Proposed Changes to Clinical Foundation
Clinical Foundation
Course
Proposed changes
Ana Marques
Contents
5.1. Current structure- no changes ............................................................. 11
6.1. Current structure- no changes ............................................................. 12
7.1. Current structure- no changes ............................................................. 13
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1.
Background
The clinical foundation course encompasses surgery, anaesthesia, diagnostic imaging, clinical oncology, pharmacology and evidence based medicine. The goal of the course is to bridge the transition from the pre- and paraclinical years and to introduce core knowledge and provide a solid foundation that will allow clinical integration into the second semester of third year during the Dog and
Cat course and beyond.
The multidisciplinary nature of this course presents some challenges to the students and staff involved in the teaching process. Currently the course has a significant component of self-directed learning and in some disciplines clinical concepts are taught in conjunction with core knowledge. In addition, many staff members are involved in the teaching process and are not always aware of what their peers have covered in previous lectures. This generates confusion among the students, who report that it can be hard to understand the key concepts and feel that information provided by staff members can sometimes seem contradictory.
With this in mind, we propose a major restructure to the course that should bring benefits to both undergraduates and staff teaching on the course. CFC will focus on core key knowledge and understanding of “normality”. Course material that requires clinical interpretation will be transferred to the Dog and Cat course. This will allow a better integration of clinical concepts later on in the year. We propose to significantly reduce the number of staff involved in teaching each discipline so a more coherent structure can be achieved. We also propose to reduce the self-directed learning component, to introduce interactive practical classes such as radiographic positioning and interpretation and to reduce the overall teaching load so the students can better concentrate and assimilate key information.
Finally, in line with the University of Edinburgh policy, learning objectives will be provided for each lecture and all provided learning materials. In addition, all staff involved in teaching CFC will attend learning outcomes and objectives writing workshops and the design of related and aligned assessment.
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2.
Surgery
2.1. Current structure
Three lectures
Self-directed learning o First 10 chapters of Fossum o Eight hours of allocated study time o Learning outcomes used for guidance
One drop in tutorial for revision/clarification
Practical’s o Bandaging- non examinable material o Ligatures, hand ties and Instrument ties o Basic wound closure
Theatre practice
2.2. Proposed change
Increasing the number of lectures from three to six (added lectures in blue) so we can reduce the self-directed learning component- SW lecturing all six o Introduction to terminology, surgical principles, tissue handling o Principles of surgical asepsis and sterilization o Suture Materials o Haemorrhage/Surgical Haemostasis o Surgical infection and antibiotic selection o Nutritional management of the surgical patient
Self-directed learning component o Five chapters from Fossum:
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Surgical facilities, equipment and personal and care and maintenance of the surgical environment (chapter 3)
Preoperative and intra-operative care of the surgical patient
(chapter 4)
Preparation of the operative site and surgical team (chapter
5&6)
Instrumentation (chapter 7) o Five hours of allocated study time o Additional power point presentation available on Learn on instrumentation (chapter 7) o Current theatre practice will re-enforce the material covered in the self-directed component and can be used to clarify any questions
2.3. Additional comments
SW will check with SA to make sure the content given in the new lecture
“Surgical site infection and antibiotic selection” is not already covered in pharmacology.
Theatre practicals will run in conjunction with the elective neutering clinic so students can see an animal being induced, clipped, prepped and moved to theatre.
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3.
Anaesthesia
3.1.
Current structure
Twenty five lectures o Core knowledge (21) o Body system (4)
Twelve seminars
Several lecturers teaching on the course
Two practicals
3.2.
Proposed change
Reduce number of lecturers to three: KJB, GS and PJM
Reduce number of lectures to 21 (focusing on core knowledge) o Introduction to anaesthesia (legal, moral obligations, definitions and principles),PJM o Pre-anaesthetic assessment and planning, PJM o Anaesthetic machines, PJM o Anaesthetic breathing systems, KJB o Sedatives and tranquilisers, PJM o General anaesthetic agents pharmacology and use 1, GS o General anaesthetic agents pharmacology and use 2, GS o General anaesthetic agents pharmacology and use 3, GS o Pharmacology of analgesics and link with physiology of pain 1, GS o Pharmacology of analgesics and link with physiology of pain 2, GS o Local anaesthetics, GS o Analgesia, GS o Fluids 1, PJM o Fluids 2, PJM
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o Anaesthetic management (including muscle relaxation, temperature etc), PJM o Monitoring 1 (clinical), KJB o Monitoring 2 (aids), KJB o Airway management etc, KJB o Physiological problems in anaesthesia, KJB o Accidents and emergencies, KJB o CPR, PJM
The excluded 4 lectures (red) will be transferred to the D&C course in association with each relevant topic: o Anaesthesia for gastrointestinal and liver disease , KW o Anaesthesia with CNS disorders, REC o Renal and endocrine, tbc o Anaesthesia and obstetrics (physiology, principles and examples for
SA e.g. caesarean, pyometra), tbc o Anaesthesia related to cardiovascular disease (nb: already in this course), KJB
Maintain two practicals: o Anaesthetic machines, PJM o anaesthetic breathing systems, KJB o both in 1/8 groups
Reduce the number of seminars concentrating on physiological and practical differences between species (5 + 2 revision seminars) o Cats and dogs and pigs (quarter class) , GS o Ruminants, lamoids (quarter class) ,PJM o Exotics (quarter class), GS o Horses and donkeys (quarter class), KJB
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o Problem solving (quarter class), PJM o Review seminar 1 (midway through course) (half class), KJB o Review seminar 2 (towards end of course) (half class), KJB
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4.
Diagnostic Imaging
4.1.
Current structure
Eleven lectures
Self-directed study o Normal images powerpoint files
Three tutorials on radiographic interpretation
4.2.
Proposed change
Reduce the number of lectures to seven: o Production of X-rays & Rad Protection TS o Principles of Rad Image Acquisition TL o Principles of Rad Interpretation TS o Image Contr, Contrast Media & Nuclear Medicine TS o Principles of CT & MRI TS o Principles of US EM o Normal and Abnormal Skeleton CG/TS
Reduce the number of tutorials to two, focusing on radiographic positioning and normal anatomy: o Tutorial 1: Skeleton - Radiographic Positioning & Normal Imaging
Anatomy o Tutorial 2: Thorax & Abdomen - Radiographic Positioning & Normal
Imaging Anatomy o G03 A & B required o 50min for 1/3 class o Given 3 times, preferentially during one 3h block
Self-directed material for the two tutorials will be available on learn with allocated study time in preparation for tutorials.
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Remaining teaching material will be transferred to the D&C course in the following form: o Online Lecture 1: Thorax Lungs & Airways TL o Online Lecture 2: Thorax Mediastinum, Pleura, Cardio MF o Tutorial 1: Thorax
G03 A & B
50min for third of class
Given 3 times o Online Lecture 3 : Abdomen GI & UG Tract TL o Online Lecture 4: Abdomen Liver, Spleen, Pancreas EM o Tutorial 2: Abdomen
G03 A & B
50min for third of class
Given 3 times o Online Lecture 5: Head, Spine, Musculoskeletal System TS o Tutorial 3: Head, Spine, Musculoskeletal System
G03 A & B
50min for third of class
Given 3 times
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5.
Clinical Oncology
5.1.
Current structure- no changes
Five lectures introducing clinical oncology
Oncology continues into Semester 2 D&C course
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6.
Pharmacology
6.1.
Current structure- no changes
Twenty seven lectures
Two “drop in” tutorials
12
7.
Evidence based Medicine
7.1.
Current structure- no changes
Five lectures
Practicals
13
8.
Assessment
8.1.
In course assessment
20 MCQ
13% of the mark
No changes made
8.2.
Peer-wise
2%
No changes this year although this will be monitored
8.3.
Final examination:
8 Short Answer Questions
40 Multiple choice questions
Propose change: o Separate the examination into two papers as we feel that students do not always time-manage well and this may compromise performance in one section of the examination o Paper 1:
40 MCQs allowing 90 seconds per question provides for a one hour paper contributing 35 % to the final mark o Paper 2:
8 SAQs allowing 11.25 minutes per question provides for a 90 minute paper contributing 50% to the final mark
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