Annapoorana Medical College & Hospitals, Salem

Department of Surgery

Phase III Part I Lesson Plan

Lecture

Competency

Topic

Teaching Method

Number

Topic: METABOLIC REPONSE TO SURGERY

describe basic concepts of homeostasis , enumerate the metabolic changes in injury and

SU 1.1

their mediators

OBJECTIVES

1.Basic concepts of homeostasis

2.Metabolic changes in injury

LECTURE

SU 1.2

Describe the factors that affect the metabolic response to injury

OBJECTIVES

1.Factors that affect the metabolic responseto injury

SU 1.3

Describe the basic concepts of perioperative care

LECTURE

OBJECTIVES

1.Basic concepts of perioperative care

Topic: SHOCK

Describe pathophysiology of shock, types of shock and principles of resuscitation

SU 2.1

including fluid replacement and monitoring .

SU2.2

OBJECTIVES

1.Pathophysiology and types of shock

2.Principles of resuscitation of shock

LECTURE

Describe the clinical features of shock and its appropriate treatment

OBJECTIVES

1.Features of shock and its management

Communicate and counsel patients and families about the treatment and prognosis of

SU2.3

shock demonstrating empathy and care

ROLE PLAY

OBJECTIVES

1.Communication and counselling skills development

BLOOD AND BLOOD COMPONENTS

Describe the indications and appropriate use of blood and blood products and

SU3.1

complications of blood transfusion

LECTURE

OBJECTIVES

1.Indications ,appropriate usage and complications of blood transfusion

SU3.2

Observe blood transfusions

BEDSIDE CLINCS .

OBJECTIVES

1.To know how to tranfuse the blood

2. To know the precautions to be taken for transfusing blood

SU3.3

Counsel patients and family / friends for blood transfusion and blood donation .

ROLE PLAY

OBJECTIVES

1. Awareness about blood donation .

Topic: BURNS

Elicit document and present history in the case of burns and perform physical examination and

SU4.1 &

describe pathophysiology of burns . Communicate and counsel patients and families on the outcome

SU4.4

and rehabilitation , demonstrating empathy and care .

BED SIDE CLINICS

OBJECTIVES

1. History taking in burns

2. Examination of burns patient

3. Documentation in a burns case

4. Communicating and counselling skills to explain about the treatment outcome and rehabilitation

SU4.2

Describe clinical features and diagnose type and extent of burns and plan appropriate

LECTURE

treatment .

OBJECTIVES

1.Classifying burns and its appropriate management

SU4.3

Discuss the medicolegal aspects in burn injuries

OBJECTIVES

LECTURE

1.Medicolegal aspects of burn injuries

Topic: WOUND HEALING AND WOUND CARE

SU5.1

Describe normal wound healing and factors affecting healing.

SU5.2

Elicit, document and present a history in a patient presenting with wounds

SU5.1,5.2/SLO

Discuss normal wound healing mechanism

Enumerate different types of wounds , of different structures at different sites

Describe various aspects of disordered healing leading to chronic wounds

Normal wound healing and factors affecting wound healing

Lecture

Clinical examination in a patient with chronic ulcer

BED SIDE CLINICS

Topic: WOUND HEALING AND WOUND CARE

SU5.3

Differentiate the various types of wounds, plan and observe management of wounds

SU5.4

Discuss medico legal aspects of wounds

SU5.3, SU5.4/SLO

Describe variety of scars and their treatment

Enumerate differences between acute and chronic wounds

Types of wounds , investigations and management

Lecture

medicolegal aspects of wounds

Lecture

Topic: SURGICAL INFECTIONS

SU6.1

Define and describe the aetiology , pathogenesis of surgical infections

SU6.2

Enumerate prophylactic and therapeutic antibiotics plan appropriate management.

SU6.1,SU6.2 / SLO

Enumerate characteristics of common surgical pathogens and their sensitivities

Describe sources of infection and their severity

Discuss surgical infections

Discuss indications and choice of prophylactic and therapeutic antibiotic in surgical infections .

Discuss management of surgical infections

Etiology and pathogenesis of surgical infection

Lecture

6.2

Propylactic and therapeutic antibiotics in surgical infections and their management

Lecture

Incidence of surgical infection in the hospital

SDL

Gas gangrene/tetanus/cellulitis

Lecture

Topic: SURGICAL AUDIT AND RESEARCH

SU7.1

Describe the Planning and conduct of Surgical audit

SU7.2

Describe the principles and steps of clinical research in General Surgery

SU7.1,SU7.2 / SLO

Discuss planning and conduct of surgical audit and research

Describe how to write up a project

Discuss the principles and steps of clinical research in General Surgery

Planning and conduct of surgical audit

Lecture

Principles and steps of clinical research

SDL

Topic: ETHICS

SU8.1

Describe the principles of Ethics as it pertains to General Surgery

SU8.2

Demonstrate Professionalism and empathy to the patient undergoing general surgery

SU8.3

Discuss Medico-legal issues in surgical practice

SU8.1, SU8.2, SU8.3 / SLO

Discuss the principles of ethics in surgery

Enumerate medical error and adverse events

Demonstrate Professionalism and empathy to the patient undergoing general surgery

Discuss patient safety measures .

Describe Medico-legal issues in surgical practice

Ethics in surgery

Lecture

Adverse events in surgical practice

SDL

Medicolegal issues in surgical practice

SDL

Topic: INVESTIGATIONS OF A SURGICAL PATIENT

SU9.1

Choose appropriate biochemical, microbiological, pathological, imaging investigations and interpret

the investigative data in a surgical patient

Biological basis for early detection of cancer and multidisciplinary approach in management of

SU9.2

cancer

SU9.3

Communicate the results of surgical investigations and counsel the patient appropriately

SU9.1, SU9.2, SU 9.3 / SLO

Discuss appropriate investigations and its interpretation

Enumerate early cancer detection and its management

Discuss results of investigation and developing communicatinmg skills with patient

Biochemical , microbiological , pathological investigation and interpretation

BED SIDE CLINICS

Screening for malignancy and its management

SDL

Communicating skills

Role Play

Topic: PRE , INTRA AND POST OPERATIVE MANAGEMENT

SU10.1

Describe the principles of perioperative management of common surgical procedures

SU10.2

Describe the steps and obtain informed consent in a simulated environment

Observe common surgical procedures and assist in minor surgical procedures; Observe emergency

SU10.3

lifesaving surgical procedures.

Perform basic surgical Skills such as First aid including suturing and minor surgical procedures in

SU10.4

simulated environment

SU10.1, SU10.2, SU10.3 SU10.4 / SLO

Discuss various principles in perioperative management during procedures

Discuss the steps to obtain the informed , written consent

Enumerate common surgical procedures in day to day practice

Principles in perioperative management during procedures

SGD

Steps to obtain the informed , written consent

SGD

Common surgical procedures

SGD

First aid in practice

SGD

Topic: ANASTHESIA AND PAIN MANAGEMENT

SU11.1

Describe principles of Preoperative assessment.

SU11.2

Enumerate the principles of general, regional, and local Anaesthesia.

SU11.3

Demonstrate maintenance of an airway in a mannequin or equivalent

SU11.4

Enumerate the indications and principles of day care General Surgery

SU11.5

Describe principles of providing post-operative pain relief and management of chronic pain.

SU11.6

Describe Principles of safe General Surgery

SU11.1,SU11.2,SU11.3,SU11.4,SU11.5,SU11.6 / SLO

Describe various types of anaesthesia

Discuss various methods of providing pain relief/ chronic pain

Describe local and regional anesthesia techniques

Discuss the indication and principles of daycare surgery

Discuss various techniques in airway maintenance of a patient

Discuss about the safety in surgery

Assessement in anesthesia

SGD

Types of anesthesia

SGD

A, B, C of anesthesia

SGD

Day care surgery

SGD

Safety in surgery

SGD

Postoperative analgesia and management of chronic pain

SGD

Topic: NUTRITION AND FLUID THERAPY

SU12.1

Enumerate the causes and consequences of malnutrition in the surgical patient

Describe and discuss the methods of estimation and replacement of the fluid and electrolyte

SU12.2

requirements in the surgical patient

Discuss the nutritional requirements of surgical patients, the methods of providing nutritional support

SU12.3

and their complications

SU12.1, SU12.2, SU12.3 / SLO

Describe causes and consequences of malnutrition

Discuss various fluid and electrolyte requirements in surgical patient

Describe nutritional requirement in a surgical patient

Describe various methods of providing nutritional support

Malnutrition in surgery

SGD

Fluid and electrolyte balance

Lecture

TPN

SGD

Topic: TRANSPLANTATION

SU13.1

Describe the immunological basis of organ transplantation

Discuss the Principles of immunosuppressive therapy.Enumerate Indications, describe surgical

SU13.2

principles, management of organ transplantation

SU13.3

Discuss the legal and ethical issues concerning organ donation

SU13.4

Counsel patients and relatives on organ donation in a simulated environment

SU13.1,SU13.2,SU13.3,SU13.4 / SLO

Discuss HLA and MHC complex and their role in transplantation

enumerate principles and indications for transplantation

Describe about the causes of graft dysfunction

Discuss about the litely outcome after transplantation

Immunoogical basics of organ transplantation

Lecture

Immunosupressive thearpy

Lecture

Indications srgical principles and management of organ transplantation

Lecture

Medico legal issues in transplantation

SGD

Counselling on organ donation

SGD

Topic: BASIC SURGICAL SKILLS

SU14.1

Describe Aseptic techniques, sterilization and disinfection.

SU14.2

Describe Surgical approaches, incisions and the use of appropriate instruments in Surgery in general

Describe the materials and methods used for surgical wound closure and anastomosis (sutures, knots

SU14.3

and needles)

SU14.4

Demonstrate the techniques of asepsis and suturing in a simulated environment

SU14.1,SU14.2,SU14.3,SU14.4 / SLO

Discuss various Principles in sterilisation and disinfection

Describe principles of skin and abdominal incisions

Describe principles of wound closure

Demonstrate technique of suturing under aseptic condition

Sterlisation and disinfection

SGD

Surgical incision and approaches and instrument in surgery

SGD

Wound closure and anastomosis in surgery

SGD

Aseptic precautions in surgery

SGD

Topic: BIOHAZARD DISPOSAL

SU15.1

Describe classification of hospital waste and appropriate methods of disposal

SU15.1 / SLO

List out the hospital waste , seggregation and appropriate methods of disposal

Classification and appropriate methods of safe disposal

SGD

field visit

SGD

Topic: MINIMALLY INVASIVE GENERAL SURGERY

Minimally invasive general surgery : describe indications advantages and disadvantages of minimal

SU16.1

invasive general surgery

SU16.1 / SLO

Elicit principles of laparoscopic and robotic surgery

Differntiate advantages and disadvantages of laparoscopic surgery

discuss safety issues and indications in laparoscopic surgery

List out principles of postoperative care

Principles of minimal invasive surgery

Lecture

Indications and contraindications for minimal invasive surgery

Lecture

Surgical procedures - minimal invasive surgery

SGD

Robotic surgery

Lecture

Recent advances in minimal invasive surgery

SGD

Topic: TRAUMA

SU17.1

Describe the Principles of FIRST AID

SU17.2

Demonstrate the steps in Basic Life Support. Transport of injured patient in a simulated environment

SU17.3

Describe the Principles in management of mass casualties

SU17.4

Describe Pathophysiology, mechanism of head injuries

SU17.5

Describe clinical features for neurological assessment and GCS in head injuries

SU17.6

Choose appropriate investigations and discuss the principles of management of head injuries.

Describe the clinical features of soft tissue injuries. Choose appropriate investigations and discuss

SU17.7

the principles of management.

SU17.8

Describe the pathophysiology of chest injuries

SU17.9

Describe the clinical features and principles of management of chest injuries

Demonstrate Airway maintenance. Recognize and manage tension pneumothorax, hemothorax and

SU17.10

flail chest in simulated environment.

SU17.1 - SU 17.10 / SLO

Elicit importance of time in trauma management

Enumerate the steps to assess the trauma patient

Elicit techniques in basic life support management

Elicit techniques in advance cardiac life support

Discuss about principles in mass casualty managemnt

Discuss about pathophysiological response to trauma

to enlist investigative modalities for traumas

Describe pathophysiology of chest injuries

Demonstarte importance of ABC in trauma care management

List out principles of management in chest injuries

Discuss clinical features and management of soft tissue injuries

First AID in trauma

SGD

Basic life support and advanced cardiac life support

SGD

Pathophysiology , mechanism and assessement in head injuries

Lecture

Management of head injuries

Lecture

Mechanism , clinical features and managemnt in blunt chest injuries

Lecture

Mechanism , clinical features and managemnt in penetrating chest injuries

Lecture

Spleen and liver injuries

Lecture

Retroperitoneal injuries

Lecture

Hallow viscus injuries ( bowel , stomach )

Lecture

Pathophysiology , clinical features and investigations in soft tissue injuries

SGD

Management of soft tissue / crush / degloving injuries

SGD

Pelvic injuries

SGD

Urinary tract injuries

SGD

Management of mass casualty / disaster management

SGD

Topic: SKIN AND SUBCUTANEOUS TISSUE

Describe the pathogenesis, clinical features and management of various cutaneous and subcutaneous

SU18.1

infections

SU18.2

Classify skin tumors differentiate different skin tumors and discuss their management

Describe and demonstrate the clinical examination of surgical patient including swelling and order

SU18.3

relevant investigation for diagnosis. Describe and discuss appropriate treatment plan.

SU18.1,SU18.2,SU18.3 / SLO

List out structural and functional properties of skin

Classify vascular lesions of skin

Elicit cutaneous manifestations of systemic diseases

Classify benign skin lesions

Enumerate types of cutaneous malignancy and its management