Human Health and Disease: A Clinical Approach Section F Spring 2017 Instructors: Dr. Adam Witten and Dr. Niels West Hvidovre Hospital / Rigshospitalet, Monday and Thursday 15:30-17:30
Learning objectives
The objective of the course is to introduce students to the most important human diseases, their diagnosis and treatment, and to the clinical working methods of physicians as practiced at Danish referral University Hospital (Hvidovre and Rigshospitalet) in Copenhagen.
Upon completion of this course, students will be able to: 1. Write a structured medical report 2. Explain the rationale for choice of tests and treatments in clinical practice 3. Copy basic manual skills (IV insertion, Suture, Catheter Insertion) and give a basic explanation of the techniques 4. Discuss knowledge of human anatomy, physiology, and scientific context 5. Describe medical practice in a social, international, and scientific context
Content The clinical approach of the course implies studying symptoms, signs, diagnostic methods and treatment of the most important human diseases, writing patient case reviews based upon medical records, and patient interviews, visiting various clinical and diagnostic hospital departments, and performing physical examinations on phantoms or other students.
The course, however, does not provide regular medical training corresponding to that of medical students and does not include shadowing of doctors or physical examination of patients. Patient demonstrations are included in some, but not all, lectures.
Instructors:
Adam Witten M.D. (University of Copenhagen, 2015), Department of Orthopedic Surgery, Hvidovre Hospital. Affiliated with Sports Orthopedic Research Center - Copenhagen. With DIS since 2015.
Niels West M.D. (University of Copenhagen, 2014) and researcher at Department of Otolaryngology, Head and Neck Surgery, Rigshospitalet and Gentofte Hospital. With DIS since 2016.
Anna Holm Jørgensen M.D. (University of Copenhagen, 2017). Department of Cardiology, Hvidovre Hospital. Resident substitute at the Surgical Department, Bornholms Hospital since February 2015. Childrens’ respiratory assistant, NICU (neonatal intensive care unit), Rigshospitalet. Previous Course Assistant for Human Health & Disease. With DIS since 2016.
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Course assistant:
Karen Grangaard 8th semester medical student at University of Copenhagen Medical School, B.sc. Medicine, University of Copenhagen 2016. Medical Secretary in the Emergency Clinic, Glostrup Hospital. Agency Nurse FADL (Association of Danish Medical Students). With DIS since 2016.
DIS Contacts Lisbeth Borbye, Program Director Stephanie Clemente, Project Manager Ryan Polito, Program Assistant Science & Health Program Office, Vestergade 10-B12
Prerequisites At least one year of biology and one year of chemistry at the university level. The course is oriented towards serious students with a documented academic interest in medicine.
Evaluation Students will be evaluated based on participation, 2 written clinical case reviews, 1 oral presentation on the theoretical case review, two small tests and final examination. There will also be a small assignment related to the study tours. The grade on this assignment will contribute to your participation grade.
Tests (2 at 10%) 20% Participation 10% Patient cases (3 at 10%) 30% Study tour Assignment 10% Final examination 30%
Participation covers the following areas 1. Attendance 2. Level of preparation and ability to answer questions asked in class 3. Involvement in class and group discussions 4. Level of individual research and contribution to discussions
Policy on late papers: Late papers will be accepted, but your grade for the paper will be reduced by half a point for each day that it is late.
Electronics You may use your laptop for note‐taking, fact‐checking, or assignment in the classroom, but only when indicated by us. Other than that all laptops and electronic devices should be put away during class time.
Short Schedule Tests Test 1, February 2 Test 2, April 10 Final Exam, May 9
Clinical Case presented: Clinical Case Reviews due date February 13 TBA March 9 TBA
Theoretical Cases handed out for all groups A-D: TBA
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Theoretical Case Reviews due date: DATE group presentation (15 minutes each group, 3 minutes per person)
Practical Information Medical Practice & Policy faculty and staff have put many hours into selecting and organizing the readings for this course. Please make sure to read all the material assigned; the reading material has been carefully chosen and all of it is pertinent to your success in Human Health and Disease: A Clinical Approach. You have an obligation to your fellow classmates and yourself to come prepared to class. Lectures will not cover all of the readings; however, you are still responsible for the information. If you have questions or need clarification about a reading or lecture material do not hesitate to speak up and/or contact the course assistant. This is very important. The professors for this course have no office hours, as such; please feel free to set up appointments with them via email, or better yet, use them in their teaching breaks. The professors’ emails have been provided; please feel free to email them, the course assistant Ryan Polito or DIS to set up an appointment or simply ask a question.
Disability resources: Any student who has a need for disability accommodations should contact the office of academic support to coordinate this. Upon DIS approval, students should inform the instructor of accommodations within the first two weeks of class.
Academic Honesty: DIS expects that students abide by the highest standards of intellectual honesty in all academic work. DIS assumes that all students do their own work and credit all work or thought taken from others. Academic dishonesty will result in a final course grade of “F” and can result in dismissal. The students’ home universities will be notified. DIS reserves the right to request that written student assignments be turned in electronic form for submission to plagiarism detection software. See the Academic Handbook for more information, or ask your instructor if you have questions.
Academic Excellence Award: Each semester we recognize one outstanding student from the Medical Practice & Policy Program with an Award of Academic Excellence. It is reserved for a student who has distinguished him- or herself through diligence, commitment, academic performance, and ideally a student who contributes to a good, collaborative learning environment in class.
Tests and Final There will be a total of two tests throughout the semester. These tests will consist of a mix of short answer questions and essay questions. Tests may be given at the beginning of class or at the end. If the latter, the material covered in lecture that day may be on the test; so, make sure to pay close attention to the information discussed in lecture that day. Tests in class will generally last a maximum of 30 minutes depending on the amount of information covered. The final for this course will be cumulative and will be written in the same manner as tests. The final will be two hours in duration.
Patient Cases During the semester, each student will be presented with 2 real patients (Clinical Case Reviews) and everyone will write up their own case history about the signs, symptoms, ailments and treatments for the specific patients that are introduced to the students. Students will also be assigned to a group A- D, to write up and present a Theoretical Case Review (15 minutes for each group, including 3 minutes oral presentation for each person). The two Clinical Case Reviews will count 10% each, and one Theoretical Case Review and Presentation will count 10%, making Patient Cases a total 30% of the final grade. It is important to note that, on these dates, attendance is mandatory. Skipping class for travel or other reasons will not be accepted. More details will be given on this activity as the time approaches.
Clinical Case Reviews All students will receive the clinical cases on February 13 and March 9, and written papers are due TBA, respectively (2 cases, each worth 10%).
Important information: It is mandatory to attend classes in which clinical case reviews are presented. Missing
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a class would result in a ‘fail’ in that paper. More information about these case reviews will be given on the first day of class.
Core Course Week and Study Tours Core Course week and study tours are an integral part of the core course as we take the classroom on the road and see how theory presented in the classroom is translated to practice in the field. You will travel with your classmates and DIS faculty/staff on two study tours; a short study tour during Core Course Week and a long study tour to relevant European destinations.
Expectations for study tours Participate in all activities Engage in discussions, ask questions, and contribute to achieving the learning objectives Respect the destination, the speakers, DIS staff, and your fellow classmates Represent yourself, your home university and DIS in a positive light
One of the learning objectives of Human Health and Disease: A Clinical Approach is for you, the student, to be able to describe medical practice in a social, international, and scientific context. The study tours are a way to achieve this learning objective.
Learning Objectives: The objectives of both the short study tour and the long study tour are: to showcase examples of clinical practice and health care systems in different sectors and countries to broaden the students’ view of the challenges that health care providers face to show examples of research with clinical relevance to explore and learn more about Denmark and other societies in Europe
While on a program study tour DIS will provide hostel/hotel accommodation, transportation to/from the destination(s), approx. 2 meals per day and entrances, guides, and visits relevant to your area of study or the destination. You will receive a more detailed itinerary prior to departure.
Travel policies: You are required to travel with your group to the destination. If you have to deviate from the group travel plans, you need approval from the program director and the study tours office.
CORE COURSE Week- February 6-10 Short Tour: Ribe/Middlefart: Monday, February 6 – Wednesday, February 8 Copenhagen Portion: Thursday, February 9 – Friday, February 10
Long Tour: Berlin/Poznan, Sunday, February 26 – March 3
Study Tour Assignment: Before going on the short study tour, you will be divided into groups of 3-4 people and be given a specific subject to focus on in your study tour assignment. An observation booklet should be used on both trips for notes, these notes with which should be discussed within your group. A more in- depth description of the study tour assignment will be provided closer to the short study tour. The study tour assignment is due on Friday, March 17 to Canvas by 16.00 All parts of the assignment must be completed in order to obtain full credit for the assignment which counts toward 10% of your grade.
Required readings
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Textbooks: • Hole JW: Essentials of Human Anatomy & Physiology, 11th Edition. WC Brown Publishers, London 2004: Hole’s. • Ford MJ, Hennessey, I, and Japp, A: Introduction to Clinical Examination, 8th Edition. Churchill Livingstone, London 2005: Ford. • O'Neill P, Dornan T, Denning DW: Medicine. A Core Text with Self-Assessment. Churchill Livingstone, 3rd Edition, 2008: O'Neill.
*NOTE: Not all reading assignments will be covered in class, but all reading assignments are absolutely necessary in order to follow what is actually covered in class. In some cases, where noted, skimming the reading and picking out important points will be sufficient.
Canvas Canvas is a web-based system that allows you to access course resources and communicate with your classmates and faculty. To access Canvas, you can go to the DIS homepage and click the ‘Canvas’ link on the bottom of the website, or go to: https://canvas.disabroad.org/login/canvas. You can also download the Canvas App (By: Instructure) on iPhone and Android mobile smart phones.
Useful Links and Online Medical Dictionaries 1. Medline Plus Medical Dictionary http://www.nlm.nih.gov/medlineplus/mplusdictionary.html 2. Medical Dictionary http://www.nlm.nih.gov/medlineplus/mplusdictionary.html 3. Medicine Net http://www.medicinenet.com/script/main/hp.asp 4. Inteli Health http://www.intelihealth.com/IH/ihtIH/WSIHW000/408/408.html 5. UK Medical Search Engine & Health Guide http://www.medic8.com/index.htm
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Location and Meeting Times Classroom: All lectures will be held at the Education Center (See below) Meeting times: 15.30 – 17.30
For CAMES day: Course assistant will determine a meeting time and location.
Detailed Map of Hvidovre Hospital:
Transportation To get to the hospital, you will be using public transportation; your transportation pass provided by DIS will cover you from DIS to the hospital (zones 1, 2, 33).
The following routes are recommended to get to Hvidovre Hospital: Bus: 1A,22,65E,200S stops at Kettegård alle, Hvidovre Hospital Bus: 132,133 stops at Hvidovrevej, 5 min walk to Hvidovre Hospital
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Meeting location Bus stop for 150S Course Assistant will establish Rigshospitalet Meeting Spot. and 6A – both Detailed Map of the National University Hospital (Rigshospitalet): leave from Nørreport
Entrance Main entrance #3
Bus stop
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Course Schedule Day / Date Time Title Read Present Wed 18/01 14:50-16:10 DIS Mandatory Science & Metroanneks Medical Practice & Policy Health on Fiolstræde Program Orientation Department (See Arrival Booklet)
Thurs 19/01 15.30-17.30 Lecture 1 Adam & Introduction, expectations and Niels Rigshospitalet pre-course knowledge
Entrance 2, **Meet CA in V7 courtyard at 7th floor 14:50 to depart for hospital by public transportation**
Mon 23/01 15.30-17.30 Lecture 2 Hole’s: Chapter 14 Niels Infectious diseases O’Neill: Chapter 10 Rigshospitalet (+HIV)
Entrance 2, 7th floor
Thur 26/01 15.30-17.30 Lecture 3 Ford, p 48-52, 58- Niels ENT (Ear, Nose, Throat) 59, 126-133, 27 Rigshospitalet O’Neill 393-395 ** Elect Class Hand outs Entrance 2, Representatives** 7th floor
Mon 30/01 15.30-17.30 Lecture 4 Ford, p 83-96, 22- Niels Respiratory System 24 Rigshospitalet Hole’s: Chapter 16 O’Neill: Chapter 2 Entrance 2, 7th floor
Wed 01/02 17.30-19.00 The Danish S&H Healthcare system Department DIS F24-206 Mandatory Study Tour (On Canvas), What Orientation Can We Learn From Denmark (On Canvas)
Thurs 02/02 15.30-17.30 Lecture 5 Adam Organization of Danish Hvidovre Healthcare system and catch up Hospital TEST 1 Auditorium 3- 4 **Note Location Change** Fri 03/02 18:00-20:00 MPP Program Social Café Klaptræet Kultorvet 11, København K
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Mon 06/02- Wed 08/02 Short Study Tour Ribe/Middlefart
Thurs 09/02 15.30-17.30 Lecture 6 Hole’s: pp 132- Adam Orthopaedic surgery 143(7-7.5), 164- Hvidovre 171(7.13) Hospital
Room: 26 Section: 156
Mon 13/02 15.30-17.30 Lecture 7 Hole’s 68, 454 Niels Oncology O’Neill 80-83, 130, Rigshospitalet 150-151, 301-302 Clinical Patient Case 1 Hand outs Entrance 2, 7th floor
Thur 16/02 Reserved for make-up class
Mon 20/02 15:30-19:30 Lecture 8 Hole’s: 211-220, Niels Neurology I + II 228-233, 247-251, Rigshospitalet **Note skim 234-246 Extended O’Neill: 218- Entrance 2, Time** 222(meningitis), 7th floor 225-231 (stroke), 235-236 (epilepsy) Ford: 118-120, 123, 126-132
Thur 23/02 Reserved for make-up class
Long Study Tour Sunday, February 26 – Friday, March 3 Berlin, Germany and Poznan, Poland
Mon 06/03 15.30-17.30 Lecture 9 TBA Anna Cardiology I Hvidovre Anatomy and Hypertension Hospital
Room: 26 Section: 156
Thurs 09/03 15.30-17.30 Lecture 10 TBA Anna Cardiology II Hvidovre ECG, Rhythms and AMI Hospital
Room: 26 Clinical Patient Case 2 Section: 156
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Mon 13/03 15:30-20:30 Lecture 19 On Canvas Ditte Emergency Medicine Herlev Simulation Session Hospital 25th Floor • The management of stopped-heart *Meet CA at diagnosing designated • Treatment of cardiac arrest location to • Practical training in depart for resuscitation hospital by • Team training public using simulation transportation* centre in various
patient case scenarios
*NOTE: TIME CHANGE*
Patient Case Due to Canvas Thurs 16/03 15.30-17.30 Lecture 11 TBA Adam Paraclinical Tests and Radiology
Hvidovre Hospital
Room: 26 Section: 156
Study Tour Assignment Due Friday, March 17 By 16.00 to Canvas
Travel Break Monday, March 20 – Friday, March 24
Mon 27/03 15.30- Lecture 12 TBA Anna 17.30 Gastrointestinal system 1 Hvidovre Hospital
Room: 26 Section: 156
Thur 30/03 16.00- Lecture 13 On Canvas DIS 19.30 Introductory DIS Clinical Course Instructors Simulation og - IV Insertion Træning **Note Time - Suture Center and Location - Catheter Insertions (Gentofte Change** *Meet CA at designated location Hospital) to depart for hospital by public transportation*
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Mon 03/04 15:30- Lecture 14 TBA Anna 17:30 Gastrointestinal Hvidovre system 2 Hospital
Room: 26 Section: 156
Thur 06/04 Reserved for make-up class
Mon 10/04 15.30- Lecture 15 Ford, p 50-52 Niels 17.30 Endocrinology Hole’s: Chapter 11 Rigshospitalet O'Neill: Chapter 7 Test 2 Entrance 2, 7th floor
Break Wednesday, April 12 – Monday, April 17
Thur 20/04 15.30-17.30 Lecture 16 TBA Anna Gynecology Hvidovre Hospital
Room: 26 Section: 156
Mon 24/04 15.30-17.30 Lecture 17 Ford, p 48-52, 58- Niels Practical ENT and Catch Up 59, 126-133, 27 Rigshospitalet O’Neill 393-395 Hand outs Entrance 2, 7th floor
Thur 27/04 Reserved for make-up class
Mon 01/05 Reserved for make-up class
Thur 04/05 15.30- Lecture 19 Adam + 17:30 Wrap up, tying it together Niels + Rigshospitalet Preparation for the final Anna
Entrance 2, 7th floor
Final Exam Tuesday, May 9 Time: 15:00 – 17:00 Location: DIS TBA
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