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Studyguide for UKM's Comprehensive Health Care Module

Studyguide for UKM's Comprehensive Health Care Module

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  • 1. INTRODUCTION TO COMPREHENSIVE HEALTH CARE MODULE MEDICINE & SOCIETY II B COMPREHENSIVE HEALTH CARE MODULE (FFFF2622)I. DIRECTORY OF TEACHING STAFFNO. NAME OF LECTURERS/TUTORS TEL NO. E-MAILA. Department of Family Medicine 1. Dr Rashidi Mohd Pakri 012-3945786 Drrashidi5377@yahoo.com 2. Dr Hizlinda Tohid 019-2222109 hizlinda2202@gmail.com 3. Dr Aida Jaffar 9145 6126 aida.jaffar@gmail.com 4. Dr Tan Chai Eng (Module Coordinator) 9145 6126 tce@ppukm.ukm.edu.my 012-3343145 5. Dr Saharuddin Ahmad 012-3838204 bulat1977@yahoo.com 6. Dr Mohd Fairuz Ali 9145 6116 phere1@gmail.com 7. Dr Zuhra Hamzah 9145 6124 zuhradr@yahoo.com 8. Dr Syahnaz Mohd Hashim 9145 6124 syahnaz74@gmail.com 9. Dr Noorlaili Mohd Tauhid 9145 6120 lailitauhid@yahoo.comB. Faculty of Pharmacy 1. Dr Noraida Mohamed Shah noraida_mohamedshah@yah 9289 8038 oo.com 2. Puan Siti Azdiah Abd Aziz 9289 7964 sitiazdiah@yahoo.com 3. Dr Adyani Md Redzuan 9289 7987 adyani.hairul@gmail.com 4. Cik Adliah Mohd Ali 9289 7964 adliah_ali@yahoo.com.sg 1
  • 2. C. Department of Nursing 1. Puan Gurbinder Kaur a/p Jit Singh 9145 6254 gurbin@ppukm.ukm.edu.my 2. Cik Hasnah Yahaya 9145 6261 hasnah@ppukm.ukm.edu.my 3. En. Che Salim Sulaiman 9145 6260 chesalim@ppukm.ukm.edu.my 4. Puan Nour Dhiaeyah Supuan Zaki Nour.dhaeyah@ppukm.ukm.edu 9145 6266 .myD. Department of Parasitology 1. Dr „Azlin Muhammad @ Mohd Yassin 9289 7229 azlinoshin@yahoo.co.uk 2. Dr. Aishah Hani Bt Azil 9289 7209 aishahhani@medic.ukm.myE. Department of Community Health 1. Prof Madya Dr Azmi Mohd Tamil 9145 5890 drtamil@gmail.com 2. Dr Azmawati Mohammad Nawi 9145 6404 atienawi@yahoo.com 3. Dr Jamsiah Mustafa 9145 5906 Jamsiah_jkm@yahoo.com 4. Dr Ahmad Taufik Jamil 9145 5888 atjamil@gmail.comE. Department of Medical Education 1. Dr Mohd Arif Kamaruddin 9145 6241 drmdarif@hotmail.com 2. Dr Mohd Nasri Awang Besar 9145 6241 drmohdnasri@gmail.com 3. Dr Md Nurman 019- mdnurman@yahoo.com 2272269 4. Pn Siti Mariam Bujang 013- Eentan80@yahoo.com 3335233 2
  • 3. II. This module is aimed to introduce the concept of comprehensive health care according to the modern medical principle. It includes the principle of solving health problems at the individual, family and community level. The module discusses the holistic approach in patient management. It also emphasizes on the concept of patient, family and community interactions from the aspect of health. The students will be exposed to the needs of patient with chronic diseases and how it is assessed and managed comprehensively. Functions of health organizations and health facilities at various levels in the community are also discussed. PRE-REQUISITES The students should have prior knowledge of 1. Medicine & Society I 2. Medicine & Society IIAIII. MODULE OBJECTIVES This is a 2 credit module (80 hours of students learning time) conducted throughout 16 weeks during semester 4 of the undergraduate medical program. Second year medical students and third year pharmacy students will participate in this module. Students will be divided into small groups consisting of 5 -6 students. Each small group will be assigned to a patient with chronic illness. Students are required to work as a team to: 1. Identify and describe the impact of the illness on the patient as well as on the family and community. 2. Identify their roles as health professionals in addressing the bio-psycho-social issues faced by the patient, from the aspect of health promotion, prevention, treatment and rehabilitation. 3. Identify relevant community and other facilities and services available for the patient. 4. Provide relevant advice to the patient regarding the use of these facilities and services. 3
  • 4. IV. METHODS OF ASSESSMENT Continuous assessment based on o Family Case Study Presentation (group work) 30% o Family Case Study Report (group work) 30% o Reflective writing (individual) 25% o Peer Assessment 5% o Facilitator‟s Report 5% o Attendance 5% Total 100% Note: Students are required to submit their Family Case Study Report (group work) and reflective writing (individual) on-line by week 15 (10th May 2013 by 2400hrs). Please avoid sending in your assignments on the date line because your actions may “freeze” the system. (http://www.medicine.ukm.my/apps/e.learning) Family Case Study Presentation, Family Case Study Report and reflective writing assignments are marked by the respective facilitators. Satisfactory attendance is only considered when students attend at least 80% of all teaching-learning activities (Lectures, Small group discussions, Visits).V. RESOURCE MATERIALS 1. Reagan, P.A. Brookins-Fisher, J. Community Health in the 21st Century. 2nd Edition. San Francisco: Pearson Education, Inc; 2002. 2. Phoon, W.O. Chen, P.C.Y. Textbook of Community Medicine in South East Asia. Singapore: John Wiley & Sons; 1986. 3. Mc Whitney, I. R. Freeman T. A Text Book of Family Medicine. 3rd ed. Oxford University Press; 2009. 4. Rakel, R.E. Text Book of Family Medicine. 7th ed. Philadelphia: Saunders; 2007. 5. Taylor, R. Fundamentals of Family Medicine: The Family Medicine Clerkship Textbook. 3rd ed. Springer Pub. Co; 2003. 6. Unwin BK, Jerant AF. The Home Visit. American Family Physician. 1999; Vol 60: 1481-8. 4
  • 5. VI. TEACHING-LEARNING TOPICS AND SPECIFIC OBJECTIVES Concept Lectures At the end of the lectures, students should be able to:L1 Comprehensive Health Care I & II& describe characteristics of comprehensive health care at the individual, family andL2. community level describe the function of family and „at risk‟ family describe various stages of disease prevention at the individual, family and community levelL3. Family Case Study approach and discuss the patient‟s problems in a holistic manner identify and analyze the health problems in relation to the patient, family and community appreciate that any health issues have an impact towards the patient, family and community understand the management of relevant health problems by means of health promotion, prevention, and appropriate treatment and rehabilitation measures with appropriate and effective use of resources recognize the value of home visits in assisting health personnel to assess patient‟s condition at home (e.g.: family dynamics, surroundings etc). realize the importance of adopting a non-judgmental attitude and being sensitive to religious and cultural diversity as well as differing moral values and beliefs.L4. Holistic Approach to Medicine define the meaning of `holistic‟ discuss the concept of `mind-body medicine‟ recognize the importance of a holistic approach in patient care understand how to practice holistic patient care 5
  • 6. Small Group Discussion (SGD)During the following SGDs, students should:SGD 1 - Receive information regarding their assigned patients - Learn how to organize a home visit and respective organizational visit. - Plan their activities during each visitSGD 2&3 - Update their facilitator and discuss the progress of their family case study - Clarify particular issues or problems they are facing. - Arrange corrective measures to overcome these problems - Discuss with their facilitator regarding the family case study presentation.SGD 4 - Present their Family Case Study - Prepare their Family Case Study Report.VisitsA. Home Visit During the home visit, students should: Evaluate holistically patient‟s problems and status (e.g. health and functional) at home. Evaluate patient‟s home environment (e.g. physical conditions, social environment such as family dynamic, safety issues etc) and assess the impacts of this environment on his/her health and function. Identify „at-risk‟ patient (e.g. at-risk of abuse, neglect or social isolation). Identify potential home-based interventions that are suitable for the patient. Evaluate patient‟s support system and functions of family members. Evaluate coping behavior of the patient and family members. Identify medical, psychosocial, environmental and financial problems faced by the patient and family members. Identify impacts of patient‟s illness on his/her own life, family and community Identify and promote disease prevention and health promotion to the patient and family members. Plan appropriate management (e.g. treatment, rehabilitation measures etc) for the patient, family members and community Demonstrate non-judgmental attitude and sensitivity to religious and cultural diversity as well as differing moral values and beliefs. 6
  • 7. B. Visit to relevant organizations that provide aftercare to the respective patient (where applicable) identify appropriate resources (e.g. NGOs, facilities, programs etc) available for the patient in his/her community identify the roles and functions of these resources incorporate the related community resources in the patient‟s rehabilitation planReflective Writing Each student is required to write a reflection on: Working together with other healthcare professionals in patient care 7
  • 8. STUDENT’S ASSIGNMENTFormat for Family Case Study Presentation(Duration of presentation: 15 – 20 minutes) Title of Slides Description1. Title slide Title of case study SGD group and name of members2. Introduction Patient Demographic Data (Why do you think it is important to know about this case and to approach it in a holistic/ comprehensive manner?)3. Clinical Summary Summary of the clinical history and physical findings from your own observation or clinical examination – please do not copy from the case note.(list it in chronological order)4. Investigations List appropriate investigations and interpretation of the results.5. Home Visit/Visit to relevant Students are expected to synthesize important / relevant organization data from the home visit as well as visit to relevant organization and apply them appropriately into their case study in a holistic perspective for the patient‟s overall care and quality of life.6. Summary and Problem list Summary of the patient‟s condition and “List of problems” (according to the bio-psycho-social model).7. Management & Discussion Non-pharmacological and pharmacological management (short/long term) Multidisciplinary care and community resources Important points of discussion8. Reflection & Conclusion Conclusion and recommendations for further or better care (as appropriate). Add your reflection on how this Family Case Study can help you in the future, your learning issues, how would you deal with this patient differently.9. References List them in UKM or Vancouver style. References should be the most recent available.Additional instruction: Present using Microsoft Office PowerPoint. Discuss with facilitators as to what to present and flow of presentation. As the Family Case Study is a report of events that happened in the past, it should be written in the past tense. Please ensure consistent formatting, line spacing and choice of fonts. Photos of the house, lesions/disease, and surroundings may help in your case presentation. (Only with permission from the patients) Do „spelling and grammar‟ check. 8
  • 9. Format for Family Case Report(3000 words, include relevant photos only)SGD Group:Name of members:Facilitator‟s name:Demographic dataDate of clerking:Name: Registration No:Contact Address:Contact Number:Primary Care Giver details: (where applicable) Title Description1 Introduction Why do you think it is important to know about this case and to approach it in a holistic/ comprehensive manner?2. Summary of clinical history and History: presenting complaint, history of present physical findings (from your own illness, systemic reviews. observation or clinical examination Past history: medical/surgical/obstetric history – please do not copy from the case Menstrual history notes). Growth & developmental history History of allergies: (List in chronological order) Drug history/medications (indications) - over the counter medication/prescribed drugs/street drugs etc. Smoking, Alcohol, Assessment of Risk behaviors. Social history& Financial history Dietary history Progression of disease (as appropriate) Physical examination (with your interpretations of what abnormal findings means and its relevance)3. Investigations: List of all appropriate investigations based on your own knowledge and clinical judgment (If results are available, state the dates when the tests were done, normal ranges and your interpretation of the results)4. Home Visit/Visit to relevant Floor plan, neighborhood, exterior &interior of organization home ( crowding, housekeeping, homely Synthesize important / relevant data environment, privacy) from the home visit and visit to Water, electricity, sewage, air circulation, relevant organizations. Apply them windows, toilets. appropriately into the case study in Any animals or pets a holistic perspective for the Assess to transportation (private or public)/ other patient’s overall care and quality of basic amenities. life. 9
  • 10. Title Description5. Summary and Problem list Summary of the patient‟s condition and “List of problems” (according to the bio-psycho-social model). Impact of the disease o On the patient o On the family o On the community6. Management & Patient’s Non-pharmacological and pharmacological progress treatment/management Multidisciplinary care / role of other support groups / NGO‟s. Long term management plans (as appropriate) Any recommendations specific to the disease (other drugs, simpler regimes, less costly alternatives, etc.). Disease related complications Response to treatment or deterioration in clinical condition7. Discussion Patient‟s bio-psycho-social-spiritual issues/problems Impact on the patient, family and community, and management Students should incorporate Evidence-based Medicine and cite the sources of information. Discuss these relevant to the case.8. Conclusion Conclusion and recommendations for further or better care (as appropriate). Thoughts: Add your reflection on how this Family Case Study can help you in the future, your learning issues, how would you deal with this patient differently.8. References List them in UKM or Vancouver style. References should be the most recent available.Additional instruction: As the Family Case Study is a report of events that happened in the past, it should be written in the past tense. Assessment is based on the ability to identify the bio-psychosocial and spiritual issues of the patient and how it has impacted the patient, family and community. Add photos of the house and surroundings (if possible and with permission of patient) Do NOT discuss medical information like a textbook. Do NOT cut and paste from websites or reference materials. Please ensure consistent formatting, line spacing and choice of fonts. Do „spelling and grammar‟ check. 10
  • 11. Vancouver style referencingYou may refer to the following website:http://www.library.uq.edu.au/training/citation/vancouv.pdfUKM style referencingYou may refer to the following website:http://www.ukm.my/pps/pdf/Penulisan%20Gaya%20UKM.pdf 11
  • 12. Format for Reflective Writing:REFLECTIONPlease write the learning points (BASED ON THE PROVIDED THEMES) you have pickedup during this session and relate it to the objectives of the Comprehensive Health CareModule. (300 – 500 words)…………………………………………………………………………………………….…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………… Marks:……../ 10 12
  • 13. ASSESSMENT COMPONENTS Family Case Study Evaluation Sheet Case PresentationSGD Rooms:Name of Group:(Please refer to the list of names provided)Facilitator:Date of Case Presentation: Items Marks Marks allocatedContent- holistic and 25comprehensive inapproachStyle of presentation / 10Overall presentationGroup work( active 5participation of othergroup members)Total 40Facilitator‟s comments:Facilitator‟s Signature: 13
  • 14. Family Case Study Evaluation Sheet Case ReportSGD Rooms:Name of Group:Facilitator:Date of Family Case Study Received: Marks Marks allocated1. Introduction & Demographic Data 22. Clinical history & Physical Examination 103. Problem List / Diagnosis (bio-psycho-social 10 model)4. Patient‟s progress / Discussion & Management 305. Conclusion 56. References/Lay out 3 TOTAL 60Facilitator‟s comments:Facilitator‟s Signature: 14
  • 15. Scoring System in Reflective writing ELEMENT OF REFLECTION SCORE Brief description of eventTime, place, location, who were involved (the job title, not the name of the person) 0-1 Attending to feeling (during the incident) Explore your affective (feelings) reaction to the event What were your concerns and thoughts at that time? 0-1What do you think other people (friends, facilitator) felt at that time, and how do you know what they felt? Critical analyses Your thoughts, your assumptions, other people involved and the context (place, 0-3 time, set-up) Synthesis/Evaluation Weighing up different interest, room for dilemma and uncertainties, evaluate own position and emancipation. 0-3 -What have you learnt from the event? How does this relate with your previous experiences? In what ways do theories or underlying knowledge explain the situation? Outcomes(learning needs, changed of perception, behavior or acquired new skill) Given a similar situation in the future, how would you behave? 0-2 Has this changed your way of practice? What are your learning needs arising from this experience? What are your strategies to achieve those learning needs? Total 10 15
  • 16. Peer AssessmentStudent‟s Name: Date:Domains Overall Item ratingTeam work Able to establish a shared understanding among members. Actively participate in the activities Display individual accountability and responsibility Handle conflicts in a positive manner Being supportive towards each other.Communication Using terms or phrases that can be understood by all members ( no professional jargons) Actively participate in the discussion in a positive manner.Task Participate actively in planning and preparation in a positive mannermanagement Able to complete the assigned task within the time frame and standards.Leadership Able to display good leadership skills.Professional Display punctuality.Attitudes Being proactive and motivated.Knowledge Able to gather relevant information required. Able to understand and interpret information gathered. Able to approach the case discussed in a comprehensive manner. Able to anticipate future requirements or demands relevant to the case discussed. Able to offer other options or new ideas relevant to the case discussed.Standard: The standard should be judged against the standard expected at completion of thestage of training based on the program objectives or outcomes.***Rating scale: 1- Very Poor; 2- Poor; 3- Average; 4-Good; 5- Excellent ; 1- Very Poor: Performance potentially effects patient safety and quality care. Serious intervention plan and action is needed 2- Poor: Performance indicated cause of concern, consider further improvement plan and action is needed. 3- Average: Performance was of a satisfactory standard but could be improved. 4- Good: Performance was consistent and at good standards, enhancing patient‟s safety and quality care. 5- Excellent: Performance was consistent and at high standards, enhancing patient‟s safety and quality care. It could be a positive reference for others. 16
  • 17. Facilitator’s ReportStudent‟s Name:Domains Overall Item ratingTeam work Able to establish a shared understanding among members. Actively participate in the activities Display individual accountability and responsibility Handle conflicts in a positive manner Being supportive towards each other.Communication Using terms or phrases that can be understood by all members ( no professional jargons) Actively participate in the discussion in a positive manner.Task Participate actively in planning and preparation in a positive mannermanagement Able to complete the assigned task within the time frame and standards.Leadership Able to display good leadership skills.Professional Display punctuality.Attitudes Being proactive and motivated.Knowledge Able to gather relevant information required. Able to understand and interpret information gathered. Able to approach the case discussed in a comprehensive manner. Able to anticipate future requirements or demands relevant to the case discussed. Able to offer other options or new ideas relevant to the case discussed.Standard: The standard should be judged against the standard expected at completion of thestage of training based on the program objectives or outcomes.***Rating scale: 1- Very Poor; 2- Poor; 3- Average; 4-Good; 5- Excellent ; 1- Very Poor; Performance potentially effects patient safety and quality care. Serious intervention plan and action is needed 2- Poor; Performance indicated cause of concern, consider further improvement plan and action is needed. 3- Average; Performance was of a satisfactory standard but could be improved. 4- Good; Performance was consistent and at good standards, enhancing patient‟s safety and quality care. 5- Excellent. Performance was consistent and at high standards, enhancing patient‟s safety and quality care. It could be a positive reference for others.Facilitator‟s Name & Signature :Date: 17