INSTRUCTIONAL DESIGN

A. Training Title: Renal Health Problem in the Community

B. Target Audience Description: The primary learners for this training will be
primary health care physicians. Typically these individuals will have educational
backgrounds and/or work experience in renal health.

C. Benefits to Target Audience: Every primary health care physician should

know how to manage any patient with or with possible renal problem. He should
also know how to handle the renal problem in the community as well as to deal
with issues associated with the renal problem, such as bioethical, psychosocial,
medicolegal and research issues.

D. Competency-based Learning Objectives :

At the end of the course, the student must be able to:

1. Write an overview and a personal perspective on the renal health

problem in the community.
2. Manage any patient presenting with renal problem.
2.1 Demonstrate skills in
2.1.1 Establishing rapport
2.1.2 Clinical diagnostic process
2.1.3 Preclinical diagnostic process
2.1.4 Treatment process
2.1.5 Giving advice
2.1.6 Making referrals
2.2 Demonstrate qualities of an effective, efficient, and
humane physician
2.3 Discuss/explain the biological foundation and basis of the
clinical management of a patient with renal problem.
3. Discuss the following issues on renal problem.
3.1 Clinical management issues
3.2 Psychosocial or behavioral issues
3.3 Bioethical issues
3.4 Medicolegal issues
 4. Conduct a public health education program on the prevention and
management of renal problem.
5. Perform a research activity on the renal problem.

6. Formulate a community health plan on the renal problem.

7. Pass examinations on the renal problem.

E. CONTENT

 Overview and Perspective of Renal Health Problem in the Community

 Concept of Renal Problem
 Common Types of Renal Problem
 Common Causes of Renal Problem
 Magnitude of the Renal Health Problem at the Global,
National, and Local Levels
 Personal Perspective on Possible Solutions of the Renal
Health Problem in the Local
o Community

 Generalities on Renal Problem - Concept and Principles and Basic Sciences

o Biomedical/Individual Domain
 Pathophysiology
 Concept of Renal Problem
 Anatomy of the Urinary System
 Physiology of the Urinary System
 Epidemiology of Renal Problem
 Types of Renal Problem
 Causes of Renal Problem
 Natural History of Renal Problem
(Untreated and Failure of
 Treatment)
o Prognosis (Recovery,
Disability, and Death)
 Diagnosis
 Clinical Cues (Signs and Symptoms)
 o Cues for the Different Renal
Problems
 Parenchymal and Tract
Disorders
 Obstructive and Non-
obstructive Disorders
 Urine Flow and Urine
Constituent Disorder
 Flow - anuria, oliguria,
polyuria
 Constituents - hematuria,
pyuria,
 bacteriuria, proteinuria,
 glucosuria
 Localized and Systemic
Effects
 Fluid and Electrolyte
Imbalance
 Azotemia
 Clinical Diagnostic Process
o Pattern Recognition and
Prevalence
 Paraclinical Diagnostic Procedures
o Urine Analysis
o Blood Analysis
o Imaging Procedures
o Biopsy
 Paraclinical Diagnostic Process
o Indication
o Selection
 Benefit, Risk, Cost,
Availability
o Interpretation
 Diagnostic Algorithm
 Severity and Staging
 Treatment
 Goals in Treatment
o Preventive, Curative, and
Palliative
 Forms of Treatment
 o Nonoperative and Operative
o Parenchymal and Tract
Disorder Treatment
o Dialysis
o Transplantation
 Selection of Treatment
o Benefit, Risk, Cost,
Availability
 Palliative Care
o Hospice Care
 Follow-up Care
o Social/Population Domain
 Community Health Management
 Epidemiology
 Management Approach to the Renal Health
Problem in the
o Community (Primary Health
Care)
 Community Health
Program
 Renal Problem Control
Program
 Preventive Nephrology
Project
 Public Health Education
 Psychosocial Issues
 Prevention
 Early Detection
(Screening)
 Research
 Issues
 Psychosocial Issues
 Bioethical Issues
o Organ Transplantation
 Medicolegal Issues
o Legal Medicine
 Organ Donation Act of
1991 (R.A. 7170)
o Medical Jurisprudence
  Approach to Issues (Prevention and
Solution)

 Specifics on Renal Problems and Clinical Sciences

 Common Renal Problems in the Philippines (male and
female/young and old)
 Parenchymal and Tract Disorders
 Problems of the Kidney, Ureter, Bladder, Urethra
o Congenital Disorders
o Inflammations/Infections
o Metabolic Disorders
o Tumors
o Trauma
o Neurogenic Disorders
o Other Degenerative Disorders

 Problems of the Kidney

o Glomerular Diseases
 Acute Glomerulonephritis
 Rapidly Progressive (Crescentic)
Glomerulonephritis
 Nephrotic Syndrome
 Membranous Glomerulonephritis
 Focal Segmental Glomerulosclerosis
 Membranoproliferative Glomerulonephritis
 Berger’s Disease
 Focal Glomerulonephritis
 Chronic Glomerulonephritis
 Glomerular Lesions Associated with
Systemic Diseases
o Systemic Lupus
Erythematosus, Henoch-
Schonlein
 Purpura, Bacterial Endocarditis, Diabetic
 Glomerulosclerosis, Amyloidosis
 Hereditary Nephritis
 o Problems Affecting Tubules and Interstitium
 Acute Tubular Necrosis
 Tubulointerstitial Nephritis
 Pyelonephritis, Urinary Tract Infections, Tubulointerstitial Nephritis
Induced by Drugs and Toxins, Urate Nephropathy, Hypercalcemia and
Nephrosclerosis

o Problems of Renal Blood Vessels

 Benign Nephrosclerosis
 Malignant Nephrosclerosis
 Renal Artery Stenosis
 Thrombotic Microangiopathies
 Adult and Childhood Hemolytic-Uremic Syndrome, Thrombotic
Thrombocytopenic Purpura

o Congenital Problems
 Cystic Diseases
 Cystic Renal Dysplasia, Autosomal Dominant and Recessive Polycystic
Kidney, Cystic Diseases of the Renal Medulla, Simple Cysts

o Tumors/Cancers
 Benign Tumors/Cancers
 Malignant Tumors/Cancers

o Inflammations/Infections
 Pyenephritis

o Metabolic Disorders
 Stones
 o Trauma

 Problems of the Ureter

o Inflammations/Infections
 Ureteritis
o Obstructive Lesions
 Stones
 Tumors/Cancers
o Congenital Anomalies
 Double and Bifid Ureters, Diverticula
o Trauma

 Problems of the Urinary Bladder

o Inflammations/Infections
 Acute Cystitis, Chronic Cystitis, Hunner’s
Ulcer, Malakoplakia
o Congenital Anomalies
 Diverticula, Exstrophy, Vesicoureteral Reflux, Congenital Vesicouterine
Fistulas, Urachus
o Tumors/Cancers
o Trauma
o Neurogenic Disorder

 Problems of the Urethra

o Inflammations/Infections
 Gonococcal Urethritis
 Nongonococcal Urethritis
o Trauma
o Hypospadias
  Overview and Perspective of the Specific Renal Health
Problem in the Community

o Concept of the Specific Renal Problem

o Common Types of the Specific Renal Problem
o Common Causes of the Specific Renal Problem
o Magnitude of the Specific Renal Health Problem at
the Global,
 National, and Local Levels
o Personal Perspectives on Possible Solutions of the
Specific Renal
 Health Problem in the Local Community
 Special and Related Topics
 Problems of the Prostate
o Anatomy and Physiology of the Prostate
o Pathology, Diagnosis, and Treatment
 Inflammatory/Infectious Disorder
 Benign Prostatic Hypertrophy
 Prostatic Cancers
 Sexually Transmitted Diseases
 Fluid and Electrolyte Balance

F. Training Methodologies/Strategies:

 Hypothetical Patient Management

 Actual Patient Management
 Demonstration-Return Demonstration
 Projects
 Discussion
 Debates
 Role Play
 Independent Study
G.Evaluation: Learning Objectives-Referenced Evaluation

A student must pass the following assessment tools:

 Written examination
 Posttest - MPL of 75 %
 Practical examinations
 Presentation in a Symposium (PASS)
 Clinical Examination - MPL of 75%

 Written Reports
 Overview and Personal Perspectives
(PASS) - individual output
 Reports on Symposium (PASS) - group
output
 Case Presentation and Discussion of 3
Actual Patient Management (PASS)