Final work including essential skills integration - Part III, Integrated module

Complex problem solving

Each cARP session concerns a discipline and targets an illustrative complex clinical situation. General medicine

Gyneco-obstetrics

Neurology

Anesthesia-resuscitation

Internal medicine (cardiology)

Internal medicine (gastro)

Physiotherapy/physical medicine

Pediatrics

Palliative care

Geriatrics

Health organization and societal medicine

Notes: the student workbook and all course information can be found on eCampus.

Four large-group courses are included in your timetable.

Between these classes, you will meet in small groups (limited number of students per group), accompanied by a medical tutor with an interest in palliative medicine, to discuss and reflect on your professional/placement experiences (based on your own input) and develop your professional and expert skills in particular. There will be 4 meetings of 1h30 for each small group.

These large and small group sessions are MANDATORY, as you'll understand: a large number of speakers and your tutors, all of whom are involved in palliative medicine, will leave their professional practice to accompany you in your training, participate in the development of your medical and professional skills, and discuss the ethical issues you'll encounter in this particular field of palliative care.

These small-group meetings are an opportunity made available to you by your teachers.

You choose the composition of the groups: we suggest that you register now for one of the small groups listed on eCampus. Please register (deadline mentioned in the letter you receive at the beginning of the year and on the eCampus page).

IMPORTANT: Your group will not change for subsequent sessions. There will therefore be NO possibility of changing groups at a later date (the group formed will get to know each other, build on each other and exchange ideas over 4 sessions in the delicate field of end-of-life care. It is important to preserve the composition and trust of each group, without changing it). The dates of the 3 subsequent meetings of the small group will be fixed between you.

Palliative medicine small group meetings take place outside class hours, during internship periods. You are authorized to leave your internship to attend these meetings. You can use eCampus to send a letter to your department head at the beginning of the month, excusing your absence (and a certificate of attendance signed by your tutor, to be given to the department head afterwards).

The ULiège Quality of Student Life department (contact details on eCampus) is also available to help you with any difficulties you may have in tackling the difficult and complex subject of end-of-life care. As a future healthcare professional, it's important to work on the more personal difficulties you may be experiencing. We encourage you to do so, for greater serenity in the future. Don't hesitate to talk to your tutor and teachers..

Complex problem solving

The integration of ARPc sessions within the professionalization process has a number of objectives: to enable students to appreciate the complexity of medical action, and the value of networking and recourse to other health professionals. At this stage of training, the aim is also to highlight the limits of medical action and the need to manage the doubts that arise when dealing with complex situations.

Integrated therapy

Be aware of therapeutic resources, organised around frequent and important issues for any future doctor

Be able to critically analyse the complete drug treatment of a clinical situation of low to moderate complexity and, if necessary, make the decision to start, adapt or stop a drug treatment

Health organization and societal medicine

The objectives of the Palliative Care program are for students to:
1) to become aware ... 
2) develop a personal and collective response ...
3) discuss and question ...
4) adapt their thinking in the light of interactions...
5) demonstrate prior learning...
in the following areas of Palliative Care : 
 
- notions of curative, supportive and ongoing palliative care
- breaking bad news
- palliative and curative treatments: therapeutic intent
- family dynamics in crisis situations
- delimitation of care
- advance declaration of euthanasia
- suffering of caregivers, patients and families
- addressing the patient's and family's experiences
  
- prevention, diagnosis and treatment of symptoms such as :
- cachexia/anorexia
- hyperthermia
- asthenia
- dehydration
- nausea
- adapt drug administration routes to suit the clinical situation and context
- principles, advantages and disadvantages of palliative radiotherapy
o when, for what problem?
o management of side effects
 
- Oncological pain

specific features of the history and clinical examination of oncological pain
pharmacological approaches to oncological pain (non-opioids, co-analgesics / opioids - adjuvants)
management of complex pain problems
- Parenteral and enteral nutrition

- operation of a hospital palliative care team

- organization of a home supportive care team

- end-of-life sedation

- legal aspects of the decriminalization of euthanasia

- management of euthanasia in hospital and at home

- requesting euthanasia

The learning objectives described above define the common framework targeted by the course, with students at different levels (on a continuum) in each area

Complex problem solving

knowledge and internships between BAC 1 and Master 2

Integrated therapy

To have followed the specific pathology modules organised since the BAC3, including pathology and therapeutics matters

Health organization and societal medicine

Acquired knowledge from Bac 1 to Master 2.

Internships during Master 3.

Complex problem solving

Students are divided into working sub-groups, accompanied by a discipline-specific tutor.

The ARPc begins with a role-playing sequence in which the tutor takes the patient's place. During this 20-minute sequence (sequence 1), which is generally very lively, students explore the patient's complaints and the context in which they arise.

Sequence 2 is devoted to analyzing the scenario. A document containing all the anamnestic data, the results of the clinical examination and complementary investigations is distributed to the students. The group works independently, supported by the tutor. The tutor's role is limited, essentially ensuring that all teaching objectives are met in the form of formulated and listed questions.

During Sequence 3, the members of each student group split up and share the task of meeting with experts who can answer their unanswered questions. The tutor attends one or other of the meetings with the experts, without intervening.

The objectives of the 4th sequence are to synthesize the information received, and to develop ideas for the overall management of the patient. The groups, once again reconstituted, operate independently. However, the tutor plays a more active role, providing supervision, correcting any misunderstandings or inaccuracies in the reports from the meetings with the experts, and contributing his or her expertise when consensus is difficult to reach within the group.

Integrated therapy

to be translated

Health organization and societal medicine

Thursday 10/17/24
1:30 pm 4:30 pm
Introduction and organization of the Palliative Medicine program
Dr CH. Serre Pr V. Bonhomme
Prof. G. Jerusalem

Lesson 1: Introduction to patient-physician relationships
ACP - PIC
Communication with patients suffering from incurable diseases
CH Serre, Mrs L. Peternelj, Mrs Hardy
A Dessard

between Fri 18/10/2024 and Wed 06/11/24 Meeting n° 1 with the tutor, in small groups
Your date (required): ..................................
Thursday 07/11/24

Amphi ROSKAM 1:30 pm - 4:30 pm Symptom management in the hospi
Managing symptoms at home
Caregivers' experience and suffering
video on caregiver suffering (interview with Dr Salmon, onco and Dr Ariane Simon, MG)

DELTA G. Jerusalem,
D. Giet
A. Dessard

between Fri 08/11/24 and Wed 27/11/24
Meeting n°2 with the tutor, in small group
Your date (to be chosen by the group): ..................................

Thursday 28/11/24
Amphi Théâtre Dick Annergarn in B8 1:30 pm - 4:30 pm Course no. 3: Pain management
V. Bonhomme

between Fri 29/11/24 and Wed 11/12/24
Meeting n°3 with the tutor, in small group
Your date (to be chosen by the group): ..................................

Thursday 12/12/24
1:30 pm - 4:30 pm
Course n°4: Euthanasia and end of life
D. Giet
Ch-H Serre
A. Rorive

after Fri 13/12/24
Meeting n°4 with the tutor, in small group
Your date (to be chosen by group): ..................................

Complex problem solving

Face-to-face course


Further information:

Face-to-face mode. 

Integrated therapy

Blended learning


Additional information:

The preparation part includes watching educational videos  focused on therapeutic subjects and accomplishing a distance learning test on these subjects (via e-campus).


The integrated modules will be either face-to-face or distance learning. Group work and plenary sessions will take place either on site or via videoconference platforms.

The Psychiatric Therapeutics module is delivered face-to-face as an ex-cathaedra course.

Health organization and societal medicine

Face-to-face course


Further information:

The 4 large-group courses take place in a lecture hall, face-to-face.

The 4 small-group meetings with a tutor take place in a small room, face-to-face. The location is determined by the tutor. This location and the 1st meeting date can be found on ecampus.

Complex problem solving

Some ARPc offer additional non-compulsory reading. These resources are posted on eCampus

Integrated therapy

The main resources of the modules are the support documents for the educational videos, as well as the other resources (addendum, articles, web links) offered in the e-campus space of each integrated module.


Below are other useful resources for any future doctor:

• http://www.cbip.be/fr/start
• https://farmaka.cbip.be/fr/formulaire-p-a)
• https://www.inami.fgov.be/fr/publications/Pages/reunions-consensus-rapports-jury.aspx
• https://www.cbip.be/fr/chapters/12?frag=8000010
• https://organesdeconcertation.sante.belgique.be/fr/documents/recommandations-de-traitements-anti-infectieux-en-milieu-hospitalier-2017-integral
• http://www.prescrire.org/Fr/169/753/0/0/About.aspx
• https://www.cybele.be/CybeleF/index.htm#t=introfr%2Fintrozw_f.htm
• http://e-lactancia.org/
• http://lecrat.fr/

Health organization and societal medicine

Platform(s) used for course materials:
- eCampus


Further information:

All the information needed for the course is available on eCampus.

All communications to students are posted on eCampus and/or sent by email (student.uliege).

A student workbook containing all course information is posted on eCampus (in addition to the eCampus sections).

Complex problem solving

Exam(s) in session

Any session

- In-person

oral exam

Continuous assessment


Further information:

ARPc contributes to the basic medical training of medical students and to the integrated end-of-cycle assessment (competency exam).

ARPc sessions alone do not lead to an assessment.

Attendance at ARPc sessions is compulsory.

The deliberation jury takes this into account.


Weighting:

ARPc - attendance grade only = .. %.
Health organization and societal medicine = .. %.

Integrated therapy

Exam(s) in session

Any session

- In-person

written exam ( multiple-choice questionnaire )

Continuous assessment


Additional information:

Examination material: the resources (video clips, PPT slides, articles, addenda) made available for the 5 integrated modules (gynaeco-obstetrics, paediatrics, internal medicine 1 and 2, geriatrics) and the psychiatry module and the material discussed during the debriefing of each integrated module

The final grade, as announced at the beginning of the year:

25% related to your activities in each module: 2 points for QRMs answered remotely on e-campus (pass threshold at 70% before the module, or 90% after the module or in case of failure at the first attempt) and 3 points for attendance and completion of analysis concept maps (remotely with validation from module coordinators); 75% related to a written exam: 55 QRMs with 4 proposals covering the subjects concerned by the examination (above), on the same model as those offered throughout the year in preparation for the modules on e-campus

At the end of each module, you will be informed of your activities (QRM and presence in group work) by the provision of a summary excel file for these 2 activities, with the possibility of reacting to them; it will not be possible to return to them at a distance from the modules

A personalised message will be sent to each student so that he/she can find out, before the written exam, the points obtained via the activities carried out during the integrated modules.

Health organization and societal medicine

Exam(s) in session

Any session

- In-person

written exam ( open-ended questions )


Further information:

The course is assessed at the end of the academic year in the form of a short open response question (QROC). The question consists of a clinical story that you are asked to analyze. It addresses the themes described in the objectives above and dealt with in the large-group classes and small-group discussions. Following the presentation of the clinical story, you will be asked a series of questions.

Note that each year you will be tested on your knowledge of the law on the decriminalization of euthanasia (fundamental notions for all doctors).

All integrated with the other courses of the M3 "return" days:



Regarding the weighting:

ARPc - attendance grade only = .. %
Health organization and societal medicine, including a palliative care QROC = .. %

The weighting will be communicated on eCampus as soon as possible.



A sample question can be found in the student workbook on eCampus.

 

Complex problem solving

The internship experience is to be integrated into the comprehensive and complex patient care submitted during the ARPc session.

Complex problem solving

Students must be punctual at the various stages of the ARPc. In fact, the tutors and experts who support students' learning are professionals who take time away from their function to benefit the students.

Health organization and societal medicine

All necessary and useful information for students can be found in the student handbook and on eCampus (the handbook can be found on eCampus).

Complex problem solving

General coordination of ARPc sessions: Department of General Medicine of the University of Liège
Professor D. Giet
pedagogical counselor : Valérie Massart
Coordinating secretary: Stéphanie Jérôme sjerome@uliege.be

Integrated therapy

For general coordination
Jean Luc Belche jlbelche@uliege.be
Régis Radermecker r.radermecker@uliege.be
For administrative topics: Stéphanie Jérôme, Department of General Medicine sjerome@uliege.be

Health organization and societal medicine

The teachers in charge are :
Professor V. Bonhomme
Professor D. Giet
Professor G. Jérusalem

Pedagogical support: V. Massart v.massart@uliege.be

Health organization and societal medicine

Slides pain management cancer patient - 23/22/2023
Slides of the lecture given on 23/11/2023

Theorietical sheets for pain management in palliative care
These theoretical sheets are meant to provide the theoretical basis for pain management in palliative care. They should be studied in preparation to the lecture that will be given on December 15, 2022. The lecture will consist in clinical reasoning learning, based on conrete clinical examples.