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MBChB - Manchester Medical School

Module 3, Mind and Movement 2012


This document describes the general aims and objectives for this module together with the more specific intended learning outcomes for the PBL cases. The way we describe our aims objectives and outcomes is changing and we are beginning to categorise all such outcomes for the programme in terms of the Tomorrows Doctors themes of Doctor as Scientist & Scholar, Dr as Practitioner and Dr as Professional. With this, we will be moving away from some of the categories used here such as Knowledge, skills and attitudes. However during the transition you will find that the Aims & Objectives are categorised as Knowledge, skills and attitudes but the PBL case ILOs are categorised by the Tomorrows Doctors themes. This should not affect the way you interpret these but, with time, we anticipate that the change will make the description of the programme outcomes across the course clearer and more consistent.

Module aims
Knowledge: To promote acquisition of knowledge and facilitate the understanding of the areas of neurological, locomotor and mental health and illness, illness prevention and disease management, in the context of the individual and society. Skills:

To develop student competence in the performance of a number of basic procedures.

Attitudes: To encourage students to develop attitudes necessary for the achievement of high standards of medical practice.

Module Objectives
Knowledge: To demonstrate knowledge of the structure and function of the head, neck and vertebral column, including basic concepts of their development To demonstrate knowledge of the structure and function of the central and peripheral nervous systems; including associated connective tissues, specialised cells (neurones and glia) and associated vascular components, including basic concepts of their development To demonstrate specific knowledge of the structure and function of the cerebral hemispheres including the cerebral cortex, amygdala and limbic systems relating to the case scenarios To demonstrate knowledge of the structures and functions of the motor and sensory systems (including the special senses) To demonstrate specific knowledge of the thalamus, brain-stem, cerebellum and spinal cord relating to case scenarios

To demonstrate knowledge of pain and its modulation; including physiology, perception, theories and management To demonstrate knowledge of the pathways and principles of neurotransmission in the brain and spinal cord and related drug actions To demonstrate knowledge of the mechanisms of action of the main classes of CNS drugs, including local and general anaesthetics To demonstrate knowledge of the structure and function of skeletal muscle To demonstrate knowledge of the structure and function of the lower limb To demonstrate knowledge of the physiology and psychology of consciousness; emotions and motivation To demonstrate knowledge of the cognitive functions of attention, perception, and memory; and their assessment To demonstrate knowledge of the physiological, psychological and environmental factors involved in the development of mental illness To demonstrate knowledge of individual responses (coping) and social responses to chronic illness and disability; including Mental Health Legislation: definitions of health and mental health, competence and incompetence To demonstrate basic knowledge of the neurological, locomotor diseases and mental illnesses relating to the case scenarios including; pathology, epidemiology, investigation, prevention and treatment To demonstrate knowledge of basic ethical and legal issues in health care To demonstrate the ability to test the functions of the cranial nerves To demonstrate the ability to use an ophthalmoscope to inspect the retina To demonstrate the measurement of visual acuity for distance vision; near point and visual field To demonstrate the ability to use an otoscope to inspect the ear To demonstrate testing conduction and sensation in the ear, and obtaining an audiogram To demonstrate the ability to test somatic reflexes (including ankle, knee, triceps, biceps, supinator, plantar and abdominal reflexes) To demonstrate testing visual reflexes (including light and accommodation reflexes) To demonstrate intradermal injection of a sterile solution To demonstrate the application of drops of solution to the eye To calculate the volume of a drug required for a specific application and demonstrate accurate drug dilution techniques To demonstrate recording an EMG

Skills:

Attitudes: To demonstrate respect via use of appropriate language when discussing chronic illness (mental and physical) and disability To demonstrate respect via use of appropriate language when discussing people whose symptoms cannot be fully explained by organic pathology To recognise that patients and health professionals may have different opinions about what constitutes best outcomes of treatment

PBL Cases Intended Learning Outcomes The following is a list of your Intended Learning Outcomes (ILOs) for PBL cases this semester. There will also be ILOs for other aspects of your learning (e.g. early clinical experience, evidence based medicine, portfolio) you will receive these as part of the preparation for those sessions These ILOs are categorised by GMC Tomorrows Doctors outcomes, as part of which they identify three vertical themes. The GMC provide guidance to all UK medical schools about your medical education (http://www.gmc.uk.org/education/undergraduate/tomorrows_doctors_2009.asp ). GMC outcomes are what will you achieve by the end of your course at Manchester Medical School Most of the ILOs for PBL are based within Doctor as scientist and scholar, other elements of Phase 1 will provide more focus on the other themes (practitioner, professional) You should use these ILOs together with the more general aims and objectives for the semester (see above). For example, the Objective To demonstrate knowledge of the mechanisms of action of the main classes of CNS drugs, including local and general anaesthetics will be seen to be relevant to many cases but individual case ILOs referencing particular drugs may not be specifically listed.

Doctor as Scientist and Scholar


The graduate will be able to apply to medical practice biomedical scientific principles, method and knowledge relating to: anatomy, biochemistry, cell biology, genetics, immunology, microbiology, molecular biology, nutrition, pathology, pharmacology and physiology.

To demonstrate basic knowledge about neural tube defects including pathology, epidemiology, investigation, prevention and treatment To demonstrate knowledge of the structure and development of the CNS and associated connective tissues To demonstrate basic knowledge of the overlap between physiological and psychological functioning (using back pain as an example) To demonstrate knowledge of how the development of the vertebral column and spinal cord affects their anatomical relationship with each other and with the spinal nerves (dermatomes) To demonstrate knowledge of pain pathways, receptors and the neurotransmitters involved in differentiating between chronic pain and acute pain To demonstrate knowledge of the actions of local anaesthetics and analgesics using examples of the different classes of drugs To demonstrate knowledge of the distinguishing structural features at different levels of the vertebral column and spinal cord To demonstrate knowledge of the key features of gate control theory To demonstrate knowledge of the location of nerves in the lower limb

To demonstrate knowledge of the uses of MR scanning, CT scanning and X-ray imaging To demonstrate basic knowledge of abnormalities of the eye associated with strabismus, errors in refraction, visual reflexes and visual fields To demonstrate knowledge of how the movements of the eye are controlled To demonstrate knowledge of the effect of an intracranial tumour on the structure and function of visual pathways To demonstrate knowledge of the structure and function of the eyes and the role of the individual components in focusing light on the retina, phototransduction and processing of signals transmitted to the brain To demonstrate knowledge of the visual pathways involved in image formation and perception To demonstrate knowledge of the functional links between speech and hearing To demonstrate knowledge of the neuronal pathways between the ear and the auditory areas of the cerebral hemispheres To demonstrate knowledge of the pathology of the ear, nose and throat To demonstrate knowledge of the structure and function of the ear To demonstrate knowledge of the anatomy and function of the vestibular system To demonstrate knowledge of the structures in the nose and throat that can affect the ear To demonstrate basic knowledge of the dysfunctions arising from lesions to upper and lower motor neurons To demonstrate basic knowledge of the repair processes that follows a cerebrovascular accident (CVA) To demonstrate knowledge of the brain areas involved in language To understand the rational for thrombolysis in acute ischaemic stroke To understand the risk factors for vascular disease To demonstrate knowledge of the brainstem (emphasising cranial nerves) To know the definition of a stroke and to demonstrate knowledge of the events that comprise a cerebrovascular infarct To understand the presenting symptoms of stroke and the FAST response To understand how neurological symptoms fit with anatomy of the lesion To demonstrate knowledge of the long term management of stroke To demonstrate knowledge of the structural and functional organisation of sensory and motor pathways to and from the cerebral cortex To demonstrate knowledge of the structure, functional organisation and vascular supply of the cerebral cortex

To demonstrate knowledge of the uses of MR scanning, CT scanning and X-ray imaging To demonstrate knowledge of neuronal structure and function including the propagation and conduction of action potentials To demonstrate knowledge of the brainstem (emphasising cranial nerves) To demonstrate knowledge of the cellular composition of the CNS To demonstrate knowledge of the pathological process involved in demyelination To demonstrate knowledge of the structural and functional organisation of sensory and motor pathways to and from the cerebral cortex To demonstrate knowledge of the structure and functional organisation of the midbrain, pons and cerebellum To demonstrate basic knowledge of the uses of PET and SPECT scanning To demonstrate knowledge of the mechanisms responsible for slowness of movement (bradykinesia), increased muscle tone (rigidity), resting tremor and intention tremor in Parkinsons disease To demonstrate knowledge of the roles of the basal ganglia and of the cerebellum in the initiation and coordination of voluntary movement To demonstrate knowledge of the scientific basis of therapy for Parkinsons disease, indicating how dopaminergic transmission may be modulated by drugs To demonstrate basic knowledge of alcohol and drug abuse, including epidemiology and treatment To demonstrate basic knowledge of Impact of alcohol on memory limbic system, memory and learning To demonstrate knowledge of the drugs used to treat alcoholism To demonstrate basic knowledge of the symptoms of psychosis and the role alcohol and cannabis can play in precipitating a psychotic illness To demonstrate knowledge of the principle neurotransmitters in the limbic system and amygdala To demonstrate basic knowledge of complementary medicines and treatments, the evidence base and placebo effect To demonstrate basic knowledge of the treatment of ligament damage and fractures To demonstrate knowledge of gait and how this may be affected by musculoskeletal abnormality To demonstrate knowledge of muscle contraction, determinants of muscle strength, blood flow to muscle and the effects of training To demonstrate knowledge of skeletal muscle structure; including types of fibre, motor unit, motor end plate, transmission and excitationcontraction coupling To demonstrate knowledge of the structure and function of the lower limb

To demonstrate basic knowledge of recovery of movement in the lower limb after brain injury (rehabilitation) To demonstrate basic knowledge of sleep and consciousness To demonstrate basic knowledge of the effect of cerebral oedema and seizure on the cerebral cortex To demonstrate basic knowledge of the treatment of fractures To demonstrate knowledge of the anaesthetic agents including mechanisms of action and unwanted effects To demonstrate knowledge of the blood supply to the scalp To demonstrate knowledge of the fronto-temporal cerebral cortex relating to acute brain injury To demonstrate knowledge of the motor end plate, transmission and excitation-contraction coupling To demonstrate knowledge of the structure and function of the eyes and the role of the individual components in focusing light on the retina, phototransduction and processing of signals transmitted to the brain To demonstrate knowledge of the structure and function of the head and neck

Apply psychological principles, method and knowledge to medical practice.


To demonstrate basic knowledge of the overlap between physiological and psychological functioning (using back pain as an example) To demonstrate knowledge of models of disability and their management To demonstrate knowledge of the key social and psychological consequences of hearing loss To demonstrate knowledge of the process of attention and its role in information processing

To demonstrate basic knowledge of the main theories of memory To demonstrate knowledge of the key features of language and its role in cognitive functioning To demonstrate knowledge of coping strategies on the impact of sudden and severe illness To demonstrate knowledge of at least one generic and one disease specific measure of Quality of life (QoL) To demonstrate knowledge of changing patterns of drinking culture To demonstrate knowledge of the brain structures involved in mood and emotion To demonstrate basic knowledge of alcohol and drug abuse, including epidemiology and treatment

To demonstrate basic knowledge of Impact of alcohol on memory limbic system, memory and learning To demonstrate basic knowledge of complementary medicines and treatments, the evidence base and placebo effect To demonstrate basic knowledge of the key features of language and its role in cognitive functioning To demonstrate knowledge of neurocognitive assessment

Apply social science principles, method and knowledge to medical practice.


To demonstrate knowledge of models of disability and their management To demonstrate knowledge of the key social and psychological consequences of hearing loss To demonstrate basic knowledge of the impact of sudden and severe illness on social and employment status To demonstrate basic knowledge of peoples experience of accessing care and recovery from illness to social status (or socio-economic class) To demonstrate knowledge of changing patterns of drinking culture To demonstrate knowledge of the social support available and the socioeconomic consequences of disability

Apply to medical practice the principles, method and knowledge of population health and the improvement of health and healthcare.

To demonstrate knowledge of the epidemiology of stroke To demonstrate knowledge of the epidemiology of multiple sclerosis To demonstrate basic knowledge of alcohol and drug abuse, including epidemiology and treatment

Apply scientific method and approaches to medical research.


To demonstrate knowledge of the evidence base in medicine


The Doctor as a Practitioner


The Doctor as a Professional

The graduate will be able to behave according to ethical and legal principles.
To demonstrate basic knowledge of consent as applied to minors To demonstrate knowledge of the ethical and legal issues surrounding termination of pregnancy for minors To demonstrate knowledge of the philosophical/ethical debate around quality of life To demonstrate knowledge of GMC Good Medical Practice relating to personal health To demonstrate knowledge of GMC Good Medical Practice relating to "whistle-blowing"

Protect patients and improve care.


To recognise the difference between medical and social care, and the transition from one to the other