26730 - Tutorial Practice Classes
2.2. Learning goals
The student, to pass this subject, must demonstrate the following results
- Collect the signs and symptoms that require the patient to consult with the doctor and translate them into a document
-To be able to perform a complete anamnesis focused on the main manifestations of the clinical picture, oriented to the various pathologies and interpreting their meaning.
- Be able to perform a physical examination by devices and systems, interpreting their meaning.
-Make a diagnostic orientation based on the data collected.
-Request complementary tests appropriate to the differential diagnosis.
- Be able to assess and link in a reasoned way the basic analytical modifications, alterations of the ekg, basic radiology and other complementary explorations properly indicated.
- Establish the most appropriate diagnosis in clinical situations.
- Carry out adequate information on the process that affects the patient taking into account the ethical aspects.
- Plan an appropriate treatment to all the medical and personal circumstances of the patient. In professional and social skills related to the care environment in which it is performed. In knowing how to properly plan clinical work in different healthcare settings: Hospital Emergencies, Health Center, Hospital Medical Services.
Reflect on the limits in the health care provided to patients in different specialties: family and community medicine, emergencies and different medical specialties.
SURGERY: During and at the end of the period of clinical practices in Surgery, students must:
Recognize, diagnose and guide their management:
1. To propose and evaluate the surgical risk.
2. Prevention and treatment of decubitus ulcers
3. Wound healing. Pathology of the scar.
4. General treatment before and after surgery
5. Antibiotic and thromboembolic prophylaxis in Surgery.
6.- Informed Consent in Surgery
7. Asepsis and Antisepsis in Surgery.
1. The main postoperative complications.
2. The foundation and indications and types of Oncological Surgery
3. The foundations and care management of ambulatory surgery
4. The fundamentals, indications and limitations of minimally invasive surgery.
4. The basic surgical maneuvers and general aspects of the surgical technique.
5. The basic surgical material
6. The foundation, indications and management of most common probes and drainages
KNOW TO DO:
Know how to do with competence (Routinely and without supervision)
1. Preoperative assessment of surgical risk. Scale A.S.A.
2. Standards of asepsis in the operating room and in surgical maneuvers and cures.
3. Diagnose the main general postoperative complications
4. Local treatment of surgical cures
To have practiced under supervision:
1. Simple surgical sutures
2. Remove suture material from a wound (and cure an ostomy)
5. Surgical hand washing and basic aseptic and antisepsis techniques
6. Realization of Clinical Stories in Surgery
7. Presentation of clinical cases in Surgical Clinical Sessions
Having seen it practiced by an expert:
1. Local anesthesia technique.
2. Posing and prescribing treatments in the postoperative period.
3. Most frequent surgical interventions in open and minimally invasive surgery.
4. Gold-tracheal intubation and anesthetic monitoring and controlled management of the airway
5. General and loco-regional anesthesia techniques
1.-Acquire skill in the anamnesis to obtain the clinical information that allows to elaborate a correct clinical history, to obtain physical exploration in the pediatric age.
2.-Know how to use precise tools to adapt in the interview to the peculiarities of each pediatric age: Clinical interview technique with parents. Teen interview
3.-Knowing how to perform a complete physical examination in different pediatric ages, interpreting their meaning adequately and using the growth charts correctly.
4.- Be able to establish a clinical reasoning with identification of problems, development of diagnostic hypotheses, differential diagnosis according to the age of the patient and choose the appropriate complementary tests.
5.-Establish a plan of therapeutic action and prevention, focused on the needs of the patient and their family and social environment
1.- Know how to use triage as a risk stratification method for patients who come to the Emergency Room. In the most prevalent emergency reasons:
2.-Collect the signs and symptoms that require the patient to go to the emergency room and translate them into the documents in force in these Services
3.- Be able to make an anamnesis focused on the main manifestations of the clinical picture, oriented to the urgent action
4.- Being able to perform a physical examination that assesses the "urgent" situation
5.- Be able to perform diagnostic guidance in the most prevalent urgent cases and request the necessary complementary tests to clarify the reason for urgency
6.-Be able to indicate the basic treatments of life support
7.- Be able to distinguish between patients who must be discharged and those who require prolonged observation / admission
TRAUMATOLOGY and ORTHOPAEDIC SURGERY
1.- Being able to make a clinical history
2.- Know how to carry out basic clinical exploration maneuvers in musculoskeletal pathology
3.- Know how to recognize the indications of the available imaging tests in the most prevalent pathologies
4.- Be able to recognize the indications of the available laboratory tests in the most prevalent pathologies
5.- Know how to indicate the preparation of a patient before surgery
6.- Know how to make immobilization bandages, either simple or in plaster, in the most prevalent pathologies
7.- Know how to perform a cure of a basic process
8.- Know the indications of surgery, in the most prevalent traumatic or orthopedic pathologies
9.- To know the basic operation of an operating theater where Locomotive Apparatus surgery is performed, and its differences with operating rooms of other specialties
OBSTETRICS and GYNECOLOGY
1.-Before a patient who comes to the obstetric consultation, the student must acquire and demonstrate the ability to:
- Obtain the clinical history, analyze the personal and family history and the current symptomatology to assess the evolution of the pregnancy, documenting the information obtained.
- Perform the physical examination, including bimanual genital exploration, exploration with valves and speculum, measurement of the height of the uterine fundus, Leopold maneuvers and fetal auscultation. The student must know how to document and interpret the clinical findings obtained, as well as select the complementary examinations that should be performed in the care of a normal pregnancy.
- Identify risk situations during pregnancy that require the attention of women in other levels of assistance.
- Demonstrate the ability to inform the pregnant woman about hygiene and nutrition during pregnancy.
- Identify the symptoms and clinical signs that suggest the beginning of childbirth, know the basic rules of their driving and witness their attendance.
- Attend puerperal evolution, identifying the alarm symptoms and performing the appropriate clinical examination, including mammary exploration. Must be able to report on the benefits and disadvantages of breastfeeding and on the basic rules for their proper development.
- Be able to report on the expected and normal postpartum evolution of the resumption of physical activity and sexual relations, as well as family planning options
2.- Before a patient who comes to the gynecological consultation, the student must acquire and demonstrate the ability to:
- Obtain the clinical history by taking an anamnesis appropriate to the reason for the consultation, assessing the characteristics associated with each genital, paragenital or extragenital symptom and personal, family history, menstrual history and reproductive history.
- Perform gynecological clinical examination including inspection, abdominal examination, exploration with valves and speculum, obtaining samples for cytological study and fresh examination and bimanual genital examination. Perform the mammary physical examination including the inspection and palpation, as well as the exploration of the axillary and supraclavicular spaces.
- Know, select and interpret the complementary examinations that must be performed to support or establish the diagnosis: Cytology, colposcopy, biopsy, ultrasound, radiodiagnosis, hysteroscopy, laparoscopy, endocrine evaluation.
- Be able to raise the differential diagnosis and establish an initial therapeutic plan for those clinical situations that are most often causes of gynecological consultation: Vulvovaginitis, abdominal pain, genital hemorrhage, mammary tumor and family planning.
- Identify the clinical situations that require the attention of the patient in other levels of health care, making a written report on the contents of the clinical history and the reasons for the referral.
- Know how to clearly and tactfully communicate to the patient and, where appropriate, the family members, the established diagnosis, the foreseeable evolution of the process, the recommended treatment and the prognosis.