COLLEGE OF MEDICINE AND HEALTH
Medicine, Nursing and Allied Health Professions

Description

Clinical Pathways 2

Module titleClinical Pathways 2
Module codeMDC4001
Academic year2020/1
Credits120
Module staff

Professor Alison Curnow (Lecturer)

Dr Julie Thacker (Lecturer)

Duration: Term123
Duration: Weeks

15

13

10

Number students taking module (anticipated)

218

Description - summary of the module content

Module description

As your medical studies continue, the focus of your work will continue to 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.  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 modern 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 vivo clinical skills assessments with patients as well as three termly Objective Structured Clinical Examinations in which you will demonstrate a range of clinical and communication skills such as history taking, examination skills, procedures and clinical reasoning. 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 scholarly activities related to the wider discipline of medicine.  You will undertake two longitudinal SSUs of three weeks duration each in the areas of Medical Humanities and Doctor as Teacher, both cumulating in an SSU Assessment conference.

Students may register for Clinical Pathways 2 following the successful completion of MDC3000 or MDC3001 (Clinical Pathways 1).

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 diagnosis, investigation and management of core clinical conditions and will be competent to manage 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 study in-depth an area of interest to you within each of the themes of education and the medical humanities.

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

Syllabus plan

Clinical Pathways 2 comprises of three rotating clinical pathways, each lasting nine weeks, plus seven longitudinal SSU weeks, one Integrated Care Week and three catch up study/assessment 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 by encouraging you to work through a series of clinical problems to build up your knowledge, 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 and teaching

Learning activities and teaching methods (given in hours of study time)

Scheduled Learning and Teaching ActivitiesGuided independent studyPlacement / study abroad
254599347

Details of learning activities and teaching methods

CategoryHours of study timeDescription
Scheduled Learning and Teaching Activities105Tutorials (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 Activities24Professional Development Group Sessions
Scheduled Learning and Teaching Activities54Clinical placement feedback sessions with senior Clinicians/GPs
Scheduled Learning and Teaching Activities24Clinical Skills Resource Centre sessions
Scheduled Learning and Teaching Activities32SSU delivery sessions and conference attendance
Scheduled Learning and Teaching Activities15Integrated Care and Development week sessions
Placement347Clinical Placements in acute (286 hours) and community based (61 hours) settings
Guided Independent Study292Self-directed preparation and study for teaching sessions and assessment
Guided Independent Study199Self-directed SSU learning and assessment preparation
Guided Independent Study108Self-directed, including experiential, learning opportunities within acute and community placements

Assessment

Formative assessment

Form of assessmentSize of the assessment (eg length / duration)ILOs assessedFeedback method
Formative Prescribing Assessment1 x prescribing assessment (30 minutes; undertaken within the Clinical Skills Resource Centre) 8, 13, 15, 19-20 Written feedback provided
Formative Observed Structured Clinical Examination20 minutes 1-4, 9-17, 22Written feedback provided with results
Case Based Discussions (CBD)27; one during each clinical placement week Feedback Session1-5, 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 TutorAllVerbal 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 + 2 x SSUs + 3 x OSCE). 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.AllWritten feedback, available online

Summative assessment (% of credit)

CourseworkWritten examsPractical exams
33.3333.3433.33

Details of summative assessment

Form of assessment% of creditSize of the assessment (eg length / duration)ILOs assessedFeedback method
Applied Medical Knowledge (AMK) Examinations33.344 x 3hr tests of 125 multiple choice questions1-4, 9-17, 22Grades presented in online Log Book showing performance within individual disciplines and offering comparison with overall cohort scoring
Clinical Competency Assessments undertaken on clinical placement)33.3312 x in vivo Mini Clinical Evaluation Exercises (Mini CEX) (time as appropriate to the competency being demonstrated)1-17, 19-20, 22-26Verbal feedback followed by written results
Objective Structured Clinical Examinations (OSCEs)3 x OSCEs, time as appropriate to the clinical skill being assessed1-17, 19-20, 22-26Pass/fail decision, score and written feedback available online
Assessment of e-portfolio (including the Clinical Log and Direct Observation of Procedural Skills (DOPS) record)20 minutes discussion with Professional Development Group Tutor1-17, 19-20, 22-26Verbal feedback followed by written results
Doctors as Teachers and Medical Humanities Longitudinal Special Study Units 33.331 x 500 word education theory explanation, 1 x 1,000 word reflective evaluation and a 10 minute verbal presentation (including Q&A) plus a presentation of a creative piece of work (e.g. performance of a piece of music or dance or a poem) accompanied by a 500 word reflective statement1-5, 15-20, 22-26Pass/fail decision, score and written feedback available online
Fitness to Practise0.00The 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: Procedures for Fitness to Practise will not be able to progress on the medical degree programme. AllWritten and verbal feedback in accordance with University of Exeter Policy and Procedures for Fitness to Practise

Re-assessment

Details of re-assessment (where required by referral or deferral)

Original form of assessmentForm of re-assessmentILOs re-assessedTimescale for re-assessment
For deferred students, see notes, below
For referred students, all original assessmentsAs for original assessmentAs for original assessmentDuring 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 Preparation for Medical Practice 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.

Resources

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

Web based and electronic resources available at http://uemsvle.exeter.ac.uk/res/UEMS-BMBS-homepage/

Module has an active ELE page

Indicative learning resources - Other resources

Other resources available at http://uemsvle.exeter.ac.uk/res/UEMS-BMBS-homepage/

Key words search

Medicine; BMBS; Healthcare

Credit value120
Module ECTS

60

Module pre-requisites

MDC3000 or MDC3001

Module co-requisites

None

NQF level (module)

6

Available as distance learning?

No

Origin date

30/11/2012

Last revision date

24/06/2020