Gastrointestinal Module Logbook 2012
Gastrointestinal Module
Semester 5.1
Student Name (Block Capitals):
________________________________________
Student Number:
________________________________________
Photo:
GIT Module Logbook
Confidentiality
Any breach of confidence in a clinical case is taken extremely seriously by the medical school and
the persons involved may be liable for disciplinary action. The student is referred to the Code of
Conduct as outlined in the 5.1 Handbook.
You must sign this prior to commencing the module
I have read and understood the University Code of Conduct and will abide by this.
___________________________
Signature
_______________________
Date
1
Gastrointestinal Module Logbook 2012
Surgical Ward Rounds Attended
Date
Signature of Tutor
1 _____________________________________________
________________________
2 _____________________________________________
________________________
Medical Ward Rounds Attended
Date
Signature of Tutor
1 _____________________________________________
________________________
2 _____________________________________________
________________________
Surgical Clinics Attended
Date
Signature of Tutor
1 _____________________________________________
________________________
2 _____________________________________________
________________________
Medical Clinics Attended
Date
Signature of Tutor
1 _____________________________________________
________________________
2 _____________________________________________
________________________
Date
Hepatology / Haemachromatosis Clinic Attended
Signature of Tutor
1 _____________________________________________
________________________
Surgical Clinic – Patients Clerked and Presented
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
________________________
2 _____________________________________________
________________________
2
Gastrointestinal Module Logbook 2012
Medical Clinic – Patients Clerked and Presented
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
________________________
2 _____________________________________________
________________________
ERCP Session – Procedures Observed
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
________________________
Surgical Emergency Admissions Clerked and Presented
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
________________________
2 _____________________________________________
________________________
Medical Emergency Admissions Clerked and Presented
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
________________________
2 _____________________________________________
________________________
Gastrointestinal Surgeries Observed
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
________________________
2 _____________________________________________
________________________
3____________________________________________
________________________
3
Gastrointestinal Module Logbook 2012
Endoscopies Observed
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
________________________
2 _____________________________________________
________________________
Patients clerked for Gastrointestional Surgery
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
________________________
2 _____________________________________________
________________________
Ultrasound Cases Attended
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
________________________
2 _____________________________________________
________________________
Barium Studies Observed
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
________________________
2 _____________________________________________
________________________
Surgical Journal Club Attended
Date
Signature of Tutor
_____________________________________________
________________________
Gastroenterology Journal Club Attended
Date
_____________________________________________
Signature of Tutor
________________________
4
Gastrointestinal Module Logbook 2012
Gastroenterology / Radiology Conference, if attended
Date
Signature of Tutor
_____________________________________________
________________________
Gastroenterology / Histopathology Conference Attended
Date
Signature of Tutor
_____________________________________________
________________________
GI Cancer MDM Attended
Date
Signature of Tutor
_____________________________________________
________________________
Medical Case Conference Attended
Date
Signature of Tutor
_____________________________________________
________________________
_____________________________________________
________________________
Surgical Case Conference Attended
Date
Signature of Tutor
_____________________________________________
________________________
_____________________________________________
________________________
5
Gastrointestinal Module Logbook 2012
Patient's initials and identifier
Data Interpretation
FBC – Comment on significance
Date
Signature of Tutor
2 _____________________________________________
Indices
Value
HB
WCC
Plts
Hct
MCV
MCH
Neutrophil count
Differential of Interest
________________________
Range
Explain Significance of Result in the context of patient’s clinical status
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Patient's initials and identifier
Data Interpretation
FBC – Comment on significance
Date
Signature of Tutor
2 _____________________________________________
Indices
Value
HB
WCC
Plts
Hct
MCV
MCH
Neutrophil count
Differential of Interest
________________________
Range
Explain Significance of Result in the context of patient’s clinical status
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
6
Gastrointestinal Module Logbook 2012
Data Interpretation
U&E (Biochemistry) – Comment on significance
Patient's initials and identifier
Date
Signature of Tutor
1 _____________________________________________
Indices
Value
Urea
Creatinine
Potassium
Sodium
Chloride
Others (Calcium, Cardiac
Enzymes etc)
________________________
Range
Explain Significance of Result in the context of patient’s clinical status
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
U&E (Biochemistry) – Comment on significance
Patient's initials and identifier
Date
Signature of Tutor
1 _____________________________________________
Indices
Value
Urea
Creatinine
Potassium
Sodium
Chloride
Others (Calcium, Cardiac
Enzymes etc)
________________________
Range
Explain Significance of Result in the context of patient’s clinical status
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
7
Gastrointestinal Module Logbook 2012
________________________________________________________________________________
________________________________________________________________________________
Data Interpretation
Coagulation Profile – Comment on significance
Patient's identifier (last 4 digits of board number)
Date
1 _____________________________________________
Indices
PT
aPPT
INR
Value
Signature of Tutor
________________________
Range
Explain Significance of Result in the context of patient’s clinical status
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Coagulation Profile – Comment on significance
Patient's identifier (last 4 digits of board number)
Date
2 _____________________________________________
Indices
PT
aPPT
INR
Value
Signature of Tutor
________________________
Range
Explain Significance of Result in the context of patient’s clinical status
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
8
Gastrointestinal Module Logbook 2012
Data Interpretation
Specialised Gastrointestinal Investigation– Comment on significance
(maybe laboratory or radiological investigation)
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
Investigation
Value
________________________
Range
What other investigations would you carry out on this patient and what findings might these expect
to yield?
_______________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Specialised Gastrointestinal Investigation – Comment on significance
(maybe laboratory or radiological investigation)
Patient's name and identifier (last 4 digits of board number)
Date
Signature of Tutor
2 _____________________________________________
Investigation
Value
________________________
Range
What other investigations would you carry out on this patient and what findings might these expect
to yield?
_______________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
9
Gastrointestinal Module Logbook 2012
Data Interpretation
Radiology – Comment on significance
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
________________________
Plain abdominal X-Ray
Reason for X-Ray _______________________________________________________________________________
_______________________________________________________________________________
Describe Findings
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Significance of Result
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Data Interpretation
Radiology – Comment on significance
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
2 _____________________________________________
________________________
Plain abdominal X-Ray
Reason for X-Ray _______________________________________________________________________________
_______________________________________________________________________________
Describe Findings
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Significance of Result
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
10
Gastrointestinal Module Logbook 2012
Data Interpretation
Radiology – Comment on significance
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
________________________
Ultrasound of the abdomen
Reason for ultrasound _______________________________________________________________________________
_______________________________________________________________________________
Describe Findings
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Significance of Result
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Data Interpretation
Radiology – Comment on significance
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
________________________
CT scan of the abdomen
Reason for CT _______________________________________________________________________________
_______________________________________________________________________________
Describe Findings
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Significance of Result
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
11
Gastrointestinal Module Logbook 2012
Data Interpretation
Radiology – Comment on significance
Patient's identifier (last 4 digits of board number)
Date
Signature of Tutor
1 _____________________________________________
________________________
Upper GI Barium study (Barium swallow / follow-through / enema)
Reason for Barium study _______________________________________________________________________________
_______________________________________________________________________________
Describe Findings
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Significance of Result
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
12
Gastrointestinal Module Logbook 2012
Gastrointestinal Surgery Attachment
Note to tutor: this evaluation form should be completed at the end of the 2 weeks with the surgical
team. During this did the student:
Introduce him/herself, and was polite
Agree
Agree Somewhat
Offered to help out (did ECGs, flow sheets, carry charts, admissions)
Agree Somewhat
Stayed around for the day unless they had tutorials (8.30 – 5pm)
Agree Somewhat
Expressed an interest, got involved and asked questions
Agree Somewhat
Know the inpatients, was aware of their status and management plan
Agree Somewhat
Attended clinic and was generally helpful
Agree Somewhat
Signature of Tutor: ______________________________ Date: _______________
13
Gastrointestinal Module Logbook 2012
Gastroenterology Medical Attachment
Note to tutor: this evaluation form should be completed at the end of the 2 weeks with the medical
team. During this did the student:
Introduce him/herself, and was polite
Agree
Agree Somewhat
Offered to help out (did ECGs, flow sheets, carry charts, admissions)
Agree Somewhat
Stayed around for the day unless they had tutorials (8.30 – 5pm)
Agree Somewhat
Expressed an interest, got involved and asked questions
Agree Somewhat
Know the inpatients, was aware of their status and management plan
Agree
Agree Somewhat
Attended clinic and was generally helpful
Agree Somewhat
Signature of Tutor: ______________________________ Date: _______________
14
Gastrointestinal Module Logbook 2012
Tutorials
Surgical Core Topics
Date
Signature of Tutor
Oesophageal & gastric carcinoma
___________
________________________
GORD, Barrett’s oesophagus, hiatus hernia
___________
________________________
GI bleeding
___________
________________________
Intestinal obstruction
___________
________________________
Diverticular disease
___________
________________________
Abdominal hernias
___________
________________________
Medical Core Topics
Date
Signature of Tutor
Inflammatory bowel disease
___________
________________________
Peptic ulcer disease
___________
________________________
Cirrhosis, liver failure
___________
________________________
Malabsorption syndromes
___________
________________________
Medical jaundice
___________
________________________
Small Group / Bedside Tutorials
Topic
Date
Signature of Tutor
__________________________________
___________
________________________
__________________________________
___________
________________________
__________________________________
___________
________________________
__________________________________
___________
________________________
15
Gastrointestinal Module Logbook 2012
For tutor use only
Logbook
Tutorials
Remedial action required
Y
No
16