Malta - Extending Patient Contact Handbook 2019/20

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Book: Malta - Extending Patient Contact Handbook 2019/20
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Date: Thursday, 18 April 2024, 2:39 AM


Extending Patient Contact Handbook

1. Contact information

Contact details for Unit Convenor

Maria Hayfron-Benjamin

020 7882 2505

Dr Meera Sood

Contact details for Unit Administrator

Ms Jade Dotse


2. Introduction

This is a community based placement for all Year 2 students at Barts and The London School of Medicine and Dentistry. Students need to continue to meet patients, building on their experiences in Medicine in Society in Year 1 and continue their professional development with the benefit of authentic clinical experiences.

General practice will work as a setting which will bring to life the PBL scenarios, contextualising and broadening your learning and encouraging you to think about the wider, more varied, range of disease presentation. The opportunity to actively engage with patients in a safe, yet authentic, clinical environment will allow you to reflect on your communication skills and your attitudes to patients and illness, forming an important aspect of their professional development. 

Module Aims:

To build on the general practice experience and patient contact in Medicine in Society in Year 1, bring to life the ‘core’ conditions covered in the PBL sessions with clinical experience.

Learning Outcomes:

By the end of this unit, students should be able to:

  1. Apply their theoretical knowledge to clinical situations,
  2. Talk appropriately with patients,
  3. Identify the variety of patients’ concerns, the patients perspective of illness,
  4. treatment and its impact on them and their families
  5. Perform appropriate clinical examinations such as blood pressure and other basic examinations under adequate supervision
  6. Use their observation of senior colleagues in clinical practice to reflect on the attributes required of them as professionals 

3. Extending Patient Contact Timetable

Extending Patient Contact Timetable


Group CD

Group AB














Human Development



Human Development


Brain and Behaviour



Brain and Behaviour









HSPH and review



HSPH and review



3.1. Clinical conditions to be covered

 Tutors should choose some of the common listed conditions to cover on each EPC day.  Ideally the choice should be discussed with the students.  Tutors are not expected to cover all conditions.



Suggested clinical cases



Diabetes, renal disease including renal failure, thyroid disease, change in bowel habit (inflammatory bowel disease, Irritable BD, gastroenteritis, malignancy)



Ischaemic heart disease, hypertension, heart failure, COPD


Brain and Behaviour

Parkinson’s disease, back pain, epilepsy, dementia, depression


Human Development

Developmental delay/disability, nutrition, chronic disease in childhood, pregnancy, antenatal and post-natal care cervical screening



Osteoarthritis and osteoporosis, inflammatory joint disease including rheumatoid arthritis


Human Sciences and Public Health and review

Public health in primary care, health promotion and preventative, falls prevention, drug and alcohol use and misuse, patient self-management of chronic disease

Revision of any areas that students feel less confident in – should be negotiated with group, observed history taking, final assessment

3.2. Suggested Lesson plan for EPC session

Sample Lesson plan for EPC day 2 - Cardio-respiratory conditions

10.00 - 11.00       Students arrive and are allocated to sit-in individually or in pairs with a doctor or other HCP, students to observe particualrly for cardiovascular or respiratory presentations.

11.00  -  12.00     Tutorial with GP tutor on common cardiovascular and respiratory conditions, students may have been asked to prepare short presentations on a particular condition e.g. asthma or stroke.

12.30 - 13.30       Meet patients with relevant conditions either at home or in health centre e.g. 2 students interview a parent and a child with asthma in the health centre, 2 visit a patient who is recovering from a stroke at home.

13.30  - 14.00      Lunch

14.00 – 15.00     Debrief with GP on meeting with patients, discuss any issues that arose in the interview with the patient, areas not covered, difficult areas, practice history taking or relevant clinical skills. 

15.00 - 16.30     Tutorial on relevant conditions – may include student presentations on topics with feedback from tutor.  Meet other health-care professionals working with patients e.g. physiotherapist working with stroke patient, paediatric nurse working with child with asthma.

16.30  - Students leave

4. Course Description

You will be at a GP practice for a full day (Tuesday)  on 6 occasions during the year alternating with your year 2 MedSoc placement;  you will be in a group of 4 students.

A timtable for an EPC day might look like this:

    • 10.00  - students arrive at clinic and are rostered to sit in with different clinicians
    • 11.00  - Tutorial with GP tutor covering the conditions students will be focussing on that day and including plan for the day
    • 12.30   - meet patients with relevant conditions either at home or in health centre
    • 13.30  - lunch
    • 14.00 – debrief with GP on meeting with patients, practice history taking or relevant clinical skills.  Tutorial on relevant conditions – may include student presentations on topics with feedback from tutor.  Meet other health-care professionals working with patients e.g. midwife on Human Development day.
    • 16.30  - Students leave

5. Student Assessment



Tutors are required to complete a placement attendance register, this must be returned with the grade sheets and Professionalism Assessment forms at the end of the unit.

Student attendance is recorded at each placement. Tutors must inform us at the time of any non-attendance.

Any student unable to attend must submit a self certificate form to the University.

Please click here for link to the self certificate form.

5.1. Reflective write up EPC placement

Students must write a 500 word reflective essay on an occasion where they interacted with a patient that resonated with them for some reason, for example it made them think of a patient / medical condition in a new light, or it raised some ethical issues, for example where they were required to gain consent from a patient for a task that they were about to perform. You will mark this assignment.


Students should demonstrate insight into: their exploration of their feelings about the task; what they said and why; how they approached the patient; how the patient responded; evidence of reflection on achieving ‘informed consent’: what could they do to develop their performance?


We suggest the first draft is discussed as a formative exercise as a group on week seven and that student are encouraged to revise their work in the light of the feedback they received from you and their peers. The final submission is for summative assessment at the end of the placement, please consider the students progress in the revision of this document as a key aspect in your mark. Students should be advised to add this to their professional portfolios.

5.2. End of placement assessments for EPC

Please complete an assessment form for each student and return this with their professionalism assessment form by Friday May 2nd 2014. Please discuss your assessment with them on the last day, students find it very valuable to get timely feedback and to have the opportunity to discuss their progress with you. Guidance is provided for the completion of the assessment form. If you have serious concerns about a student for any reasons please let us know as soon as possible so we can take action before the end of the year.

 Students who do not pass their clinical placements have not completed the year and so are not eligible to sit the summer exams;  if they remediate they are allowed to take the late summer exams as a 2nd sit i.e. they forfeit their first sit.


Extending Patient Contact Unit Marking Guide



Pass (8-10)

Pass (5-7)           

Referred (≤ 4)



Knowledge at or above expected for a second year student. Applies scientific knowledge well to clinical care. 

Knowledge level satisfactory, beginning to apply scientific knowledge to clinical scenarios

Knowledge level unsatisfactory, ill-prepared for sessions, poor linkage of scientific knowledge in clinical situations.

Communication Skills

Excellent communication with patients, staff and student colleagues.

Developing communication skills, improvement seen during the year, becoming more confident and skilled in communication in group, with patient and with practice staff.

Communication skills unsatisfactory

Clinical Skills

Competent in performing basic clinical skills e.g. blood pressure, HR, resp. rate, urinalysis, BMI measurement with minimal supervision. Good underpinning knowledge

Understands principles of routine clinical skills, able to perform skills but not yet fluent.

Underpinning knowledge and ability to perform basic clinical skills inadequate.


Reflective write-up

Demonstrated insight into patient feelings, own emotional response, context.  Able to stand back from the situation, perhaps looking from different points in time.

Satisfactory account of patient encounter, some insight into patient feelings, own emotional responses

Encounter with patient described but not explored. No insight into patient feelings or own role demonstrated.


Global professionalism and attitude

Excellent attitude and approach, very good timekeeping, well prepared for each session               

No problems with attitude or behaviour.

Unsatisfactory behaviour in at least one professional domain, e.g persistent lateness, absenteeism without explanation, poor behaviour with patients





Student Assessment Form – Extending Patient Contact


Overall assessment – Please grade the student’s overall performance taking into account the above attributes. Referred means scoring 20 or less and that the overall performance of the student has raised concerns. Referred students will be seen by their Academic Year Tutor.


Lead GP Tutor:

Names (and positions) of other Teachers who contributed to the assessment:

Please mark the following attributes out of 10 (4 or below is a fail grade)


Student Name:






Mark out of 10

Free text comments






Communication Skills





Clinical skills




Reflective write-up




Attitude and professionalism

















6. Student Safety and Home Visit Policy

Escorted Visits

These refer to visits to patients in their own homes by members of the primary care team accompanied by the medical student. The patient's permission for the medical student to be present during the home visit should be obtained.

Unescorted visits

Where students are expected to visit patients in their own homes without an accompanying healthcare worker the supervising clinician will have previously selected and consented an appropriate patient for such an activity. Patients will have been given details about the purpose of the visit, the timing and the names of the students. Students should ideally visit in pairs, but if they are on a single-student attachment and have met the patient previously and wish to undertake a visit on their own this can be safely managed.

If the following are adhered to all should be well:

  1. Know where you are going and plan your journey
  2. Ask for help and instructions from your tutor if unsure
  3. Ensure your practice knows where you are going and when you are expected back
  4. Be clear about the purpose of your visit and how to conduct yourself
  5. Always carry your identification card, adequate finances to get you home, your mobile phone and a map
  6. Terminate and excuse yourself from the visit if for any reason you feel unsafe

Students are asked to discuss with their tutors any planned visits they feel uncomfortable with, so you can be accompanied, or the visit postponed.

7. Ethics and Confidentiality

Please remind all students of the importance of patient confidentiality when they begin their placement with you, this should include outlining your practice procedures to maintain confidentiality and examples of how they might inadvertently breach confidentiality e.g. discussing a patient in a public area within or outside the practice; discussing one patient with another; or including patient identifiable data on notes they have made as a resource for their own learning.

Students will be seeing patients either in the GP surgery or visiting them in their own home. They have been asked to bear in mind the following:

  • Patients have a right to confidentiality; therefore please ensure you do not discuss any personal patient information outside of the practice.
  • Although patients should have been informed prior to the session that medical students will be present, you must respect their wishes if they decline to be interviewed or examined by any student.
  • Treat all patients and staff with courtesy and respect, they are generally going out of their way to provide a valuable learning experience for you.
  • Please ensure that you are neatly attired.
  • Please remember that, even though the tutor may have gained consent from the
  • patient, it is important that you reaffirm that consent personally.