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Al- Azhar University
Faculty of Medicine, Cairo
Department of Chest Diseases
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CHEST MEDICINE
UNDERGRADUATE COURSE
(Fifth Year)
2014-2015
I – Course Specifications
Undergraduate Chest Medicine Course 2014-2015 Page 1
A- Basic Information1. Course title: chest disease (fifth academic year of MB.,B.CH. program).
2. Code: 07-501 chest
3. Faculty: Faculty of Medicine, Al- Azhar University
4. Department: Department of Chest Diseases
5. Total theoretical hours: 20 hours + 20 practical and clinical hours
6. Allocated marks: 10 marks
7. Course duration: 2 weeks / year
8. Co-coordinator: Prof. Salem Sabea
9. Assistant co-coordinator: Ass. Prof. Ayman Amin, Dr Ahmed Taha
10. Last date of program approval: May 2014
11. Teaching staff: Professors – Assistant Professors – Lecturers, Assistant lecturers, and Demonstrators.
B- Professional Information1- Course Aims:
Studying this course should produce a competent general practitioner:
1. With standard knowledge and skills of chest medicine, at the level of the primary health care system, with proper awareness of the social and community contexts of health care.
2. Able to diagnose and treat common chest diseases.3. Able to recognize and manage pulmonary conditions that require urgent intervention and when to
take the appropriate decision of referral.4. Have a diagnostic, problem solving and decision-making skills necessary for proper evaluation
and management of common chest diseases.5. Have appropriate ethical and professional skills necessary for establishment of excellent
communication with patients and colleagues.6. Able to develop positive attitude of continuous medical education and promotion of professional
skills and research capabilities7. Have basic administrative skills necessary for delivery of health services.
2- Intended Learning Outcomes (ILOs):
Undergraduate Chest Medicine Course 2014-2015 Page 2
A- Knowledge and understanding
By the end of the course the candidate will be able to:
1. Describe the common respiratory problems and the life-threatening conditions resulting from it as regards etiology, risk factors (including the role of genetics in disease predisposition), pathogenesis, clinical features, differential diagnosis, complications and the principles of management including non-invasive and invasive interventions and palliative care.
2. Describe the theoretical basis of professional, practical skills and evidence based medicine (EBM).
3. Recognize basics of health and patient’s safety and safety procedures during practical and clinical rounds.
4. Define principles of clinical audit.5. Recognize the basic principles of formulating specific clinical sheets and the art of
utilizing sources of information.6. Interpretation of common diagnostic studies and proper choice among them according to
the situation.
B- Intellectual skills:
By the end of the course the candidate will be able to:
1. Integrate the results obtained from history, clinical examination and investigational data into meaningful diagnostic formulation.
2. Combine clinical and investigational data with evidence based knowledge and skill of deductive reasoning for clinical problem solving.
3. Select clinical decisions regarding the common chest diseases4. Design a management plan for common chest diseases. 5. Comment on a case study.6. Recognize the critical medical chest problems.7. Identify common (major) radiological and laboratory abnormalities of chest diseases.8. Interpret the results of commonly used diagnostic procedures.9. Identify the indications and logistics of referring patients to higher levels of experience or
specialization.10. Design scientific research through the formulation of research questions pertinent to
medicine and the collection, analysis and interpretation of medical data.
C. Professional and Practical Skills:
By the end of the program the candidate should be able to:
1. Take a thorough history of chest patients, relative to the clinical context.2. Demonstrate a complete general examination of chest patients.3. Demonstrate a complete local examination of chest (inspection, palpation, percussion and
auscultation).4. Clinically diagnose the main chest diseases including critical respiratory diseases.
Undergraduate Chest Medicine Course 2014-2015 Page 3
5. Recognize urgent life-threatening conditions, and institute appropriate initial management.
6. Choose the oxygen level need for various respiratory cases.7. Formulate drug dosage based on patient's criteria and health condition.8. Write safe prescriptions of different types of drugs.9. Adopt suitable measures for safety and infection control.10. Practice inhalational methods for drug administration.
Procedures and technical skills will be learned under appropriate supervision during undergraduate and house officer training:
1. Insert intercostal tube drain.2. Perform sampling of arterial blood gases.3. Demonstrate aspiration of pleural effusion.4. Perform and interpret basic respiratory function tests.
D. General and Transferable Skills:
By the end of the program the candidate should be able to:
1. Have the ability to explore both disease and illness with patients, and meet their communication needs and those of their relatives.
2. Communicate effectively with the patients, their families and all health care personnels.3. Acquire standard ethical behavior.4. Exemplify good manners and attitude.5. Be able to work in a team.6. Demonstrate proper infection control.7. Avoid frightening of the patients and accept the unsuitable behavior of them.8. Deal with the patient as a person not as a disease.9. Exhibit and display a professional image (professional look), following the Islamic code
of medical ethics.10. Ensure confidentiality and privacy of patient's information.11. Treat all patients equally, and avoid stigmatizing any category regardless of beliefs,
culture, and behaviors.12. Work cooperatively demonstrating respect with other health care professions for effective
patient management.13. Be willing to share in all types of inter- professional activities including collaborative and
shared learning.14. Ensure the cost effectiveness of health care management.
UNDERGRADUATE CHEST MEDICINE COURSE CONTENTS
A: TOPICS
Undergraduate Chest Medicine Course 2014-2015 Page 4
TOPICS WEIGHT (%)
1 (5)
4(20)
4(20)
1(5)
1(5)
1(5)
2(10)
3(15)
1(5)
1(5)
1(5)
20(100)
1. Radiology in chest diseases
2. Infectious diseases of the lung
3. Obstructive lung diseases
4. Occupational and environmental lung diseases
5. Diffuse parenchymal (Interstitial) lung diseases
6. Lung cancer
7. Pulmonary vascular disorders
8. Diseases of the pleura
9. Mediastinal and chest wall disorders
10.Sleep related disorders
11.Respiratory failure and oxygen therapy
Total
Practical and clinical hours are allocated in the following formats:
How to approach a case with chest disease 1h
History in a case with chest disease 1h
General examination in a case with chest disease 1h
Local examination in a case with chest disease 1h
Undergraduate Chest Medicine Course 2014-2015 Page 5
Course Specifications
1. Radiology in chest diseases (1 hour)
(5 % of the course)
INTENDED LEARNING OUTCOMES: (ILOs)
1.1 Knowledge: By the end of the course the student will be able to: A1 and A6
Description Method of teaching Assessment1.1.1 CXR normal and abnormal findings
LecturesTutorials
Independent learning (IDL)
MCQShort Essay
VIVA
1.1.2 Chest CT conventional and HRCT1.1.3 MRI chest1.1.4 Thoracic ultrasound
2.2 Skills and Attitude: Level of competence (5)
By the end of this course the student will be able to:
The Skill Level of competence
Method of teaching
Assessment
1.2.1
B1ـــــB10C1ـــــC10D1ــــــD14
(5)
Clinical Rounds
Audiovisuals
Clinical examOSCEOSPE
1.2.2
1.2.31.2.4
Undergraduate Chest Medicine Course 2014-2015 Page 6
2. Infectious diseases of the lung (4 hours) (20 % of the course)
INTENDED LEARNING OUTCOMES: (ILOs)
2.1 Knowledge:
By the end of the course the student will be able to: A1 and A6
Description Method of teaching Assessment2.1.1 Bronchitis: definition , etiology , clinical picture, and
treatment Lectures
Tutorials
Independent learning (IDL)
MCQ
Short Essay
VIVA
2.1.2 Pneumonia: definition, etiology, classification, pathology, clinical manifestations, investigations, signs of severity, complications, and treatment.
2.1.3 Lung abscess: definition, etiology and pathogenesis, clinical manifestations, differential diagnosis, investigations, complications, and treatment.
2.1.5 Tuberculosis: definition, causative organism, epidemiology, clinical course, primary tuberculosis,post-primary tuberculosis (clinical features, diagnosis, and treatment)
2.2 Skills and Attitude: Level of competence (5)
By the end of this course the student will be able to:
The Skill Level of competence
Method of teaching
Assessment
2.2.1
B1ـــــB10C1ـــــC10D1ــــــD14
(5)
Clinical Rounds
Audiovisuals
Clinical exam
OSCE
OSPE
2.2.2
2.2.32.2.42.2.5
Undergraduate Chest Medicine Course 2014-2015 Page 7
3. Obstructive lung diseases (4 hour) (20 % of the course)
INTENDED LEARNING OUTCOMES: (ILOs)
3.1 Knowledge:
By the end of the course the student will be able to: A1 and A6
Description Method of teaching Assessment3.1.1 Bronchial asthma: Definition, etiology, risk factors,
pathogenesis, pathology, classification, clinical manifestations, diagnostic testing, monitoring, differential diagnosis, complications, and management of chronic asthma, and asthma exacerbation.
Lectures
Tutorials
Independent learning (IDL)
MCQ
Short Essay
VIVA
3.1.2 Chronic obstructive pulmonary disease (COPD): definition , etiology, risk factors, pathogenesis, pathology, clinical manifestations, investigations, differential diagnosis, complications, management of stable COPD and COPD exacerbations
2.1.4 Bronchiectasis: definition, etiology, clinical manifestations, investigations, complications, and treatment.
3.1.3 Cystic fibrosis: definition3.1.4 Bulbous diseases of the lung: enumeration.3.1.5 Bronchiolitis: definition, and presentations
3.2 Skills and Attitude: Level of competence (5)
By the end of this course the student will be able to:
The Skill Level of competence
Method of teaching
Assessment
3.2.1
B1ـــــB10C1ـــــC11D1 ــــــ D14
(5)
Clinical Rounds
Audiovisuals
Clinical exam
OSCE
OSPE
3.2.2
3.2.33.2.43.2.5
Undergraduate Chest Medicine Course 2014-2015 Page 8
4. Occupational and environmental lung disease (1 hour)
(5 % of the course)
INTENDED LEARNING OUTCOMES: (ILOs)
4.1 Knowledge:
By the end of the course the student will be able to: A1 and A6
Description Method of teaching Assessment4.1.1 Occupational and environmental lung diseases:
Definition and classification.
Lectures
Tutorials
Independent learning (IDL)
MCQ
Short Essay
VIVA
4.1.2 Asbestos-Related Lung Disease, (Asbestosis): Clinical features, diagnosis, treatment and prognosis, mesothelioma: Clinical features, diagnosis, treatment and prognosis)
4.1.3 Chronic Beryllium disease: Definition, risk factors, clinical presentation, diagnosis, differential diagnosis, and treatment.
4.1.4 Coal Workers’ Lung Diseases|: Definition, risk factors, pathology, clinical features, diagnosis , and management.
4.1.5 Silicosis: Definition, risk factors, pathology, clinical features, diagnosis, and management.
4.1.6 Byssinosis: Definition, risk factors, pathology, clinical features, diagnosis, and management.
4.2 Skills and Attitude: Level of competence (5)
By the end of this course the student will be able to:
The Skill Level of competence
Method of teaching
Assessment
4.2.1
B1ـــــB10C1ـــــC11D1 ــــــ D14
(5)
Clinical Rounds
AudiovisualsClinical examOSCEOSPE
Undergraduate Chest Medicine Course 2014-2015 Page 9
5. Diffuse parenchymal (Interstitial) lung diseases (ILDs) (1 hour)
(5 % of the course)
INTENDED LEARNING OUTCOMES: (ILOs)
5.1 Knowledge: By the end of the course the student will be able to: A1 and A6
Description Method of teaching Assessment5.1.1 Approach to a case of diffuse parenchymal lung
disease
Lectures
Tutorials
Independent learning (IDL)
MCQ
Short Essay
VIVA
5.1.2 Idiopathic pulmonary fibrosis: Clinical features diagnosis , differential diagnosis, treatment and prognosis
5.1.3 Sarcoidosis: Definition, etiology, clinical presentations, classification, diagnosis, and treatment.
5.1.4 Hypersensitivity Pneumonitis: Definition, etiology, clinical features, and treatment
5.1.5 The Eosinophilic Pneumonias: definition, and enumeration
5.2 Skills and Attitude: Level of competence (5)
By the end of this course the student will be able to:
The Skill Level of competence
Method of teaching
Assessment
5.2.1
B1ـــــB10C1ـــــC10D1 ــــــ D14
(5)
Clinical Rounds
Audiovisuals
Clinical exam
OSCE
OSPE
Undergraduate Chest Medicine Course 2014-2015 Page 10
6. Lung cancer (1 hour) (5 % of the course)
INTENDED LEARNING OUTCOMES: (ILOs)
6.1 Knowledge:
By the end of the course the student will be able to: A1 and A6
Description Method of teaching Assessment6.1.1 Bronchogenic Carcinoma: Definition, types, clinical
features, diagnosis, treatment and prognosis Lectures
Tutorials
Independent learning (IDL)
MCQ
Short Essay
VIVA
6.1.2 The Solitary Pulmonary Nodule: A Systematic Approach
6.2 Skills and Attitude: Level of competence (5)
By the end of this course the student will be able to:
The Skill Level of competence
Method of teaching
Assessment
6.2.1
B1ـــــB10C1ـــــC10D1 ــــــ D14
(5)
Clinical Rounds
Audiovisuals
Clinical exam
OSCE
OSPE
Undergraduate Chest Medicine Course 2014-2015 Page 11
7. Pulmonary vascular disorder (2 hours) (10 % of the course)
INTENDED LEARNING OUTCOMES: (ILOs)
7.1 Knowledge: By the end of the course the student will be able to: A1 and A6
Description Method of teaching Assessment7.1.1 Pulmonary Hypertension and CorPulmonale:
Definition, etiology, clinical presentations, and management
Lectures
Tutorials
Independent learning (IDL)
MCQ
Short Essay
VIVA
7.1.2 Pulmonary Thromboembolic Disease: Definition, risk factors, clinical presentations, diagnosis, and treatment
7.1.3 Pulonary vsculitides: Enumeration
7.2 Skills and Attitude: Level of competence (5)
By the end of this course the student will be able to:
The Skill Level of competence
Method of teaching
Assessment
7.2.1
B1ـــــB10C1ـــــC10D1 ــــــ D14
(5)
Clinical Rounds
Audiovisuals
Clinical exam
OSCE
OSPE
Undergraduate Chest Medicine Course 2014-2015 Page 12
8. Diseases of the pleural space (3 hours) (15 % of the course)
INTENDED LEARNING OUTCOMES: (ILOs)
8.1 Knowledge:
By the end of the course the student will be able to: A1 and A6
Description Method of teaching Assessment8.1.1 Pleurisy :Definition, causes, clinical presentations,
diagnosis, and treatment Lectures
Tutorials
Independent learning (IDL)
MCQ
Short Essay
VIVA
8.1.2 Pleural Effusions: Definition, causes, clinical presentations, diagnosis, and treatment
8.1.3 Empyema: Definition, causes, clinical presentations, diagnosis, and treatment
8.1.4 Pneumothorax: Definition, etiology, classification clinical presentations, diagnosis, and treatment
8.2 Skills and Attitude:
By the end of this course the student will be able to:
The Skill Level of competence
Method of teaching
Assessment
8.2.1B1ـــــB10C1ـــــC10D1 ــــــ D14
(5)
Clinical Rounds
Audiovisuals
Clinical examOSCE OSPE
8.2.2 Insert intercostal tube (1) Clinical RoundsAudiovisuals
8.2.3 Demonstrate aspiration of pleural effusion
(1) Clinical RoundsAudiovisuals
8.2.4 Take a pleural biopsy (1) Clinical RoundsAudiovisuals
Undergraduate Chest Medicine Course 2014-2015 Page 13
9. Diseases of the mediastinum and chest wall (1 hour)
(5 % of the course)
INTENDED LEARNING OUTCOMES: (ILOs)
9.1 Knowledge:
By the end of the course the student will be able to: A1 and A6
Description Method of teaching Assessment9.1.1 Mediastinitis :Common causes, clinical presentations,
and diagnosis Lectures
Tutorials
Independent learning (IDL)
MCQ
Short Essay
VIVA
9.1.2 Mediastinal masses: Common causes, clinical presentations, and diagnosis
9.1.3 Diaphragmatic weakness and paralysis: Common causes, clinical presentations, and diagnosis
9.1.4 Diaphragmatic hernias: Classification clinical presentations, and diagnosis
9.2 Skills and Attitude:
By the end of this course the student will be able to:
The Skill Level of competence
Method of teaching
Assessment
9.2.1B1ـــــB10C1ـــــC10D1 ــــــ D14
(5)
Clinical Rounds
Audiovisuals
Clinical examOSCE OSPE
Undergraduate Chest Medicine Course 2014-2015 Page 14
10. Sleep related disorders (1 hour) (5 % of the course)
INTENDED LEARNING OUTCOMES: (ILOs)
10.1 Knowledge:
By the end of the course the student will be able to: A1 and A6
Description Method of teaching Assessment10.1.1 Sleep Apnea :Definition, types, causes, clinical
presentations, diagnosis, and treatment Lectures
Tutorials
Independent learning (IDL)
MCQ
Short Essay
VIVA
10.2 Skills and Attitude:
By the end of this course the student will be able to:
The Skill Level of competence
Method of teaching
Assessment
10.2.1B1ـــــB10C1ـــــC10D1 ــــــ D14
(5)
Clinical Rounds
Audiovisuals
Clinical examOSCE OSPE
Undergraduate Chest Medicine Course 2014-2015 Page 15
11. Respiratory failure and oxygen therapy (1 hour)
(5 % of the course)
INTENDED LEARNING OUTCOMES: (ILOs)
11.1 Knowledge:
By the end of the course the student will be able to: A1 and A6
Description Method of teaching Assessment11.1.1 Respiratory Failure: Definition, classification,
common causes, clinical presentations, diagnosis, and treatment
Lectures
Tutorials
Independent learning (IDL)
MCQ
Short Essay
VIVA
11.1.2 Oxygen therapy: Indications, technique, and complications
11.2 Skills and Attitude:
By the end of this course the student will be able to:
The Skill Level of competence
Method of teaching
Assessment
11.2.1B1ـــــB10C1ـــــC10D1 ــــــ D14
(5)
Clinical Rounds
Audiovisuals
Clinical examOSCE OSPE
Undergraduate Chest Medicine Course 2014-2015 Page 16
TEACHING AND LEARNING METHODS:
I) Methods used:
A. Lectures.
B. Tutorials.
C. Independent learning (IDL)
D. Clinical classes:
1) Clinical Lectures.2) Bedside education
3) Commentary
4) Case presentations.
II) Teaching plan:
a. Lectures:
At the lecture halls (No) on the __ floor in the in El- Hussein and/or
Bab Elshaareya University Hospital . One lecture/day. Each lecture
will take one hour according to the current t ime table in the general
lecture halls from 8.30 am to 9.30 am.
b. Tutorials:The students will discuss with the tutor some topics related to the
investigation and intervention in chest diseases (chest x ray, basic
pulmonary function, arterial blood gases, aspiration of pleural fluid,
chest tube insertion, pleural biopsy, bronchoscopy, and thorachoscopy)
which will take one hour every day in the tutorial classes (the same
lecture hall) from 9.30 am to 10.30 pm according to the current t ime
table in the general lecture halls.
c. Clinical classes: clinical Lectures:
The lecture halls (No ) on the __ floor in the in El- Hussein
University Hospital. One clinical lecture/day . Each lecture
will take one hour according to the current t ime table in the
Undergraduate Chest Medicine Course 2014-2015 Page 17
general lecture halls from 10.30 am to 11.30am, and will be
followed by bedside education .
Commentary:
Alternating with clinical lectures in the same halls at the same
time which will take one hour according to the current time table
in the general lecture halls from 10.30 am to 11.30 am, and will
be followed by bedside education.
Case presentations:
Alternating with clinical lectures and commentary in the same
halls at the same time. The students will be divided into
3groups; each group will be supervised by assistant lecturer
and will be asked to prepare a case alternatively with other
group and present it in the clinical class according to the
current time table in the general lecture halls from 10.30 am to
11.30 am, and will be followed by bedside education.
Bedside education:
After the clinical course the candidate will be asked to detect
the physical sign in the admitted patient in the chest
department with his supervisor assistant lecturer.
d. Independent learning (IDL):Each group will be asked to prepare a research in a topic related to
their presented case and will present the research after termination
of case presentation.
Undergraduate Chest Medicine Course 2014-2015 Page 18
III) Time plan:
Item Time schedule Total hours
Lectures one t ime/day, 1-2 hours
each between
9 am -11 am
20 hours
Clinical
lectures ,
tutorials,
commentary,
case
presentat ions
and bedside
education
2 hour/day
11 am - 1 pm
20 hours
Total 40 hours
Undergraduate Chest Medicine Course 2014-2015 Page 19
IV) Teaching and learning facilities:
These include:
I. Lecture halls: Equipped with white board and data show projector.
El- Hussein University Hospital : The lecture hall (No ) on the fifth
floor of the new building.
Bab El Shaareya University : The lecture halls (No ) on the 11th floor
of the new surgery and pediatrics building.
II. Clinical rounds halls : they are equipped with facili ties to perform the
required work:
El- Hussein University Hospital The lecture halls (No ) on the fifth floor
of the newbuilding.
Bab El Shaareya University: The lecture hall ( No ) on the fifth floor of
the clinics building.
III. Tutorial classes: Held in the lecture halls.
IV. Bedside education:chest medicine department (30 ward beds ,and 6
respiratory intensive care beds ) at each hospital .
V. Commentary: in the clinical round hall .
VI. Case presentations: in the clinical round hall.
V) Student Assessment:
I. Attendance: The minimum acceptable attendance in the lectures, clinical
and tutorial classes is 75%. Students fail to attend the required percentage
will not be allowed to attend the final oral term exam.
Undergraduate Chest Medicine Course 2014-2015 Page 20
II. Assessment tool:
Tool Purpose
Written
examination
Assessment of knowledge and understanding
Clinical
examination
Assessment of cl inical , intellectual and general
skil ls
Oral
examination
Assessment of attitude, knowledge and
understanding
Log book Assessment of attendance and sharing the
overall activities during the course.
III. Examination description:
A. Log book: (attached at the end of this curriculum) must be
completed during the course and every student should have to:
1. Attend at least 75% of the lectures and clinical classes.
2. Actively participate in case presentation and research
preparation .
B. Examination:
A. Formative examination: at the last day of the course (oral
examination)
B. Final examination: In June(internal medicine examination)
Those who fail to pass the final exam or postpone it can enter
the final exam re-held in September.
Undergraduate Chest Medicine Course 2014-2015 Page 21
IV. Total marks (10 marks):
Items marks
Attendance 4 Attend at least 75% of
the lectures and
clinical classes
Formative examination 6 Examiner
Learning and reference material:
I. Basic materials:
II. Suggested materials (recommended books):
Course Co-ordinator: Prof. Salem Sabea.
Professor of Chest Diseases.
Undergraduate Chest Medicine Course 2014-2015 Page 22