Introduction Cluster Abdomen Bouvy 2009

7/29/2019 Introduction Cluster Abdomen Bouvy 2009

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INTRODUCTIONcluster abdomen

1DE RUN

31-8-09Nicole Bouvy

surgeon


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Purpose

1. To gather knowledge about abdominalcomplaints

2. To get used to the abdominal complaintsquestions and the abdominal clinicalsurvey


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What drives learning?

Clinical presentations


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26 clinical presentations (p.17)and p28 Sheffield list

1. Dysphagia

2. Dyspepsia

3. Weight loss adult4. Child with bending growth

curve

5. Chronic abdominal pain adult

6. Chronic abdominal pain child7. Colic pain upper abdomen

8. Increase abdominalcircumference

9. jaundice10. Rectal blood loss

11. Chronic diarrhoea adult

12. Chronic diarrhoea child

13. Changed stool pattern

14. Faeces incontinence

15. Obstipation

16. Inguinal swelling17. Dysuria

18. Urine retention

19. Problems with sexual organs

20. Urine incontinence

21. Obstructive urination

22. Haematuria

23. Vaginal fluor24. Disturbance of menstruation

pattern

25. Problems with pelvic floor

26. Pregnancy


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Clinical presentations Basic medical sciences Clinical Sciences Common Index Conditions

Abdominal distention Knowledge of structures within

the abdomen and pelvis

Pathophysiology of bowel obstruction and

peritonitis

Ascites

Causes of enlarged organs in the abdomen

and pelvis

Bowel obstruction

Peritonitis

Enlarged intra abdominal

organs

Obesity

PregnancyAbdominal mass Structure and function of

internal abdominal organs

Pathophysiology of index conditions and their

cause

Hepatomegaly

Splenomegaly

Kidney enlargement

Bowel masses

Enlarged bladder

Aortic aneurysm

Uterine/ovarian masses

Abdominal wall hernias

Abdominal pain Knowledge of structures within

the abdomen and pelvis

Pathophysiology of index conditions and their

cause

Peptic ulcer disease

Mechanisms of abdominal pain Biliary tract diseasePrinciples of management of index conditions Pancreatic disease

Endometriosis

Aortic aneurism

Recurrent abdominal pain in

children

Ectopic pregnancy

Renal colic

Acute pyelonephritis

Diverticular disease

Appendicitis

Irritable bowel syndrome

Mesenteric ischemia

Intussusception

Bladder retention

Prostatitis

Adnexal torsion

Anorectal pain Structure and function of the

anal canal and the rectum

Pathophysiology of haemorrhoids Fissure in ano

Pathology and principles of management of

ano-rectal carcinoma

Thrombosed haemorrhoids

Knowledge of management of index

conditions

Carcinoma

Fistula

Pilonidal sinus abcessPerianal abcess

Rectal prolapse

Change in bowel habit Structure and function of the

large bowel

Pathophysiology of index conditions Carcinoma of large bowel

Knowledge of management of index

conditions

Diverticular disease

Inflammatory bowel disease

Toddlers diarrhoea

Irritable bowel syndrome

Constipation Structure and function of the

large bowel

Pathophysiology of index conditions Constipation

Pharmacology of laxatives and constipation

inducing drugs

Carcinoma

Laxative abuse

Drug related constipation


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Learning Methods Cluster Abdomen

Base group (Tuesday morning)

Outpatient clinic (Wednesday)

Training of skills (prostate, uterus) Anatomy, Physiology, pharmacology,

microbiology

Lectures Consulting experts

Self study


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Optional

Watching department of Endoscopy(Gastroscopy, colonoscopy, ERCP)

Watching operations department of

Surgery (phone Thursday morning 6-6883)

(laparoscopic cholecystectomy inguinalhernia repair etc)


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Esophyxrepair of Lower Esophageal Spincter


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Robot geassisteerdelittekenbreuk correctie na

opheffen stoma


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Example casus

Patient

vignettePrediscussion

on Tuesday

Vignette / casus

A 36-year old women

presents with rectal blood

los at the department ofsurgery

waarom een nieuwcurriculum?

curriculumstructuur

onderwijsprocess basisgroep

coach

voorbespreking

vignette

praktijkbegeleider

voor / nabespreking

terugrapportage

specifieke taken

logistiek /ondersteuning

Focus op Mechanisme van Ziekte


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neoplasia

circulatory

traumatic

BLOEDBLOED

congenital

anatomical

inflammatory /

immunological

Infection

functional /psychosomatic

metabolic /

endocrine


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Anotherexample

Symptoms


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Anatomy of liver

and bile ductsystem

Physiology gall


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Outpatient Clinic


curriculumstructuur

Learning processyear 3

basisgroep

coach

voorbespreking

casus / vignet

praktijkbegeleider

pre / post patint contact

terugrapportage

specifieke taken logistiek /

Outpatient clinic

08.30 08.35 prediscussion

08.35 08.50 Questions to patient

08.50 09.05 physical examination withspecialist

09.05 09.20 Discussion and learning objectives+ feedback

Structured individual feedback


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Self study

create a SOEPEL

Study learningtargets

create powerpointand word document


curriculumstructuur


basisgroep

coach

voorbespreking

casus / vignet

praktijkbegeleider

voor / nabespreking

terugrapportage



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Report back in base group

(Tuesday morning) Sunday evening worddocument en powerpointon eleum

Max20 minutes perclinical presentation


curriculumstructuur


basisgroep

coach

voorbespreking

casus / vignet

praktijkbegeleider

voor / nabespreking



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Onderwijsproces doorlopen

Voorbespreking

basisgroep

Voorbespreking

praktijkbegeleider

zelfstudie

Patinten

contactNabespreking

praktijkbegeleider

zelfstudie

Terugrapportage

basisgroep

Patinten

vignet/casus

activiteiten

rondom

patinten

contact


curriculumstructuur

onderwijsproces jr 3 basisgroep

coach

voorbespreking

casus / vignet

praktijkbegeleider

voor / nabespreking

terugrapportage

specifieke taken



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Task coach


curriculumstructuur

onderwijsproces jr 3 basisgroep

coach

voorbespreking

casus / vignet

praktijkbegeleider

voor / nabespreking

terugrapportage

task coach


coach giving feedback on

presentations

professional behaviour

stimulating discussion

preparing oral exam


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Lectures Cluster Abdomen Pathology

Physiology Radiology

Medical Microbiology

Pharmacotherapy

Genetics/cell biology

GP

Gastro-enterology

Pediatrics

Urology

Gynaecology enObstetrics

General Surgery


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Student is fully responsibel for

cluster file


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You have to be present to dowritten and oral exam


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Absence of studentsSanctionering : dit wordtmeegenomen in debeoordeling PG

Hetzij als onderdeel van de regulierebeoordeling, hetzij als incidentelemelding

NEE

Herkansing medisch- expert

ieder cluster biedt studententijdens de grote vakantie eenherkansingsperiode van eenweek aan (binnen een

vastgelegde periode van 3weken) week 29 is op zijnvroegst de eersteherkansingsweek.Niet toegelaten

tot

clustertoetsing

(Medisch Expert)Herhaling cluster

het volgende jaar

Exposure aan

klinische

presentaties1

Voldoet aanvoorwaardenreparatie(in totaal nietmeer gemist dannpraktijkcontact entwee

basisgroepen)

Voldoetniet aanvoorwaardenreparatie

(zie boven)

Coach

geeft

student

reparatie

opdracht

J A Studentvoldoet

aan

opdracht

(beoordelingdoor coach /examinator)

J A

NEE

Afwezigheidgerepareerd

(beoordeling doorcoach / examinator)

Hiermee wordt zowel bedoeld hetdaadwerkelijke patintencontactalsook de voorbereiding als denabespreking ervan in debasisgroep

overmacht(beoordeling doorexaminator / CCO)

geen

overmacht


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Conclusion

Good luck with your first real doctorexperience

Become a good doctor by constant

asking for feedback

Documents

Introduction Cluster Abdomen Bouvy 2009