1. INTRODUCTION TO COMPREHENSIVE HEALTH CARE MODULE
MEDICINE & SOCIETY II B
COMPREHENSIVE HEALTH CARE MODULE (FFFF2622)
I. DIRECTORY OF TEACHING STAFF
NO. NAME OF LECTURERS/TUTORS TEL NO. E-MAIL
A. Department of Family Medicine
1. Dr Rashidi Mohd Pakri 012-3945786 Drrashidi5377@yahoo.com
2. Dr Hizlinda Tohid 019-2222109 hizlinda2202@gmail.com
3. Dr Aida Jaffar 9145 6126 aida.jaffar@gmail.com
4. Dr Tan Chai Eng (Module Coordinator) 9145 6126 tce@ppukm.ukm.edu.my
012-3343145
5. Dr Saharuddin Ahmad 012-3838204 bulat1977@yahoo.com
6. Dr Mohd Fairuz Ali 9145 6116 phere1@gmail.com
7. Dr Zuhra Hamzah 9145 6124 zuhradr@yahoo.com
8. Dr Syahnaz Mohd Hashim 9145 6124 syahnaz74@gmail.com
9. Dr Noorlaili Mohd Tauhid 9145 6120 lailitauhid@yahoo.com
B. Faculty of Pharmacy
1. Dr Noraida Mohamed Shah noraida_mohamedshah@yah
9289 8038 oo.com
2. Puan Siti Azdiah Abd Aziz 9289 7964 sitiazdiah@yahoo.com
3. Dr Adyani Md Redzuan 9289 7987 adyani.hairul@gmail.com
4. Cik Adliah Mohd Ali 9289 7964 adliah_ali@yahoo.com.sg
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2. C. Department of Nursing
1. Puan Gurbinder Kaur a/p Jit Singh 9145 6254 gurbin@ppukm.ukm.edu.my
2. Cik Hasnah Yahaya 9145 6261 hasnah@ppukm.ukm.edu.my
3. En. Che Salim Sulaiman 9145 6260 chesalim@ppukm.ukm.edu.my
4. Puan Nour Dhiaeyah Supuan Zaki Nour.dhaeyah@ppukm.ukm.edu
9145 6266 .my
D. Department of Parasitology
1. Dr „Azlin Muhammad @ Mohd Yassin 9289 7229 azlinoshin@yahoo.co.uk
2. Dr. Aishah Hani Bt Azil 9289 7209 aishahhani@medic.ukm.my
E. Department of Community Health
1. Prof Madya Dr Azmi Mohd Tamil 9145 5890 drtamil@gmail.com
2. Dr Azmawati Mohammad Nawi 9145 6404 atienawi@yahoo.com
3. Dr Jamsiah Mustafa 9145 5906 Jamsiah_jkm@yahoo.com
4. Dr Ahmad Taufik Jamil 9145 5888 atjamil@gmail.com
E. Department of Medical Education
1. Dr Mohd Arif Kamaruddin 9145 6241 drmdarif@hotmail.com
2. Dr Mohd Nasri Awang Besar 9145 6241 drmohdnasri@gmail.com
3. Dr Md Nurman 019- mdnurman@yahoo.com
2272269
4. Pn Siti Mariam Bujang 013- Eentan80@yahoo.com
3335233
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3. II.
This module is aimed to introduce the concept of comprehensive health care according
to the modern medical principle. It includes the principle of solving health problems at
the individual, family and community level. The module discusses the holistic approach
in patient management. It also emphasizes on the concept of patient, family and
community interactions from the aspect of health. The students will be exposed to the
needs of patient with chronic diseases and how it is assessed and managed
comprehensively. Functions of health organizations and health facilities at various
levels in the community are also discussed.
PRE-REQUISITES
The students should have prior knowledge of
1. Medicine & Society I
2. Medicine & Society IIA
III. MODULE OBJECTIVES
This is a 2 credit module (80 hours of students learning time) conducted throughout 16
weeks during semester 4 of the undergraduate medical program. Second year medical
students and third year pharmacy students will participate in this module. Students will
be divided into small groups consisting of 5 -6 students. Each small group will be
assigned to a patient with chronic illness. Students are required to work as a team to:
1. Identify and describe the impact of the illness on the patient as well as on the family
and community.
2. Identify their roles as health professionals in addressing the bio-psycho-social
issues faced by the patient, from the aspect of health promotion, prevention,
treatment and rehabilitation.
3. Identify relevant community and other facilities and services available for the
patient.
4. Provide relevant advice to the patient regarding the use of these facilities and
services.
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4. IV. METHODS OF ASSESSMENT
Continuous assessment based on
o Family Case Study Presentation (group work) 30%
o Family Case Study Report (group work) 30%
o Reflective writing (individual) 25%
o Peer Assessment 5%
o Facilitator‟s Report 5%
o Attendance 5%
Total 100%
Note:
Students are required to submit their Family Case Study Report (group work)
and reflective writing (individual) on-line by week 15 (10th May 2013 by
2400hrs). Please avoid sending in your assignments on the date line because your
actions may “freeze” the system. (http://www.medicine.ukm.my/apps/e.learning)
Family Case Study Presentation, Family Case Study Report and reflective
writing assignments are marked by the respective facilitators.
Satisfactory attendance is only considered when students attend at least 80% of all
teaching-learning activities (Lectures, Small group discussions, Visits).
V. RESOURCE MATERIALS
1. Reagan, P.A. Brookins-Fisher, J. Community Health in the 21st Century. 2nd
Edition. San Francisco: Pearson Education, Inc; 2002.
2. Phoon, W.O. Chen, P.C.Y. Textbook of Community Medicine in South East Asia.
Singapore: John Wiley & Sons; 1986.
3. Mc Whitney, I. R. Freeman T. A Text Book of Family Medicine. 3rd ed. Oxford
University Press; 2009.
4. Rakel, R.E. Text Book of Family Medicine. 7th ed. Philadelphia: Saunders; 2007.
5. Taylor, R. Fundamentals of Family Medicine: The Family Medicine Clerkship
Textbook. 3rd ed. Springer Pub. Co; 2003.
6. Unwin BK, Jerant AF. The Home Visit. American Family Physician. 1999; Vol 60:
1481-8.
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5. VI. TEACHING-LEARNING TOPICS AND SPECIFIC OBJECTIVES
Concept Lectures
At the end of the lectures, students should be able to:
L1 Comprehensive Health Care I & II
&
describe characteristics of comprehensive health care at the individual, family and
L2. community level
describe the function of family and „at risk‟ family
describe various stages of disease prevention at the individual, family and
community level
L3. Family Case Study
approach and discuss the patient‟s problems in a holistic manner
identify and analyze the health problems in relation to the patient, family and
community
appreciate that any health issues have an impact towards the patient, family and
community
understand the management of relevant health problems by means of health
promotion, prevention, and appropriate treatment and rehabilitation measures with
appropriate and effective use of resources
recognize the value of home visits in assisting health personnel to assess patient‟s
condition at home (e.g.: family dynamics, surroundings etc).
realize the importance of adopting a non-judgmental attitude and being sensitive to
religious and cultural diversity as well as differing moral values and beliefs.
L4. Holistic Approach to Medicine
define the meaning of `holistic‟
discuss the concept of `mind-body medicine‟
recognize the importance of a holistic approach in patient care
understand how to practice holistic patient care
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6. Small Group Discussion (SGD)
During the following SGDs, students should:
SGD 1 - Receive information regarding their assigned patients
- Learn how to organize a home visit and respective organizational visit.
- Plan their activities during each visit
SGD 2&3 - Update their facilitator and discuss the progress of their family case study
- Clarify particular issues or problems they are facing.
- Arrange corrective measures to overcome these problems
- Discuss with their facilitator regarding the family case study presentation.
SGD 4 - Present their Family Case Study
- Prepare their Family Case Study Report.
Visits
A. Home Visit
During the home visit, students should:
Evaluate holistically patient‟s problems and status (e.g. health and functional) at
home.
Evaluate patient‟s home environment (e.g. physical conditions, social environment
such as family dynamic, safety issues etc) and assess the impacts of this
environment on his/her health and function.
Identify „at-risk‟ patient (e.g. at-risk of abuse, neglect or social isolation).
Identify potential home-based interventions that are suitable for the patient.
Evaluate patient‟s support system and functions of family members.
Evaluate coping behavior of the patient and family members.
Identify medical, psychosocial, environmental and financial problems faced by the
patient and family members.
Identify impacts of patient‟s illness on his/her own life, family and community
Identify and promote disease prevention and health promotion to the patient and
family members.
Plan appropriate management (e.g. treatment, rehabilitation measures etc) for the
patient, family members and community
Demonstrate non-judgmental attitude and sensitivity to religious and cultural diversity
as well as differing moral values and beliefs.
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7. B. Visit to relevant organizations that provide aftercare to the respective patient
(where applicable)
identify appropriate resources (e.g. NGOs, facilities, programs etc) available for the
patient in his/her community
identify the roles and functions of these resources
incorporate the related community resources in the patient‟s rehabilitation plan
Reflective Writing
Each student is required to write a reflection on:
Working together with other healthcare professionals in patient care
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8. STUDENT’S ASSIGNMENT
Format for Family Case Study Presentation
(Duration of presentation: 15 – 20 minutes)
Title of Slides Description
1. Title slide Title of case study
SGD group and name of members
2. Introduction Patient Demographic Data
(Why do you think it is important to know about this case
and to approach it in a holistic/ comprehensive manner?)
3. Clinical Summary Summary of the clinical history and physical findings
from your own observation or clinical examination –
please do not copy from the case note.(list it in
chronological order)
4. Investigations List appropriate investigations and interpretation of the
results.
5. Home Visit/Visit to relevant Students are expected to synthesize important / relevant
organization data from the home visit as well as visit to relevant
organization and apply them appropriately into their case
study in a holistic perspective for the patient‟s overall
care and quality of life.
6. Summary and Problem list Summary of the patient‟s condition and “List of
problems” (according to the bio-psycho-social model).
7. Management & Discussion Non-pharmacological and pharmacological management
(short/long term)
Multidisciplinary care and community resources
Important points of discussion
8. Reflection & Conclusion Conclusion and recommendations for further or better
care (as appropriate).
Add your reflection on how this Family Case Study can
help you in the future, your learning issues, how would
you deal with this patient differently.
9. References List them in UKM or Vancouver style.
References should be the most recent available.
Additional instruction:
Present using Microsoft Office PowerPoint.
Discuss with facilitators as to what to present and flow of presentation.
As the Family Case Study is a report of events that happened in the past, it should
be written in the past tense.
Please ensure consistent formatting, line spacing and choice of fonts.
Photos of the house, lesions/disease, and surroundings may help in your case
presentation. (Only with permission from the patients)
Do „spelling and grammar‟ check.
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9. Format for Family Case Report
(3000 words, include relevant photos only)
SGD Group:
Name of members:
Facilitator‟s name:
Demographic data
Date of clerking:
Name: Registration No:
Contact Address:
Contact Number:
Primary Care Giver details: (where applicable)
Title Description
1 Introduction Why do you think it is important to know about this
case and to approach it in a holistic/
comprehensive manner?
2. Summary of clinical history and History: presenting complaint, history of present
physical findings (from your own illness, systemic reviews.
observation or clinical examination Past history: medical/surgical/obstetric history
– please do not copy from the case Menstrual history
notes). Growth & developmental history
History of allergies:
(List in chronological order) Drug history/medications (indications) - over the
counter medication/prescribed drugs/street drugs
etc.
Smoking, Alcohol, Assessment of Risk behaviors.
Social history& Financial history
Dietary history
Progression of disease (as appropriate)
Physical examination (with your interpretations of
what abnormal findings means and its relevance)
3. Investigations: List of all appropriate investigations based on your
own knowledge and clinical judgment (If results
are available, state the dates when the tests were
done, normal ranges and your interpretation of the
results)
4. Home Visit/Visit to relevant Floor plan, neighborhood, exterior &interior of
organization home ( crowding, housekeeping, homely
Synthesize important / relevant data environment, privacy)
from the home visit and visit to Water, electricity, sewage, air circulation,
relevant organizations. Apply them windows, toilets.
appropriately into the case study in Any animals or pets
a holistic perspective for the Assess to transportation (private or public)/ other
patient’s overall care and quality of basic amenities.
life.
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10. Title Description
5. Summary and Problem list Summary of the patient‟s condition and “List of
problems” (according to the bio-psycho-social
model).
Impact of the disease
o On the patient
o On the family
o On the community
6. Management & Patient’s Non-pharmacological and pharmacological
progress treatment/management
Multidisciplinary care / role of other support
groups / NGO‟s.
Long term management plans (as appropriate)
Any recommendations specific to the disease
(other drugs, simpler regimes, less costly
alternatives, etc.).
Disease related complications
Response to treatment or deterioration in clinical
condition
7. Discussion Patient‟s bio-psycho-social-spiritual
issues/problems
Impact on the patient, family and community, and
management
Students should incorporate Evidence-based
Medicine and cite the sources of information.
Discuss these relevant to the case.
8. Conclusion Conclusion and recommendations for further or
better care (as appropriate).
Thoughts:
Add your reflection on how this Family Case
Study can help you in the future, your learning
issues, how would you deal with this patient
differently.
8. References List them in UKM or Vancouver style.
References should be the most recent available.
Additional instruction:
As the Family Case Study is a report of events that happened in the past, it should
be written in the past tense.
Assessment is based on the ability to identify the bio-psychosocial and spiritual
issues of the patient and how it has impacted the patient, family and community.
Add photos of the house and surroundings (if possible and with permission of patient)
Do NOT discuss medical information like a textbook. Do NOT cut and paste from
websites or reference materials.
Please ensure consistent formatting, line spacing and choice of fonts.
Do „spelling and grammar‟ check.
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11. Vancouver style referencing
You may refer to the following website:
http://www.library.uq.edu.au/training/citation/vancouv.pdf
UKM style referencing
You may refer to the following website:
http://www.ukm.my/pps/pdf/Penulisan%20Gaya%20UKM.pdf
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12. Format for Reflective Writing:
REFLECTION
Please write the learning points (BASED ON THE PROVIDED THEMES) you have picked
up during this session and relate it to the objectives of the Comprehensive Health Care
Module. (300 – 500 words)
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Marks:……../ 10
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13. ASSESSMENT COMPONENTS
Family Case Study Evaluation Sheet
Case Presentation
SGD Rooms:
Name of Group:
(Please refer to the list of names provided)
Facilitator:
Date of Case Presentation:
Items Marks Marks allocated
Content
- holistic and 25
comprehensive in
approach
Style of presentation / 10
Overall presentation
Group work( active 5
participation of other
group members)
Total 40
Facilitator‟s comments:
Facilitator‟s Signature:
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14. Family Case Study Evaluation Sheet
Case Report
SGD Rooms:
Name of Group:
Facilitator:
Date of Family Case Study Received:
Marks Marks allocated
1. Introduction & Demographic Data 2
2. Clinical history & Physical Examination 10
3. Problem List / Diagnosis (bio-psycho-social 10
model)
4. Patient‟s progress / Discussion & Management 30
5. Conclusion 5
6. References/Lay out 3
TOTAL 60
Facilitator‟s comments:
Facilitator‟s Signature:
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15. Scoring System in Reflective writing
ELEMENT OF REFLECTION SCORE
Brief description of event
Time, place, location, who were involved (the job title, not the name of the person) 0-1
Attending to feeling (during the incident)
Explore your affective (feelings) reaction to the event
What were your concerns and thoughts at that time?
0-1
What do you think other people (friends, facilitator) felt at that time, and how do you
know what they felt?
Critical analyses
Your thoughts, your assumptions, other people involved and the context (place, 0-3
time, set-up)
Synthesis/Evaluation
Weighing up different interest, room for dilemma and uncertainties, evaluate own
position and emancipation.
0-3
-What have you learnt from the event?
How does this relate with your previous experiences?
In what ways do theories or underlying knowledge explain the situation?
Outcomes(learning needs, changed of perception, behavior or
acquired new skill)
Given a similar situation in the future, how would you behave?
0-2
Has this changed your way of practice?
What are your learning needs arising from this experience?
What are your strategies to achieve those learning needs?
Total 10
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16. Peer Assessment
Student‟s Name: Date:
Domains Overall Item
rating
Team work Able to establish a shared understanding among members.
Actively participate in the activities
Display individual accountability and responsibility
Handle conflicts in a positive manner
Being supportive towards each other.
Communication Using terms or phrases that can be understood by all members ( no
professional jargons)
Actively participate in the discussion in a positive manner.
Task Participate actively in planning and preparation in a positive manner
management Able to complete the assigned task within the time frame and
standards.
Leadership Able to display good leadership skills.
Professional Display punctuality.
Attitudes Being proactive and motivated.
Knowledge Able to gather relevant information required.
Able to understand and interpret information gathered.
Able to approach the case discussed in a comprehensive manner.
Able to anticipate future requirements or demands relevant to the
case discussed.
Able to offer other options or new ideas relevant to the case
discussed.
Standard: The standard should be judged against the standard expected at completion of the
stage of training based on the program objectives or outcomes.
***Rating scale:
1- Very Poor; 2- Poor; 3- Average; 4-Good; 5- Excellent ;
1- Very Poor: Performance potentially effects patient safety and quality care.
Serious intervention plan and action is needed
2- Poor: Performance indicated cause of concern, consider further improvement plan and
action is needed.
3- Average: Performance was of a satisfactory standard but could be improved.
4- Good: Performance was consistent and at good standards, enhancing patient‟s safety
and quality care.
5- Excellent: Performance was consistent and at high standards, enhancing patient‟s safety
and
quality care. It could be a positive reference for others.
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17. Facilitator’s Report
Student‟s Name:
Domains Overall Item
rating
Team work Able to establish a shared understanding among members.
Actively participate in the activities
Display individual accountability and responsibility
Handle conflicts in a positive manner
Being supportive towards each other.
Communication Using terms or phrases that can be understood by all members ( no
professional jargons)
Actively participate in the discussion in a positive manner.
Task Participate actively in planning and preparation in a positive manner
management Able to complete the assigned task within the time frame and
standards.
Leadership Able to display good leadership skills.
Professional Display punctuality.
Attitudes Being proactive and motivated.
Knowledge Able to gather relevant information required.
Able to understand and interpret information gathered.
Able to approach the case discussed in a comprehensive manner.
Able to anticipate future requirements or demands relevant to the
case discussed.
Able to offer other options or new ideas relevant to the case
discussed.
Standard: The standard should be judged against the standard expected at completion of the
stage of training based on the program objectives or outcomes.
***Rating scale:
1- Very Poor; 2- Poor; 3- Average; 4-Good; 5- Excellent ;
1- Very Poor; Performance potentially effects patient safety and quality care.
Serious intervention plan and action is needed
2- Poor; Performance indicated cause of concern, consider further improvement plan and
action is needed.
3- Average; Performance was of a satisfactory standard but could be improved.
4- Good; Performance was consistent and at good standards, enhancing patient‟s safety
and quality care.
5- Excellent. Performance was consistent and at high standards, enhancing patient‟s safety
and
quality care. It could be a positive reference for others.
Facilitator‟s Name & Signature :
Date:
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