BASIC INFORMATION:

 

 

Duration of the elective: 1 month

Number of students: Maximum 2 students per month

Prerequisites: None

Location(s): Koç University Hospital

 

 

CONTACT INFORMATION:

 

Elective Director: Mehmet Gökhan Gönenli

Elective Faculty: Mehmet Gökhan Gönenli

 

 

 

 

 

BRIEF DESCRIPTION OF STUDENT ACTIVITIES:

 

During Internal Medicine Elective, 5th year students attend all routine activities of the Internal Medicine Department. Student activities are supervised by the tutors. There are no nightshifts during the elective. The students spend 3 weeks in the ward and 1 week in the out-patient clinics.

 

Ward 2B is the primary “base”. The workload distribution (working on the ward or taking part in clinical evaluation and management of the patients) will be coordinated by mentors on the ward. While working in internal medicine, they will be asked to coordinate their tasks closely with the qualified specialists on the ward. They must always inform their location during the official working hours to their mentors.

 

Their official working hours begin at 08:00 am with the morning meetings in the internal medicine ward and continues until 5:00 pm. However, they are expected to participate in all clinical activities (i.e. emergencies) that may extend beyond their official working hours. As a future physician, it is important to learn to stay at work until all critical and urgent clinical issues are resolved or safely handed over to the night shift team. Their participation in routine weekly educational activities in the Internal Medicine Clinic including mortality and morbidity meetings is also encouraged. Since they are regarded as a member of the clinical team, they must coordinate their actions with their supervisors with whom they should always be in close contact.

 

Educational activities in the Internal Medicine Clinic are as follows:

 

Wednesday (08.00-9.00): Mortality-morbidity Meetings (biweekly)

 

Wednesday (12.15-13.00): Internal Medicine Seminars (weekly)

 

Wednesday (13:30-14:30): Internal Medicine-Radiology Meetings (weekly)

 

Thursday (12.15 -13.00): Internal Medicine Article Discussion Hour (weekly)

 

Friday (08.00 – 09.00): Intern Education Seminars (weekly)

 

 

While working in the outpatient clinics, students will see patients together with the tutors, will take an active part in history taking, physical examination, laboratory tests ordering and will discuss the differential diagnosis and treatment plan for each case.

 

At the end of the month, they will present one of the challenging cases that they have followed and discuss physical examination, laboratory results, differential diagnosis and treatment.

 

During the elective course, students will participate in research activities. They will also be encouraged to participate in a research project that they choose.

 

 

LEARNING OBJECTIVES:

 

 

Competencies	Level (1-4)
Taking a medical history
Taking a comprehensive medical history with effective communication with patients and relatives	4
Social history	4
Family history	3
Medication history, including side effects, interactions of the medications and allergies	4
Identifying hazardous behaviors	4
Examination Techniques
Clinical/physical evaluation; improving physical examination skills, summarizing pertinent positive and negative findings that correspond with symptoms	3
ECG; selection of the most suitable laboratory and diagnostic tests, a rational analysis of the patient information	3
Evaluation of patients with medical emergencies; demonstration of critical knowledge regarding the diagnosis and management of common and life-threatening acute/chronic medical illness	3
Orthostatic blood pressure and heart rate measurement	3
Cross matching (compatibility testing)	1
Attaching a pulse oximeter and interpreting the results	3
Clinical diagnosis of death (in a teaching situation)	3
Assessment of basic and functional activities of daily living	3
Performance of routine skills
Subcutaneous injection	2
Intravenous injection	2
Urinary catheterization	2
Writing a prescription	2
Venopuncture/drawing blood	2
Correct drawing of blood cultures	2
Interpretation of antibiogram	2
Interpretation of urine culture findings	2
Positioning a gastric tube	2
Positioning a peripheral permanent venous cannula	2
Therapeutic measures
Prescribing measures for the treatment of pain, palliative and end-of-life care	2
Using and giving instructions to use metered-dose inhalers, spacers and nebulizers	2
Determining the indication, dosage and use of oxygen therapy (timing)	2
Dosage, on-going monitoring and documentation of oral anti-coagulation	2
Evaluating drug therapy for drug interactions	2
Identification of drug side effects and their management; selecting reasonable drug therapies	2
Communication and Interaction with patient/team
Giving information to patients and relatives in an ethical and professional manner in accordance with legal requirements and making certain that the patient has understood the information	3
Verifying compliance	3
Taking informed consent for interventions	2
Breaking bad news to patients and family (simulated situation)	2
Summarizing the major points of diagnosis and management plans of a patient	3
Elucidating with nursing staff monitoring measures and calling criteria concerning patients	2
Advising and supporting patients	2
Identifying ethically problematic conditions	2
Communicating and dealing professionally with geriatric patients	2
Discussing diagnoses/prognoses with patients and their relatives	2
Managing patients with paradoxical investigation findings	2
Conservative management of patients with self-limiting disease	2
Participation in discharge management	2
Documentation
Writing letters for transfer or discharge of patient	2
Diagnostic coding	2
Working with local / national and international guidelines and protocols	2
Documentation in patient records/report of distinct medical parameters	2
Information request in hospital information system (HIS)	2
Compliance with legal requirements (Turkish Physicians’ Act, Hospitals Act, Insurance Act)	2

 

 

 

Bedside manners (communication and professionalism)

 

 

	Level
Respectful, empathic, non-discriminating communication with patients	4
Creating empathy in extreme situations	4
Non-discriminative approach in different social backgrounds	4
Respecting patient autonomy	4
Sensitivity to the individual needs of the patient	4
Sensitivity to non-verbal communication with the patient	4
Readiness for teamwork and performing as a true team player	4
Steady progress toward building autonomy	4

 

 

 

Explanations
Knowledge	1	heard about it, can stratify in the clinical context, does not need to manage it
	2	must be able to recognize it, must know the differential diagnosis, must know in depth
	D	Independent diagnosis
	T	Therapy through the Intern
	M	Independent patient management
	N	Recognition of emergency situations and their management
	P	Preventive measures
	R	Basic knowledge of the legal context
Competencies/Manners	1	Theoretical knowledge
	2	Have seen the method
	3	Can perform under supervision
	4	Can routinely apply method

 

 

 

 

ASSESSMENT OR EVALUATION:

 

Student’s knowledge, competencies including patient care, communication, professionalism and practice-based learning are observed throughout the elective. Although not graded, feedback on these competencies are provided continuously.

 

Students will present a topic and a related case at the end of the elective.

 

“KUSOM Clinical Performance Evaluation Form” is used for reporting.