University of Toronto Undergraduate Medical Education

The Art and Science of Clinical Medicine 1 - ASC 111Y

Course Director: Dr. Mary Anne Cooper

COURSE DESCRIPTION

This course is organized in hospital-based groups of 5 to 6 students, and will take place 1/2 day each week of the academic year.

The first semester, September to January, is devoted primarily to communication skills, and includes the following:

Listening skills;
Non-verbal communication;
Questioning techniques;
Empathic interviewing;
Cross-cultural and gender issues in the doctor/patient encounter;
Ethical issues in the doctor/patient encounter;
Components of the biomedical history; and,
Writing and presenting patient interviews
Selected components of the normal physical examination are presented.

The second semester, February to May, will be devoted to learning the techniques of the normal physical examination, and to refining and practicing the communications skills learned in semester one.

GENERAL OBJECTIVES

To learn the components of the traditional medical history and physical examination.
To learn the process skills by which such information is best collected in the doctor/patient interaction.
To develop verbal, non-verbal, and written communication skills in both obtaining and giving information.
To develop the psychomotor skills necessary to correct technical performance of the physical examination, and interpretation of abnormal findings.
To develop a non-judgmental, patient-centred approach to the doctor/patient interaction, in order to promote the physical, emotional and social well-being of patients. This includes a sensitivity to communicating with people from different cultural, community and religious backgrounds.
To develop humanistic attitudes of honesty, fairness and compassion towards patients, peers and other members of the health care professions.

EVALUATION

ASCM-1 is transcripted as a Credit/Non Credit Course.
This grade is submitted to the Board of Examiners.
In order to obtain Credit the student must obtain a passing grade demonstrating mastery in each of:
    -Final Exam
    -In-course narrative evaluation
    -Case report writing
No grade is assigned to Professional Behaviour but a passing performance is required to pass the course, regardless of performance in the graded elements of the course.
Students deemed to have failed the course by the Board of Examiners will be required to repeat the course in the following academic year.
In the case of inadequate performance, supplemental or remedial work and/or examinations will be recommended by the Course Director to the Board of Examiners.
Students granted supplemental or remedial privileges by the Board of Examiners must successfully complete this work prior to entering ASCM-2.
Individual course regulations and procedures may further specify relevant general statements found in section titled Grading And Promotion in the Academic Regulations contained in the Office of the Faculty Registrar section.

REQUIRED TEXTS

Coulehan, J and M. Block, The Medical Interview - Mastering Skills for Clinical Practice, fifth edition,   F.A. Davis Company, 2006.
Swartz, M., Textbook of Physical Diagnosis: History and Examination, fifth edition, Elsevier Science,  2005.
 
Additional material students may use:

Bickley, L., R. Hoekelman, Bates' Guide to Physical Examination and History Taking, ninth edition revised, Lippincott, Philadelphia, 2007.
Bickley, L., R. Hoekelman, A Pocket Guide to Physical Examination and History Taking, fifth edition, Lippincott, Philadelphia, 2006.
Butalia Sonia, H. H. Koh, C. Lam, J. Tan, eds., Essentials of Clinical Examination Handbook, fifth edition, 2006.
Colapinto, M., ed., The ASCM 1 Clinical Skills Handbook, second edition, University of Toronto, Faculty of Medicine, 2004.(Provided by the Undergraduate Medical Education Office)
Lumley J.,  and P-M. Bouloux , Clinical Examination of the Patient, Butterworth-Heinemann, 1994.
(good colour photographs)