Medicine and Surgery - Roma Azienda Ospedaliera Sant'Andrea

Activity type

C_20. Scienze umane, politiche della salute e management sanitario e lingua inglese

SSD

L-LIN/12

Year

N/D

Semester

N/D

CFU

3

Hours distribution

36 classroom hours

Lecturers

MARIA CAPORALE

Activity type

B_01. Discipline generali per la formazione del medico

SSD

M-PSI/01

Year

N/D

Semester

N/D

CFU

1

Hours distribution

12 classroom hours

Lecturers

PIERLUIGI CORDELLIERI

Activity type

C_20. Scienze umane, politiche della salute e management sanitario e lingua inglese

SSD

M-DEA/01

Year

N/D

Semester

N/D

CFU

1

Hours distribution

12 classroom hours

Lecturers

ALESSANDRO LUPO

Activity type

B_01. Discipline generali per la formazione del medico, C_21. Tecnologie di informazione e comunicazione e discipline tecnico- scientifiche di supporto alla medicina

SSD

MED/01, MED/01

Year

N/D

Semester

N/D

CFU

3

Hours distribution

36 classroom hours

Lecturers

FABIO PRESAGHI

Activity type

C_02. Fisiopatologia, metodologia clinica, propedeutica clinica e sistematica medico-chirurgica, Tirocini formativi e di orientamento

SSD

MED/09, MED/09

Year

N/D

Semester

N/D

CFU

2

Hours distribution

12 classroom hours, 25 training hours

Lecturers

ROBERTA DI ROSA
CHIARA MARIA ASSUNTA CEFALO

Activity type

C_20. Scienze umane, politiche della salute e management sanitario e lingua inglese

SSD

M-PED/03

Year

N/D

Semester

N/D

CFU

1

Hours distribution

12 classroom hours

Lecturers

Pietro Lucisano

Activity type

C_20. Scienze umane, politiche della salute e management sanitario e lingua inglese

SSD

MED/02

Year

N/D

Semester

N/D

CFU

1

Hours distribution

12 classroom hours

Lecturers

MARIA CAPORALE

The integrated course in Medical-Scientific Methodology and Basic Human Sciences has the following essential objectives in the first year: the basic concepts of the evolution of medicine over the centuries; the modern scientific method; the basic concepts of patient personality; the basic concepts of anthropology; the general concepts of clinical medicine; the foundations of medical statistics; and a good knowledge of the English language.

The integrated course in Methodology and Human Sciences introduces students to a multidisciplinary approach to theoretical and practical training through the interaction of different fields of knowledge.

Educational objectives:
a. Outline the evolution of medical thought throughout history and of ethical and deontological principles throughout the history of medicine.
b. Promote knowledge, attitudes, and logical, discerning, listening, and communication skills.
c. Cultivate technical and operational qualities.
d. Stimulate the ability to critically collect and evaluate data relating to the health and illness status of individual patients from a clinical perspective.
e. Develop communication and relationship skills with patients, family members, and the various professional figures involved in team activities.
f. Promote encounters and exchanges with the different cultures living in a multiethnic society.
g. Develop fundamental knowledge for understanding the doctor-patient relationship and the intra- and interpersonal dynamics involved in illness.
h. Develop problem-solving skills
i. Stimulate critical awareness regarding professional decision-making, increasing the motivation and skills needed to make ethically informed and professionally responsible choices.

The final objective of the course is to provide students with the technical skills to integrate all the elements that contribute to defining the state of illness of the subject within a holistic vision of the disease process.

Students enrolled in the first year are required to have acquired basic knowledge in the scientific and humanistic areas during their studies, which are essential for understanding the contents proposed in the Medicine course in order to achieve the established objectives.

Module: scientific english
N/D
Module: General psychology: personality individual differences in the relation with patients
Course
1. Introduction to General Psychology
• Origins and domains of scientific psychology
• Main theoretical approaches: behaviorism, cognitivism, neuroscience
2. Learning processes and phobias
• Classical and operant conditioning
• Social learning theory
• Psychological mechanisms of phobias
3. Emotions and trauma
• Primary and secondary emotions
• Neurobiology of emotions
• Traumatic responses and psychological implications
4. Principles of communication and breaking bad news
• Interpersonal communication models
• Active listening and empathy
• SPIKES protocol for delivering bad news
• Psychological aspects of grief and emotional support

Testi in inglese
Teaching materials provided by the instructor (slides, articles, clinical examples).



Module: Medical anthropology: the culturally determined representation of the body, health and disease
The course offers an anthropological perspective on the following issues: the cultural and social shaping of human beings; the culturally determined definition and representation of the body, health and disease; the organic, experiential, social and political dimension of ailments, their etiology and the "sense" attributed to them; the therapeutic relationship and the effectiveness of curing acts.



Module: History of medicine and bioethics
Data collection and preliminary checks.
Frequency distribution: simple and multiple.
Graphical representation of frequency distribution.
Central tendency indicators: mode, median, arithmetic mean, percentiles
Variability indicators: variance, standard deviation, inter-quartile range
Shape of frequency distribution.
Elements of probability.
Sampling.
Random variables and probability distribution: The Normal Distribution, Student t Distribution. Tabulated probability values for the Standardized Normal Distribution.
Sampling Distribution: Sampling Distribution of Mean, Sampling Distribution of the difference of two means
Parameter estimation. Confidence intervals. Statistical hypothesis testing.
Statistical Tests: χ2, z-test, Student-t, zero-order correlations.



Module: Psycho-social anamnesis - interprofessional team and centrality of the patient in the process of care
Programme

1. Introduction to Medicine as a Science and the Art of Healing: Origins of the clinical method, evidence-
based medicine vs narrative medicine
2. Internal Medicine and Clinical Reasoning: Models of clinical reasoning: hypothetico-deductive, pattern
recognition, probabilistic reasoning; the role of internal medicine in clinical governance
3. Patient Communication: Verbal and non-verbal language, empathetic communication, active listening
techniques, communication barriers
4. Informed Consent: Ethical and regulatory aspects, information, voluntariness and decision-making
capacity, consent documentation
5. Medical History Taking (Anamnesis): Structure of anamnesis: reason for admission, history of present
illness, past medical history, family history, physiological, pharmacological, and social history; clinical
interview techniques, common errors in history taking
6. Physical Examination: General observation of the patient, assessment of vital signs (BP, HR, RR, T, SpO₂)
7. Systematic Physical Examination: Inspection, palpation, percussion, auscultation of the various
systems6. Physical Examination
8. General observation of the patient
9. Assessment of vital signs (blood pressure, heart rate, respiratory rate, temperature, SpO₂)
10. Systematic physical examination: inspection, palpation, percussion, auscultation



Module: General and special pedagogy: medical patient relationship
N/D
Module: Statistics in medical and scientific research
The course aims to develop the critical skills needed to make ethically responsible choices through an interactive teaching methodology witch has the purpose to integrate theoretical learning with an experiential approach. The program is divided into two interacting sections: 1. Historical and evolutionary path of medical science. History of medical ethics, deontology, and the doctor-patient relationship through its fundamental stages: from classical times to the contemporary era; 2. The principles of medical ethics. General bioethics and applied bioethics.

Topics covered:

Section1

1) Definition of health in history
2) Illness in the theurgic-templar era in ancient civilizations. Magical-religious thought. egyptian medicine and the first knowledge of human anatomy
3) Health care in classical Greece. The birth of rational medicine. Harmony and disorder in the Hippocratic theory of the humors
4) Places of care
5) Health education for Hippocrates. The oath, norms and principles. Paradigms of Hippocratic ethics. The doctor-patient relationship between the principle of beneficence and non-maleficence and the principle of paternalism
6) From the Hippocratic Oath to modern codes of ethics. The fundamental principles of the medical profession
7) Medicine in Rome. Galen and the concept of disease
8) The transmission of scientific knowledge through arab medicine. The birth of the hospital
9) Health care in monastic medicine
10) The school of Salerno
11) The human body and anatomy. The concept of disease from the Modern age to the age of Enlightenment
12) The achievements of medicine and the study of diseases between the 19th and 20th centuries
13) From the wellness revolution to the biotechnology revolution


Section 2

1) Human health: from the biomedical model to the biopsychosocial model From Hippocratic Ethics to Bioethics
2) Health promotion and protection. The right to health in the Constitution. Third and fourth generation rights: the right to assistance, the right to training and prevention, the right to research, the right to safeguard the environment and the ecosystem, the right to scientific and technological development, the right to self-determination and to refuse treatment art. 32.
3) Health and prevention. Risk behaviors. Wrong lifestyles. Preventive medicine
4) The evolution of the doctor-patient relationship in history. From the principle of beneficence-non-maleficence to the principle of autonomy. The therapeutic relationship in the modern age.
5) Informed consent to the medical act. The normative foundations of consent. Article 32 of the Constitution and the code of ethics for doctors. Conditions of validity of consent. Exceptions to consent. The state of necessity and the TSO. The consent of minors. Law n.219/2017: advance processing declarations.
6) The art of communicating. Verbal and non-verbal communication. Communication barriers and communication errors. Personalized information; information to third parties; active listening; the helping relationship
7) The ancient Hippocratic principles and the birth of bioethics
8) General bioethics: principles and values in the field of health Sciences
9) Ethical models in biomedicine
10) Applied Bioethics. The end of life between euthanasia and therapeutic obstinacy. Palliative care. The living will
11) The definition of the concept of death according to different ethical models. Law 578 on the certification of death. Law 219/2017. Advance treatment declarations. Constitutional Court ruling on assisted suicide.
12) The beginning of human life. The treatmnet of sterility and infertility. Medically assisted procreation
13) Environmental ethics and human health
14) Food ethics and human health
15) Transcultural bioethics. Female genital mutilation. Law 7/2006
16) Regulation of biomedical and biotechnological research: principles and limitations

Module: scientific english
N/D
Module: General psychology: personality individual differences in the relation with patients

Teaching materials provided by the instructor (slides, articles, clinical examples).
Baile W.F. et al., SPIKES—A Six-Step Protocol for Delivering Bad News, The Oncologist, 2000 (articolo disponibile online)


Module: Medical anthropology: the culturally determined representation of the body, health and disease
N/D
Module: History of medicine and bioethics
- NOTES FROM THE LESSONS (SLIDES)
- HANDBOOK: Wayne W. Daniel, & Chad L. Cross (2018, 10th Ed.). Biostatistics: a foundation for analysis in the health sciences. John Wiley & Sons.


Module: Psycho-social anamnesis - interprofessional team and centrality of the patient in the process of care
2. Clinical Examination by Andrew W. Robins, G. David Perkin, Graham A. W. Hornett, Ian S. Watt,
John Cookson, Owen. Mosby,2008



Module: General and special pedagogy: medical patient relationship
N/D
Module: Statistics in medical and scientific research
N/D

Module: scientific english
N/D
Module: General psychology: personality individual differences in the relation with patients
N/D
Module: Medical anthropology: the culturally determined representation of the body, health and disease
N/D
Module: History of medicine and bioethics
N/D
Module: Psycho-social anamnesis - interprofessional team and centrality of the patient in the process of care
N/D
Module: General and special pedagogy: medical patient relationship
N/D
Module: Statistics in medical and scientific research
N/D

Face-to-face/traditional face-to-face teaching. The lessons take place through a power point presentation by the teacher with a space dedicated to clarification questions and possible debate on the topics covered. The theoretical lessons are integrated with seminars, work shops, exercises, simulations and group work. The choice is for an interactive teaching methodology that combines doctrinal knowledge with an experiential approach with the aim of developing analytical, clinical investigation and evaluation skills, methodological, relational, organisational, communicative attitudes and to increase motivations and qualities useful for making choices ethically aware and responsible.

Mandatory presence in the classroom is required for 67 % of lessons. The tool for detecting attendance in the classroom is paper: signature sheet.

The training course makes use of an interactive teaching methodology which has the aim of integrating theoretical learning based on the holding of lectures with the experiential approach through simulations of clinical and ethical-deontological cases, work shops, in-depth seminars, practical tests, allowing the acquisition of diagnostic, methodological, relational and organizational skills for the management of individual cases.
The exam is divided into 3 sections: 1) a written test; 2) an optional oral test (in case of obtaining a sufficient result as a result of the written test); 3) a practical test to verify the acquisition of reasoning and critical evaluation skills, relationships, communication with the patient and with the professional team and problem solving skills,
The simulation techniques adopted for evaluation as part of the practical test enhance the students' ability to work in a team, stimulate discussion, educate in a medicine open to social demands in close relationship with the environment and the territory, encourage work team by developing analysis, resolution and communication skills through an immersive experience of realistic reproduction of environments and situations.
For the purposes of the final evaluation, the criteria of attendance at 50% are relevant; of active participation/reasoning, argumentation and communication skills at 50%.
The written tests consist of completing a questionnaire of 60 closed-ended questions.
The practical test is carried out using clinical and ethical-deontological case simulation techniques. The class is divided into working groups of 20 students. Through the projection of slides, the teachers describe and illustrate a clinical case and bring to the attention of the students an ethical-deontological dilemma in relation to the case described. This is followed by accurate case analysis and conflict highlighting, evaluation of alternative resolution options. The audience of student observers participating in the debate will be actively involved through a simulation experience. At the end of the debate, each student will explain their analyses, reflections, evaluations in written form with an open formula and indicate their proposed resolution of the case in the light of the knowledge acquired and the shared simulation experience.
The dates of the written/oral tests set for the 2025/2026 academic year are
12 January; 25 February; 9 June; 7 July; 29 September. Further extraordinary appeals will be included, including a recovery appeal in November 2025.
The date of the practical test which takes place in collaboration with the other teachers of the integrated course will be defined at the end of the course.
Incoming international mobility students will be able to take tests in English.

The doctor-patient relationship in classical times is based on:

(a) Principle of solidarity
(b) Principle of autonomy-self-determination
(c) Principle of consent
(d) Principle of beneficence-non-maleficence


The Consent:

(a) It shall always be expressed in written form
(b) It is not required in the case of minors or incapacitated persons
(c) May be given by third parties
(d) It is not required of the patient in the case of compulsory health treatment

The right to refuse treatment:

(a) It is a right introduced by the code of ethics for doctors
(b) It is not recognized by our legal system as the doctor has an obligation to treat the patient under any circumstances
(c) It is a right recognized in the Civil Code (art.5)
(d) It is a constitutionally guaranteed right


For Hippocrates, health is:

(a) Ability of the organism to maintain constants over time and control essential physiological variables
(b) Organic, psychic, social welfare state
(c) Harmony of humours, ordered set of fluids
(d) Dual relationship between organ and function

Microscopic anatomy was introduced by:

a) Malpighi
b) Pasteur
c) Spallanzani
d) Koch

The right to health in our legal system is:

(a) Right to psycho-physical integrity
(b) Right to equality in access to medical care
(c) Right to freedom not to be treated
(d) Beyond the above rights, the right to environmental protection, to the promotion of research, to biotechnological development, to the well-being of future generations

Clinical case presentation:

Patrizia, 48 years old, underwent chemo and radiotherapy for carcinoma in her left breast. Two years later, the treating doctor finds the formation of a neoplasm affecting the right breast. She was hospitalized for respiratory failure. E’ perfectly capable of understanding and wanting and subscribes a DAT in which it expresses the desire not to be treated except with analgesics. She appoints her husband as trustee. The husband, without her knowledge, asks the doctor to continue with adequate therapy.

What should the doctor do?
(a) Respect the patient's wishes as expressed through DAT and administer only palliative care
(b) Fulfil her duties in accordance with the principle of the protection of life and health and the cod deont. of doctors, treating the patient with suitable therapies
(c) Complying with the husband's request
(d) To place the decision in the hands of the judge of the competent Court

Module: scientific english
N/D
Module: General psychology: personality individual differences in the relation with patients



Module: Medical anthropology: the culturally determined representation of the body, health and disease



Module: History of medicine and bioethics

• -Data collection and preliminary checks. -Frequency distribution: simple and multiple. -Graphical representation of frequency distribution. -Central tendency indicators: mode, median, arithmetic mean, percentiles -Variability indicators: variance, standard deviation, inter-quartile range-Shape of frequency distribution. 
  • Books: - Wayne W. Daniel, & Chad L. Cross (2018, 10th Ed.). Biostatistics: a foundation for analysis in the health sciences. John Wiley & Sons.- Notes from lessons (slide)


• - Elements of probability. Sampling. - Random variables and probability distribution: The Normal Distribution, Student t Distribution. - Tabulated probability values for the Standardized Normal Distribution. 
  • Books: - Wayne W. Daniel, & Chad L. Cross (2018, 10th Ed.). Biostatistics: a
    
    foundation for analysis in the health sciences. John Wiley & Sons.-
    
    Notes from lessons (slide)


• -Sampling Distribution: Sampling Distribution of Mean, Sampling Distribution of the difference of two means-Parameter estimation. -Confidence intervals. -Statistical hypothesis testing. - Statistical Tests: χ2, z-test, Student-t, zero-order correlations.
  • Books: - Wayne W. Daniel, & Chad L. Cross (2018, 10th Ed.). Biostatistics: a
    
    foundation for analysis in the health sciences. John Wiley & Sons.-
    
    Notes from lessons (slide)

• Introduction to the clinical method
  • Books: Clinical Examination by Andrew W. Robins, G. David Perkin, Graham A. W. Hornett, Ian S. Watt, John Cookson, Owen. Mosby,2008


• Doctor–patient communication and informed consent
  • Books: Clinical Examination by Andrew W. Robins, G. David Perkin, Graham A. W. Hornett, Ian S. Watt, John Cookson, Owen. Mosby,2008


• Medical history and symptom characterization
  • Books: Clinical Examination by Andrew W. Robins, G. David Perkin, Graham A. W. Hornett, Ian S. Watt, John Cookson, Owen. Mosby,2008


• Fundamentals of the general physical examination and vital signs assessment
  • Books: Clinical Examination by Andrew W. Robins, G. David Perkin, Graham A. W. Hornett, Ian S. Watt, John Cookson, Owen. Mosby,2008


• System-based physical examination
  • Books: Clinical Examination by Andrew W. Robins, G. David Perkin, Graham A. W. Hornett, Ian S. Watt, John Cookson, Owen. Mosby,2008

• Il corso si svolge
  nel secondo semestre. Consta di 60 ore
  complessive, 20 ore di lezione per Storia della Medicina. La valutazione dell’apprendimento
  avverrà attraverso prove scritte (questionari di 60 domande a risposta
  multipla) integrate da prove orali e da prove pratiche consistenti in
  simulazioni di casi.    Inglese:     The course takes place in the second semester. The integrated course consists of approximately 60 hours in total, 20 hours of lessons for History of Medicine. The lectures will be integrated with seminars, workshops, simulations of clinical and ethical-deontological cases, meetings-debates. Assessment of learning will take place through written tests (questionnaires of 60 multiple choice questions) supplemented by oral tests and by practical tests consisting of case simulations.