CS 2015

Block 2 IntroductionChristian Stricker

Associate Professor for Systems PhysiologyANUMS/JCSMR - ANU

Christian.Stricker@anu.edu.au http://stricker.jcsmr.anu.edu.au/Block_2_Introduction.pptx

THE AUSTRALIAN NATIONAL UNIVERSITY

CS 2015

CS 2015

Aims

After this session, students should

• understand the aims of Block 2 in regard to cardiovascular system, kidney and lung;

• be aware of the specifics of the PBL process in Block 2;

• have an idea what Block 2 is NOT about; and

• be familiar with how to maximise learning opportunities in Block 2.

CS 2015

Content

• Importance of Block 2• Structure of Block 2• Aims of Block 2• What Block 2 is NOT about• Notes to PBLs in Block 2• Learning support around PBLs• Maximising learning opportunities• Feedback

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Who Is Responsible?

• Block Chairs– Girish Talaulikar – Renal physician at TCH– Me – Physiologist

– Responsible for lecture series planning, updating of PBLs and resources

– Not responsible for the PBL process (tutor instruction, etc. – Gerry Corrigan)

• Resource delivery of the PBLs and “slotting” of lecturers: MEU

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Importance of Block 2

• Over 80% of medical encounters deal with cardiovascular, renal or respiratory “problems”.

• You will learn most of the basic & relevant medical knowledge and skills in Block 2.

• However DO NOT to get side-tracked: concentrate on the basic sciences (themes) and not on the clinical application.

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Structure of Block 2

• 12 PBLs cover “most” of medicine

• 5 cardiovascular PBLs– 4 “cardiac” PBLs– 1 vascular PBL

• 3 renal PBLs• 4 respiratory PBLs• Mostly cover

“important” topics

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Aims of Block 2At the end of Block 2 you will be able to describe and explain the structure and function of the cardiovascular, renal and respiratory systems.

You will

1. have developed your knowledge of the relevant medical sciences and can apply this to an understanding of the cardiovascular, renal and respiratory systems in health and disease;

2. use your knowledge of the cardiovascular, renal and respiratory systems to inform your approach to clinical encounters and examination;

3. be able to apply your growing knowledge of psychological, social and cultural factors to clinical encounters relevant to the cardiovascular, renal and respiratory systems; and

4. be able to apply the tools of population health to questions concerning health and disease of the cardiovascular, renal and respiratory systems.

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MS Objectives• Cardiovascular objectives:

1. are able to explain the mechanisms involved in generating and modulating the cardiac action potential and how the pacing of the heart muscle results in the generation of pressure.

2. have developed a framework to systematically evaluate and interpret ECGs.

3. understand the cardiac cycle and its determinants, including Starling’s law of the heart.

4. are able to identify the determinants of cardiac output, venous return and their regulation.

5. recognise the nervous regulation of the circulation and control of blood pressure.

6. are cognisant of the various determinants of pressure, flow and pulse in arterial, capillary and venous vascular beds.

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MS Objectives• Renal objectives:

1. understand the concept and determinants of glomerular filtration and tubular re-absorption including the limitation of tests used to measure kidney function

2. know the key processes required to maintain acid-base balance including interplay between the respiratory and renal compensatory mechanisms.

3. are able to explain the regulation of fluid and sodium balance including the interplay between the different control systems (neural, endocrine and autonomic).

4. recognise the key difference in the mechanisms involved in renal sodium and potassium regulation.

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MS Objectives• Respiratory objectives:

1. understand how the various pressure and volume changes occur during the respiratory cycle and how these determine airflow and ventilation, including their clinical determination.

2. are able to explain the key concepts that determine the interplay between pulmonary ventilation and perfusion and how these affect the partial pressures of alveolar gasses.

3. have an in-depth knowledge of the principles involved in gas exchange, including the difference between diffusion of O2 and CO2.

4. appreciate the different control elements involved in the regulation of respiration.

5. are able to identify the key role of the respiratory system to the control of the acid-base base metabolism..

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PAL Objectives1. know about the importance of ethics in research on humans,

demonstrate an ability to assess whether a research project requires ethics committee approval, and complete an ethics application.

2. have developed a preliminary understanding of the role of regulation and ethical practice in the prescription and administration of medication.

3. have developed a preliminary understanding of how the multifactorial and multilevel determinants of health and wellbeing including the role of culture, society and attitude as well as the influence of socio-economic, environmental and governmental regulatory factors impact on human rights, health and access to health care using the Northern Territory Intervention and renal disease as an example.

4. understand how multiple factors combine to create errors and adverse events in hospitals and gain a preliminary understanding of clinical governance systems and processes which work to mitigate against harm occurring to patients as a result of these factors.

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PH Objectives1. know about the magnitude and important risk factors for major

cardiac, respiratory and renal diseases.

2. understand the role of inference in determining disease causation.

3. know about the multifactorial and multilevel determinants of health and wellbeing including the role of culture, society and attitude as well as the influence of socio-economic, environmental, infectious, genetic, biological and other factors.

4. understand measures of attribution of risk including Population Attributable Fraction.

5. be able to articulate critically about complex bio-psycho-social and cultural determinants of health and disease.

6. understand the wide array of health outcomes related to some determinants e.g. transport, water supply.

7. understand the link between causation and designing approaches to preventive action.

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What Block 2 Is NOT About• Block 2 DOES NOT focus on specific

investigations, diseases nor disease management.

• However, the disease process is used as a contextual framework to support understanding of physiological, anatomical, biochemical, pharmacological and patholo-gical principles of the cardiovascular, renal and respiratory organ systems.

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PBLs in Block 2• Full PBL – after easing in…• Clinically realistic

– Most of a full history– Clinically relevant questions

• Focus on FUNCTION and MECHANISM(s).

– Supported by investigations• CXR: carefully analyse and

identify functional implications.• ECGs: analyse and try to come

to a conclusion yourself.• Blood “parameters”:

biochemistry, etc.• Others … : try to understand

– how such investigations work &– what can be learnt from them.

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Support for PBLs• Lectures

– Most systematic lectures early– Typically, ~4 MS lectures and 2 “other

topics” per week – Pharmacology in 2nd half (application)– Few introductions into pathophysiology,

clinical applications, etc.• Practicals

– Cover relevant topic(s) of PBL– Clinical skill days– Make links to lectures and PBLs– Synchronised with PBLs

• Patient data sheet and investigations• Self-study• Questions to teachers (tutors, lecturers,

skills tutors, etc.)

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How to Maximise Learning• Engage with PBLs and

other opportunities: become active! Unless you are doing it, you don’t learn!

• Work the materials up as soon as possible:– Summaries, questions…

• Keep on top of the lecture series.

• Prepare for classes.• Use clinical skills to

apply theory to practice.

• Share work in study groups.

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I see and I forget,

I hear and I remember,

I do and I understand.Confucius (551– 479 BC)

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Give Effective Feedback• Be constructive• Closes the loop between

teaching, learning and assessment.– We do act on feedback

• Several changes done for this year (2015)– Reworked PBLs 9 – 12

(respiratory part)• Make them simpler and less

management oriented

– Settle changes introduced last year (AP, modulation and ECG lectures)

– Improved X-rays

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No Take Home Message

The Lot Is It

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And What – No MCQ?

There Must Be Something Wrong!?

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That’s it folks…