Basic Principles of Medicine III

Revision 7th January, 2020

This version will supersede any previous editions of this document. The university reserves the right to change or amend the rules and regulations at any time. The new rules and regulations will be applicable to all students registered on the course.

How do we define participation in course activities?

For all onsite activities, participation is defined as full engagement for the whole duration of the academic activity at the scheduled time and venue and answering all participation questions provided through the audience response system. 

For all online activities, participation is defined as full engagement for the whole duration of the academic activity at the scheduled time on the appropriate Zoom session and answering all participation questions through the audience response system. Note that different students in the class may be scheduled at different times, your scheduled time is the only one that counts for your participation. If you miss an activity do not ask to be placed at a later time, this will not be permitted because students at the last session of the day do not have this opportunity.

All Wi-Fi enabled electronic devices must be registered to the user for use on campus. The Wi-Fi connection of your registered devices to the SGU internet will be used along with the participation data from the audience response system to verify your presence in teaching facilities. Using a device not registered to you may result in you loosing participation credit. Misrepresentation of participation records using another person’s device is unprofessional behavior and will result in academic penalties outlined in the Unprofessional Behavior section of the syllabus. 

SGU expects that students enrolled in the MD program demonstrate 100% participation in all scheduled activities. Participation below 100% means you are failing to meet our expectations, additionally, if your participation falls below 80% there are academic consequences. 

* These activities are mandatory, and a score must be achieved for every assessment. Without scores in all of the listed examinations and assessments, a passing course grade cannot be assigned, and a course grade of F will be registered at the end of term. A score of zero will be retained for any exam that is missed and not subsequently completed on the scheduled completion date.

** All activities must be fulfilled to the required performance, participation, and professionalism standards to earn these 10 points. Any single event activity must be remediated before a course grade can be earned. Participation in any element <80% may incur an additional professionalism penalty (up to 10% of the total course points per incidence). <70% participation in any of the multiple event activities subject to the 80% participation requirement will result in an incomplete grade that will be converted to an F at the end of term. For events where participation is recorded using the audience response system, all questions in the session must have a recorded response to earn credit for the session. Late submission of any mandatory assignments will result in a reduced professionalism grade (see unprofessional behavior section).

*** Maximum of 10 points available .

Note: For any activity in which the audience response system is used, participation credit is only awarded for full participation in all polled questions. Some activities (e.g., IMCQs) have an additional performance requirement standard (i.e.  all questions are answered with at least 50% correct) in order to earn points associated with the activity.

**** In addition to the lectures, ITI students need to participate in 80% of their scheduled ITI sessions. There is a 1-hour ITI session scheduled to cover 2 lectures and to earn the participation credit for the ITI session you must participate for the entire 1-hr session. 

The final course grade is calculated by converting the course points obtained by the student into a percentage. The student manual outlines the grading scales used in the SOM. 

To pass the BPM502 course a minimum of 205.4 points is required, corresponding to a percentage score of 72.50%. In addition, all relevant assessment and participation criteria must be fulfilled. 

***** Mandatory Advising Meeting

After the APRC meetings, students who have not performed will receive an email regarding the attendance to a mandatory advising with an academic advisor from AADS.  Failure to attend will result in loss of Participation and Professionalism points.

ONSITE DELIVERY

Live onsite course activities are delivered by course faculty in predetermined venues. Venues will be available in the course schedule and on Sakai. All lectures, small groups, IMCQ’s and ITI sessions are delivered live onsite. 

ONLINE DELIVERY

Synchronous course activities use a live online platform for delivery. The live online platform is used for all lectures, small groups, IMCQ’s, ITI sessions and faculty office hours. It is important that you sign into the Zoom platform using the application (not the browser version) and sign in using the SGU SSO – see link below for instructions.

ZOOM

https://www.iorad.com/player/1657673/SGU-Zoom---How-to-Sign-in-with-SSO

Additional guidance for online delivery of course requirements is given from IT/OIA in the following link:

RESOURCES FOR LEARNING REMOTELY FOR STUDENTS

https://mycourses.sgu.edu/access/content/group/7a7ac639-acc5-4f33-b106ae0778aabff6/TeachingLearningRemotely/LearningRemotely.html https://mycampus.sgu.edu/office-of-institutional-advancement/Training-Resources

For all technical support for course delivery at home please contact support@sgu.edu see link below https://www.sgu.edu/office-of-information-technology/it-support/

Computer requirements for the course and examinations are outlined in the above link under Examplify guidelines from Examination Services. 

TIME ZONE:

All live activities will follow the time zone in Grenada (Atlantic Standard Time GMT -4) with no summertime adjustment in Grenada.

CLASS SCHEDULE

Class schedules can be found on the Office of the University Registrar’s page (under Student Departments Tab).

 https://mycampus.sgu.edu/group/oep-registrar/academic-class-schedules

GRADING

Any errors in scores for formative assessments or participation data that are displayed in the Sakai gradebook must be reported to the Course Director within 48 hours of their publication. Errors reported later than this will not be considered for correction. You will not be able to query participation scores once modules are completed. 

Any errors in summative course assessment that are displayed in the Sakai gradebook must be reported to the Course Director within 24 hours of their publication. Errors reported later than this will not be considered for correction. 

For all online proctored examinations, the published scores are preliminary at the time of publication; course penalties may apply if a subsequent investigation demonstrates a failure to comply with examination regulations or the online proctoring requirements. For Online Assessments, where results are immediately accessible upon submission, errors must be reported before the submission deadline.   

CONTACT DETAILS

Please direct all queries to:

sombpm3@sgu.edu

The Basic Principles of Medicine III (BPM3) course is an 8-credit course taught over 6 weeks in Term 3 of the Doctor of Medicine (MD) program of St George’s University School of Medicine, Grenada. The core aim of this course is to equip physicians with the knowledge and skills to understand fundamental principles inherent to a future understanding and diagnosis of microbial infections; devise and utilize strategies that improve the health of entire communities and populations and help reduce health inequities among population groups; and to uphold standards of ethics and professionalism expected across North America. A broad range of microbial, immune, and environmental factors and conditions that have a strong influence on human health are considered and discussed. Medical professionalism and associated attitudes and behaviors expected of physicians in much of the world are introduced, and opportunities are provided for students to develop skills and competencies with which to meet those expectations including critical and independent thinking. The ethical principles and duties of physicians, and beginning and end of life issues are examined, as are fundamental concepts of law that interface with ethical decision making. Core public health assessment tools such as biostatistics and epidemiology are introduced, including techniques for design and interpretation of medical research. The role that human behavior, the environment, and politics play in influencing health in different societies is considered. Finally, a biopsychosocial approach to patient care is introduced, and the role cultural factors play within doctor-patient encounters discussed and examined.

The BPM3 course is sub-structured into four thematic areas:

1. Ethics, Professionalism and Medical Jurisprudence: A survey of bioethics introduces research ethics, public health ethics, medical and clinical ethics, professional ethics, and the professional responsibilities of today’s physicians. These responsibilities derive from professional knowledge, attitudes, and practices involved in clinical medicine, medical research, and disease prevention, surveillance, and control. They stem from the medical profession itself, and from fundamental concepts of law and ethics related to the medical profession and doctor-patient relationships. Specific topics addressed include environmental health ethics, physician impairment, social and community ethics, patient autonomy and informed consent, beginning of life issues and termination of pregnancy, and end-of-life decisions. Fundamental concepts of law and ethics that relate to the medical profession are discussed, along with issues bearing on physician professionalism and boundary crossings.  Societal trust and related concerns involving the regulation of medical practice are emphasized along with basic principles of patient privacy, confidentiality, medical malpractice and liability.
2. Basics of Immunology and Microbiology: Microorganisms are the single most significant contributor to human health and disease worldwide. The Basics of Immunology and Microbiology component focuses on presenting the fundamental principles of microorganisms in the context of their interaction with humans as the core knowledge necessary for effective and efficient diagnosis and treatment of infectious diseases. The course begins with an overview of microbial groups, introduction of some common pathogens, their features, replication strategies and basic mechanisms of pathogenesis. In parallel the key immunological principles will be discussed. This will facilitate cross-linkage and a more in-depth understanding of the body’s natural defense mechanisms against infectious agents. Examples of immune system failure will be presented in the context of diversity of the infectious disorders and some primary immunodeficiency syndromes. This compound knowledge will allow students to understand how microbial growth and pathogenicity could be controlled through the use of therapeutic compounds combined with physical and chemical control methods. The detail as to the specific microbial infections that result from human-microbial interactions will be covered in PCM500 (Term 4).
3. Public Health Assessment Tools: Basic biostatistics concepts and tools are introduced, which will enable physicians to understand and critically examine the medical literature.  Core concepts in clinical epidemiology, preventive medicine and evidence-based medicine that are most relevant to physicians are taught. Emphasis is on recognizing patterns of disease occurrence and disease outcomes in human populations and using such information to 1) inform diagnosis and treatment strategy in patient care; and to 2) foster application of ethically and scientifically sound principles in community intervention.  Quantitative topics are enhanced with clinical examples from the medical literature, providing a transition from research findings to care of individual patients. The ways in which human behavior, the environment, and politics influences health in different societies are also considered. An international comparison of health systems is provided, and factors underlying existing disparities in healthcare is explored.  Current issues in healthcare financing and delivery are discussed, along with insurance systems, cost containment, different types of medical practice, and medical practice economics.
4. Culture and Societal Issues/Physician-Patient Relationship: The biopsychosocial approach to patient care is introduced, and the role of cultural factors within the doctor-patient encounter is discussed. Emphasis is placed on development of cultural sensitivity and competence in the provision of care.  The role of the family and the patient’s social network are explored, and lifedisrupting conditions such as substance abuse, domestic violence, child/elder abuse, and selfharm behavior are discussed with reference to the physician’s role in detection and intervention.

GOALS AND OBJECTIVES

The Basic Principles of Medicine 3 (BPM3) course embraces the mission of the Doctor of Medicine Program of St George’s University School of Medicine.

The BPM3 course specifically addresses a number of MD program objectives within the three categories of knowledge (1b,1d), clinical skills (2a, 2b, 2e, 2k) and professional attitudes (3d, 3e, 3f, 3i). The course objectives are:

1. Describe the framework of population health and contrast how it differs from clinical patient care
2. Apply ethical and legal principles, theories, and standards relevant to medical and public health practice, education, and research; use these to examine current topics in medicine and public health; and motivate students to value high standards of ethics and professionalism
3. Describe and illustrate the relevance and need to identify the determinants of health at the population level and how best to respond to those determinants
4. Identify non-clinical determinants of health and demonstrate how these impact on the health of individuals and populations
5. Evaluate health inventions at the population level using tools of foundational skills and knowledge.
6. Understand the concepts that impact on the provision of best healthcare practices and protocols
7. Explain relationships and apply appropriate terminology relating to the structure, metabolism, genetics, and ecology of prokaryotic microorganisms, Eukaryotic microorganism, and viruses.
8. Distinguish the basic biological features and identifying characteristics of microorganisms with particular focus on those capable of causing damage to the host.
9. Demonstrate a knowledge of basic clinical laboratory skills and techniques related to the isolation, staining, identification, assessment of metabolism, and control of microorganisms.
10. Discuss the principles of physical and chemical control of microorganisms and apply as relevant for the prevention and control of infectious diseases.
11. Analyze and distinguish therapeutic treatments for microbial infections, and distinguish when a vaccine, antibiotic, or other therapy is likely to be the most appropriate response.
12. Explain the individual components and players of the immune responses and correlate this knowledge to the body defense during the infectious disease process.
13. Describe examples of failure of the immune system and potential treatment procedures and predicted outcomes.
14. Demonstrate basic knowledge of infection preventive treatments such as vaccines and other elements of contemporary immunotherapy procedures 
15. Identify strengths, deficiencies and limits in one’s own medical knowledge, clinical skills and professional behaviors.
16. Set learning and improvement goals in medical knowledge, clinical skills and professional behaviors.
17. Identify resources to guide and perform learning activities to address one’s gaps in medical knowledge, clinical skills and professional behaviors.
18. Continually identify, analyze and implement new and updated knowledge, guidelines, standards, technologies, products or services that have been demonstrated to improve outcomes.

For all administrative questions (including notification of absence from lab or small group activities) contact our departmental secretaries and course director at SOMBPM3@sgu.edu.  Please do not send a message to all faculty. Your query will typically be responded to within 24 hours. Response to queries received after 4:00PM on Friday may be delayed. 

Course Leadership Team: CD and Module Coordinators

The course director oversees the overall organization of the course. Module coordinators organize specific modules within the course and are responsible for Sakai site.

Content Managers

Content Managers are responsible for the content related to their discipline in lectures, small groups and multiple-choice questions.

Table of Content Managers

Teaching Faculty 

A full list including a biography of the teaching faculty will be provided on SAKAI.  

Clinical Instructors and Teaching Fellows 

A group of physicians responsible for facilitating small group sessions and other educational activities. See SAKAI for further information. 

Standardized Patient (SPs) 

St. George’s University employs standardized patients in the training and evaluation of medical students. Individuals of various backgrounds who are trained to portray, in a consistent and standardized manner, a patient in a medical situation, allowing students to practice their communication, history taking and physical examination skills.  The standardized patients have agreed to undergo physical examination and ultrasound thereby affording student’s the opportunity to learn surface anatomy, physical examination skills and professional communication and conduct in a simulated clinical environment. 

Required textbook, lecture slides, small group material and additional resources as provided on My Courses.

Copyright 2022 St. George's University.  All rights reserved. 

All course material, whether in print or online, is protected by copyright. Course materials, in part or in their entirety, may not be copied, distributed or published in any form, printed, electronic or otherwise. 

As an exception, students enrolled in the course are permitted to make electronic or print copies of all downloadable files for personal and classroom use only, provided that no alterations to the documents are made and that the copyright statement is maintained in all copies. 

Lecture recordings are explicitly excluded from download and creating copies of these recordings by students and other users is strictly prohibited.

Course Website

The BPM3 course offers a website through Sakai, our learning management system. This site is used for COMMUNICATION (Announcements, Syllabus, Resources, Tests & Quizzes, Gradebook, a web link to the student resources of the Required Books, and a link to Lecture Recordings).

To login, go to myCampus Secure Login , type in your user ID and password, and click on MyCourses. 

Electronic Resources

Distribution of course material will be in electronic format. Links to external websites are included, where appropriate. In accordance with Committee for Technology based Teaching and Learning (CTTL) recommendation, students are provided with unlocked PDF files, which may be annotated for personal use. This format facilitates active learning, as it allows highlighting and annotations, using a variety of platforms, operating systems and annotation software. Copyright restrictions regarding the duplication of materials apply (see copyright statement above).

The Resources folder contains multiple subfolders in which students will be able to find the course material provided.

Recommended Textbooks

• Abbas, A. K. M., Lichtman, A. H. M., & Pillai, S. M. (2015). Basic Immunology: Functions and Disorders of the Immune System (5^th edition). Elsevier.
• Bodenheimer, T., & Grumbach, K. (2016). Understanding Health Policy: A Clinical Approach (7^th edition). McGraw-Hill Education / Medical.
• Carroll, K., Butel, J., & Morse, S. (2015). Jawetz Melnick & Adelbergs Medical Microbiology (27^th edition). McGraw-Hill Education / Medical.
• Fletcher, G. S. (2020). Clinical Epidemiology: The Essentials (6^th edition). LWW.
• Glaser, A. (2013). High-Yield Biostatistics, Epidemiology, and Public Health (4^th edition). LWW.
• Veatch, R. M. (2011). The Basics of Bioethics (3^rd edition). Routledge.

Optional additional resources for self-study:

List of all online medical textbooks available through SGU library: https://mycampus.sgu.edu/group/library/databases-and-ebooks

Free online access for SGU students (requires log-in with SGU credentials) AccessMedicine https://accessmedicine.mhmedical.com.periodicals.sgu.edu/

This resource contains searchable medical textbooks and is highly recommended. It has a search function to look up concepts relevant to medical student education.

Required Readings

The content of each Required Reading is integrated into course activities including lectures, Small Groups, and Directed Learning Activities. 

Each required reading should be previewed before the relevant lecture and/or Small Group and read closely afterwards to reinforce knowledge and understanding. Some readings are referred to repeatedly during different parts of the course. 

Small Group Instructions for Students

Read the instructions before each Small Group and also the Cases and Readings relevant to each Small Group, which are listed on MyCourses.

 Turning Point

Turning Point is the audience response system utilized in all basic sciences courses. Its use is assumed to reflect the participation and performance of the student to whom the device or account is registered. Misrepresentation of participation and/or performance through the misuse of the audience response system constitutes academic dishonesty and may result in loss of professionalism points, additional course penalties and/or referral to the Office of Judicial Affairs. Participation in academic activities is monitored through Zoom, Turning Point (Turning Technologies) and Wi-Fi log in data.. For  lectures, there are two options for submitting a response to a clicker question:

1. Turning Point App from Google Play or Apple Stores: This must be accessed with the students SGU turning point account.
2. Browser based TTPoll.com can also be used for the audience response system.

Students are required to participate with the audience response system in scheduled teaching sessions, and it is the students’ responsibility to ensure that they are able to do so. Any technical failures fall within the normal 80% participation requirement.

If there is any problem with the app or browser, ensure adequate steps are taken to resolve the issue (e.g. download of new app, seek assistance from IT, etc.). 

Required Electronic Equipment 

Laptop 

Students need a personal laptop that meets the specifications outlined by SGU Examination Services (access to a webcam and a stable internet connection is also required for online course delivery and assessments;  https://mycourses.sgu.edu/access/content/group/7a7ac639-acc5-4f33b106-ae0778aabff6/TeachingLearningRemotely/LearningRemotely.html  see section on Examplify guidelines from Examination Services).

It is the responsibility of each student to ensure his/her laptop is in full working condition, as specified by Examination Services, and keep it up to date. For those students in ITI on campus an ethernet cable and USB ethernet dongle will be required. In ITI venues no Wi-Fi streaming of content is allowed and all students must be equipped to have wired access to the internet.

Ethernet cables and wireless dongles are available for purchase from the University bookstore.

The main components of the BPM 3 course are listed below.

• Lectures 
• Directed Learning Activities (DLAs)
• Small Group Sessions
• Interactive Multiple-Choice Sessions (IMCQ’s)

Ensure that you review the Learning Pathway document on SAKAI for further details on the expectations for each course component

Students MUST participate in all components of the course WITH THEIR ASSIGNED COHORT. No switching is permitted. Any student who fails to participate in a session with their assigned cohort will lose the participation for that particular course activity.

Please be advised that all course activities will be subject to video recording for educational and other purposes and your participation in this course is deemed to constitute consent to the recording and use of your image and voice.

COURSE ASSESSMENTS  

Course assessments may be summative (a high-stakes assessment that counts towards points in the gradebook), formative (a low stakes assessment that provides valuable feedback to students to optimize their learning strategies), or both. 

Summative Assessment

The total assessment points that can be earned in the course are listed in the table below:

Discussion Forum

The major platform for all content related questions is the Discussion Forum on the course website. Students are encouraged to post their questions on the Discussion Forum and to respond to questions posted by others.

Students are expected to make use of the Discussion Forum rather than emailing questions to individual faculty. Many students have the same questions; therefore, posting on the Discussion Forum allows all students to benefit from the posted questions and their timely responses. Course faculty will regularly monitor the Discussion Forum and participate when appropriate.

 When posting questions on the discussion forum please tag each post with the lecture number, the small group, IMCQ or ExamSoft quiz that the question is referring to. This will ensure that the relevant faculty members will be available to answer your questions.

Students should only use professional language. Discussions should remain relevant to course material. Use of derogatory remarks or inappropriate language is unprofessional. All posts must also be accompanied with the full name of the person posting it. Failure to do so will result in deletion of the post. 

Office Hours

Office hours will be provided by the teaching faculty through a live online delivery platform as open office hours (walk in/log in) or by appointment. The available hours (open or appointments) for the different faculty members will be posted on Sakai. All appointments will be made through sombpm3@sgu.edu or by directly contacting individual faculty members. 

ACADEMIC, LEARNING & PSYCHOLOGICAL SUPPORT  

We would like to remind you of the opportunities available at SGU if you experience academic difficulties or wellness and/or mental health concerns. 

Academic Advising, Development and Support (AADS)  

The goal of the Academic Advising, Development and Support Division is to ensure that each student optimizes their path through Basic Sciences by taking full advantage of the resources available at St George’s University. 

Academic advisors are available for all SOM students who wish to receive academic advice during their time in Basic Sciences. Full time academic advisors are available by appointment or during open hours (9 am – 4 pm daily). To schedule an appointment please send an email (academicadvisingSOM@sgu.edu), give us a call (444 4175 ext.3027 or 3494) or visit our office (Lower David Brown Hall, below the Food Court).  

Department of Educational Services (DES) 

DES is your one-stop for improving your academic performance and adapting your learning strategies. You can schedule one-to-one individual appointments with a learning strategist, MCQ approach appointments with a learning strategist (individually and in small groups of 2-3) or strategic online learning strategy support through MyCoach Med. For more information, check out the DES web site: https://www.sgu.edu/student-support-services/departmenteducational-services/  

Psychological Services Center (PSC) 

PSC provides psychological counseling services through scheduled and walk-in hours from 9 am to 4:30 pm AST, in addition to 24-hour crisis coverage. The PSC also provides group services for dealing with anxiety, grief and chronic conditions, and for learning Mindfulness Skills. Please see the attached PDF for the PSC November Group offers. For more information, please see the PSC web site: https://mycampus.sgu.edu/web/psc