lecturer - liana.rigvava@eu.edu.ge
Davit Malidze – Affiliated Professor - malidze.david@eu.edu.ge
Vladimer Tsikarishvili - Professor- vladimir.tsikarishvili@eu.edu.ge
Nana Chikhladze - assistant professor- nana.chikhladze@eu.edu.ge
Tamar Chanturia - Invited Lecturer - tamar.chanturia@eu.edu.ge
Maia Ananiashvili - Invited Lecturer - maia.ananiashvili@eu.edu.ge
Gocha Tukhashvili - Invited Lecturer - gocha.tukhashvili@eu.edu.ge
Ekaterine Jabua - Invited Lecturer - ekaterine.jabua@eu.edu.ge
Ana Jabauri - Invited Lecturer - ana.jabauri@eu.edu.ge
Davit Toloraia - Invited Lecturer - davit.toloraia@eu.edu.ge
Natia Tskhakaia - Invited Lecturer - natia.tskhakaia@eu.edu.ge
Natia Asitashvili - Invited Lecturer - natia.asitashvili@eu.edu.ge
Nino Tsirekidze - Invited Lecturer - nino.tsirekidze@eu.edu.ge
Lana Guguchia - Invited Lecturer - lana.guguchia@eu.edu.ge
Tamar Saria - Invited Lecturer - tamar.saria@eu.edu.ge
Lela Chkhitauri – Assistant - lela.chkhitauri@eu.edu.ge
Ekaterine Abzianidze - Invited Lecturer - ekaterine.abzianidze@eu.edu.ge

Consulting hours: 2 hours/week. Time and location of the hours are defined at
the beginning of the semester.
Course status Mandatory

Purposes of the course • Teach students the methods of examining patients;

• Ensure the development of clinical skills;
• Teach students to identify specific physical signs and symptoms of
various clinical syndromes and diseases;
• Teach students the methods of various clinical manipulations, their
indications and contraindications.
Amount of credits (ECTS) Total – 10 credits / 300 hours
and distribution of hours Physical Diagnosis –8/ 240
Clinical Skills –2/ 60

Lectures / Practical work (contact hours):

Physical Diagnosis –15/ 45
Clinical Skills –15/30
Total – 105
1
 Exams (hours):
Midterm – 2
Final exam – 4
Total – 6

Independent work (hours):

Total-189 hours

Semester includes 21 weeks: 15 - Training weeks, 6 - session weeks.

Mid-term exam will be held on the 8th-9th weeks of the academic semester.
The final exam of the semester will be held on the 18th - 19th weeks.
Additional exam is conducted in terms of the 20th-21st weeks.

The period between the final and the additional exams shall be not less than 5
days.
Admission preconditions Introduction to Clinical Diagnostics I
Learning outcomes
1. Field knowledge After completing the academic
course, a student:
• Describes physical and clinical
examination methods;
• Determines the method of
physical examination appropriate
for a particular system of a body;
• Describes the importance of
intra-aortic balloon
counterpulsation in congestive
heart failure, as well as
indications and contraindications
for its use;
• Describes changes in jugular vein
pressure during various cardiac
pathologies;
• Describes specific physical signs
and symptoms characteristic of
different clinical diagnoses.
2. Giving consultation to a patient After completing the academic
course, a student:
• Collects anamnesis;
• Conducts a physical
examination;
Assesses the psycho-emotional
status of a patient.
6. Conducting practical procedures After completing the academic
course, a student:
• Possesses the ability to care for
patients with disabilities;
2

7. Effective Communication in the After completing the academic
Medical Context
14. Professionalism
Content Please see Appendix 1
Teaching - learning Teaching and learning methods:
methods and activities • Lecture
• Practical work
Activities:
Lecture activities:
• Explanation
• Demonstration
• Training Video Films
Activities of practical training:
3
• Possesses the skills for an in-
bed patient care;
Performs heart palpation,
auscultation and defibrillation.
course, a student:
• Efficiently establishes
communication with a patient;
• Efficiently establishes
communication with
colleagues;
• Effectively establishes
communication with a
patient's environment;
• Effectively communicates with
person(s) with disabilities
and/or special needs, regardless
of their social, cultural,
religious or ethnic background;
• Communicates effectively to
obtain an informed consent;
Maintains written communication
(including the production of
medical records);
Students will develop the
following competencies and skills:
• Fully adheres to the principles
of impartiality, integrity and
ethics;
• Carries out the medical activity
with due quality;
• Reveals readiness for
professional growth;
Demonstrates critical and self-
critical attitude, is tolerant to
criticism.
 • Group Work;
• Demonstration of practical skills
• CBL
• Teaching using simulators (body interact)
• Presentation

Assessment system Knowledge of a student is assessed with a 100-point grading system. 100
points represents a maximum grade. The prerequisite for acquiring ECTS
credit is to accumulate at least 51 points out of 100.

The knowledge assessment system includes:

a) Five types of positive assessment:
a.a) (A) Excellent - 91-100 points;
a.b) (B) Very good - 81-90 points;
a.c) (C) Good - 71-80 points;
a.d) (D) Satisfactory - 61-70 points;
a.e) (E) Sufficient - 51-60 points.

b) Two types of negative assessment:

b.a) (FX) Did not pass - 41-50 points, which means that a student needs to
work harder to pass and is granted with the right to take one additional exam
in terms of independent work;
b.b) (F) Fail- 40 points and less out of maximum assessment, which means the
performance of a student is not sufficient and the learner has to study the
subject again.

The student will be admitted to the additional examination if he/she has

exceeded the minimum threshold of the final positive assessment (51 points)
but has not exceeded the minimum threshold of the final exam.
The student will be admitted to the final exam if he / she exceeds the
minimum threshold of the intermediate assessment.
Credit can be granted if:
a) The student's results exceeded the minimum threshold of the final exam;
b) The student got at least 51 points out of a maximum 100 points in the final
evaluation.
Minimum threshold of the intermediate assessment is 50% (30 points), for the
final exam – 50%+1 (21 points).
Evaluation components, Student’s knowledge assessment:
methods and criteria
Total assessment - 100 points
Midterm assessment- 60 points:
• Oral survey – 10 points
• Practical activities- 30

Midterm – 20 points
Final exam - 40 points

Description of evaluation criteria:

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 1. Oral Survey - 10 points
Conducted 5 times per semester in physical diagnosis. Each of them is
evaluated by 2 points.

The criteria of the oral survey are:

• 2 point: The student is well-prepared, thoroughly masters the syllabus

material. The answers to the questions are correct, substantiated and
accurate. A student has a good understanding of the material.
• 1 point: The student knows only a part of the syllabus topic, the
answers to the questions are correct, but incomplete / not exhaustive.
• 0 point: The student is completely unprepared, has not studied the
topic of the syllabus, cannot answer questions

2. Practical Activities - 30 points

Practical activities are held 6 times during semester, each activity
assess maximum 5 points: (4 times in skills, 2 times in physical
diagnosis).
• Performs manipulations without errors – 5 points
• Performs manipulations with minor errors – 4 points
• Performs manipulations with some errors – 3 points
• Performs manipulations with errors – 2-1 point
• Cannot perform manipulations– 0 point

3. Midterm Examination - 20 points

10 points- mini-OSCE - 10 points a test with multiple choices
• Each test is evaluated by 1 point.
• Mini-OSCE will be conducted at 2 stations as a practical examination.
The evaluation of each component at the stations is determined
according to the evaluation sheet so that the total evaluation amounts
to 10 points. The evaluation sheet is worked out directly considering
the specifics of the task to be performed. The distribution of the
corresponding points of the assignment to be performed at the station
is given precisely in the evaluation sheet.
The criteria are:
• Done – Candidate has fulfilled OSCE criteria and has performed the
tasks completely and with confidence
• Partially done – A fair performance fulfillment of most OSCE criteria
• Not Done – Extremely poor performance, candidate has not
performed any of the OSCE criteria

4. Final exam - 40 points.

20 points OSCE - 20 points- a test with multiple choices.
• Each test is evaluated by 1 point.

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 • OSCE exam is composed of 4 practical tasks.
The evaluation of each element at the stations is determined according to
the evaluation sheet so that the total evaluation amounts to 20 points.
The evaluation sheet is developed taking into account the specifics of the
task to be performed. The distribution of the corresponding points of the
task to be performed at the station is given in detail in the evaluation
sheet.
The criteria are:
• Done – Candidate has fulfilled OSCE criteria and has performed the
tasks completely and with confidence
• Partially done – A fair performance fulfillment of most OSCE criteria
• Not Done – Extremely poor performance, candidate has not
performed any of the OSCE criteria

Plagiarism and cheating are serious forms of academic misconduct and

violation of the norms and requirements for academic integrity. Using
somebody's ideas and opinion without proper citation and referencing is not
tolerated. If there are any precedents of plagiarism, a lecturer is required not
to assess and evaluate a student's work. Written assignments, which require
citation and referencing are checked through plagiarism detection software
(Turnitin). Written assignments with any occurrence of plagiarism will not be
assessed and a lecturer should provide feedback to a student clarifying the
reason. A student is eligible to appeal the decision about nullifying an
assignment. The appeal is studied in accordance with the University Code of
Ethic and Disciplinary Liability.
Administrative notes The course lecturer must inform the students about the academic program
requirements and the workload peculiarities at the first lecture.

The student shall:

➢ Attentively see the course syllabus.
➢ Meet with the syllabus requirements (do homework; prepare for a
seminar or practical work, test, presentation, etc.).
Basic literature 1. Evidence-Based Physical Diagnosis. Steven McGee MD. Elsevier. 5th
edition. 2021
2. Taylor's Clinical Nursing Skills: A Nursing Process Approach. Pamela B
Lynn MSN RN. Wolters Kluwer Health. Fifth edition, 2018

Auxiliary literature 1. Symptom to Diagnosis An Evidence Based Guide, Third Edition (Lange
Medical Books) by Scott D.C. Stern, Adam S. Cifu, et al., 2014, McGraw-
Hills

Appendix 1
Course Content

Week Topic (Lecture/Practical work) Literature

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 Physical Diagnosis (1/3) 1.2.
Pneumonia Chronic Obstructive Lung Disease

I Clinical Skills (1/2)

Ambulation, Assisting a Patient with
Ambulation Using a Cane, Assisting a Patient with
Ambulation Using Crutches, Assisting a Patient with
Ambulation Using a Walker, Assisting a Patient with
Physical Diagnosis (1/3) 1.2.
Pulmonary Embolism Pleural Effusion

Clinical Skills (1/2)

Bandage, Applying a Figure-Eight
II
Bath: Bed, Providing
Bath: Shower or Tub, Assisting With
Bath: Sitz, Assisting with
Bed Making, Occupied
Bed Making, Unoccupied
Bed Scale, Using
Physical Diagnosis (1/3) 1.2.
Inspection of the Neck Veins Percussion of the Heart
Oral survey

Clinical Skills (1/2)

Central Venous Access Device (CVAD): Accessing an Implanted Port
III Central Venous Access Device (CVAD): Changing Site Dressing and
Flushing
Central Venous Access Device (CVAD): Deaccessing an Implanted
Port
Central Venous Access Device (CVAD): Removing a Peripherally
Inserted Central Catheter (PICC)
Practical activities
Physical Diagnosis (1/3) 1.2.
Palpation of the Heart Auscultation of the Heart: General Principles

IV Clinical Skills (1/2)

Defibrillation, Performing Automated External (Emergency)
Defibrillation, Performing Manual External (Emergency,
Asynchronous)
Physical Diagnosis (1/3) 1.2.
The First and Second Heart Sounds The Third and Fourth Heart
Sounds
V

Clinical Skills (1/2)

Enema: Large-Volume Cleansing, Administering
Enema: Retention, Administering

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 Enema: Small-Volume Cleansing, Administering
Practical activities

Physical Diagnosis (1/3) 1.2.

Miscellaneous Heart Sounds Heart Murmurs: General Principles
Oral survey

VI Clinical Skills (1/2)

Incentive Spirometer, Teaching a Patient to Use
Inhaler: Dry Powder, Administering Medication via
Inhaler: Metered-Dose, Administering Medication via
Practical activities
Physical Diagnosis (1/3) 1.2.
Aortic Stenosis Aortic Regurgitation
Practical activities

VII
Clinical Skills (1/2)
Insulin Pump, Administering Continuous Subcutaneous Infusion via
IV Infusion: Changing an IV Solution Container and Administration
Set
IV Infusion: Monitoring an IV Site and Infusion

VIII-IX Midterm exam (2 hours)

Physical Diagnosis (1/3) 1.2.

Miscellaneous Heart Murmurs Disorders of the Pericardium

X Clinical Skills (1/2)

Medication: Mixing Medications from Two Vials in One Syringe
Medication: Removing from an Ampule
Medication: Removing from a Vial
Medication: Transdermal Patch, Applying
Physical Diagnosis (1/3) 1.2.
Congestive Heart Failure Coronary Artery Disease
Oral survey

XI
Clinical Skills (1/2)
Leg Exercises, Teaching
Logrolling a Patient
Moving a Patient Up in Bed with Assistance
Physical Diagnosis (1/3) 1.2.
Inspection of the Abdomen Palpation and Percussion of the
Abdomen
XII
Oral survey

Clinical Skills (1/2)

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 Pacemaker: Applying and Monitoring an External (Transcutaneous)
Pain Management, Continuous Wound Perfusion
Patient-Controlled Analgesia (PCA), Caring for a Patient Receiving
Peripheral Venous Access Device: Capping for Intermittent Use and
Flushing
Peripheral Venous Access Device: Initiating
Physical Diagnosis (1/3) 1.2.
Abdominal Pain and Tenderness Auscultation of the Abdomen

Clinical Skills (1/2)

XIII
Peritoneal Dialysis Catheter: Caring for a
Personal Protective Equipment (PPE), Using
Pneumatic Compression Devices, Applying
Postoperative Patient Care, Providing when Patient Returns to Room
Practical activities
Physical Diagnosis (1/3) 1.2.
Peripheral Vascular Disease The Diabetic Foot

XIV
Clinical Skills (1/2)
Shampooing a Patient’s Hair in Bed
Shaving, Assisting the Patient
Nail hygiene
Physical Diagnosis (1/3) 1.2.
Edema and Deep Vein Thrombosis Examination of the
Musculoskeletal System
Oral survey
XV
Clinical Skills (1/2)
Stool Specimen for Culture, Collecting
Stool, Digital Removal of
Stool: Testing for Occult Blood
Physical Diagnosis (1/3) 1.2.
Visual Field Testing Nerves of the Eye Muscles (III, IV, and VI):
Approach to Diplopia Miscellaneous Cranial Nerves
Practical activities

XVI
Clinical Skills (1/2)
Transferring a Patient from the Bed to a Chair
Transferring a Patient from the Bed to a Stretcher
Transferring a Patient Using a Powered Full-Body Sling Lift
Turning a Patient in Bed, Assisting
Practical activities
Physical Diagnosis (1/3) 1.2.
Examination of the Motor System: Approach to Weakness
XVII
Examination of the Sensory System Examination of the Reflexes
Disorders of the Nerve Roots, Plexuses, and Peripheral Nerves

9
 Clinical Skills (1/2)
Temperature, Assessing Body
Temperature, Regulating, Using an Overhead Radiant Warmer
XVIII -
Final Exam (4 hours)
XIX

XX - XXI Make-up Exam

Note: The literature number specified in the textual material corresponds to the number of the source
specified in the compulsory literature of this course.

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