Basis of Disease

Course Director: Gerardo Guiter, MD

Associate Directors: Chris Triggle, PhD

Associate Course Director: Shahinaz Bedri, MBBS

Staff Support: bst@qatar-med.cornell.edu

Course Overview

Basis of Disease is an integrated organ systems-based course that encompasses pathophysiology, gross and microscopic pathology, pharmacology, abnormal radiology, and clinical microbiology. The On-Site (OSF) faculty is drawn from the Department of Medical Education. Our specialties include pathology, pharmacology, family medicine, pediatrics, and internal medicine. The course synthesizes basic science and clinical information about the entire body to promote both the acquisition of fundamental knowledge and the development of diagnostic and reasoning skills. The teaching modalities utilized emphasize active student participation. Important features are the problem-based analysis sessions. This is done in three modalities: PBL sessions, clinical case discussions, and laboratory sessions on gross and microscopic pathology. Computer-based educational and research tools are integral to the sessions and also enhance many other activities; included among these resources is the Virtual Microscopy collection.

Course Objectives

Learning objectives will be distributed for each module of BOD. For some modules, the objectives are general and apply to the entire block; for others, the objectives are specific to each lecture or class exercise.

Knowledge:
  • Describe the normal functions of the organ systems as well as the pathological processes that affect them. These include genetic abnormalities, vascular derangements, inflammatory/infectious and neoplastic processes, anatomical derangements, and autoimmune processes.
  • Comprehend the impact of pathology on organ function, i.e. pathophysiology.
  • Understand the basis of pertinent radiological, laboratory and molecular studies used in defining the pathophysiology resulting from the underlying pathologic process(es).
  • Understand the pharmacological rationale for treatments and medications used in treating a disease or disease process.
  • Analyze clinical, laboratory, radiological, and pharmacological data to achieve a logical synthesis of a patient problem.
  • Understand the etiology of diseases and disorders (e.g. genetic, developmental, toxic-metabolic, infectious, autoimmune, degenerative, neoplastic, traumatic and behavioral causes)
  • Understand the clinical, laboratory, radiographic and pathologic manifestations of major diseases and disorders.
Skills:
  • Ability to formulate accurate hypotheses about the causes and solutions of medical problems, to develop strategies for exploring these problems, and to achieve reasoned conclusions.
  • Ability to search, retrieve and utilize from electronic databases and other resources, biomedical information that is useful and relevant for problem-solving and decision-making.
  • Ability to critically analyze original biomedical data and secondary data in the medical literature with special emphasis on the evaluation of the appropriateness of methodological design, statistical analysis, and data interpretation.
  • Ability to select appropriate tests for screening and evaluation and diagnosis; and to interpret results of common screening tests, diagnostic procedures and laboratory data.
Attitudes:
  • Honesty and integrity in all interactions and activities with colleagues and others, and in the collection, synthesis, analysis, and presentation of scientific and clinical data.
  • Acceptance of, collaboration with, and respect for colleagues.
  • Maintenance of a professional demeanor in one’s work and as a role model for society including the demonstration of an attitude that values timely attendance, punctuality and reliability in the performance of one’s duties.
  • Commitment to a scholarly approach to medical problems and recognition of the need to continually improve knowledge and skills through lifelong self-directed study.
  • Willingness to educate colleagues and other health professionals.
Course Organization
  1. Lectures

    Lectures are theoretically limited to six per week. They deal with key topics in both the basic science and clinical areas and, in general, have been chosen to introduce important concepts. Lecturers have been selected for their expertise in particular subjects. Lectures may be:

    1. Live, offered by on-site faculty, visiting faculty from WCM in NY, or by WCM-Q faculty at Hamad Medical Corporation.
    2. Video-streamed
    3. Live video lectures offered by WCM faculty in NY.

  2. Problem-Based Learning (PBL) Sessions:

    The PBL cases have a central role in Basis of Disease. The cases have been selected with the objective of focusing attention on issues underlying fundamental principles. Emphasis is on application of logical reasoning and critical thinking to understand clinical presentation and aid in differentiating diagnostic possibilities. There will be little emphasis on treatment selection. Creativity in presenting information is encouraged. Each PBL case has 2-3 sessions. It is the students’ responsibility to take the initiative, with the Tutors serving as a facilitator of the students’ activities. The usual procedure is for the Tutors to distribute a part of the case, which a student then reads aloud. The students then discuss the important issues that they need to inform themselves about in order to analyze the case. When the discussion appears to be complete, another section of the case is distributed and read, and so on. At the end of the first session, the students draw up a list of learning objectives to guide their preparation for the following session. Learning objectives are the prerogative of the students, not of the facilitator or the author of the case.

  3. Laboratories and Small Group Sessions

    Clinical Case Discussions (CCD). These small group sessions are conducted by a faculty member with expertise in the particular content area. The exercises consist of clinical vignettes written to highlight important pathophysiologic principles and to develop clinical reasoning skills. They are not intended to be studies in therapy or treatment. The 2-hour long interactive sessions will be conducted in Seminar rooms to be assigned.

    Pathology laboratories. These sessions teach gross and microscopic (histopathology) pathology on an organ-system basis. Integral to the study of histopathology is the VMS, the computer-based digitized collection of over 400 histopathology and cytology images. Similar to the CCD exercises, the exercises consist of clinical vignettes written to highlight basic pathologic principles and to integrate then with underlying pathophysiology.

    Post-Lecture Videoconferences (PLVC) PLVCs are designed to give students access to those NY faculty who give the video-streamed lectures. The NY faculty welcome this opportunity. The structure of the PLVCs is variable and some of that variability is determined by the individual faculty members participating. Nevertheless, it is your responsibility to maximize the educational opportunity.

Course Content

The course has been organized into 10 modules:


BOD-1 BOD-2 BOD-3
Cardiology GI/Hepatobiliary Rheumatology
Pulmonary Endocrine Hematology/Oncology
Renal Reproduction Infectious Diseases
Dermatology

Within each module, the teaching is shared by a number of clinical and basic science departments, including Medicine, Pathology, Radiology, Dermatology, Pediatrics, Gynecology, Surgery, and Pharmacology. The course content includes material contained within traditional Pathophysiology and Pathology courses, and required and recommended texts have been selected from just such sources. The course organization has been designed specifically to enable examination of problems that cut across traditional disciplines and thus approximate clinical problem solving.

Difficult Topics

Each module will contain a “difficult topic”. This focus is intended as a respite from the survey character of the course. The extra attention will likely include a timely journal article plus additional background reading. The difficult topic may be taken up in any format. The module quizzes will be expanded to include up to three additional questions on this difficult topic.

Quizzes

An hour quiz, every module, will be used as an objective assessment of the student's comprehension of the material, including the material from the PBL cases. Material from the lab sessions will be included and there may be slides or other materials used for identification of material presented in pathology and radiology sessions. The quizzes are usually scheduled on the day after a module ends. If a student fails a module quiz (< 65%), he/she must pass the make-up examination.

Triple Jump Examinations (TJE)

At the end of each six weeks of the course, students will undergo an examination based on a case similar to those discussed in the PBL sessions. The exam consists of three parts: a written analysis of the case, overnight independent study, and an oral exam. The written analysis portion will utilize actual VMS images whenever practical. The exams are composed by the module leaders for the course section: BOD-1 -- heart, lung, and kidney; BOD-2 –GI/Liver, endocrine/reproduction; and BOD-3 – rheumatology, hematology, infectious diseases, and dermatology. These exams will be conducted after the last quiz for the relevant modules in that block.

PBL Performance Assessment

Each facilitator for the PBL sessions will assess each student's skills and attitudes on the basis of attendance, participation in discussions, and quality of contribution.

Course Grades

The final grade in the course is based on the following components:

  1. Exams
    • Weekly quizzes
    • Triple Jump Examinations
  2. Analytical skills and professional attributes
    • PBL
Grading Process

The grades assigned at the end of the course are Honors (approximately top 20% of the class), Pass (65% or above in each of the above components), Marginal (65% or above for the overall course grade but below 65% in any one or more of the above components) and Failure (below 65% for the overall course grade). A Marginal grade will require remediation of each of the individual components that were below 65%; a Failure will require remediation of all components. The remediation will consist of further study and/or examination, as determined by the Course Director, to be completed at a time specified in the Academic Calendar. Failure of remediation of any component will result in a grade of Failure for the course as a whole, which will require appropriate further remediation as indicated in the Guidelines for Promotion and Graduation.



Last modified on Monday, 18-Jan-2016 11:16:04 +03