Code: | MI605 | Acronym: | PSM |
Keywords | |
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Classification | Keyword |
OFICIAL | Medicine |
Active? | Yes |
Responsible unit: | Clinical Neurosciences and Mental Health Department |
Course/CS Responsible: | Integrated Master in Medicine |
Acronym | No. of Students | Study Plan | Curricular Years | Credits UCN | Credits ECTS | Contact hours | Total Time |
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MIMED | 306 | Mestrado Integrado em Medicina 2007 | 6 | - | 4 | 43 | 108 |
Mestrado Integrado em Medicina- Plano oficial 2013 (Reforma Curricular) | 6 | - | 4 | 43 | 108 |
The overall objective of this course is the application and development of supervised clinical practice of knowledge, skills and attitudes previously acquired in the Psychiatric Mental Health course in the 5th year, with particular emphasis on clinical and preventive aspects. It is organized in professional training blocks, which include tutorial practice.
The objective in the area of knowledge is to extend the topics covered in the 5th year programme, applying them to clinical practice through tutorial monitoring of people with psychiatric disorders, developing individual capacities to carry out medical practice with increasing responsibility and autonomy.
The objectives in the field of skills include the ability development of presentation of clinical cases with autonomy in observation of a psychiatric patient, doing a clinical history and conducting an examination, establishing a diagnosis, differential diagnosis, prognosis and proposal of therapeutic orientation. It also includes bibliographic research capacity and analysis of scientific evidence.
It is also important to raise interns' awareness to aspects of the function and structure of the National Health Service, public health and in particular, the organization of mental health care in Portugal.
The objectives in the field of attitudes should value the communication capacity and the integration in teamwork with multidisciplinary collaboration, with particular emphasis on family, social, psychological, vocational / educational and medical-legal components of the mental illness framework.
One should also appreciate the need for to motivate and to strengthen the scientific basis of clinical decision-making, the methodology of self-learning and continuing education as well as the transmission of knowledge to medical students. Regular cooperation between students in scientific projects will be desirable, instilling an investigative approach early in their career.
In the area of knowledge, students are expected to extend what they have learned with contents of the main areas presented in the 5th year course, in adequacy to clinical practice.
In the scope of skills and abilities, students should gain the following results:
- Capability to develop and present clinical histories in hospital and/or academic meetings.
- Ability to conduct bibliographical research and critical analysis of the best scientific evidence.
- Ability to formulate, for the most frequent psychopathological situations, a probable diagnosis, differential diagnosis, prognosis and select and properly interpret complementary tests (interpretation of psychological assessment and biological imaging or analytical data).
- Establish a short, accurate list of problems, identifying the patient's help request, as well as assessing the urgency of the action required.
- Ability to propose psychopharmacological treatment (clinical recommendations, adverse effects, drug interaction and toxicity).
- Ability to communicate with people, developing skills of psychotherapeutic intervention (support, cognitive-behavioral, psychodynamic, family and group).
- Understanding the organization of the National Health Service and constraints that influence clinical practice and particularly mental health care in accordance with the National Mental Health Plan and Psychiatry and Mental Health Continuing Care Network.
- Ability to contextualize the patient and family, as well as refer them to the network of supportive mental health care.
The results in terms of attitudes, behaviours and values should be as follows:
- Appreciating good communication with the patient and their family (particularly in communicating the diagnosis, counseling and motivation for compliance with psychiatric treatment).
- Appreciating good communication in a multidisciplinary team (integrating the treatment plan, addressing a psychiatric problem as a team).
- Appreciating the social, psychological and educational component of mental illness.
- Appreciating the patient framework in group therapy activities and occupational therapy.
- Developing a framework for medico-legal issues in mental health.
- Motivation to deepen the scientific basis of clinical practice.
- Enhancement of self-learning and continuing medical education.
- Internalization of teaching practice as part of the medical skills.
In continuity with the programme defined in Psychiatric Mental Health and the 5th year course, students should:
Clinical practice
Each student will have a tutor in the Mental Health area (Clinical Practice) whom they must shadow in all clinical activities for 3 weeks, ideally full-time (35 hours). The goal is one-to-one teaching in which specific times of teaching and learning with constant feedback are allowed.
Students should collaborate in the clinical activity of the Inpatient, Day Hospital Liaison Psychiatry, Outpatient and Emergency Departments of CHSJ and other affiliated hospitals of the FMUP. Whenever possible, there may be an opening in the clinical internship to primary health care in a community context and in the network of continuing care (particularly in mental health).
Another priority during the period of clinical practice will be promoting involvement in research activities, stimulating the development of these capabilities, in the assumption of their applicability and continuity in the different stages of their professional career.
Clinical seminars
These will be developed in clinical areas less thoroughly covered in the previous year and taught by the teachers of the course (video presentations and the use of role-playing might also be possible).
Clinical cases
Each student must submit a case (from the three that are required), observed during the internship in one of the sessions programmed for this purpose, which are coordinated by a teacher. This should include history, probable diagnosis, differential diagnosis, the exams and the proposed therapeutic orientation and prognosis. The presentation should be discussed in group and with teacher/tutor.
Designation | Weight (%) |
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Participação presencial | 40,00 |
Trabalho escrito | 60,00 |
Total: | 100,00 |
Continuous assessment by the tutors - includes the assessment of skills acquired throughout the course preparing for improved performance, independently of the different activities. The level of knowledge and its suitability to skills (autonomy in clinical psychiatric examination, assessment of communication skills and teamwork) and attitudes (ethical and professional sense, punctuality, attendance, interest and participation, enhancing the social, psychological and educational component of the mental illness) will all be assessed. This evaluation is done by filling in a performance notebook given to the tutors at the end of the clinical internship. Tutors also supervise a group of students, noting the results of observations and actions throughout the internship. Both the quantitative aspects and qualitative performing procedures and actions (assuming the existence of a previous check-list) will be taken in to account, and these should be equally weighted in the final evaluation.
Discussion of the activity report developed during the internship - This report primarily evaluates the presentation of a clinical case followed by the student during their internship (where possible, with the practical component of supervision of the interview by the tutor).
This assessment should ideally also focus on the skills research (bibliographic research capacity, implementation of tools and critical analysis of scientific evidence), oral exposure capability and discussion of the Psychiatric and Mental Health issues. In this sense, the interest and personal commitment of students in their learning should still be considered. The importance given to the scientific basis of clinical practice should be highlighted, as well as the reframing capacity in the environment of the patient and their family. The critical sense and reflective capacity of the student should also be determined, how well they are able to integrate the patient in its broadest context, inherent to the concept of mental health taking a truly holistic view of the patient and the illness.
Final classification - Corresponds to the sum of the marks obtained in the different areas of competencies previously defined. Obtaining least than 50% in any of the evaluations means the student has failed.
Distributed evaluation without final exam.
Marks above 17 will be confirmed by an oral examination.
Individual performance a clinical history per week (three in total), with further discussion with their teachers.
Completion of the performance notebook of clinical activity, over the three weeks.
Observation of clinical conditions and basic minimum compulsory procedures in a checklist that each teacher must have previously at the beginning of the internship in order to allow the necessary planning.
There is the possibility of improving the grade confirmed by an oral examination.
Internal Evaluation of the Training Programme
After conducting a final anonymous survey of satisfaction among the students (including strengths, weaknesses and improvements) there should be a meeting with all teachers and tutors, preferably at the end of each block.
This course evaluation should include: overall assessment, evaluation methods and techniques involved, assessment of the teaching and learning context and of teachers' input.