Intro to MiC/ PPD You will need a healthy dose of common sense and reasoning especially for the

e EMI type questions Do not underestimate this strand, it makes up a fair portion of the marks and there is lots worth taking proper time to learn- especially the SDL! What is Health? Biopsychosocial model Society Culture Community Family Person Organs Tissues Cells Genes Molecules Illness is the subjective experience of ill health Sickness is the societal response to ill health Disease is the biology of ill health Intro to evidence in practise 4 reasons why med students need to know skills of evidence based practise A 21st century doctor needs up to date information Volume of medical knowledge continues to escalate Much of what we learn now will soon be out of date Future patients deserve the most up to date and effective care we can provide Family in Context Be aware that the traditional nuclear family is quite rare Be aware of the growing trends- decreasing evidence of traditional family roles e.g. young mothers in 2 parent families who stay at home while the husband works Intro to epidemiology What is the purpose of epidemiology distribution and size of health states in the population identify aetiological factors of the health states provide data for the management, evaluation and services planning for the prevention, control and treatment of ill health Incidence is the number of new cases of a health state in a specified population in a given period of time Prevalence is the number of people with that health state at a specific point in time Types of study

Health Systems A health system is the way in which people (individuals, families, communities etc) seek to maintain and improve health and deal with ill health Beliefs about health systems are intertwined with societal factors eg. a persons religion, social background, political beliefs, economic group There are 3 sectors of the health system in the UK Popular eg Common Sense, Lay knowledge Folk eg Complementary, Alternative Professional eg Scientific, biomedical Understand that people might try different things in a hierarchy of resort before going to the doctors eg discussing problem with family, friends, checking the internet etc Ethics Can be principle based or character based Kantian ethics are principle based Respect for the person you are treating, autonomy The good lies in the moral of the action, not the outcome Utilitarianism ethics are principle based Choose the best balance of good over harm Greatest good for the greatest number, beneficence and nonmaleficence Virtue based ethics are character based Focus on what a virtuous person would do typical values are courage, integrity, truthfulness etc Ethics of care are character based Emphasis on a good relationship being built during the care

Health Inequalities Understand that health inequalities are socially produced, systematic differences in the health of different socioeconomic groups within society There are different models which try and explain health inequalities Behavioural/ Cultural model Materialist Psychosocial Lifecourse Political Economy Asking the right question in Evidence Based Medicine Primary resources are case reports, clinical trials etc Secondary resources are textbooks, reviews, systematic reviews Tertiary resources are Indexes and databases eg Medline, Cochrane Library When looking through the literature to find an answer you must use PICO PATIENT/ PROBLEM identify the patient specifically and their symptoms INTERVENTION search for the intervention you are thinking about using COMPARISON INTERVENTION compare the intervention to another intervention so you can ask if your intervention is actually working OUTCOMES what is the specific outcome you are looking for, eg. Faster recovery, more effective pain relief etc Doctor Patient Interaction

Appreciate the importance of shared decision making

Info gathering ICE! stage of the Calgary Cambridge Model Initiating the Session Gathering Information

Building the Relationship Explanation and Planning Closing the Session