First cycle
degree courses
Second cycle
degree courses
Single cycle
degree courses
School of Medicine
MEDICINE AND SURGERY
Course unit
THE APPROACH TO PATIENTS
MEP8085619, A.A. 2019/20

Information concerning the students who enrolled in A.Y. 2019/20

Information on the course unit
Degree course 6 years single cycle degree in
MEDICINE AND SURGERY
ME2491, Degree course structure A.Y. 2019/20, A.Y. 2019/20
N0
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Number of ECTS credits allocated 8.0
Type of assessment Mark
Course unit English denomination THE APPROACH TO PATIENTS
Department of reference Department of Medicine
E-Learning website https://elearning.unipd.it/dimed/course/view.php?idnumber=2019-ME2491-000ZZ-2019-MEP8085619-N0
Mandatory attendance
Language of instruction English
Branch PADOVA
Single Course unit The Course unit CANNOT be attended under the option Single Course unit attendance
Optional Course unit The Course unit is available ONLY for students enrolled in MEDICINE AND SURGERY

Lecturers
Teacher in charge PATRIZIA PONTISSO MED/09
Other lecturers CHRISTIAN AGRILLO M-PSI/02
ENRICO FURLAN M-FIL/03
FABIO ZAMPIERI MED/02

ECTS: details
Type Scientific-Disciplinary Sector Credits allocated
Educational activities in elective or integrative disciplines M-FIL/03 Moral Philosophy 1.0
Educational activities in elective or integrative disciplines M-PSI/02 Psychobiology and Physiological Psychology 2.0
Core courses MED/09 Internal Medicine 4.0
Core courses MED/02 History of Medicine 1.0

Course unit organization
Period Annual
Year 1st Year
Teaching method frontal

Type of hours Credits Teaching
hours
Hours of
Individual study
Shifts
Group didactic activities 0.0 20 0.0 No turn
Lecture 8.0 60 140.0 No turn

Calendar
Start of activities 30/09/2019
End of activities 20/06/2020
Show course schedule 2019/20 Reg.2019 course timetable

Examination board
Examination board not defined

Syllabus
Prerequisites: Introductory note
“Approach to patient” is an integrated course, formed of four units: 1) bioethics; 2) brain, mind and behaviour; 3) history of medicine; 4) interview and data collection.
The overall aim of the course is to underline, since the very beginning of the medical studies, that the ultimate meaning of the practice of medicine is the competent care of an ill person. Consequently, the course highlights the ethical and psychological dimensions of the practice of medicine, considering them in a historical perspective. Furthermore, the course provides the students with the tools for correctly approaching patients and for effectively collect their clinical history.
Where necessary, in the various sections of the syllabus, contents will be presented by course unit.

Prerequisites
Basic notions of cell biology and physiology learnt in secondary school.
Acquaintance with general history and with the history of philosophy and science.
Willingness to discuss with peers and lecturer.
Target skills and knowledge: Bioethics
The aim of this unit id to raise students’ awareness of the ethical dimension of the practice of medicine, and in particular of the new challenges faced by physicians in contemporary healthcare settings. Such aim will be pursued using of a narrative approach, i.e. starting from real cases or issues, and reflecting on them in a cooperative way.
As to the skills, students will learn to identify ethical issues and conceptual challenges starting from clinical cases or concreate healthcare scenarios.

Brain, Mind and Behaviour
This unit will focus on the main psychological issues related to the inpatient medical setting. In addition, notions of the biological bases of the main cognitive processes will be considered.

History of Medicine
This unit will offer students an understanding of the nature, aims and scopes of medicine and medical care through the analysis of its historical development.

Interview and data collection
The Interview and Data Collection unit represents the first moment of interaction with the patient in order to obtain a correct setting of the clinical problem. At the end the students will be able to use the correct medical terminology and at the same time know how to use the most appropriate language for the patient in relation to the environmental conditions (clinic, place of care etc.) and to the conditions of the patient himself. In addition, they will know the principles of clinical methodology and the logical procedure of clinical diagnosis, medical processes, decisions and strategies, classification of active and inactive problems. They will also know how to collect the clinical history (medical history) both in general and in relation to a specific clinical question in different settings.
Examination methods: Depending on the course unit, the exam may be:
• Written (open questions, multiple choice quiz etc.). Examples will be provided during the course;
• Oral (including the verification of the student’s ability to collect the medical history).
Assessment criteria: As to the written exams, answers will be evaluated using the following criteria: correctness, relevance, conceptual rigor, terminological accuracy, completeness.
As to the oral exam, student’s assessment will take into account the following factors: level of knowledge, accuracy of medical vocabulary, ability to analyze and summarize, practical skills acquired (in particular, the ability to ask questions to the patient and collect information on the current and past diseases; the ability to “clinically” sort the information acquired).
Course unit contents: Bioethics
• Definitions of basic concepts: ethics, medical ethics, bioethics.
• The birth of bioethics: causes and consequences.
• Non-reductionist conceptions of medicine, disease/illness, care.
• Different kinds of ethics support services.

Brain, Mind and Behaviour
The human mind and its complexity:
• Neuropsychology of cognitive functions: The brain; Differences between left and right hemisphere in higher cognitive abilities.
• Learning and Memory: Types of learning; Classical conditioning in the brain; short- and long-term memory in the brain.
• Sensation and perception: Perceptual principles underlying our subjective representation of the world.
• Emotion: Expression and recognition of emotion; theories of emotion; biological correlates of emotion; psychological response to stress.
• Sleep and waking: Circadian rhythms; Stages of wakefulness and sleep; sleep throughout the life span; the function of sleep and dreams; consequences of sleep deprivation in the immune system.
The subjective world of the patient:
• Psychological practice in inpatient medical setting: verbal and non-verbal communication; health and illness identity
• The ancient body-mind problem in the approach to patients: materialistic vs. dualist approach
• Placebo and nocebo effect in the perception of health
• Psychological Issues in the Inpatient Setting: Adjustment to Medical Illness, Anxiety Depression Delirium and Acute Cognitive Changes; Substance Use and Abuse
• Special Issues in the Hospital Setting: Decisional Capacity; Nonadherence; Pain; End-of-Life Issues


History of Medicine
• “Possessed patients”. The concept of disease as a demoniac possession during prehistory and ancient times.
• “Imbalanced patients”. The concept of disease as an imbalance in the humoral composition of the body from classic times to the Renaissance.
• “Lesioned patients”. The anatomo-clinical concept of disease in modern medicine. The dawn of pathology. The introduction of stethoscope.
• “Dissected patients”. The dissection of living patients through medical imaging techniques in contemporary medicine.
• “Integrative medicine”. The new approach to care that puts the patient at the centre and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health.

Interview and data collection
• Clinical methodology: logic of clinical diagnosis; medical processes, decisions and strategies; active and inactive problems.
• Methodological approach to diseases.
• Anamnesis: familiar, physiological, remote pathological, present pathological, pharmacological and working activities.
• Approach to difficult patient and in complex situations
Planned learning activities and teaching methods: Each course unit will use a mix of various learning activities, including:
• lecturing with questions
• group work
• small group discussion (on real clinical cases or on specific issues)
• plenary discussions
• laboratories
• tutorials
• problem-based learning.

Visits to Padua University’s ancient anatomical theatre (first of this kind in the world, inaugurated in 1595 and still perfectly preserved at the Bo Palace) and to Morgagni Museum of Pathology might be included.
Additional notes about suggested reading: Slides and other teaching material (including audio-visual material) used during the lessons will be available on Moodle.
To support and deepen their study, students are encouraged to consult the reference texts.
Textbooks (and optional supplementary readings)
  • Laura Freberg, Discovering Biological Psychology. --: Wadsworth, Cengage Learning, 2010. Cerca nel catalogo
  • Susan M Labott, Health Psychology Consultation in the Inpatient Medical Setting. --: American Psychological Association, 2018. Cerca nel catalogo
  • Kasper D.L. et al., Harrison’s Principles of Internal Medicine. --: Mc Grow Hill, 2015. Cerca nel catalogo
  • Bickley LS et al, Bate's guide to physical examination and history taking. --: Wolters Kluwer, 2017. Cerca nel catalogo
  • Macleod J, Macleod's Clinical Examination. --: Elsevier, Innes JA, Dover AR, Fairhurst K eds, 2018. Cerca nel catalogo

Innovative teaching methods: Teaching and learning strategies
  • Lecturing
  • Laboratory
  • Problem based learning
  • Working in group
  • Questioning
  • Problem solving
  • Auto correcting quizzes or tests for periodic feedback or exams
  • Loading of files and pages (web pages, Moodle, ...)

Innovative teaching methods: Software or applications used
  • Moodle (files, quizzes, workshops, ...)
  • Kahoot

Sustainable Development Goals (SDGs)
Good Health and Well-Being Quality Education Reduced Inequalities Peace, Justice and Strong Institutions