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Presented at a training workshop on the Islamic Input in the Medical Curriculum held at the Faculty of Medicine UNISSULA on 21st December 2008 by Professor Dr Omar Hasan Kasule Sr. MB ChB (MUK), MPH (Harvard), DrPH (Harvard) WEB: http://omarkasule.tripod.com
1.0 SEMESTER 1
UNIT 1
CONCEPTUAL AND PHILOSOPHICAL BACKGROUND: religious background
1.0 Explain the academic definition of religion based on: an object of worship, a prophet, theology, scriptures, doctrines & dogmas, rites, rituals, & ceremonies, icons or symbols, holidays, ethics and social teachings
2.0 Explain why understanding the patient’s religious belief is important in medical practice.
3.0 Discuss how specific religious concepts relate to medicine: excellence / quality, ihsan; monotheism, tauhid, messengers and messages, risaalat, eschatology, aakhirat, sinning, ithm, and transgression, dhulm.
4.0 Explain how a patient’s understanding of re-determinism: qadar / taqdiir affects health-related behavior with reference to beliefs about human will, human responsibility and accountability for actions / choices, human rights and limits to individual freedom, disease (causation, prevention, and treatment), health promotion, and reconciliation between pre-determination and probability theory].
5.0 Explain dogmas with medical implications in Buddhism and Hinduism, Confucianism and Taoism, Christianity and Judaism.
CONCEPTUAL AND PHILOSOPHICAL BACKGROUND: Historical background
1.0 Explain the terms vicegerency, exploitation of natural resources (taskhiir), and building a physical civilization (omraan) and how they relate to health promotion, disease prevention, and environmental protection
2.0 Explain how nutrition, health, and disease affect the rise and fall of civilizations.
3.0 List the main achievements of ancient Egyptian, Mesopotamian, Indian, Chinese, Greek, and Roman medicine
4.0 Describe the concept Islamic medicine and explain how it has been misunderstood
5.0 Describe Prophetic medicines: definition, sources, classification, examples, modern applications
6.0 Describe the main forms of European traditional medicine.
7.0 Describe Chinese TCM: theory and philosophy, history, diagnostic techniques, treatments, efficacy and safety, modernization
8.0 Describe Ayurdevic TCM: history, diagnosis, treatments, present status, scientific study
9.0 Describe Unani TCM: historical background, humors, present status
10. Briefly outline the history of modern medicine from the renaissance to the modern period.
11. List the advantages and disadvantages of medical practice based solely on the biomedical model.
PROFESSIONALISM and PERSONAL DEVELOPMENT: Success of a medical student
1.0 Describe the etiquette of the teachers and students in a health education setting
2.0 Describe effective time management with focus on planning, prioritization, and balance
3.0 Describe effective methods of following group study
4.0 Describe the advantages and techniques of speed reading
5.0 Describe factors of successful teamwork
6.0 Explain effective approaches to motivating a medical student
7.0 List causes of student stress and explain methods of its prevention
8.0 Describe guidelines on plagiarism.
UNIT 2
CONCEPTUAL AND PHILOSOPHICAL BACKGROUND: EPISTEMOLOGY
1.0 Briefly describe the philosophy, nature, history, sources, classification, and limitations of human knowledge
2.0 Describe the intellectual crisis created by the dichotomy between European and traditional sources of knowledge
3.0 Describe the empirical scientific method: definition, strengths, weaknesses
4.0 What is your view about the possibility of integration of European and traditional knowledge in the medical field: give reasons for your view.
PROFESSIONALISM and PERSONAL DEVELOPMENT: INDIVIDUAL DEVELOPMENT
1.0 Discuss the nature of medical education: purpose, integration, balance, service, and leadership).
2.0 List physician rights: remuneration, professional independence, continuing medical education, refusal to undertake unethical procedures
3.0 Discuss physician responsibilities: to self and family, to society, and to science.
ETHICO-LEGAL-FIQH CONCEPTS & PRINCIPLES: BASICS OF LAWS
1.0 List the sources of Islamic Law: Qur’an, sunnat, ijma, qiyaas
2.0 List sources of European Law: statute and common law
3.0 List the 5 purposes of the Law: morality (diin), life, progeny, intellect, and property resources
4.0 List the 5 principles of the Law: intention, certainty, injury, hardship, custom
5.0 Define the various types of legal rulings
6.0 Discuss the relation of ethics to law: the Islamic vs. European perspectives
PERSONAL AND PROFESSIONAL DEVELOPMENT: Towards developing a scientific culture
1.0 Explain the roles of the following in developing a scientific attitude: understanding, thinking, description, analysis, objectivity, rationality, prudence, respecting the other opinion.
UNIT 3
ETHICO-LEGAL-FIQH CONCEPTS & PRINCIPLES: BASICS OF LAWS
1.0 Describe the shariah legal system: types of courts and jurisdictions as well as enabling legislation
THEORIES AND PRINCIPLES OF MEDICAL ETHICS: Theories of medical and biomedical ethics
1.0 Explain the Islamic theory of ethics based on the 5 purposes of the Law, maqasid al shariah: morality, life, progeny, intellect, and resources
2.0 Explain the main European theories of ethics: deontology vs. teleology, consequentialism / utilitarianism, principlism, Kantian, virtue, relationship, and casuistry, communitarian ethics, feminist ethics, empirical.
PROFESSIONALISM and PERSONAL DEVELOPMENT: INDIVIDUAL DEVELOPMENT: Character and behavior:
1.0 Describe the terms character, habits, and behavior
2.0 Explain with examples the following positive personality traits: integrity, responsibility, courage, wisdom, patience, humility, self-restraint, modesty, simplicity, moderation, good acts, good company, principled life, positive image.
UNIT 4
THEORIES AND PRINCIPLES OF MEDICAL ETHICS: Principles of medical and biomedical ethics:
1.0 Explain the following Islamic ethical principles: intention, certainty, harm, hardship, and custom.
2.0 Explain the ethical principles enunciated by Childress and Beauchamp’s: autonomy, beneficence, nonmaleficence, and justice.
3.0 Explain religious approaches to ethics: Christian, Buddhist, Hindi, Jewish, Confucian and Taoist
4.0 List the main provisions of the following international ethical codes: Hippocratic, Nurenberg, Helsinki, World Medical Health Association, UNESCO Universal Declaration of Bioethics and human rights 2005
THEORIES AND PRINCIPLES OF MEDICAL ETHICS: Medical consent for competent patients
1.0 Discuss patient autonomy: definition, legal and conceptual basis, significance in health care, limitations, patient autonomy vs. physician paternalism, second opinion, conflict between human rights and requirements of medical treatment).
2.0 Discuss physician autonomy with regard to procedures against personal beliefs.
3.0 Discuss competence / capacity: definition, conditions, and testing
4.0 Discuss informed consent: definition, process, and who asks?
5.0 Explain the scope of consent: physician choice, physician of a different gender, consent to treatment, and refusal or treatment.
6.0 Discuss conditions for validity of consent: understandings, disclosure, weigh info, voluntary, aware can refuse.
7.0 List information for informed consent: diagnosis, prognosis, treatment alternatives, risks and benefits.
8.0 Discuss capacity to consent: global vs. specific, tests for capacity, enhancing capacity.
PROFESSIONALISM and PERSONAL DEVELOPMENT: INDIVIDUAL DEVELOPMENT: Self Development and personality enhancement:
1.0 Describe with examples the following aspects of self improvement: commitment, effort, learning from experience, interdependence, creativity, needs vs. wants, positive attitude, futuristic outlook, assertiveness, self confidence, self reliance, contentment.
UNIT 5
ETHICO-LEGAL-FIQH PRINCIPLES: issues of consent: incompetent patients
1.0 Discuss consent / refusal for the incompetent (young children, older children, the mentally ill, and the unconscious).
THEORIES AND PRINCIPLES OF MEDICAL ETHICS: Privacy and confidentiality:
1.0 Define and describe privacy and confidentiality
2.0 Explain the basis/rationale of confidentiality
3.0 Describe truthfulness and its role in healthcare
4.0 Summarize ethico-legal guidelines on disclosure
5.0 Describe conflict of duties regarding confidentiality and disclosure
6.0 Discuss special issues relating to disclosure of family or genetic information.
7.0 Discuss the generation and handling of medical records
8.0 Discuss ethico-legal aspects of disclosure to the media.
9.0 Discuss disclosure by doctors with dual obligations
10. Discuss guidelines for physician in court: as a witness of facts vs expert witness
PROFESSIONALISM and PERSONAL DEVELOPMENT: INDIVIDUAL DEVELOPMENT:
1.0 Discuss Intellectual development, Social development, Skill development, and Professional development.
UNIT 6
THEORIES AND PRINCIPLES OF MEDICAL ETHICS: Research policies and procedures:
1.0 Describe the composition of an institutional research committee.
2.0 List the functions of an institutional research committee
3.0 List factors that are taken into consideration for ethical approval of a research proposal.
4.0 Describe the various types of fraud in research
5.0 Describe ways of preventing research fraud
THEORIES AND PRINCIPLES OF MEDICAL ETHICS: Animal research:
1.0 Describe the ethical handling animals before, during, and after research
2.0 Discuss the purposes of animal research
3.0 Discuss the purposes and principles of the Law in animal research
4.0 Discuss the relevance of animal research to humans
5.0 Discuss guidelines on the choice of animals for research
PERSONAL DEVELOPMENT AND PROFESSIONALISM
1.0 Discuss personal beliefs and conscience in health care especially abortion.
THEORIES AND PRINCIPLES OF MEDICAL ETHICS: Human research I
1.0 Describe the history of human research: historical evolution & historical ethical violations.
2.0 Describe the 4 phases of a clinical trial.
3.0 Distinguish between therapeutic and non -therapeutic research.
4.0 Summarize good clinical practice guidelines.
5.0 Discuss issues of autonomy and informed consent in research on humans.
6.0 List the information given to patients before consent.
7.0 Discuss the rights of the patient to withdraw from research.
8.0 Describe ethico-legal issues relating to material inducements for research subjects.
9.0 Describe the assurance of confidentiality in human research.
10. Discuss ethico-legal issues relating to research in emergency rooms.
11. Discuss ethico-legal issues relating to research on the mentally incompetent.
12. Discuss ethico-legal issues relating to research on children.
13. Discuss ethical issues relating to inclusion of women in clinical trials.
14. Discuss ethico-legal issues relating to research on the elderly.
15. Discuss ethico-legal issues relating to research on prisoners.
16. Discuss ethico-legal issues relating to research on students and employees.
17. Discuss ethico-legal issues relating to research on members of uniformed services, army and police.
18. Discuss ethico-legal issues relating to research on cadavers.
19. Discuss ethico-legal issues relating to research on biological samples, organs, and tissues from living donors.
20. Discuss ethico-legal issues relating to research on biological samples, organs, and tissues from dead donors.
21. Discuss ethico-legal issues relating to research on embryos.
22. Discuss ethico-legal issues relating to research on fetal tissues.
23. Discuss ethico-legal issues relating to record-based research.
24. Discuss ethico-legal issues relating to biomedical research.
25. Discuss ethico-legal issues relating to health services research.
2.0 SEMESTER 1
Year 1 Semester 2 Biomed PPSD 2008 2009 LOBs
CASE #1:
PHILOSOPHY, CONCEPTS, ETHICO-LEGAL-FIQH ISSUES: Privacy & confidentiality
1.0 Define patient privacy: definition and relation to patient autonomy
2.0 Describe patient confidentiality: definition, what information is considered confidential, anonymized information, violation with / without consent, disclosure about the deceased).
3.0 Discuss the basis/ rationale / justification of confidentiality: clinical care. Autonomy and privacy, fidelity, social basis, legal basis).
4.0 Discuss truthfulness in clinical care: obligation to tell the truth, information patient does not need/want to know, partial disclosure / white / technical lies, giving bad news, the physician’s body language).
RESEARCH SKILLS: ANALYTIC STATISTICS
1.0 Define and illustrate discrete data analysis.
2.0 Define and illustrate continuous data analysis.
CASE #2:
PHILOSOPHY, CONCEPTS, ETHICO-LEGAL-FIQH ISSUES:
1.0 Discuss disclosure in patient care: disclosure by the patient, disclosure with consent for education, research, and insurance; disclosure without consent to other healthcare professionals and in the public interest.
2.0 Discuss conflict of duties / obligations regarding confidentiality and disclosure: disclosure to insurance companies, disclosure to employers, disclosure of HIV status, disclosure as a witness in litigation with consent, without consent; disclosure of family history / genetic information: by the patient vs. by the physician, request by the employer, request by the police.
PERSONAL SKILL DEVELOPMENT: Communication:
1.0 Describe concepts and the theory of communication: definition, functions, channels, process, modes, elements of success, perception, styles, and barriers.
2.0 Discuss communication in small groups: advantages of face to face communication, on first meeting, continuing in the group, factors of success, active listening, barriers to effective listening, etiquette of telephone and online communication.
3.0 Discuss purposes and types of written communication: letters, office memos, papers, reports, and manuals.
4.0 Discuss characteristics of good writing: precision, simple language, logic, believable, purposive, draft and review.
PROFESSIONALISM: Professional misconduct:
1.0 Describe and illustrate various ways of abuse of privileges: unethical research, unnecessary treatment, iatrogenic infection, misuse of controlled drugs, false documentation.
2.0Describe and illustrate private misconduct derogatory to the profession (sexual transgression, abuse of trust, violence and felonies.
3.0Describe and illustrate financial misconduct: kick-backs and fee splitting, conflict of interest.
4.0Illustrate some felonies relating to medical practice.
CASE #3:
PHILOSOPHY, CONCEPTS, ETHICO-LEGAL-FIQH ISSUES: Generation and handling of medical records
1.0 Discuss ethico-legal-fiqh issues relating to medical records: SOAPIE, various forms of records, ideal record, omitting or removing information, legal ownership of records, ensuring record security, period of retention of records, patient access to records, access to records of the incompetent, issues in storage and retrieval of records.
RESEARCH SKILLS: ANALYTIC STATISTICS:
1.0 Define and illustrate correlation analysis.
2.0 Define and illustrate linear regression analysis.
3.0 Define and illustrate logistic regression analysis.
CASE #4:
PHILOSOPHY, CONCEPTS, ETHICO-LEGAL-FIQH ISSUES: Conflicts of duty in disclosures:
1.0 Discuss ethico-legal-fiqh issues relating to disclosure to the mass media: public vs. individual interest.
2.0 Discuss ethico-legal-fiqh issues relating to disclosure by doctors with dual obligations: occupational, army, police, prisons, sports, hospital manager (with consent, without consent.
3.0 Discuss ethico-legal-fiqh issues relating to disclosure by physician in court: as a witness of facts vs. expert witness (duty to patient vs. public duty to justice, testifying for vs. testifying against the patient).
PERSONAL SKILL DEVELOPMENT: Communication
1.0 Describe and illustrate medical writing: special characteristics of medical/technical writing and publishing a paper.
2.0Describe and illustrate problems in writing: blank page/writer’s block, writing to difficult persons, conveying unpleasant information).
3.0Describe public speaking: purposes, elements, the message, delivery, the audience).
4.0Describe methods of dealing effectively with the mass media: strengths and weaknesses of various media, impact of media on health-related KAP.
PROFESSIONALISM: Professional misconduct:
1.0 Describe conflict of financial interests: physician as a manager, occupational physician employed by the company, sports physician.
2.0 Discuss ethico-legal-fiqh guidelines for dealing with the pharmaceutical industry. Un-ethical business practices
CASE #5:
PHILOSOPHY, CONCEPTS, ETHICO-LEGAL-FIQH ISSUES, RESEARCH: Research policies and procedures:
1.0 Describe the composition of an institutional research committee
2.0 List the functions of an institutional research committee
3.0 Describe the basis for ethical approval of a research project: scientific merit, competence of researchers, social value, risks vs. benefits, informed consent, confidentiality, conflict or interests / roles, transparency, disclosure, publication / funding bias
4.0 Describe types of fraud in research: not following GCP guidelines, no consent, data falsification, plagiarism, including names that did not participate, researchers not trained, falsifying authorship
5.0 Describe ways of avoiding research fraud / malpractice: training in GCP, ethical and scientific review of research proposal, detailed recording of all research activities, researchers must be personally involved, quality assurance and audit, encourage whistle blowing.
RESEARCH SKILLS: ANALYTIC STATISTICS: Longitudinal analysis
1.0 Describe and illustrate time series analysis
2.0 Describe and illustrate the basics of survival analysis.
CASE #6:
PHILOSOPHY, CONCEPTS, ETHICO-LEGAL-FIQH ISSUES: Animal research:
1.0 Describe ethical guidelines on handling animals before, during, and after research: kindness and good treatment, forbidding cruelty, nutrition, minimize pain, respect even in death.
2.0 Discuss the purposes of animal research: spare humans from risk, the doctrine of taskhiir.
3.0 Discuss how purposes and principles of the Law apply to animal research.
4.0 Discuss the relevance of animal research to humans citing opposing views on the mater: similar physiology, findings not definitive human research still needed
5.0 Discuss guidelines on the choice of which animals to use in research: edible vs. non-edible, pets, wild vs. domestic, big vs. small, dangerous vs. innocuous.
PERSONAL SKILL DEVELOPMENT: Negotiation skills:
1.0 Describe the nature and purpose of win-win negotiation: purpose, elements of success, conducive, circumstances, interests and concessions, multi-issue negotiation, alternatives to win-win.
2.0 Describe negotiation strategies: winning strategy, negotiation power.
3.0 Describe negotiation tactics: aggressive, friendly, evasive, provocative, risk taking, incremental approach, brinkmanship.
4.0 Describe the management of a negotiation session: commitment, personal relations, self discipline and self control, learn the other side, planning a strategy, phases and agenda setting, demands and offers, narrow differences, final bargaining, persuasion, implementation and follow up.
5.0 Describe difficult negotiations: win-lose, deadlock.
PROFESSIONALISM: Professional misconduct:
1.0 Describe violation of licensing and registration regulations: specialist practice without certification.
2.0 Discuss promises of wonder cures.
CASE #7:
PHILOSOPHY, CONCEPTS, ETHICO-LEGAL-FIQH ISSUES: Human research:
1.0 Briefly describe the history of research on humans: historical evolution, historical ethical violations.
2.0 Describe the phases of clinical trials: 1,2,3, and 4.
3.0 Discuss the ethico-legal-fiqh implications of the distinction between therapeutic and non-therapeutic research.
4.0 Define the term good clinical practice guidelines.
5.0 Describe the application of autonomy / informed consent in research: research on humans, research on records, postmortem research.
6.0 List information items given to research subjects before consent: the treatment, available information, missing information necessitating research, difference between the new and the standard treatments, alternative treatments, risks and benefits, measures to ensure safety.
7.0 Discuss ethico-legal-fiqh guidelines on the freedom to withdraw from research.
8.0 Discuss ethico-legal-fiqh guidelines on material inducements for research subjects.
9.0 Describe confidentiality in research: anonymized data, personal details disclosed with consent.
STUDY DESIGN AND ANALYSIS:
1.0 Describe the processes of sample selection and data collection.
2.0 Define the 3 types of observational studies: cross-sectional study; case control study; follow-up / cohort study.
CASE #8:
PHILOSOPHY, CONCEPTS, ETHICO-LEGAL-FIQH ISSUES: research
1.0 Describe ethico-legal-fiqh guidelines for research on the mentally incompetent.
2.0 Describe ethico-legal-fiqh guidelines for research on Children: consent by competent children endorsed by parents, parental consent for incompetent children, children’s physiological vulnerability, parental consent for research in child’s interest. Parental consent for research not in the child’s interests, benefits, risks, child overriding parental consent.
3.0 Describe ethico-legal-fiqh guidelines on inclusion of women and minorities in clinical research.
4.0 Describe ethico-legal-fiqh guidelines on research on the elderly.
5.0 Describe ethico-legal-fiqh guidelines on research on prisoners.
6.0 Describe ethico-legal-fiqh guidelines on research on students and employees.
7.0 Describe ethico-legal-fiqh guidelines on research on members of uniformed services, army and police (consent vs. obeying chain of command).
PERSONAL SKILL DEVELOPMENT: Leadership:
1.0 Describe basic characteristics of effective leadership.
2.0 List personal attributes of leaders.
3.0 List conceptual leadership skills.
4.0 List technical leadership skills: (communication, decision making, planning and execution, team leadership, motivation, conflict resolution, maintaining relations).
5.0 List human skills of leaders: concern, respect, compassion etc.
6.0 Briefly describe the careers of model leaders in medicine.
7.0 List diseases of leaders: personality, and poor human relations.
8.0 List diseases of followers: hypocrisy, insincerity, bad advice for leader, flattery.
PROFESSIONALISM: Malpractice & negligence.
1.0 Define negligence/malpractice.
2.0 List the Ingredients of a negligence suite.
3.0 List methods of avoiding negligence suits.
CASE #9:
PHILOSOPHY, CONCEPTS, ETHICO-LEGAL-FIQH ISSUES:
1.0 Describe ethico-legal-fiqh guidelines on research on cadavers.
2.0 Describe ethico-legal-fiqh guidelines on research on biological samples.
3.0 Describe ethico-legal-fiqh guidelines on research on organs, and tissues from living donors: informed consent if not anonymous, storage of material, benefits and risks, confidentiality.
4.0 Describe ethico-legal-fiqh guidelines on research on organs and tissues from dead donors: consent by family, storage, confidentiality.
STUDY DESIGN AND ANALYSIS:
1.0 Define randomized community studies
2.0 Define randomized clinical studies
3.0 Define health surveys
CASE #10:
PHILOSOPHY, CONCEPTS, ETHICO-LEGAL-FIQH ISSUES:
1.0 Describe ethico-legal-fiqh guidelines on research on embryos: sources of embryos, types of disease that benefit.
2.0 Describe ethico-legal-fiqh guidelines on research on fetal tissues: spontaneous abortions, induced abortions, financial inducements.
PROFESSIONALISM: Malpractice & negligence.
1.0 Describe the standard of care according to the Bolam principle as modified by Bolitho.
CASE #11:
PHILOSOPHY, CONCEPTS, ETHICO-LEGAL-FIQH ISSUES:
1.0 Describe ethico-legal-fiqh guidelines on record-based research.
STUDY INTERPRETATION:
1.0 Define and illustrate measures of association: T test, F test, and the chi square.
2.0 Define and illustrate measures of effect: risk ratio and odds ratio.
CASE #12:
PHILOSOPHY, CONCEPTS, ETHICO-LEGAL-FIQH ISSUES:
1.0 Describe ethico-legal-fiqh guidelines on biomedical research.
PROFESSIONALISM: Malpractice & negligence.
1.0 Describe ethico-legal-fiqh guidelines on record-based research.
2.0 Discuss patient complaint / grievance system as a tool to prevent malpractice.
CASE #13:
PHILOSOPHY, CONCEPTS, ETHICO-LEGAL-FIQH ISSUES:
1.0 Describe ethico-legal-fiqh guidelines on public health research.
2.0 Describe ethico-legal-fiqh guidelines on health services research.
STUDY INTERPRETATION:
1.0 Describe sources of bias & treatment of bias in epidemiological studies: selection bias: misclassification bias; confounding bias.
3.0 SEMESTER 1
PROFESSIONAL AND PERSONAL DEVELOPMENT (PPSD) FOR YEAR 2 Semester 1 2008-2009
Year 2 Semester 1: CASE 1: PUAN FATIMAH (Hypertension) 06-08-08
REVIEW OF THEORIES AND PRINCIPLES OF MEDICAL ETHICS: ethical theories
1.0 List the 5 purposes of the Law.
2.0 List the most commonly used European theories of ethics.
ETHICO-LEGAL-FIQH APPLICATIONS IN CLINICAL PRACTICE
1.0 Describe salat hajj, and puasa in dyspnea due to cardiovascular causes
RESEARCH SKILLS
1.0 Describe the simple logistic regression.
2.0 Describe the multiple logistic regressions
3.0 Interpret the result of multiple logistic regressions.
YEAR 2: SEMESTER 1: CASE 2: PAK CIK AHMAD (Myocardial infarction) 13-08-08
REVIEW OF THEORIES AND PRINCIPLES OF MEDICAL ETHICS: ethical principles
1.0 List Islamic principles of ethics
2.0 List European principles of ethics according to Childress and Beauchamp
ETHICO-LEGAL-FIQH APPLICATIONS IN CLINICAL PRACTICE
1.0 Describe puasa in case of congestive cardiac failure
PERSONAL DEVELOPMENT AND PROFESSIONALISM
1.0 Describe the ideals of physician competence, responsibility, and accountability.
2.0 Explain ethical guidelines for the doctor-patient relationship: compassion, competence, disclosure & truthfulness, confidentiality, etiquette of the patient, bedside visit, uncovering awrat, interaction with the opposite gender, interaction with the family.
YEAR 2: SEMESTER 1: CASE 3: AWANG ROSLI HJ. JUMAAT (Syncope) 20-08-08
REVIEW OF THEORIES AND PRINCIPLES OF MEDICAL ETHICS: consent for competent patients
1.0 Define and discuss patient autonomy.
2.0 Define physician autonomy.
ETHICO-LEGAL-FIQH APPLICATIONS IN CLINICAL PRACTICE: Respiratory disorders
1.0 Discuss the performance of religious obligations (salat, hajj, and puasa) for patients with dyspnea due to respiratory causes (pneumothorax, pulmonary embolism, chronic bronchitis, emphysema)
RESEARCH SKILLS
1.0 Describe survival data and survival data analysis.
2.0 Describe, analyze and interpret the following: survival curve, survival rate, median-survival time.
3.0 Describe, analyze and interpret the comparison of survival curves
YEAR 2: SEMESTER 1: CASE 4: AMJIT SINGH (Tuberculosis) 27-08-08
REVIEW OF THEORIES AND PRINCIPLES OF MEDICAL ETHICS: consent for competent patients
1.0 Discuss informed consent: definition and process.
2.0 Describe the scope of consent.
3.0 Discuss the conditions for validity of consent
ETHICO-LEGAL-FIQH APPLICATIONS IN CLINICAL PRACTICE
1.0 Discuss ethico-legal issues of isolation, contact tracing, and immunization for cases with contagious respiratory infections.
PERSONAL DEVELOPMENT AND PROFESSIONALISM
1.0 Discuss the following fidelity obligations: patient-doctor contract, dual obligations: (army, police, prisons, sports, factory, school & university, conflict of duties and conflict of interests).
2.0 Discuss ethico-legal issues in dealing with disabled patients
YEAR 2: SEMESTER 1: CASE 5: RAFFIUDDIN RAHMAN (Blood transfusion) 03-09-08
REVIEW OF THEORIES AND PRINCIPLES OF MEDICAL ETHICS: consent for competent patients
1.0 Discuss the type of information for informed consent (diagnosis, prognosis, treatment alternatives, risks and benefits).
ETHICO-LEGAL-FIQH APPLICATIONS IN CLINICAL PRACTICE
1.0 Discuss ethico-legal issues that arise in the treatment of anemic patients.
2.0 Discuss ethico-legal issues in treatment of patients with coagulation disorders.
RESEARCH SKILLS: Data presentation:
1.0 Describe three ways of data presentation: text, tabulation, and graph and describe the application of each type of presentation.
2.0 Outline the data presentation of descriptive statistics.
3.0 Describe the comparison of means
4.0 Describe the comparison of proportions
5.0 Describe linear regression
6.0 Describe logistic regression
YEAR 2: SEMESTER 1: CASE 6: NORHAYATI ABDULLAH (Multiple myeloma) 10-09-08
REVIEW OF THEORIES AND PRINCIPLES OF MEDICAL ETHICS: consent for competent patients
1.0 Discuss competence / capacity: definition and conditions.
2.0 Discuss capacity to consent: global vs. specific, tests for capacity, and enhancing capacity.
3.0 Describe the process of consent / refusal for the competent
ETHICO-LEGAL-FIQH APPLICATIONS IN CLINICAL PRACTICE
1.0 Discuss ethico-legal-fiqh issues relating to managing patients with lymphoma
PERSONAL DEVELOPMENT AND PROFESSIONALISM: Professional etiquette with the terminally ill/dying: palliative care.
1.0 Discuss ethico-legal-fiqh issues relating to the terminally ill / dying: comfort, hygiene, alleviation of pain, acts of worship, legal preparation, spiritual preparation.
YEAR 2: SEMESTER 1: CASE 7: AIRWAN AHMAD (HIV) 17-09-08
REVIEW OF THEORIES AND PRINCIPLES OF MEDICAL ETHICS: consent for the incompetent
1.0 Discuss consent / refusal for the incompetent: young children, older children, the mentally ill, the unconscious.
ETHICO-LEGAL-FIQH APPLICATIONS IN CLINICAL PRACTICE
1.0 Discuss ethico-legal-fiqh issues in sexually transmitted disease: pre-marital screening, condoms for sexually active teenagers, confidentiality in treatment, partner tracing and notification.
RESEARCH SKILLS: Writing a research report (Methods):
1.0 Outline the contents of method section with regards to sampling, sample size, and statistical analyses
YEAR 2: SEMESTER 1: CASE 8: SUFRI HIDUP (Eczema) 24-09-08
REVIEW OF THEORIES AND PRINCIPLES OF MEDICAL ETHICS: consent for the incompetent
1.0 Discuss consent in emergencies: competent patient but no time for consent, incapacitated patients, resuscitation after attempted suicide, carrying out an unauthorized / unfamiliar procedure to save life.
2.0 Discuss ethico-legal-fiqh issues relating to refusal of emergency treatment by a competent / incompetent person.
3.0 Discuss ethico-legal-fiqh issues relating to advance refusal of resuscitation.
ETHICO-LEGAL-FIQH APPLICATIONS IN CLINICAL PRACTICE
1.0 Discuss fiqh issues relating to treatment of skin disorders: eczema, psoriasis, etc.
PERSONAL DEVELOPMENT AND PROFESSIONALISM: Professional etiquette with the terminally ill/dying:
1.0 Discuss fiqh issues relating to death, mourning, and bereavement.
YEAR 2: SEMESTER 1: CASE 9: AHMAD HJ IRSHAD (shoulder dislocation) 08-10-08
REVIEW OF THEORIES AND PRINCIPLES OF MEDICAL ETHICS: consent for the incompetent
1.0 Discuss ethico-legal issues relating to forensic /police issues (search of unconscious patients, disclosure of emergency room information to the police, forensic searches of emergency patients: blood alcohol levels, domestic violence and child abuse in ER).
ETHICO-LEGAL-FIQH APPLICATIONS IN CLINICAL PRACTICE
1.0 Discuss ethico-legal issues relating to orthopedic problems: sprains & fractures, orthopedic fixation, osteomyelitis, malignant bone neoplasms (salat, hajj, work-related injury, workmen compensation, factory work with tremors, physical activity, rest, and sleep).
RESEARCH SKILLS
1.0 Critical appraisal: Appraise statistical issues in quantitative research.
YEAR 2: SEMESTER 1: WEEK 10: HASHIMA HASHIM (hip fracture)
REVIEW OF THEORIES AND PRINCIPLES OF MEDICAL ETHICS
1.0 Discuss ethico-legal issues relating to medical practice by an off-duty doctor in an emergency.
ETHICO-LEGAL-FIQH APPLICATIONS IN CLINICAL PRACTICE
1.0 Discuss social and religious obligations for patients with osteoporosis and myasthenia.
2.0 Discuss social and religious obligations for patients with laryngeal, pharyngeal, or oral disease.
3.0 Describe how an immobilized patient can perform ablution.
4.0 Describe 3 ways in which an immobilized patient can pray.
PERSONAL DEVELOPMENT AND PROFESSIONALISM
Collegial relations / etiquette in a health team:
1.0 Discuss principles of successful group work.
2.0 Discuss general and special group dynamics.
3.0 Discuss the ideal student-teacher relation.
4.0 Illustrate the need for mutual respect and cooperation
YEAR 2: SEMESTER 1: WEEK 11: HARUN SALLEH (esophageal cancer)
REVIEW OF THEORIES AND PRINCIPLES OF MEDICAL ETHICS
1.0 Discuss ethico-legal issues relating to admission of relatives into ER.
ETHICO-LEGAL-FIQH APPLICATIONS IN CLINICAL PRACTICE: alimentary disorders
1.0 Discuss the impact on wudhu, salat, and puasa of the following GIT conditions: nausea, vomiting / hematemesis, peptic ulcer.
RESEARCH SKILLS
1.0 Define the main steps in the epidemiologic research process, including research problem identification, literature review, research framework development, research question and hypothesis formulation, appropriate design strategy selection, protocol development, preparation and pilot study, data collection, data management, data analysis, report writing, and report dissemination.
YEAR 2: SEMESTER 1: WEEK 12: MARY NURAMELIA O’SULLIVAN ABDULLAH (Celiac disease)
REVIEW OF THEORIES AND PRINCIPLES OF MEDICAL ETHICS: Decisions on medical interventions in the absence of informed consent:
1.0 Describe the physician assessment of best interests of the patient in deciding for the incompetent.
2.0 Describe the use of proxy decision makers.
3.0 Describe advance statements
ETHICO-LEGAL-FIQH APPLICATIONS IN CLINICAL PRACTICE
1.0 Discuss the impact on wudhu, salat, and puasa of the following GIT conditions: rectal bleeding, incontinence, and fistulae.
PERSONAL DEVELOPMENT AND PROFESSIONALISM: Collegial relations / etiquette in a health team:
1.0 Describe techniques of conflict resolution in a healthcare team.
2.0 Explain how whistle blowing can deter unethical behavior.
3.0 Discuss guidelines for cooperation with traditional healers.
YEAR 2: SEMESTER 1: WEEK 13: JENNY AND LI SOON ZIN (Hepatitis)
RESEARCH SKILLS
1.0 Compute the sensitivity and specificity of the screening test.
2.0 Compute the false positive and the false negative proportions for the screening test.
3.0 Compute the positive predictive value (PV+) and the negative predictive value (PV-) for the test.
4.0 Describe the main principles, methods, advantages, disadvantages, and applications of the main types of epidemiologic study, including case reports, case series reports, cross-sectional surveys, longitudinal descriptive studies, ecological studies, cross-sectional analytic studies, case-control studies, cohort studies, field trials, and clinical trials.
5.0 Discuss the design, under supervision, epidemiologic studies that are suitable as SSM2 or SSM3 projects.
YEAR 2: SEMESTER 1: WEEK 14: AWANG MOHSIN (bladder cancer)
REVIEW OF THEORIES AND PRINCIPLES OF MEDICAL ETHICS
1.0 Discuss consent to treatment by the court.
2.0 Discuss ethico-legal issues in treatment options with economic and other considerations.
ETHICO-LEGAL-FIQH APPLICATIONS IN CLINICAL PRACTICE
1.0 Discuss ethico-legal issues associated with chronic renal failure.
2.0 Discuss fiqhi issues associated with urinary incontinence, fistulae, and catheters.
3.0 Discuss fiqhi issues relating to renal colic.
RESEARCH SKILLS (Review)
1.0 Describe the main principles, methods, advantages, disadvantages, and applications of the main types of epidemiologic study, including case reports, case series reports, cross-sectional surveys, longitudinal descriptive studies, ecological studies, cross-sectional analytic studies, case-control studies, cohort studies, field trials, and clinical trials.
4.0 SEMESTER 1
PROFESSIONAL AND PERSONAL SKILL DEVELOPMENT for Year 2 Semester 2 2008-2009
YEAR 2 SEMESTER 2 2008-2009: CASE 1: KHAIRUL HAJI JUMAAT (Spinal injuries)
REVIEW OF ETHICAL PRINCIPLES: Privacy and confidentiality
1.0 Privacy (definition, relation to patient autonomy). Confidentiality (definition, what information is considered confidential, anonymized information, violation with / without consent, disclosure about the deceased)
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
CASE ANALYSIS
RESEARCH SKILLS
1.0 Measures of incidence (incidence number, incidence rate, cumulative incidence, surrogate measures).
YEAR 2 SEMESTER 2 2008-2009: CASE 2: MOHAMMAD DAUD (Hearing loss)
REVIEW OF ETHICAL PRINCIPLES: Basis / rationale for confidentiality
1.0 Basis / rationale / justification of confidentiality (clinical care. Autonomy and privacy, fidelity, social basis, legal basis).
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
Sensory system: Blindness and deafness (salat, hajj, court testimony, marital contracts, civil contracts, financial contracts, leadership, judgeship, employment). Olfactory disorders (wudhu, salat, halitosis in puasa, use of perfume in public). Taste disorders (selling and buying food). Tactile disorders (work accidents). Temperature disorders (heat stroke in hajj, salat and puasa in extreme temperatures, work accidents). Pain disorders: headache (salat in extreme pain, dyspareunia and marital stress). Hunger and thirst (delay of salat for hunger, puasa with extreme hunger/thirst).
Practical: visits to the eye, ENT, and pain clinics.
CASE ANALYSIS
PERSONAL DEVELOPMENT AND PROFESSIONALISM
1.0 Abuse of privileges (unethical research, unnecessary treatment, iatrogenic infection, misuse of controlled drugs, false documentation). Private misconduct derogatory to the profession (sexual transgression, abuse of trust, violence and felonies). Financial misconduct (kick-backs and fee splitting, conflict of interest). Felonies.
YEAR 2 SEMESTER 2 2008-2009: CASE 3: Pg Hjh KAMARIAH Pg Hj IBRAHIM (Stroke)
REVIEW OF ETHICAL PRINCIPLES: truthfulness
1.0 Truthfulness (obligation to tell the truth, information patient does not need/want to know, partial disclosure / white / technical lies, giving bad news, the physician’s body language)
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
CASE ANALYSIS
RESEARCH SKILLS
1.0 Prevalence (point prevalence, period prevalence, lifetime prevalence, uses of prevalence, limitations of prevalence for etiological studies, relation between prevalence and incidence).
YEAR 2 SEMESTER 2 2008-2009: CASE 4: Hajah SALMAH MOKSIN (Cranial nerve palsies)
REVIEW OF ETHICAL PRINCIPLES: Disclosure
1.0 Disclosure (by the patient, with consent for education, research, and insurance; without consent to other healthcare professionals and in the public interest)
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
CASE ANALYSIS
Background
Awg Mohsin had bladder cancer causing intermittent hematuria. He did not want to miss his prayers but yet he believed that any blood would nullify his ablution. He went to the hospital with the sole objective of getting the doctors to stop the blood. At the hospital, a detailed history was taken and extensive investigations were carried out. No one seemed to pay attention to his concern about prayers. They treated him with radiotherapy and asked him to come back for follow-up. He did not understand the purpose of the treatment. When he realized that hamaturia continued despite the treatment he saw no reason to return to the hospital for follow up.
Discussion issue
Describe how a patient with intermittent hematuria can pray.
PERSONAL DEVELOPMENT AND PROFESSIONALISM
1.0 Conflict of financial interests (physician as a manager, occupational physician employed by the company, sports physician). Dealing with the pharmaceutical industry. Un-ethical business practices.
YEAR 2 SEMESTER 2 2008-2009: CASE 5: Hjh SA’ADIAH AHMAD (Parkinson Disease)
REVIEW OF ETHICAL PRINCIPLES: Conflict of duties
1.0 Conflict of duties regarding confidentiality and disclosure to: insurance, employer, HIV, witness in litigation (with consent, without consent)
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
CASE ANALYSIS
RESEARCH SKILLS
1.0 Rates & proportions (crude, specific, and standardized). Measures of excess disease occurrence (OR, RR, RD, and AR; difference between OR and RR, concept of the null value).
YEAR 2 SEMESTER 2 2008-2009: CASE 6: ZALEHA ABDUL HAMID (Postpartum depression)
REVIEW OF ETHICAL PRINCIPLES: Disclosure of family / genetic information
1.0 Disclosure of family history / genetic information (by the patient vs. by the physician, request by the employer, request by the police)
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
CASE ANALYSIS
PERSONAL DEVELOPMENT AND PROFESSIONALISM
1.0 Violation of Licensing and registration (specialist practice without certification). Promises of wonder cures.
YEAR 2 SEMESTER 2 2008-2009: CASE 7: CATHERINE NG (Multiple Sclerosis)
REVIEW OF ETHICAL PRINCIPLES: Medical records
1.0 Generation and handling of medical records (SOAPIE, various forms of records, ideal record, omitting or removing information, legal ownership of records, ensuring record security, period of retention of records, patient access to records, access to records of the incompetent, issues in storage and retrieval of records)
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
CASE ANALYSIS
RESEARCH SKILLS
1.0 Diagnostic tests (TP, TN, FP, FN, sensitivity, specificity, predictive value, ROC).
YEAR 2 SEMESTER 2 2008-2009: CASE 8: JOANA LIM (intra-uterine development and abnormalities & SB)
REVIEW OF ETHICAL PRINCIPLES: Disclosure to the media
1.0 Disclosure to the mass media (public vs. individual interest).
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
Neonatal and infant conditions. Congenitally abnormal fetid / infants: anencephaly, spina bifida, hydrocephalus (delivery time: before or at term, delivery method: vaginal or Caesarean, CPR at birth, long-term life support).
CASE ANALYSIS
PERSONAL DEVELOPMENT AND PROFESSIONALISM
1.0 Definition of negligence/malpractice. Ingredients of a negligence suite. Avoiding negligence suits.
YEAR 2 SEMESTER 2 2008-2009: CASE 9: NURUL JANNAH IBRAHIM (Child development, cerebral palsy)
REVIEW OF ETHICAL PRINCIPLES: Disclosure by doctors with dual obligations
1.0 Disclosure by doctors with dual obligations: occupational, army, police, prisons, sports, hospital manager (with consent, without consent)
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
Yr2 S2 #9
Child conditions. Yr2 S2 #8
Pre-natal diagnosis / screening / genetic testing/treatment (indications, methods, test performance, counseling pre and post, informed consent, risks and benefits, relation to abortion, human rights of the embryo/fetus).
CASE ANALYSIS
RESEARCH SKILLS
1.0 Screening tests (definition, types, methods, suitable disease, suitable test, evaluation, cost benefit analysis, ethical issues). Parameters of screening tests (false positive, false negative, sensitivity, specificity, predictive value)
YEAR 2 SEMESTER 2 2008-2009: CASE 10: MUHD FIKRI ABDULLAH (Multiple miscarriage and TOP)
REVIEW OF ETHICAL PRINCIPLES: Physician as a witness in court
1.0 Physician in court: as a witness of facts vs. expert witness (duty to patient vs. public duty to justice, testifying for vs. testifying against the patient).
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
Reproductive system 1: normal conditions: Menstruation (salat, puasa, recitation, use of hormones to delay menses in Ramadan and hajj, activities allowed/prohibited during menstruation). Pre-menstrual tension (impact on social and religious obligations). Irregular menstruations in the climacteric period (impact on salat, puasa, sexual life). Prolonged menstruation (puasa, salat, coitus). Dysmenorrhea (salat). Menopause (definition, early induction medically or surgically, artificial delay, HRT).
Induced abortion (maternal disease, unwanted pregnancy, gender selection, congenital anomalies)
CASE ANALYSIS
PERSONAL DEVELOPMENT AND PROFESSIONALISM
1.0 The standard of care: Bolam principle as modified by Bolitho.
YEAR 2 SEMESTER 2 2008-2009: CASE 11: NORA SULAIMAN (pregnancy with complications of GDM)
REVIEW OF ETHICAL PRINCIPLES: Fidelity obligations
1.0 Fidelity obligations (patient-doctor contract, dual obligations: army, police, prisons, sports, factory, school & university, conflict of duties and conflict of interests).
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
Human sexuality & sexual behavior (forms sexual expression and behavior, regulation of human sexuality, guidelines on coitus, moral/cultural relativism regarding sexual behavior). Pregnancy (legal minimum and maximum duration). Prenatal screening & diagnosis genetic/non-genetic (benefits & risks, non-therapeutic abortion, human rights of the embryo).
CASE ANALYSIS
RESEARCH SKILLS
1.0 Time series analysis (patterns and trends, forecasting, longitudinal regression, auto-regression, auto-correlation).
YEAR 2 SEMESTER 2 2008-2009: CASE 12: NUR SUHADA AMEER (Childbirth, Caesarean Section)
REVIEW OF ETHICAL PRINCIPLES
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
Labor (puasa and salat). Delivery (autonomy in choice of method, refusal of CS, request for CS, maternal-fetal conflict). Postnatal care (iqamat and adhan at birth, naming, aqiiqat). Breast-feeding (duration, foster feeding). Practical: visits to gynecological and ante-natal clinics.
CASE ANALYSIS
PERSONAL DEVELOPMENT AND PROFESSIONALISM
(12) Patient complaint / grievance system as a tool to prevent malpractice.
YEAR 2 SEMESTER 2 2008-2009: CASE 13: Hajah SALMAH AWANG YUSOF
REVIEW OF ETHICAL PRINCIPLES
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
Women and maternal conditions.
CASE ANALYSIS
RESEARCH SKILLS
Review descriptive statistics
5.0 SEMESTER 1
PROFESSIONAL AND PERSONAL SKILL DEVELOPMENT FOR Year 3 Semester 1 2008-2009
YEAR 3 SEMESTER 1 2008-2009 CASE 1: LEONE COOPER (PID, contraception, and reproductive technology)
ETHICO-LEGAL-FIQH PRINCIPLES:
1.0 List the composition and functions of an Institutional Ethical Review Board.
2.0 List the potential types of fraud in research.
3.0 describe measures of avoiding research fraud
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
1.0 Explain the difference in legal consideration between contraception as a choice of a couple and contraception as public policy.
2.0 Explain circumstances in which female contraception is allowed even if the husband refuses.
3.0 List and explain guidelines on choice of contraceptive methods.
4.0 List and describe allowed male contraceptive methods.
5.0 List and describe allowed female contraceptive methods.
6.0 Explain the legal position about contraception out of marriage.
7.0 Explain the legal position regarding sterilization
8.0 Explain how easy availability of contraception causes sexual promiscuity.
9.0 List and explain demographic effects of wide-spread contraceptive use.
10. Discuss ethico-legal issues related to assisted reproduction.
11. Discuss ethico-legal issues related to stem cell and embryo research.
12. Discuss ethico-legal guidelines on genetic technology.
RESEARCH SKILLS
1.0 Explain the role of Sample Size Determination.
2.0 List and describe advantages and disadvantages of various sources of secondary data.
3.0 List and describe 4 methods of questionnaire administration with the advantages and disadvantages of each.
4.0 Summarize the principles of data management and data analysis.
YEAR 3 SEMESTER 1 2008-2009 CASE 2: TARA DEVI RAI (uterine bleeding) 09-08-08
ETHICO-LEGAL-FIQH PRINCIPLES
1.0 Describe ethico-legal guidelines on handling research animals.
2.0 Discuss the purposes and relevance of animal research to human disease.
3.0 Discuss ethico-legal guidelines for choosing animals for research.
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
1.0 Discuss ethico-legal issues in use of HRT to treat menopausal disorders.
2.0 Discuss ethico-legal and fiqh issues in dysfunctional uterine bleeding.
PERSONAL DEVELOPMENT AND PROFESSIONALISM
1.0 Discuss the concepts and theories of communication.
2.0 List and explain practical guidelines for successful small group communication.
YEAR 3 SEMESTER 1 2008-2009 CASE 3: MILTON JOHNSON (prostate cancer) 14-08-08
ETHICO-LEGAL-FIQH PRINCIPLES
1.0 Briefly describe the history of human research including ethical violations.
2.0 Describe the phases of a clinical trial.
3.0 Distinguish between therapeutic and non-therapeutic research.
4.0 Explain what you understand by the term GCP.
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
1.0 Discuss ethico-legal issues in palliative care.
2.0 Discuss the definition and criteria of brain death.
3.0 Discuss ethico-legal guidelines on initiating / withdrawing artificial life support.
4.0 Discuss ethico-legal guidelines on euthanasia and physician assisted suicide.
5.0 Discuss ethico-legal guidelines on solid organ transplantation.
6.0 Discuss ethico-legal issues regarding postmortem examination.
7.0 Discuss ethico-legal issues on dissection of cadavers and their use in research.
RESEARCH SKILLS
1.0 Review practical aspects of data management.
2.0 Review practical methods of data summary and inference for epidemiologic analysis.
YEAR 3 SEMESTER 1 2008-2009 CASE 4: HAJAH SITI AISHAH BAKAR (ageing, osteoporosis)
ETHICO-LEGAL PRINCIPLES
1.0 Discuss autonomy / informed consent for research on humans, research on records, postmortem research.
2.0 List types of information given to patients before consent.
3.0 Discuss the research subject’s rights to withdraw from research.
4.0 Discuss ethico-legal issues relating to material inducements for research subjects.
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE: Osteoporosis and HRT
1.0 Describe how geriatric physical dysfunction (musculoskeletal, senses, nutrition) affect religious obligations (taharat, wudhu, salat, puasa, hajj).
2.0 Describe how geriatric psychoneurological conditions and dementias affect the following social and religious obligations: civil and financial transactions, salat, puasa, hajj.
3.0 Describe guidance on how to deal with the following geriatric psychosocial dysfunctions: depression, dependency/loss of self esteem, sexual dysfunction, poor quality of life, and impaired ability to carry out civil transactions.
4.0 Discuss in general rights and obligations in geriatric disabilities.
5.0 Discuss ethico-legal guidelines for research on the elderly.
PERSONAL DEVELOPMENT AND PROFESSIONALISM
1.0 Discuss the purposes and types of written communications: letters, office memos, papers, reports, and manuals.
2.0 List the characteristics of good writing.
3.0 Discuss the special characteristics of medical/technical writing.
4.0 List specific guidelines for writing and publishing a paper.
5.0 Discuss problems in writing.
YEAR 3 SEMESTER 1 2008-2009 CASE 5: AWANG SELAMAT TUAH (psychosis, schizophrenia)
ETHICO-LEGAL PRINCIPLES
1.0 Discuss ethico-legal issues regarding confidentiality in clinical research.
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
1.0 Discuss the impact of personality disorders on social and religious obligations.
2.0 Discuss the impact of psychiatric conditions on social and religious obligations.
3.0 Discuss stigmatization in psychiatric conditions.
4.0 Describe the main provisions of the Brunei Lunacy Act 1984.
5.0 Discuss issues related to psychosurgery and ECT for some psychiatric conditions.
6.0 Discuss issues of confidentiality in psychiatric conditions
RESEARCH SKILLS
1.0 Describe the study design, execution, analysis, strengths and weaknesses of cross sectional studies.
2.0 Describe the study design, execution, analysis, strengths and weaknesses of case control studies.
3.0 Describe the study design, execution, analysis, strengths and weaknesses of follow up studies.
YEAR 3 SEMESTER 1 2008-2009 CASE 6: CHRISTOPHER NORRIS (substance abuse)
ETHICO-LEGAL PRINCIPLES
1.0 Discuss ethico-legal issues of research in emergency rooms.
2.0 Discuss ethico-legal issues of research on the mentally incapacitated.
3.0 Discuss issues relating to inclusion of women and minorities in research.
4.0 Discuss ethico-legal issues of research on the elderly.
5.0 Discuss ethico-legal issues of research on prisoners.
6.0 Discuss ethico-legal issues of research on students and employees.
7.0 Discuss ethico-legal issues of research on members of uniformed services.
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
1.0 List and discuss ethico-legal issues related to substance abuse.
PERSONAL DEVELOPMENT AND PROFESSIONALISM: Communication
1.0 Describe public speaking: purposes, elements, the message, delivery, the audience.
2.0 Explain approaches to dealing effectively with the mass media.
3.0 List the strengths and weaknesses of various media.
4.0 Describe the impact of media on health-related KAP.
YEAR 3 SEMESTER 1 2008-2009 CASE 7: ANTHONY WILLIAM (headaches, anxiety, depression, suicidal thoughts)
REVIEW OF ETHICO-LEGAL-FIQH PRINCIPLES
1.0 Discuss the following ethico-legal issues relating to research on children: consent by competent children endorsed by parents, parental consent for incompetent children, children’s physiological vulnerability, parental consent for research in child’s interest, parental consent for research not in the child’s interests, the benefit-risk ration, and child overriding parental consent.
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE: Psycho-social conditions:
1.0 Discuss the legal impact of loss of competence on religious, social, and civil obligations.
2.0 Describe human drives and the genesis of emotions: positive and negative.
3.0 Discuss ethico-legal issues relating to anxiety disorders.
4.0 Discuss ethico-legal issues relating to stress.
5.0 Discuss ethico-legal issues relating to depression and suicide / para-suicide.
6.0 Discuss ethico-legal issues relating to psychogenic sexual disorders.
7.0 Discuss ethico-legal issues relating to neurotic / anxiety / compulsive-obsessive disorders.
RESEARCH SKILLS: Study design and analysis:
1.0 Describe the design, execution, and analysis of community randomized studies.
2.0 Describe the design, execution, and analysis of clinical trials.
3.0 Describe the used of meta-analysis.
YEAR 3 SEMESTER 1 2008-2009 CASE 8: STEPHANIE MORGAN (Huntington’s chorea)
REVIEW OF ETHICO-LEGAL PRINCIPLES
1.0 Discuss the ethico-legal issues relating to research on: biological samples, organs, and tissues from living or dead donors.
2.0 Discuss ethico-legal issues relating to research on embryos and fetal tissues.
3.0 Discuss ethico-legal issues relating to biomedical research, public health research, and health services research.
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL PRACTICE
1.0 Discuss ethico-legal-fiqhi issues relating to loss of consciousness.
2.0 Discuss ethico-legal-fiqhi issues related to stroke.
3.0 Discuss ethico-legal issues related to epilepsy.
4.0 Discuss ethico-legal issues related to Parkinson disease.
5.0 Discuss ethico-legal issues related to Senile dementias.
6.0 Discuss ethico-legal issues related to brain tumors.
7.0 Discuss ethico-legal issues related to brain / skull trauma.
8.0 Discuss ethico-legal issues related to spinal cord injury.
9.0 Discuss ethico-legal issues related to aphasic disorders.
10. Discuss ethico-legal issues related to vestibular disorders.
11. Discuss ethico-legal issues related to peripheral / diabetic neuropathy.
12. Discuss ethico-legal issues related to limb disorders.
13. Discuss ethico-legal issues related to involuntary movements.
PERSONAL DEVELOPMENT AND PROFESSIONALISM: Negotiation:
1.0 Describe the nature and purpose of win-win negotiations.
2.0 Discuss negotiation strategies and tactics.
3.0 Describe principles of successful management of a negotiation session.
4.0 Describe what is meant by difficult negotiations.
6.0 SEMESTER 1
Year 3 Semester 2 Medical PPSD 2008 2009 LOB1
CASE #1:
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL APPLICATIONS: Blood and endocrine and others:
LOB1
1.0 Describe ethico-legal-fiqh issues of patho-physiological disturbances: fever, dehydration, infections: wudhu, salat, hajj, civil and financial transactions.
2.0 Describe ethico-legal-fiqh issues of hematological disorders: anemia, leukemia, lymphoma, coagulation disorders.
3.0 Describe ethico-legal-fiqh issues of skin disorders: eczema, psoriasis, SLE, etc.
4.0 Describe ethico-legal-fiqh issues of diabetes mellitus (pasa).
RESEARCH SKILLS: Study interpretation
1.0 Review measures of association: t test; F test; chi square.
CASE #2:
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL APPLICATIONS: Locomotion, support, and connective system:
LOB1
1.0 Describe ethico-legal-fiqh issues of orthopedic problems such as sprains & fractures, orthopedic fixation, osteomyelitis, osteoporosis, malignant bone neoplasms: salat, hajj, work-related injury, workmen compensation, factory work with tremors, physical activity, rest, and sleep.
2.0 Describe ethico-legal-fiqh issues of limb disorders: salat and hajj.
3.0 Describe ethico-legal-fiqh issues of gait disorders (salat and hajj).
4.0 Describe ethico-legal-fiqh issues of involuntary movements: chorea, athetosis, spasticity etc: salat, hajj, work with moving machinery, driving, accidents in activities of normal living.
5.0 Describe ethico-legal-fiqh issues of myasthenia gravis: salat, puasa, hajj).
6.0 Describe ethico-legal-fiqh issues of joint disorders with restricted/painful movements:
LEADERSHIP SKILLS:
1.0 List and illustrate basic characteristics of effective leadership.
2.0 List and illustrate Personal Attributes of leaders.
3.0 List and illustrate Conceptual leadership skills.
4.0 List and illustrate Technical leadership skills: communication, decision making, planning and execution, team leadership, motivation, conflict resolution, maintaining relations.
5.0 List and illustrate Human skills of leaders: concern, respect, compassion etc.
6.0 Briefly describe the careers of some model leaders in medicine.
CASE #3:
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL APPLICATIONS: Locomotion, support, and connective system:
LOB1
1.0 Describe ethico-legal-fiqh issues of osteoarthritis and rheumatoid arthritis: tayammum if cold exacerbates the pain, salat, hajj, risk-benefit analysis of chronic pain medication, addiction to analgesics and opiates.
2.0 Describe ethico-legal-fiqh issues of vertebral column pain: spondylosis, intervertebral disease, spondyloisthesis, ankylosing spondylitis, root compression, etc: salat, hajj.
3.0 Describe ethico-legal-fiqh issues of laryngeal, pharyngeal, or oral disease: recitation of Qur’an, public duties like judging, leadership, and court testimony.
RESEARCH SKILLS: Study interpretation
1.0 Define and illustrate measures of effect: risk ratio and odds ratio.
2.0 Discuss the Odds ratio: (properties, advantages, disadvantages, interpretation).
CASE #4:
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL APPLICATIONS: Input/output systems: alimentary and urinary:
LOB1
1.0 Describe ethico-legal-fiqh issues of upper GIT conditions: nausea, vomiting / hematemesis, peptic ulcer: wudhu, salat, pausa.
2.0 Describe ethico-legal-fiqh issues of lower GIT conditions: rectal bleeding, incontinence, fistulae: wudhu, salat, puasa, and hajj.
3.0 Describe ethico-legal-fiqh issues of chronic renal failure: dialysis, renal transplantation.
4.0 Describe ethico-legal-fiqh issues of urinary incontinence, fistulae, and catheters: wudhu, salat, and hajj.
5.0 Describe ethico-legal-fiqh issues of renal colic: salat, hajj.
LEADERSHIP SKILLS:
1.0 Describe and illustrate diseases of leaders: personality cult and poor human relations.
2.0 Describe and illustrate diseases of followers: hypocrisy, insincerity, bad advice for leader, flattery.
CASE #5:
ETHICO-LEGAL-FIQH ISSUES IN CLINICAL APPLICATIONS: Transport systems: cardiovascular & respiratory:
LOB1
1.0 Describe ethico-legal-fiqh issues of dyspnea due to cardiovascular causes: salat, hajj, puasa.
2.0 Describe ethico-legal-fiqh issues of dyspnea due to respiratory causes: pneumothorax, pulmonary embolism, chronic bronchitis, emphysema: salat, hajj, and puasa.
3.0 Describe ethico-legal-fiqh issues of congestive cardiac failure: puasa.
RESEARCH SKILLS: Study interpretation
1.0 Describe and illustrate selection bias.
CASE #6:
ETHICO-LEGAL-FIQH ISSUES IN PSYCHOSOCIAL APPLICATIONS:
LOB1: Discuss health-related problems related to gender discrimination
1.0 Describe the family as a natural social unit.
2.0 Describe the fiqh aspects of marriage.
3.0 Describe fiqh guidelines for parents and relatives.
4.0 Describe ethico-legal-fiqh issues of child protection: definition of child protection, limits to parental rights, state intervention to protect children.
MANAGEMENT SKILLS:
1.0 Describe and illustrate strategy.
2.0 Describe and illustrate methods of planning, and implementation.
3.0 Describe and illustrate control and evaluation.
4.0 Describe and illustrate quality assurance/quality improvement.
CASE #7:
ETHICO-LEGAL-FIQH ISSUES IN PSYCHOSOCIAL APPLICATIONS:
LOB1
1.0 Describe the concept of culture: definition, relativism, relation to personality, ethnocentrism.
2.0 Define and illustrate the concept of trans-cultural ethics.
3.0 List and describe elements of a life-style: essentials of life, dress and ornamentation, entertainment, social failure.
4.0 Describe various forms of sexual perversion: background, antecedents, adverse effects, prostitution, abnormal coital behaviors, sexual paraphilias, and criminal sexual aggression, abnormal marital arrangements.
5.0 Describe ethico-legal-fiqh issues of unwanted pregnancy: (determinants and causes, adverse effects, relation to abortion, alternatives to abortion, prevention and mitigation).
RESEARCH SKILLS: Study interpretation
1.0 Define and illustrate misclassification bias.
CASE #8:
ETHICO-LEGAL-FIQH ISSUES IN PSYCHOSOCIAL APPLICATIONS:
LOB1
1.0 Describe ethico-legal-fiqh issues of addiction and substance abuse: nicotine, drugs, alcohol (causes, prevention and treatment, rehabilitation.
2.0 Discuss issues of poverty and its impact on health.
3.0 Discuss violence in society.
4.0 Describe ethico-legal-fiqh issues of child abuse & neglect: definition and classification of abuse, sexual exploitation, child protection, best interests, physician reporting /non-reporting of abuse to authorities: benefits and risks.
5.0 Describe ethico-legal-fiqh issues of women discrimination.
MANAGEMENT SKILLS
1.0 Describe decision-making: principles, process, and steps of rational decision making.
2.0 Describe problem-solving: principles, process, and steps of rational problem solving.
3.0 Describe crisis management: definition, stages, identification, isolation, and intervention.
CASE #9:
ETHICO-LEGAL-FIQH ISSUES IN PSYCHOSOCIAL APPLICATIONS:
1.0 Describe and illustrate the following forms of community action: enjoining the good and forbidding the bad, health promotion, social change, professional and occupational organizations, social welfare, disaster relief, refugees.
RESEARCH SKILLS: Study interpretation
1.0 Define and illustrate confounding bias.
CASE #10:
ETHICO-LEGAL-FIQH ISSUES IN PSYCHOSOCIAL APPLICATIONS:
LOB1
1.0 Describe health-related ethico-legal issues in marital contracts: selection of a spouse, forbidden spouses, marriage contract conditions, conjugal rights and responsibilities.
2.0 Describe fiqh issues of divorce & annulment: divorce in menstruation and pregnancy, purposes of post-divorce waiting period.
3.0 Describe ethico-legal-fiqh issues in inheritance.
4.0 Discuss fiqh guidelines on endowments & gifts.
MANAGEMENT SKILLS
1.0 Describe techniques and uses of economic analysis in health: terminology, CBA, CEA, and CUA.
2.0 Describe ethical issues in health policy: allocation of health resources, preventive vs. curative medicine, justice.
3.0 Discuss ethical issues in health care financing: reasons for high cost of medical care, managed care, waste control, cost control.
4.0 Discuss ethical issues in health services delivery: barriers, access and poverty.
CASE #11:
ETHICO-LEGAL-FIQH ISSUES IN PSYCHOSOCIAL APPLICATIONS:
LOB1:
1.0 Describe ethico-legal-fiqh issues in occupational health: Pre-employment testing (infectious disease, addiction to drugs and alcohol, genetic, psychological).
2.0 Describe ethico-legal-fiqh issues in health examination and testing during employment: purposes, disclosure to employer, sick leave, random test for drugs, removal of hazards.
RESEARCH SKILLS: Study interpretation
1.0 Define and illustrate interaction and effect modification.
2.0 Describe and illustrate validity and precision (internal and external).
CASE #12:
ETHICO-LEGAL-FIQH ISSUES IN PSYCHOSOCIAL APPLICATIONS:
LOB1:
1.0 Discuss ethico-legal-fiqh issues of legal competence: ahliyyat
MANAGEMENT SKILLS
1.0 Describe basics of organizational management: organizational design, structure, culture, and development; recruitment, placement, and maintenance of personnel; job design, description, and assignment; advantages & disadvantages of specialization; training process, advantages and disadvantages of delegation, worker appraisal.
CASE #13:
ETHICO-LEGAL-FIQH ISSUES IN PSYCHOSOCIAL APPLICATIONS:
LOB1
1.0 Describe ethico-legal-fiqh issues regarding public health measures in an epidemic without consent: quarantine, isolation, mass immunization, mass treatment.
2.0 Describe ethico-legal-fiqh issues regarding disease screening and surveillance.
3.0 Describe ethico-legal-fiqh issues regarding control of infectious disease: control and eradication, infectious disease control Act.
4.0 Describe ethico-legal-fiqh issues regarding vaccination / immunization: cost benefit analysis.
RESEARCH SKILLS: Study interpretation
1.0 Illustrate critical appraisal of epidemiological studies.
2.0 Illustrate critical appraisal of clinical trials.
CASE #14:
ETHICO-LEGAL-FIQH ISSUES IN PSYCHOSOCIAL APPLICATIONS: HIV
LOB1
1.0 Describe ethico-legal-fiqh issues regarding HIV testing: premarital testing, voluntary testing, counseling, confidentiality.
2.0 Describe ethico-legal-fiqh issues regarding HIV prevention: free condoms in schools, sterile needles for IV drug users.
3.0 Describe ethico-legal-fiqh issues regarding HIV victimization: discrimination in employment, immigration, and healthcare.
MANAGEMENT SKILLS
1.0 Describe basics of organizational financial management
2.0 Describe and illustrate health information management systems: definition of MIS, types and structure of databases, information dissemination, privacy and confidentiality.