Medicine and Surgery

Activity type

Formazione clinica interdisciplinare e medicina basata sulle evidenze

SSD

MED/03

Year

2nd year

Semester

1st semester

CFU

1

Hours distribution

13 classroom hours

Lecturers

IRENE BOTTILLO

Activity type

Scienze umane, politiche della salute e management sanirario

SSD

MED/02

Year

2nd year

Semester

1st semester

CFU

2

Hours distribution

25 classroom hours

Lecturers

MARIA CONFORTI

Activity type

Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica

SSD

MED/09

Year

2nd year

Semester

1st semester

CFU

1

Hours distribution

12.5 classroom hours

Lecturers

MAURIZIO MUSCARITOLI

Activity type

Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica

SSD

MED/18

Year

2nd year

Semester

2nd semester

CFU

2

Hours distribution

25 classroom hours

Lecturers

LAURA GIACOMELLI

Activity type

Inglese scientifico e abilità linguistiche, informatiche e relazionali, pedagogia medica, tecnologie avanzate e a distanza di informazione e comunicazione

SSD

L-LIN/12

Year

2nd year

Semester

2nd semester

CFU

4

Hours distribution

48 classroom hours

Lecturers

ALESSIA DI COSTANZO

Activity type

Tirocini formativi e di orientamento

SSD

MED/41

Year

2nd year

Semester

2nd semester

CFU

1

Hours distribution

5 training hours, 20 others hours

Lecturers

MARCELLO ARCA

Activity type

Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica, Tirocini formativi e di orientamento

SSD

MED/09, MED/09

Year

2nd year

Semester

2nd semester

CFU

2

Hours distribution

13 classroom hours, 25 training hours

Lecturers

MARCELLO ARCA

Activity type

Inglese scientifico e abilità linguistiche, informatiche e relazionali, pedagogia medica, tecnologie avanzate e a distanza di informazione e comunicazione

SSD

MED/01

Year

2nd year

Semester

1st semester

CFU

1

Hours distribution

12.5 classroom hours

Lecturers

LUIGI PALLA

First course
Main teaching objectives:
- know the development of scientific thought in relation to medical care based on reasoning and clinical method; the methodological study of genetic diseases and the new frontiers of genetics for the development of medicine; health as primary benefit of man and the community;
- know how to apply scientific method in the medical field in order to define the basis of the formulation of clinical reasoning, in the light of fundamental ethical models of reference;
- be able to evaluate the close relationship between health-person-bioethics-genetic inheritance-symptoms and objective examination in order to provide appropriate management of the patient.

Second course
The course aims to develop the theoretical and practical skills necessary to allow a correct medical-patient interaction, to develop a method of collecting information and clinical data as well as the ability to accurately collect, recognize and interpret the main normal and pathological physical signs for all organs and systems.
At the end of the course, the student must be able /or have:
to perform patient’s interviewing and health history taking (Adapting Interviewing Techniques to Specific Situations)
to perform physical examination of major organs including collection of vital signs
to collect blood pressure
to perform basic surgical maneuvers
to perform a basic interpretation of ECG
basic knowledge of clinical reasoning
to perform the main Basic Life Support maneuvers (licensed by American Heart Association)

To enable students to acquire the ability to conduct anamnestic data collection and, more generally, to know how to conduct conversations with patients. To know how to collect patients' vital signs. Knowing how to set up clinical reasoning
Acquire the ability to understand and interpret simple scientific papers in English

Basic knowledge of anatomy, and physiology

Module: PRE-CLINICAL SCIENTIFIC METHODS I - MEDICAL GENETICS
Contents:
Introduction to Human Genome: organization, protein-coding genes, gene families, pseudogenes, ncRNAs, DNA methylation
Human Genetic Diversity: pathogenic and benign variants (SNPs, Indels, CNVs, Inversions)
Genome analysis: genomic array and DNA sequencing
Prenatal Diagnosis and Screening
Principles of bioinformatics
Genetic counselling
Imprinting disorders



Module: PRE-CLINICAL SCIENTIFIC METHODS I - HISTORY OF MEDICINE
History of medicine
- general features
- antiquity and middle ages: surgery and its early history
- early modern and Enlightenment: the beginnings of rehabilitation
- 19th and 20th centuries developments
- history of the healing professions, history of hospitals and public health
Elements of bioethics and of medical philosophy




Module: PRE-CLINICAL SCIENTIFIC METHODS I - INTERNAL MEDICINE
Contents:
Introduction to Clinical Medicine; Introduction to physical examination; Introduction to Medical Diagnosis; Introduction to Medical Record; The Doctor-Patient Relationship; To cure and to care; Illness, Disease, Sickness; Evidence-based Medicine; How is evidence generated; How to search the sources of evidence; How to perform a bibliographic search; How to read a scientific paper.

APP: Doing an imformatic library research; Analyzing tools for scientific papers: How to use e-portfolio tools
These activities will be held in classroom. These activities are strictly linked with the contents of the course, in particular with the section dedicated to the evidence-based medicine. After attending these APPs, the students will be able to perform by themselves a literature search and to orient themselves within the digital resources, with the needed critical approach.



Module: PRE-CLINICAL SCIENTIFIC METHODS I - STATISTICS
Contents:
Lectures to provide the theoretical elements of the anamnesis in the surgical patient and practical activities with patients to practice the collection of the medical history and to put into practice the maneuvers for the evaluation of the vital status.


Module: PRE-CLINICAL SCIENTIFIC METHODS II - SCIENTIFIC ENGLISH
1. Reading of scientific articles to develop the ability to critically discuss medical research articles in English. Frontal lectures to refresh: the knowledge on scientific articles (what they are, how to read them); types of primary medical research; pyramid of evidence-based medicine sources; basic concepts on statistical analysis methods; what a journal club is and how to make a scientific presentation in power point.
2. Scientific seminars of young researchers of Sapienza University of Rome focusing on the application of precision medicine in cardiovascular and oncological diseases. Groups of students will be engaged in round table sessions (as chairpersons, moderators, discussants) to direct the group discussion and create an engaging atmosphere for the audience. The teacher will provide one research article related to each seminar and further reading material to understand the topic. All the students will be required to read the article the week before each seminar, to ask questions and participate in discussion.
3. Journal Club organized as group activities. Students will be asked to study and present by power point presentations selected articles (journal club) to practice their communication and computer skills necessary to perform scientific communications in English.


Module: PRE-CLINICAL SCIENTIFIC METHODS II - ANESTHESIOLOGY

Principles and methodologies for taking a medical history in internal medicine
Principles and methodologies for taking a medical history in surgery
Measuring blood pressure
Assessing respiratory function
Principles and methodologies for the main resuscitation procedures
Psychological aspects of the doctor-patient relationship
How to conduct a conversation
The basics of clinical reasoning
Practical activities in the skill lab for learning how to take blood samples and assess vital signs
Practical activities in the clinic with real and simulated patients
Presentation and discussion of scientific papers in English

Contents:
Practical activities with patients to practice collecting the medical history. Perform exercises for measuring blood pressure in patients. Receive training in the main resuscitation maneuvers (BLS).



Module: PRE-CLINICAL SCIENTIFIC METHODS II - INTERNAL MEDICINE
Contents:
Theoretical lessons and practical activities to acquire the conceptual bases and to develop skills for the collection of the medical history in real clinical cases and in a clinical setting. Principles of blood pressure measurements.



Module: PRE-CLINICAL SCIENTIFIC METHODS II - GENERAL SURGERY
Contents:
Probability distribution (binomial and normal) and their properties and biomedical applications. Sampling distributons of proportions and means and their properties. Logic of statistical inference and of the long run (frequentist). Confidence intervals for sampling estimates. Statistical hypothesis test theory. Normal and t tests for single, paired and independent tests. Nonparametric tests and when to use them. Testing hypotheses on linear regression coefficients. Foundations and interpretation of logistic regression.

APP: Using and interpreting common statistical tests: This APP, carried out first in small groups by students and then in the classroom is meant to apply to concrete scientific problem the theory of statistical tests of hypothesis, in various steps: understand the scientific problem, determine the appropriate test, apply the logic of inference, calculate the test and the p-value using statistical tables and interpreting the results.

Module: PRE-CLINICAL SCIENTIFIC METHODS I - MEDICAL GENETICS
Suggested Textbooks: ·
Thomson and Thomson, Genetics in Medicine, Elsevier, VIII Edition, 2016



Module: PRE-CLINICAL SCIENTIFIC METHODS I - HISTORY OF MEDICINE
Roy Porter, Blood and Guts, 2017


Module: PRE-CLINICAL SCIENTIFIC METHODS I - INTERNAL MEDICINE
Suggested Textbooks: Harrison’s Principles of Internal Medicine; Goldman-Cecil Medicine.


Module: PRE-CLINICAL SCIENTIFIC METHODS I - STATISTICS
Suggested textbooks:
Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins - Lynn Bickley MD (Author), or Goldman’s Cecil medicine 24th edition


Module: PRE-CLINICAL SCIENTIFIC METHODS II - SCIENTIFIC ENGLISH
No text is required. Lesson, articles and additional material will be provided by the teacher digitally.


Module: PRE-CLINICAL SCIENTIFIC METHODS II - ANESTHESIOLOGY
Suggested textbooks:
Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins - Lynn Bickley MD (Author), or Goldman’s Cecil medicine 24th edition



Module: PRE-CLINICAL SCIENTIFIC METHODS II - INTERNAL MEDICINE
Suggested textbooks:
Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins - Lynn Bickley MD (Author), or Goldman’s Cecil medicine 24th edition



Module: PRE-CLINICAL SCIENTIFIC METHODS II - GENERAL SURGERY
Suggested Textbooks:
Lecture slides/materials will be available via e-learning. Further readings :

Kirkwood and Sterne, Essential Medical Statistics, Blackwell 2003 (reference book)

Huff, D. How to lie with statistics.
Vickers, A. J. What is a p-value anyway?

Module: PRE-CLINICAL SCIENTIFIC METHODS I - MEDICAL GENETICS
N/D
Module: PRE-CLINICAL SCIENTIFIC METHODS I - HISTORY OF MEDICINE
N/D
Module: PRE-CLINICAL SCIENTIFIC METHODS I - INTERNAL MEDICINE
N/D
Module: PRE-CLINICAL SCIENTIFIC METHODS I - STATISTICS
N/D
Module: PRE-CLINICAL SCIENTIFIC METHODS II - SCIENTIFIC ENGLISH
N/D
Module: PRE-CLINICAL SCIENTIFIC METHODS II - ANESTHESIOLOGY
N/D
Module: PRE-CLINICAL SCIENTIFIC METHODS II - INTERNAL MEDICINE
N/D
Module: PRE-CLINICAL SCIENTIFIC METHODS II - GENERAL SURGERY
N/D

The course includes lecture sessions and practical activity sessions in small groups in the clinic and in the skill lab.

Students will be required to attend at least 75% of lectures and small group practical activities .Classroom attendance tracking

Complete a multiple-choice questionnaire on the topics and content of the lectures.
Complete a practical test involving taking a medical history and interviewing a real or simulated patient.
Practical test involving collecting vital signs.

Examples of question included in the MCQ

The purposes of a conversation with a patient is:
a) to establish a trusting and supportive relationship
b) to know the patient’s health condition
c) to be empathetic
d) none the above

Which are the component of a comprehensive health history? (may select more than one)
a) Identifying data
b) Chief complain
c) Past history
d) Relatives’ data

Which of the following are part of the sequence of the interview?(may indicate more than one):
a) Establishing the agenda of the interview
b) Negotiating a plan
c) Checking patient’ blood test
d) Seeing one of patient’s family member

How can you identify the chief complain?
a) By identifying a life-threatening condition
b) By asking to patient’s relative
c) By looking for abnormal physical signs
d) None all above

How can you identify the chief complain?
a) By identifying a life-threatening condition
b) By asking to patient’s relative
c) By looking for abnormal physical signs
d) None all above

The blood pressure measurement should be always taken with the only exception:
a) When the patient is sitting
b) When the patients is lying
c) When the patients is standing
d) When the patient is walking

Module: PRE-CLINICAL SCIENTIFIC METHODS I - MEDICAL GENETICS

• Introduction to Human Genome: organization, protein-coding genes, gene families, pseudogenes, ncRNAs, DNA methylation; Human Genetic Diversity: pathogenic and benign variants (SNPs, Indels, CNVs, Inversions)


• Genome analysis: genomic array and DNA sequencing


• Principles of bioinformatics


• Prenatal Diagnosis and Screening


• Genetic counselling

• FROM CLINICAL TO EVIDENCE-BASED MEDICINE FIRST CLASS, COURSE START UP
  • Books: HARRISON'S PRINCIPLES OF INTERNAL MEDICINE, 19TH ED; SIR ARCHIE COCHRANE: EFFECTIVENESS AND EFFICACY


• WHAT IS EVIDENCE AND WHY WE NEED IT
  • Books: HARRISON'S PRINCIPLES OF INTERNAL MEDICINE, 19TH ED; SIR ARCHIE COCHRANE: EFFECTIVENESS AND EFFICACY


• HOW EVIDENCE IS GENERATED IN THE BIOMEDICAL FIELD
  • Books: SEE ABOVE


• FROM CLINICAL TRIALS TO METANALYSES TO GUIDELINE
  • Books: READ TEACHER'S SLIDES


• HOW TO READ A SCIENTIFIC PAPAER
  • Books: READ TEACHER'S SLIDES


• HOW TO PUBLISH SCIENTIFIC DATA: INSTRUCTION MANUAL
  • Books: READ TEACHER'S SLIDES


• LAST ACTIVITY - COURSE END APP: Doing an imformatic library research; Analyzing tools for scientific papers: How to use e-portfolio toolsThese activities will be held in classroom. These activities are strictly linked with the contents of the course, in particular with the section dedicated to the evidence-based medicine. After attending these APPs, the students will be able to perform by themselves a literature search and to orient themselves within the digital resources, with the needed critical approach. 

• Learning outcomes:      Act as chairperson, moderator, discussant
  to direct roundtable sessions during scientific seminars in English   Prepare and deliver an oral
  presentation supported by powerpoint slides on selected scientific articles
  (Journal Club)    Understand
  research presentations in English
  
  
  
  Formulate questions and participate in discussions    Develop a logical and
  orderly approach to reading a scientific article   Assess the quality of an oral
  presentationExercise critical thinking skills, improve
  presentation and debate abilities
  • Books: No specific textbook. Selected scientific articles provided by the professor.


• Frontal
  lectures to refresh the knowledge of the students in statistics, methodology
  and epidemiology that is necessary to understand a scientific research article. 


• Scientific
  seminars to practice the ability of the students to understand research
  presentations in English, to ask questions and to participate in discussions. 


• Journal Club
  organized as group activities to teach students how to understand and
  critically discuss medical research articles in English.

• The theoretical and practical basis of the main resuscitation maneuvers
  • Books: BLS manual

• Theoretical and practical aspects of anamnestic collection Part I)
  • Books: Bates'
    
    Guide to Physical Examination and History-Taking - Lippincott Williams &
    
    Wilkins -  Lynn Bickley MD (Author),    


• Theoretical and practical aspects of anamnestic collection (Part II)
  • Books: Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins -  Lynn Bickley MD (Author),  


• Theoretical and practical aspects of anamnestic collection (Part III)
  • Books: Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins -  Lynn Bickley MD (Author),  


• Clinical
  reasoning, assessment and plans. The medical vocabulary
  • Books: Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins -  Lynn Bickley MD (Author),  


• Theoretical and practical aspects of blood pressure measurement
  • Books: Bates' Guide to Physical Examination and History-Taking - Lippincott Williams & Wilkins -  Lynn Bickley MD (Author),  


• Practical activity sessions (3 hours) of anamnesis collection with real or simulated patients

• Probability distribution (binomial and normal) and their properties and biomedical applications. 


•  Sampling distributons of proportions and means and their properties. 


•  Logic of statistical inference and of the long run (frequentist). 


• Confidence intervals for sampling estimates.


•  Hypothesis test statistical theory. 


• Normal and t tests for single, paired and independent tests.


• Nonparametric tests and when to use them. 


• Testing hypotheses on linear regression coefficients.


• Foundations and interpretation of logistic regression.