Emergency care of patients at the department of internal medicine, 7.5 credits

Completion of the first term of the course "Clinical medicine"

The general aims of the course are that students, after participation in the course, should have acquired advanced knowledge and skills in acute treatment of patients in internal medicine. The course is an advanced course and is based on knowledge and skills that the students have acquired during the first semester of the course in clinical medicine. The knowledge is tiered according to the SOLO taxonomy and the skills according to Miller's pyramid *. Knowledge and understanding Know and understand (S3) abnormal physical structure and function, risk factors, symptoms, cause of disease, disease mechanisms, natural progress, prognosis, principles of investigation and treatment in acute and/or life-threatening internal medicine diseases. Be familiar with (S2) guidelines for treating a patient in the final stage of life. Skills Be able to in depth identify, handle acutely and treat (M3) patients with acute serious/life-threatening internal medicine medical conditions such as acutely unconscious patients, anaphylactic shock, acute difficult infections and other serious/life-threatening internal medicine diseases. Be able to treat (M3) less common but potentially dangerous diseases in general. Be able to handle (M3) and interpret the results of medical history and common examinations, set diagnosis, discuss differential diagnoses, make clinical decisions, and identify and set up a treatment plan for intensive care-demanding patients. Be able to (M3) critically review and assess clinical issues based on evidence-based medicine and formulate aims and action plans for the care. Be able to (M3) handle the weaknesses and limitations of the medical and the personal knowledge such as the effect of stress on the decision making. Attitude Knowledge and attitude To be able to develops knowledge and attitude concerning the fundamental values, basic ethical principles, own values and attitudes of the health care that were acquired during the first semester of clinical medicine . Behaviour Be able to (M3) demonstrate a critical and scientific attitude. Be able to (M3) identify, discuss and explain ethical problems and consequences of his/her own and others' action in acute clinical situations, and in the final stage of life.

The course is given in collaboration between the different subspecialities of internal medicine and physiology. The course consists of 7.5 HE credits including internal medicine with cardiology and physiology. Coordination also takes place with previous and following courses. The course is a specialisation of the course in clinical medicine. Basic scientific knowledge will be integrated in the different parts of the course, i. a. by participation of teachers with basic scientific development (physiology) in the teaching. Professional skills are integrated, above all, in the placement clinical duty. Ethical issues and attitudes are discussed. Scientific development is included as a natural part of the course. The teaching is focused on evidence-based medicine where each part in the course should include instruction, in which this is taken into account. Integrating assignments: Mental: Unconsciousness/coma Circulation: Abnormal Heart activity, Heart arrests Respiration: Dyspnea

The course consists of lectures, case-based and student-activating seminars, rounds, a medical ventilator demonstration, practical exercises etc. Placement will take place in the emergency ward and the intensive care ward (MIVA) where the students will participate in the on-call service actively. Many parts of acute internal medicine will be included in the course at an advanced level. The course is completed with an examination.

Compulsory parts Roll-calls, all seminars, demonstrations, proficiency training and all placement including on-call service is compulsory. At the end of the course, an examination is arranged. Limitation of number of examination or practical training sessions: clinical parts can, as a rule, only be repeated once.

If a course has been closed down or undergone major changes, at least two additional examinations (excluding regular examinations) in the previous contents are provided during a period of a year from the date of the change.

The examiner may with immediate effect interrupt a student's placement if the student demonstrates such serious deficiencies in knowledge, skills or attitudes that patient safety or patient confidence in healthcare is at risk. If the placement is interrupted, it implies that the student fails in the current part. In such cases, an individual action plan should be set up, where it comes clear which activities and examinations are required, before the student is given the possibility to further placement. The course connects to and advances knowledge within Stage B such as the core of the Study Programme in Medicine. Course evaluation takes place according to the guidelines that have been established by the board of education at Karolinska Institutet.