Clinical Pathways 1
| Module title | Clinical Pathways 1 |
|---|---|
| Module code | MDC3001 |
| Academic year | 2020/1 |
| Credits | 120 |
| Module staff | Professor Alison Curnow (Convenor) Dr Julie Thacker (Convenor) |
| Duration: Term | 1 | 2 | 3 |
|---|---|---|---|
| Duration: Weeks | 15 | 13 | 10 |
| Number students taking module (anticipated) | 218 |
|---|
Module description
As your medical studies continue, the focus of your work will shift further towards the clinical environment. You will build upon the skills and knowledge that you have already developed that underpin modern person and patient centred clinical practice. You will continue to work across integrated teaching, learning and assessment themes: Medical Knowledge, Clinical Practice and the Student Selected Special Study Units (SSUs).
You will continue to develop your Medical Knowledge of the medical sciences (biomedical, psychological, sociological, population health) that underpin medical practice, building on the knowledge previously gained in your programme. Your Medical Knowledge will develop through your interactions with patients and with a wide range of NHS staff, and through taught sessions (e.g. during the Academic Day).
In the area of Clinical Practice you will continue to acquire the core clinical skills and professional behaviours that underpin person and patient centred clinical practice. Developing the skills and attitudes required to address health inequalities and perform professional advocacy roles. You will be given feedback on your developing professionalism through working with assessors who are experienced professionals and who hold and maintain professional registration in either Medicine or Nursing. You will undertake in vitro and in vivo clinical skills assessments working with real patients as appropriate. Your Professional Development groups will provide a supportive environment in which you can learn from your placement experiences and explore what it means to be a medical professional.
Within your SSU programme, you will consider clinical care and its essential support services and will be required to locate and critically evaluate evidence to support conclusions and recommendations to improve healthcare via a variety of methods, with a developing ability to review the reliability, validity, significance and generation of this evidence. You will undertake both a Research and an Improving Healthcare SSU each with learning spread longitudinally across the year and cumulating in an SSU Assessment conference.
Students may register for Clinical Pathways 1 following the successful completion of MDC1000 or MDC1001 and MDC2000 or MDC2001, which are Years 1 & 2 of the BMBS programme.
Module aims - intentions of the module
This module focusses on three integrated areas of study that will allow you to acquire and demonstrate the knowledge, skills and behaviours that are expected of a medical student, and that underpin modern clinical and academic practice. The aims of the three areas of study are outlined, as follows.
Medical Knowledge
You will be taught how to demonstrate the integrated application of the medical sciences (biomedical, psychological, sociological and population health) that underpin medical practice.
Clinical Practice
You will further develop your understanding and application of appropriate professional behaviour and will develop the core and advanced skills in clinical history, examination and diagnostic techniques relevant to modern clinical practice with particular reference to the ‘core case presentations’ within the syllabus. On completion of this year you will be familiar with the management of core clinical conditions and will be competent to manage common emergency clinical situations. You will develop skills in managing the initial response to common emergency clinical situations.
Special Study Units (SSUs)
You will further develop the written & verbal communication, research and critical thinking skills that you have previously acquired. You will identify important questions about medical practice and clinical service development and study in-depth an area of interest to you within the themes of improving healthcare and research as these relate to modern clinical practice.
Professionalism and Fitness to Practise:
In addition to these three integrated assessment themes you will be supported in the acquisition of professional and ethical behaviours and skills, with person-centred and patient-centred approaches relating to your development in reflective practice, team working, time-management, issues of consent, and giving and receiving feedback.
Intended Learning Outcomes (ILOs)
ILO: Module-specific skills
On successfully completing the module you will be able to...
- 1. Apply to medical practice the biomedical scientific principles, method and knowledge, as appropriate for this level of study (Outcome 3, Point 22 in Outcomes for Graduates (General Medical Council) 2018).
- 2. Apply psychological principles, method and knowledge to medical practice, as appropriate for this level of study (Outcome 3, Point 23 in Outcomes for Graduates (General Medical Council) 2018).
- 3. Apply social science principles, method and knowledge to medical practice, as appropriate for this level of study (Outcome 3, Point 24 in Outcomes for Graduates (General Medical Council) 2018).
- 4. Apply to medical practice the principles, method and knowledge of population health and the improvement of health and sustainable healthcare, as appropriate for this level of study (Outcome 3, Point 25 in Outcomes for Graduates (General Medical Council) 2018).
- 5. Communicate effectively, openly and honestly with patients, advocates and colleagues, as appropriate for this level of study (Outcome 2, Point 10 in Outcomes for Graduates (General Medical Council) 2018).
- 6. Carry out an effective consultation with a patient, as appropriate for this level of study (Outcome 2, Point 11 in Outcomes for Graduates (General Medical Council) 2018).
- 7. Work collaboratively with patients and colleagues to diagnose and manage clinical presentations safely, as appropriate for this level of study (Outcome 2, Point 12 in Outcomes for Graduates (General Medical Council) 2018).
- 8. Perform diagnostic, therapeutic and practical procedures safely and effectively, as appropriate for this level of study (Outcome 2, Point 13 in Outcomes for Graduates (General Medical Council) 2018).
- 9. Work collaboratively with patients, advocates and colleagues to make clinical judgements and holistic decisions, as appropriate for this level of study (Outcome 2, Point 14 in Outcomes for Graduates (General Medical Council) 2018).
- 10. Make appropriate clinical judgements for patients who are nearing or are at end of life, as appropriate for this level of study (Outcome 2, Point 15 in Outcomes for Graduates (General Medical Council) 2018).
- 11. Provide immediate care in medical emergencies, as appropriate for this level of study (Outcome 2, Point 16 in Outcomes for Graduates (General Medical Council) 2018).
- 12. Recognise when a patient is deteriorating and take appropriate action, as appropriate for this level of study (Outcome 2, Point 17 in Outcomes for Graduates (General Medical Council) 2018).
- 13. Prescribe medications safely, appropriately, effectively and economically, as appropriate for this level of study (Outcome 2, Point 18 in Outcomes for Graduates (General Medical Council) 2018).
- 14. Recognise and identify factors that suggest that a patient is vulnerable, as appropriate for this level of study (Outcome 1, Point 7 in Outcomes for Graduates (General Medical Council) 2018).
ILO: Discipline-specific skills
On successfully completing the module you will be able to...
- 15. Use information effectively and safely in a medical context, as appropriate for this level of study (Outcome 2, Point 19 in Outcomes for Graduates (General Medical Council) 2018).
- 16. Demonstrate how patient care is delivered in the health service, as appropriate for this level of study (Outcome 3, Point 20 in Outcomes for Graduates (General Medical Council) 2018).
- 17. Recognise there are differences in healthcare systems across the four nations of the UK, as appropriate for this level of study (Outcome 3, Point 21 in Outcomes for Graduates (General Medical Council) 2018).
- 18. Apply scientific method and approaches to medical research, as appropriate for this level of study (Outcome 3, Point 26 in Outcomes for Graduates (General Medical Council) 2018).
ILO: Personal and key skills
On successfully completing the module you will be able to...
- 19. Behave in accordance with Good Medical Practice (General Medical Council) making care of patients their first concern, as appropriate for this level of study (Outcome 1, Point 1 in Outcomes for Graduates (General Medical Council) 2018).
- 20. Behave according to ethical and professional principles, as appropriate for this level of study (Outcome 1, Point 2 in Outcomes for Graduates (General Medical Council) 2018).
- 21. Demonstrate awareness of the importance of their personal physical and mental wellbeing, as appropriate for this level of study (Outcome 1, Point 3 in Outcomes for Graduates (General Medical Council) 2018).
- 22. Demonstrate knowledge of the legal framework of medicine, as appropriate for this level of study (Outcome 1, Point 4 in Outcomes for Graduates (General Medical Council) 2018).
- 23. Demonstrate that they can practise safely and improve care, as appropriate for this level of study (Outcome 1, Point 5 in Outcomes for Graduates (General Medical Council) 2018).
- 24. Recognise complexity and uncertainty, learning to manage these situations as appropriate for this level of study (Outcome 1, Point 6 in Outcomes for Graduates (General Medical Council) 2018).
- 25. Recognise the role of doctors in contributing to the management and leadership of the health service, as appropriate for this level of study (Outcome 1, Point 8 in Outcomes for Graduates (General Medical Council) 2018).
- 26. Learn and work effectively within a multi-professional team, as appropriate for this level of study (Outcome 1, Point 9 in Outcomes for Graduates (General Medical Council) 2018).
Syllabus plan
Clinical Pathways 1 comprises of three rotating clinical pathways, each lasting nine weeks, plus seven longitudinal SSU weeks, one Community Care Week and three catch up study weeks. Each clinical pathway week is set in different clinical specialties and centres on important clinical presentations. It will involve clinical teaching, patient contact and expert feedback, with small group sizes.
This year of the curriculum is delivered in locations across the South West. You will rotate through a series of hospital and community placements in three clinical pathways which provide extensive experience of a wide range of clinical settings. These rotations emphasise the importance of continuing to acquire knowledge in the medical sciences, while also refining and building on the clinical and communication skills you have started to develop. Your learning during each rotation is supported by relevant resources, which develop your knowledge of common medical conditions and clinical skills by encouraging you to work through a series of clinical problems to build up your knowledge, clinical and procedural skills, as well as clinical reasoning and analytical skills.
Your learning is centred on patients and will continue to develop your problem solving skills through self-facilitated Community of Practice problem based learning case units, supported by video masterclasses, internet resources and clinically facilitated sessions, while also maintaining your exposure to the widest possible array of clinical experiences. You will meet patients at home, in general practice, in acute and community hospitals and other community clinical settings, and interact with healthcare professionals in their working environment. You will experience first-hand how the NHS works as a team to deliver patient care.
In addition to your learning in clinical environments, one day each week is devoted to tutorials, Clinical Skills Resource Centre and Professional Development Group sessions, which build on your previous learning and help to integrate your scientific and clinical knowledge. Teaching and learning will occur mainly in small groups and will help you understand the key concepts and knowledge that relate to each block. In addition at the end of each clinical block there will be a Consolidation/WRAP session of the Community of Practice learning facilitated by a clinician as well as some whole cohort learning events in each locality.
The academic content of the module is aligned with the outcomes as specified within Outcomes for Graduates (General Medical Council) 2018:
Outcome 1: Professional Values and Behaviours
Professional and ethical responsibilities
Legal responsibilities
Patient safety and quality improvement
Dealing with complexity and uncertainty
Safeguarding vulnerable patients
Leadership and team working
Outcome 2: Professional Skills
Communication and interpersonal skills
Diagnosis and medical management
Prescribing medications safely
Using information effectively and safely
Outcome 3: Professional Knowledge
The health service and healthcare systems in the four countries
Applying biomedical scientific principles
Applying psychological principles
Applying social science principles
Health promotion and illness prevention
Clinical research and scholarship
Learning activities and teaching methods (given in hours of study time)
| Scheduled Learning and Teaching Activities | Guided independent study | Placement / study abroad |
|---|---|---|
| 272 | 581 | 347 |
Details of learning activities and teaching methods
| Category | Hours of study time | Description |
|---|---|---|
| Scheduled Learning and Teaching Activities | 105 | Tutorials (54 hours), Consolidation/WRAP sessions (18 hours) and whole/half locality cohort learning events (18 hours) and Induction week sessions (15 hours) |
| Scheduled Learning and Teaching Activities | 24 | Professional Development Group Sessions |
| Scheduled Learning and Teaching Activities | 54 | Clinical placement feedback sessions with senior Clinicians/GPs |
| Scheduled Learning and Teaching Activities | 24 | Clinical Skills Resource Centre sessions |
| Scheduled Learning and Teaching Activities | 50 | SSU delivery sessions and conference attendance |
| Scheduled Learning and Teaching Activities | 15 | Community Care and Development week sessions |
| Placement | 347 | Clinical Placements in acute (286 hours) and community based (61 hours) settings |
| Guided Independent Study | 292 | Self-directed preparation and study for teaching sessions and assessment as well as problem based learning cases (x 9) to be worked on by a Community of Practice Group in addition to personal engagement with signposted video masterclasses and online resources |
| Guided Independent Study | 181 | Self-directed SSU learning and assessment preparation |
| Guided Independent Study | 108 | Self-directed, including experiential, learning opportunities within acute and community placements |
Formative assessment
| Form of assessment | Size of the assessment (eg length / duration) | ILOs assessed | Feedback method |
|---|---|---|---|
| Formative Observed Clinical Competencies (undertaken during clinical placements) | 12 in vivo Mini Clinical Evaluation Exercises (Mini CEX) (20 minutes each undertaken on placement). Please note these are repeated in Clinical Pathways 2 as summative assessments. | 1-4, 9-17, 22 | Verbal and written feedback provided by a Clinical Skills Tutor and/or a senior clinician/GP |
| Case Based Discussions (CBD) | 27; one during each clinical placement week Feedback Session | 1-5, 7, 9-10, 12, 14, 19-20, 22, 24, 26 | Verbal and written feedback provided by a senior clinician/GP |
| Formative Assessment of e-portfolio (including the Clinical Log and Direct Observation of Procedural Skills (DOPS) record) | 2 x 20 minutes discussions with Professional Development Group Tutor | All | Verbal feedback followed by written results |
| Professionalism Judgements (PJ) | ~20; 17 compulsory judgements from a variety of assessors based on observations of professional behaviours in scheduled teaching sessions (e.g. 3 x clinical pathways + 3 GP placements + 3 x PDG + 3 x portfolios + 3 OSCE + 2 x SSUs). In addition, 3 termly Locality Professionalism Judgements will be given considering attendance (as detailed in the Attendance Policy) and any additional 'On the Spot' feedback forms received. These judgements may trigger a Fitness to Practise enquiry and therefore may have significant implications on student progression. | All | Written feedback, available online |
Summative assessment (% of credit)
| Coursework | Written exams | Practical exams |
|---|---|---|
| 33.33 | 33.34 | 33.33 |
Details of summative assessment
| Form of assessment | % of credit | Size of the assessment (eg length / duration) | ILOs assessed | Feedback method |
|---|---|---|---|---|
| Applied Medical Knowledge (AMK) Examinations | 33.34 | 4 x 3hr tests of 125 multiple choice questions | 1-4, 9-17, 22 | Grades presented in online Log Book showing performance within individual disciplines and offering comparison with overall cohort scoring |
| Objective Clinical Skills Examinations (OSCEs) | 33.33 | 3 x OSCEs, time as appropriate to the clinical skill being assessed | 1-17, 19-20, 22-26 | Verbal feedback followed by written results |
| Assessment of e-portfolio (including the Clinical Log and Direct Observation of Procedural Skills (DOPS) record) | 0 | 20 minutes discussion with Professional Development Group Tutor | All | Verbal feedback followed by written results |
| Improving Healthcare and Research Special Study Units | 33.33 | 1 x 600 word business case proposal + 10 minute oral presentation (including Q&A) plus 1 x one page abstract + A3 poster presentation & discussion | 1-5, 15-20, 22-26 | Pass/fail decision, score and written feedback available online |
| Fitness to Practise | 0.00 | The Fitness to Practise Panel in accordance with University of Exeter Policy and Procedures for Fitness to Practise will consider/determine the Fitness to Practise of each student as follows: | All | Written and verbal feedback in accordance with University of Exeter Policy and Procedures for Fitness to Practise |
| 0 |
Details of re-assessment (where required by referral or deferral)
| Original form of assessment | Form of re-assessment | ILOs re-assessed | Timescale for re-assessment |
|---|---|---|---|
| For deferred students, see notes, below | |||
| For referred students, all original assessments | As for original assessment | As for original assessment | During the referral year (the following academic year) |
Re-assessment notes
Students, please note that your medical degree is a pass/fail award, and the traditional classification system does not apply. The percentages referred to in the summative assessment table (above) should be used as a guide to indicate the amount of work required for each type of assessment. You must pass each 'form of assessment' (column 1 in the summative assessment table, above) and be deemed “Fit to Practise” or “Fitness to Practise in Question & Subject to Review” by the Fitness to Practise Panel in order to pass this module, and therefore progress to the next year of the programme.
AMK grades are based on percentiles within the cohort. Each AMK test result is incorporated into the student’s running aggregate grade.
All clinical skills are assessed in the Clinical Skills Resource Centre or whilst undertaking clinical placements. They are assessed by trained core teaching staff, as well as honorary staff, all of whom have a nursing or medical qualification. Students will be expected to demonstrate each mastery clinical skill to a satisfactory level with additional progress support. Progression in the Clinical Practice component of assessment is dependent on passing two or more of the summative OSCEs, as detailed in the Assessment Handbook. Should they require it, students will be offered a further opportunity via a resit OSCE. All Mini Clinical Evaluation Exercises (Mini CEX), Case Based Discussions (CBD), Direct Observation of Procedural Skills (DOPS) and the clinical log also need to be satisfactorily demonstrated and completed at least one week in advance of the Assessment Theme Panel, as detailed in the Assessment Handbook.
Progression in the Special Study Units component of assessment is dependent on passing both summative SSU themes. Should they require it, students will be offered one SSU resubmission opportunity, as detailed in the Assessment Handbook.
Judgements of your professionalism will be made by a range of teachers, tutors and placement supervisors, in order to obtain a range of perspectives and feedback. The combination of these may trigger a Fitness to Practise enquiry and therefore may have significant implications on student progression. SSUs are also assessed by both University-employed staff and external medical or allied to medicine professionals.
All students who receive a less than satisfactory grade in any summative assessment will be automatically offered remediation and support by an appropriate member of staff within 15 academic days of the mark release date.
For some individual elements of the assessments listed in the table above, students are provided with multiple opportunities to demonstrate competence or remediate to a satisfactory level. Further information can be found on the UEMS intranet. Attempts at the elements of assessments are not counted as ‘referrals’ (second attempts following failure), but are instead opportunities to demonstrate competence and engage with remediation. A pass mark for each assessment theme (Medical Knowledge, Clinical Practice and the Student Selected Special Study Units) is usually determined by the aggregated scores of the individual elements that contribute to that assessment.
For deferred students who have had their extenuating circumstances validated, UEMS will endeavour, where possible given timetables and circumstances, to ensure those students are able to submit individual elements of an assessment within the academic year, in order that the student has a complete assessment profile. Where it is not possible for a deferred student with valid extenuating circumstances to have a complete assessment profile, an adjusted profile may be submitted to the Assessment Theme Panel where it will be decided if the student has attained an aggregated pass mark for the overarching assessment theme (Medical Knowledge, Clinical Practice and Special Study Units) and whether progression to the next year of the programme will be recommended to Assessment, Progression and Awarding Committee from where a student can progress with a ‘doubtful’ categorisation. Students who progress to the next year with a ‘doubtful’ aggregate categorisation will be offered remediation.
Students who fail to reach an aggregated pass for any overarching assessment theme (Medical Knowledge, Clinical Practice or the Student Selected Special Study Units), will fail the module overall and are therefore dealt with as referred students, and are given the opportunity to be re-assessed for this module in the following academic year. Referred students must repeat all teaching and assessment in the following academic year, and must gain a pass through their aggregated scores for all overarching assessments (Medical Knowledge, Clinical Practice and the Student Selected Special Study Units) to pass the module in their referred year.
Indicative learning resources - Basic reading
Basic reading available at http://uemsvle.exeter.ac.uk/res/UEMS-BMBS-homepage/
Indicative learning resources - Web based and electronic resources
ELE – please see the UEMS intranet available at http://uemsvle.exeter.ac.uk/res/UEMS-BMBS-homepage/
Web based and electronic resources available at http://uemsvle.exeter.ac.uk/res/UEMS-BMBS-homepage/
Indicative learning resources - Other resources
Other resources available at http://uemsvle.exeter.ac.uk/res/UEMS-BMBS-homepage/
| Credit value | 120 |
|---|---|
| Module ECTS | 60 |
| Module pre-requisites | MDC1000 or MDC1001 & MDC2000 or MDC2001 |
| Module co-requisites | None |
| NQF level (module) | 6 |
| Available as distance learning? | No |
| Origin date | 30/11/2012 |
| Last revision date | 24/06/2020 |
