Ministry of Health of Uzbekistan
TASHKENT MEDICAL ACADEMY
Department of Internal Medicine Training general doctors
endocrinologists medical faculty
POSITION
TO HOLD FINAL INSPECTION FOR STUDENTS 6
COURSE MEDICAL FACULTY IN
ENDOCRINOLOGY
Tashkent - 2012
Terms and conditions of final control was established on the basis of provisions of
TMA, discussed and approved at a meeting of the department from August 26,
2012 (Minutes № 1).
The final control on a 5 course on the subject of children's diseases is carried out in
two stages:
Stage 1 - OSKE the department;
Stage 2 - test examination (in the test center TMA)
OSKE the department to take in accordance with the schedule of the training of the
TMA, after the workshops and lectures. OSKE not allowed to students with
outstanding academic and practical training lectures.
OSKE consists of 10 stations and 2 blocks:
1. Practical skills are 60% - maximum 50 points. In this section, 6 stations, each
station depending on the difficulty selected from 5 to 10 points. At these stations,
the student answers orally (on models or volunteers). Practical skills students
demonstrate the steps, if a mistake in any step, the student receives a score of 0.
2. Analytical questions (case studies), up 40% - a maximum of 50 and a minimum
of 15 points. In this section, four stations (in each task to 3 questions). At these
stations, the student answers in writing.
The answers to each station allocated for 3 minutes. After 3 minutes, at the
direction of the observer student moves to another station. Exam duration of 30-35
minutes.
For the task are written standards answers. For each subgroup are new options.
The written work of students in the department are kept for 2 years.
The evaluation criteria of the final control.
100-86 points - excellent
85,9-71 points - good
70,9-55 points - satisfactory
54.9 and below - is unsatisfactory.
If a student receives OSKE below 55 points, he will not be allowed to take the
test exam.
Retaking OSKE done to resolve the dean's office at the end of the semester.
If the student does not agree with the estimates, at 24 hours after the
announcement points he has the right to appeal. For this, he has to write an
application to the head of the department and the department with the dean or
associate dean, a commission to review the student's work.
Results of OSKE regularly discussed at faculty meetings.
The written work of students in the department are kept for 2 years.
OSKE the department to take in accordance with the schedule of the training
of the TMA, after the workshops and lectures. OSKE not allowed to students with
outstanding academic and practical training lectures.
OSKE consists of 20 steps:
The evaluation criteria of the final control.
The final control is carried out by assessing the learning of theoretical and
practical knowledge (skills) for objective structured clinical examination (OSKE).
OSKE is based on problem-based learning by reviewing the clinical case. Turnbased assessment of practical skills of students is 20 points. To assess the
practical skills sham, volunteers from among students, assignments for analysis or
interpretation of the ECG, radiology, ultrasound, endoscopy. The final grade is
determined by the amount of points earned for each item of the scorecard of the
case. A student can score a maximum of 100 points.
For example:
20 steps for the final task OSCE.
A patient of 58 years. Complaints about polyuria, polydipsia, decreased sensitivity
in the fingers of the upper and lower extremities, shared weakness, fatigue.
From history: periodic increase in blood pressure for 15 years, especially the last 2
years. There mycosis in the heel area. My father was a patient with type 2 diabetes.
Do not diet. No bad habits.
OBJECTIVE: height - 173 cm, weight - 87 kg, subcutaneous fat is distributed
evenly. The skin has a normal color and moisture. Pulse - 72 ud.v min.,
Rhythmically. BP - 160/90 mm.rt. Art. left border of the relative dullness of the
heart is located on the 1 cm outwards from the middle clavicular line in the fifth
mezhrebere. Heart sounds are muffled, the focus of the 2nd tone of the aorta.
Abdomen soft, increased by the subcutaneous fat. The liver does not act under the
right costal arch.
Laboratory data: hyperlipidemia. Fasting glucose - 6.4 mmol / l, 2 hours after a
meal - 8.2 mmol / l. In the daily urine glycosuria not.
steps of receiving
1
Received in the office
Hello.
of the GP with a
He planted himself in front of
demonstration of
the patient.
interpersonal skills
Collected passport data.
2
Carefully collected
Asked "how can I help?" Or
complaints with the use "What kind of problems?"
of open and test
How long have worried about
questions
these complaints?
3
Carefully collected
a) the beginning of the
history of present illness disease;
(anamnesismorbi)
b) The course of the disease;
4
Carefully collected the
life history
(anamnesisvitae)
5
Identify and define the
risk factors (managed
and unmanaged) in the
patient, considering the
complaints, history and
the data in the prehospital study.
After a thorough
collection of
complaints, medical
history, and life
problems identified
patient (basic and
auxiliary).
Started physical
examination (the
student must
demonstrate the correct
and consistent study of
the patient in
accordance with the
relevant syndrome).
6
7
c) the existence of common
disorders.
-heredity,
- The development,
- Bad habits
- Living conditions and
nutrition
managed:
unmanaged
The main problem:
Related problem:
general condition
consciousness of the patient,
position, gait
constitutional type, BMI
(height, weight)
Skin and visible mucous
membranes, the presence of a
rash (erythema, roseola,
papules, pustules, vesicles,
wheal, petechiae, scabs,
bruises, erosion, cracks,
ulcers, scratches), scars, spider
veins, skin moisture, skin
turgor, type ovoloseneniya).
Development of subcutaneous
fat (poorly developed,
moderately, too) showing the
location of the largest deposits
of fat;
Availability pastosity,
characteristic swelling on
location and extent of
Determine the value,
consistency, tenderness,
mobility, and lymph nodes
(submandibular, cervical,
supra-and infraclavicular,
elbow, armpit, groin).
Determine the degree of
muscle development (normal,
excessive, weak, muscle
atrophy - either full or partial,
muscle hypertrophy - either
full or partial), muscle tone
(high, low, normal).
Tenderness and movement;
shaking or tremors of
individual muscles;
paresis, paralysis of the limbs.
Examine the skull, chest,
pelvis and extremities to
detect deformation of
periostitis, distortions,
acromegaly, change the
terminal phalanges of fingers
and toes, drum your fingers,
pain on palpation.
Joint configuration (normal,
swelling, deformity).
Head: shape, size, proportion
of the structure of the brain
and the front of the skull.
Hair: type body hair of the
head and face, male or female,
hair loss and graying of hair
Eye: the eye slit width, the
condition of the conjunctiva,
the pupils, their shape, size,
uniformity, reaction to light,
bright eyes, watery eyes,
convergence.
Lips: color, dryness, flattening
portion of the lips ("lacquered
lips"), cracks in the corners of
the mouth.
Neck shape, symmetry.
thyroid gland
Inspection: the nose, throat,
chest, breathing.
Palpation.
Percussion light:
comparative percussion
Topographic percussion.
Auscultation.
Inspection: the neck, the heart.
apical beat
Palpation.
Percussion.
Auscultation.
Research vessels.
Measure blood pressure on the
arms and legs
Inspection: the mouth,
stomach.
Palpation (superficial
palpation of the abdomen,
moving deep methodical
palpation of the abdomen).
Percussion of the abdomen.
Auscultation of the abdomen.
Of the liver.
Inspection: (determine the
presence of limited or diffuse
bulging, throbbing in the right
hypochondrium.)
Percussion.
Palpation.
The size of the liver.
Examination of the
gallbladder.
Inspection (in inspiratory
phase determine the presence
or absence of protrusions,
fixed in the projection of the
gallbladder to the right upper
quadrant)
Palpation.
Investigation of the spleen.
Inspection. (Determined by
the presence or absence of
bulging in the left upper
quadrant in breathing).
Percussion.
Palpation.
The size of the spleen.
Inspection. (Determined by
the presence of the lumbar
swelling, redness and swelling
of the skin).
Palpation.
Percussion.
Auscultation.
8
Proceed to making a
main:
preliminary diagnosis
Complication: 1
with the type of services
the patient's disease
9
Made a plan for the
Informed destination:
patient surveys
additionally:
(laboratory and
instrumental
investigated in SVP and
beyond).
Independently carried
out the necessary
amount of research
under category 3.1 of
care provided in a
hovercraft.
After a comprehensive
survey of student
demonstrates
knowledge of the
objective interpretation
of laboratory and
instrumental data.
Briefly, clearly and the
student must make a
10
11
12
13
14
15
16
17
18
19
differential diagnosis
with several common
diseases that have
similar symptoms with
this disease.
Established and proved
the final diagnosis with
the type of service the
disease of the patient.
Determined the form in
which the patient
requires prevention
Identified the nonpharmacological
treatment with a
demonstration and
explanation of the
patient.
Appointed medical
treatment, indicating
dose, time, and duration
of the multiplicity of
medications.
Spent the feedback to
set a date and time of
the visit the patient in
the joint venture or
hovercraft assigned to
monitor the
effectiveness of nondrug and drug
treatment.
Took the patient's
records, previously
identified by a group of
follow-up.
Turning to the
observers, the student
demonstrates the
theoretical knowledge
Main:
complication:
Category of services - 1
secondary
thirds
Elimination of managed risk
Healthy living
drug therapy
Supervision of a general
practitioner.
Follow-up group D3
frequency of observations
KLA study, blood
biochemistry, fundus, ECG
Performance measurement of
the clinical examination:
improving the clinic, reducing
temporary disability.
Translation group ...
-Primary prevention prevention of the disease:
A) promotion of healthy
lifestyles
20
and practical steps of all B) early detection of risk
relevant disease
factors and the removal of
prevention.
controlled risk factors
- Secondary prevention:
A) early detection of the
disease in the early stages
(preventive checkups,
screenings)
B) timely drug and non-drug
treatment of identified
diseases with the use of drugs
with proven efficacy.
Tertiary prevention:
A) timely observation of
patients, prevention of acute
and chronic complications,
monitoring, laboratory and
instrumental studies, the use
of drugs with the evidence
base in the correction of risk
factors, and dynamic
monitoring;
B) continuing treatment
measures and qualitative
rehabilitation of existing
complications
Turning to the
Healthy lifestyle. The
observers, the student
correlation of risk factors,
demonstrates the
restriction of salt, fats.
theoretical knowledge
Exercise. Medication. Spa
and practical steps for
treatment. The criterion is to
the appropriate clinical improve the effectiveness of
examination stages of
medical examination clinics,
the disease.
reduction of temporary
disability, reduced primary
disability
OBSERVATIONS OF THE FINAL EVALUATION FORM
control of students
VI course of a patient on ENDOCRINOLOGY
In the module SVP
date « __ »____________2012 y.
group №_________________
Name student ________________________________________________________
stage
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Всего
score
(Circle one of the scores of relevant knowledge, skills and abilities of students
placed with increasing from 0.1 to 10-low-high, 0 points-phase missing)
0
0,1
0,2
0,3
0,4
0,5
0
0,1
0,2
0,3
0,4
0,5
0
1
2
3
4
5
0
1
2
3
4
5
0
0,5
0,8
1,0
1,2
1,5
0
0,5
0,8
1,0
1,2
1,5
0
1
2
4
6
8
0
1
2
3
4
5
0
1
2
3
4
5
0
2
4
6
8
10
0
1
2
3
4
5
0
0,5
1
3
5
7
0
1
2
4
6
8
0
0,5
1
2
3
4
0
0,5
1
2
3
4
0
0,5
1
3
5
7
0
1
2
3
4
5
0
1
2
4
6
8
0
2
3
4
5
6
0
0,5
1
2
3
4
100
Total score _________________________________________________
Name teacher ______________________________
student Signature ________________
signature _____________