1) To describe the role of family medicine in the organization of primary healthcare in Portugal.
2) To appreciate the clinical implication of the principles of clinical reasoning in primary care.
3) To apply prevention strategies during the lifecycle.
4) To rank/order diagnostic hypotheses for the most common symptoms in primary care and to defend the corresponding diagnostic plan.
5) To devise a therapeutic plan for the most common conditions in primary care.
1) To communicate with patients in a simulated environment.
2) To communicate with healthcare professionals in a simulated environment.
3) To autonomously perform simple medical procedures.
Prof. Doutor Bruno Heleno
Weekly - Available soon
Total - Available soon
There are four main references:
1) Murtagh J, Rosenblatt J. Murtaghs General Practice. 7.ª Edition. North Ryde. McGraw-Hill Education. 2018.
2) UpToDate, Post TW (Ed), UpToDate, Waltham, MA.
3) Freeman TR, editor. McWhinneys Textbook of Family Medicine.4 edition. Oxford; New York: Oxford University Press; 2016.
4) Family practice formulary.
Detailed references are provided in Moodle.
Due to constraints caused by the COVID-19 pandemic, the curricular unit will be implemented through blended learning, relying heavily on distance learning methods. The learning outcomes and teaching methodologies will be harmonized with the clerkship of family medicine in the Curricular Unit in the sixth year. This curricular unit spans through 5 weeks.
The learning activities of the family medicine curricular unit are based on the flipped classroom. Teachers mentor the students, providing educational resources (e.g.: texts, assignments and videos) for each item in the syllabus. Learners can study these materials before an activity, at their own pace. The learning activities will help students to apply the gained knowledge and to practice clinical reasoning. Teachers will supervise the students clinical reasoning, either directly or indirectly. There will be live synchronous, distance synchronous and distance asynchronous activities.
Teaching will be in Portuguese. Study material may be in Portuguese or English.
Synchronous live activities
Non-clinical practical classes will be offered to groups of approximately 15 students and they may have one or more teachers. Students will be able to train, in a safe environment, consultation techniques, lifestyle counselling, and simple clinical procedures. Teachers will mentor and supervise students while they practice these techniques. There is no formal assessment in these activities.
Distance synchronous activities
All these activities are offered to groups of approximately 25 students and they may have one or more teachers.
Seminars cover learning outcomes related to the foundation of clinical reasoning and that require immediate feedback from a clinical teacher.
The virtual practice sessions cover learning outcomes related to prevention in the patients lifecycle, diagnosis, investigation plans and treatment. Students will receive short clinical vignettes about common complains and conditions in family medicine. In each session, about 10 students will be invited to discuss parts of the clinical vignette. That discussion will be assessd by the teacher.
The single subject clinical case discussions will be offered to groups of approximately 25 students and they may have one or more teachers. Students will be offered a set of clinical vignettes to prepare individually or in groups. The discussion with the teacher will be centred on the choice of a therapeutic plan for each case. There is no formal assessment in these activities.
There will be no lectures.
Asynchronous distance learning
Teachers have selected learning resources which cover all cognitive learning outcomes: what is family medicine, fundamentals of clinical reasoning, prevention in the persons lifecycle, diagnosis of common complaints, therapy of common conditions. These can be studied at the students pace. We estimate that students will require around 65 h or study to process all these materials.
The online lecture modules will cover learning outcomes such as what is family medicine, the fundamentals of clinical reasoning and communication with other healthcare providers. These modules combine text, videos and student activities. Students will have automated feedback for some of these activities, in other cases they will have assignments that will be assessed by teachers.
Learners can simulate clinical decision-making in interactive clinical vignettes that are hosted in Moodle. These clinical vignettes cover the learning outcomes related to prevention in the persons lifecycle, ranking differential diagnoses and, in lesser degree, the choice of therapy.
Approval at the curricular unit has two requirements:
1. Proof that students acquired the topics from synchronous activities. This will consist of an oral examination marked as approved / not approved. Oral examination will be waived if students attend at least 13 of the 20 seminars, if students complete 90% of the online modules and 90% of the interactive clinical vignettes.
2. Written test with at least 50% correct answers.
The final assessment will have three components:
1 individual written test, marked for 16 points, and composed of questions (multiple choice questions, short answer questions, true/false, and matching blocks). In the special period, the written test can be replaced by an oral examination.
2 4 assignments (3 points in total). These are individual assignments. They include:
a. Analysis of a clinical interview (1 point)
b. Assessing a family (1 point)
c. Writing a patient record (0.5 points)
d. Writing a referral letter (0.5 points).
3 Continuous assessment during the virtual clinic sessions (1 point).
The written test may include questions about any of the syllabus topics. In other words, the written test will include content that will not be covered in the synchronous activities.
Procedures for grade reassessment or improvement are described in the annex. The assessment from the assignements is valid until the end of the school year.
1st call: 15/01/2021 (4:00 PM)
2nd call: 29/01/2021 (4:00 PM)
1st call: 18/06/2021 (4:00 PM)
2nd call: 02/07/2021 (4:00 PM)
Special period: 16/07/2021 (4:00 PM).
1. For students who do not have to comply with minimum attendance criteria, assessment will be the same as for other students. Approval at the curricular unit requires that students prove that they learned the knowledge and skills taught in synchronous and asynchronous activities.
2. Students from previous years will need to repeat all assessment components.
3. Students may apply for a grade improvement of the written exam, in agreement to article 34 in the Educational Regulation of the Integrated Masters in Medicine.
1) To describe the role of family medicine in the organization of primary healthcare in Portugal:
a) What is family medicine and the role of the general physician
b) Organizational structure of primary care in Portugal.
2) To appreciate the clinical implication of the principles of clinical reasoning in primary care:
a) The main symptoms and complains in primary care
b) The interpretation of the results of studies about treatment and interventions
c) The impact of somatic, psychological and social factors in health and illness
d) The definition of family
e) Nuclear, extended, single-parent, reconstructed, single-person and other families
f) Family function
g) Inter-relationships between family functionality and chronic conditions
h) Family interventions
i) Duvalls family life cycle
j) Single-parent families special features
k) Reconstructed families special features
l) The concepts of illness, disease, health and integrated diagnosis
m) The Calgary-Cambridge consultation model
n) Exploring health, disease and illness experiences
o) Understanding the whole person
p) Finding common ground
q) Enhancing patient-clinician relationships
r) Myths about the patient centred clinical method
s) The role of self-knowledge and self-awareness
t) Quaternary prevention
u) How to prioritize multiple complaints and conditions in a single consultation.
3) To apply prevention strategies during the lifecycle:
a) The national programme on child and young people health
b) The interpretation of growth, blood pressure and lipid percentiles
c) The structured assessment of the healthy teenager
d) Development milestones and alarm signs
e) Optimum ages for paediatric surgery
f) The national immunization programme
g) Family planning
h) Clinical, laboratory and ultrasound assessment of pregnancy; lifestyles, supplementation, psychological adaptation to pregnancy
i) Frailty, Beers criteria, therapeutic obstinacy, fall prevention
j) The role of secondary and quaternary prevention when choosing screening programmes
k) Screening programmes in Portugal.
4) To rank/order diagnostic hypotheses for the most common symptoms in primary care and to defend the corresponding diagnostic plan:
c) Neck pain
f) Knee pain
h) Vaginal discharge
i) Low back pain
j) Sore throat
k) Shoulder pain
l) Unintentional weight loss
n) Chest pain
5) To devise a therapeutic plan for the most common conditions in primary care:
a) Alcohol use disorder
b) Knee osteoarthritis
d) Vulvovaginal candidiasis and vaginosis
e) Tension headache
f) Unspecific neck pain
g) Bacterial conjunctivitis
h) Benzodiazepine abuse
o) Acute gastroenteritis
q) Dental infections
r) Upper respiratory tract infections (acute tonsillitis, common cold, flu, acute sinusitis, acute otitis media, SARS-CoV-2 infection)
s) Lower respiratory tract infection (acute bronchitis, community acquired pneumonia)
t) Urinary tract infections (cystitis and pyelonephritis)
u) STD: trichomoniasis, Chlamydia, gonorrhoea
v) Unspecific low back pain
x) Anxiety disorders
z) Rotator cuff syndromes
aa) Somatophorm conditions
bb) Tobacco use disorder
cc) Insomnia (treatment).
1) To communicate with patients in a simulated environment:
a) Communication techniques that ground person-centred medicine
b) Techniques to reach a common list of reasons for consultation and consultation planning
c) Techniques to establish the relationship
e) Throwers family circle
f) Family Apgar
g) The motivational interview
h) Interpersonal influence model
i) Prochaska and DiClemente behavioural change model
j) Influence techniques
2) To communicate with healthcare professionals in a simulated environment:
a) Problem-based medical records
b) Writing medical letters
c) Fit-to-drive assessment
d) The sick leave certification in Portugal
3) To autonomously perform simple medical procedures:
a) The spine physical examination
b) The knee physical examination
c) The shoulder phys. Examination
d) The foot examination for the person with diabetes
e) How to explain and teach how to use insulin
f) How to acquire and appraise evidence to answer clinical questions.
Programs where the course is taught: