Undergraduate Work Experience I (20410)

Qualification/course: Bachelor's Degree in Medicine
Year: 1
Term: 3
Number of  ECTS credits: 4 credits
Student study time: 50 hrs of face-to-face sessions and 50 hrs of individual work
Course language(s):
Teaching staff: The lecturers are Mariano Sentí (UPF), Ramon Miralles (UAB) and Josep-E. Baños (UPF).

1. Presentation of the course

The main objectives of the syllabus of the joint Pompeu Fabra University and Autonomous University of Barcelona degree course in Medicine are to offer students an integrated medical training and to provide early experience of the reality of healthcare in its various different aspects.  With regard to the latter point, the aim is to acquaint students at a very early stage with the context in which their future professional activity is to take place. In order to achieve this, the degree syllabus allows for three subjects, entitled Undergraduate Work Experience I, II and III, to be taken during the first three years of the course, when contact with the world of healthcare is still very rare.  These should not be considered as periods of clinical practice, since the students do not yet have sufficient knowledge to be able to use them for this purpose.  This function will be performed from the third year of the degree course onwards, and will be pursued in a range of healthcare environments so as to be able to attain the required skills.

The purpose of these subjects is for students, through day-to-day contact, to become acquainted with the reality of healthcare, the role of the various healthcare professionals in the system and the complexity of the medical profession.  A parallel objective is for students to come to understand the concept of professionalism and to see how psychological and sociological factors form a part of the experience of illness.  Last but not least, the Undergraduate Work Experience courses aim to maintain students' motivation for their studies and to help them understand the role of the basic disciplines in clinical practice.
The organization of these subjects involves the cooperation of the academic administrators (of both universities) and of the tutors of the participation institutions of the work experience programme. The universities will seek to ensure smooth communication between the two bodies, and expect students to fully understand their responsibilities during each part of these courses.

 

2. Competences to be achieved

1. To learn about the fundamental bases of medical ethics.
2. To apply personal and professional values of excellence, altruism, sense of duty, responsibility, integrity and honesty in the exercise of the profession. 
3. To learn about the aspects of communication with patients, relatives and the social environment. 
4. To learn about the structures of the clinical relationship (dialogue with the patient, verbal and non-verbal communication) and possible sources of interference.
5. To understand the importance of working in multi-disciplinary teams.

3. Contents

Attendance at the designated centres will take place in the afternoon and early evening, over two-week periods, for a duration of five hours per day (from 3.00 p.m. to 8.00 p.m.), from Monday to Friday. The three groups of collaborating centres where the work practice will take place are as follows:

- Group A (primary healthcare): covers primary healthcare centres belonging to IMAS (Barcelona Municipal Healthcare Institute) or other institutions. Students will work with health professionals (doctors and/or nurses) in local health centres.

- Group B (hospital healthcare): covers IMAS hospitals (Hospital del Mar, Hospital de l'Esperança) or other institutions. Students will work in the hospital services and nursing departments.

- Group C (specialized healthcare): covers IMAS nursing homes/clinics such as the Centre Fòrum (attached to the Hospital del Mar) or other institutions. Students will work in some of the healthcare activities of the centre concerned.  Optionally, other sectors of the health service may be involved in this group.

Students will be divided into six groups. Each group of students will attend a centre from Groups A, B or C. In the second and third years students will be organized according to a rota system so that they form part of groups attending centres where they have not already worked in the previous year, to ensure that all students form part of each of these three groups during their degree course.

 

4. Assessment

The assessment process consists of three parts (contribution to the final mark as follows):

1. Assessment by the tutors (30%): students will be assessed by their tutor to determine the extent to which they have attained the pre-established degree of competence, through the application of a formula designed for this purpose.
2. Work experience diary (Notebook) (40%): students will keep a written diary noting the tasks undertaken, the activities that they have observed, or their personal evaluation of the activities observed.  They will be required to hand this Notebook to the designated lecturer during the week following the completion of the work experience. The Notebook is an objective and reflective account of the daily activity undertaken. 
3. Portfolio (30%): students will compile a Portfolio in which they will highlight what they consider to be the most significant aspects of their work experience. The Portfolio should be a overall view of the work experience.

 

5. Bibliography and teaching resources

5.1. Basic bibliography

Students should consult all the sources that they consider useful for understanding the situations they encounter during their work experience. As a general bibliography the following are recommended:

ROZMAN, C. (dir.) Farreras-Rozman. Medicina Interna. 16ª ed. Madrid: Harcourt-Brace España, 2009.
KASPER D.L. Harrison. Principios de medicina interna. 16ª ed. México: McGraw-Hill Interamericana, 2005.
WYNGAARDEN J.B.; SMITH L.H.; BENNETT C. Cecil Textbook of Medicine. 19ª ed. Filadelfia: WB Saunders, 1992.

5.2. Complementary bibliography

ANONYMOUS Dorland diccionario enciclopédico ilustrado de medicina. 30ª ed. Madrid: Elsevier, 2005.
BORRELL F. Manual de entrevista clínica 2ª ed. Ed. Doyma. Barcelona, 1993.
CLÈRIES X. La Comunicación. Una competencia esencial para los profesionales de la salud Editorial Elsevier Masson. Barcelona, 2006 (1ª edición).
FOZ M.; LLAURADÓ E.; RAMIS J. Diccionari enciclopèdic de medicina. Barcelona: Enciclopèdia Catalana, 2000.
GLASS L. Sé lo que estás pensando: utiliza los cuatro códigos del lenguaje corporal. 1ª ed. Ed. Paidós. Barcelona, 2003.
GROOPMAN J. ¿Me está escuchando, doctor? Un viaje por la mente de los médicos. Barcelona: RBA, 2008.
LAÍN ENTRALGO P. La relación médico-enfermo. 1ª ed. Alianza Editorial. Madrid, 1983
SKRABANEK P. La muerte de la Medicina con rostro humano 1ª ed. Editorial Díaz de Santos. Madrid, 1999
SKRABANEK P, McCormick J. Sofismas y desatinos en medicina. Barcelona: Doyma, 1992.
TIZÓN JL. Pérdida, pena, duelo: vivencias, investigación y asistencia. 1ª ed. Ed. Paidós. Barcelona, 2004.

 

6. Methodology

The main activities that students are required to undertake (depending on the centre where they carry out their work experience,  and bearing in mind the short duration of the subject) are as follows:

- To accompany the tutor in his/her regular healthcare duties, so as to form a first hand idea of the reality of the different aspects of healthcare in a location where it is habitually provided (skills 1-5).
- To learn about the characteristic features of the Spanish health system, particularly its universal nature and the fact that there are no direct costs to be paid by the patients (principle of social justice); and to realize that this represents social progress, but also a special responsibility for healthcare professionals (skill 2).
- To learn about the channels of access to healthcare: ways of requesting care, methods of admission, information received by patients, departments involved, types of care (skill 3).
- To observe the principles of anamnesis and of the routine of physical examination (skill 4).
- To learn about the main routine healthcare documents which are used in the healthcare environment (skill 4).
- To observe the relationship established between healthcare professionals, patients and relatives so as to understand the experience of falling ill and its consequences (skills 1 and 4).
- To observe the regular procedures used to determine the vital signs (temperature, heart rate, blood pressure, respiration rate, pain intensity) (skill 4).
- To observe the basic techniques of treatment of the patient (mobilization; application and changing of dressings; subcutaneous, intramuscular and intravenous injections; placing of probes; application of collyria and lotions) (skill 4).
- To interact with the various healthcare professionals (doctors, nurses, social workers, physiotherapists, psychologists, nursing assistants), and with other staff working at the centres (administrative staff, secretaries, managers, receptionists, cultural mediators) (skill 5).
- To learn about the workings of the centres and of the healthcare services (skill 5).

 

7. Activities schedule

Students will attend the designated work experience centres during a two-week period at the beginning of the third term.  The work experience timetable will be in the afternoon (from 3.00 p.m. to 6.00 p.m.). Students must hand in their work experience diary the week following the end of work experience, and their portfolio within two weeks after finishing the work experience.