Gastrointestinal system, liver and kidneys

PHAR11002 Gastrointestinal system, liver and kidneys 60 Semester 2 Undergraduate Level 4 Richard Campbell Unit coordinator Division of Pharmacy and Optometry 1 FHEQ level (Framework for Higher Education Qualifications) ' First part HE study/Bachelors ' European Credit Transfer & Accumulation System Rating : 30.0 The unit is split into two 6-week blocks. Block 1 (Gastrointestinal tract: absorption and nutrition) uses basic gastrointestinal function and malfunction as the focus for integration of scientific, clinical and professional learning. Block 2 (Liver and kidneys: metabolism and excretion) switches the focus to the more complex functions of the liver and kidneys to integrate learning. Conceptual understanding is developed through a series of "core concepts" lectures which provide learning in the threshold concepts mapped to year 1 of the programme. Core knowledge is then built using a flipped classroom approach, supported by EBL workshops in which learning is consolidated and independent learning skills developed. This learning is supplemented by a series of laboratory practical classes, professional skills workshops and placements in which learning from EBL and lectures is applied to introductory-level scenarios to develop practical, communication, leadership, decision-making and prescribing skills. The unit is split into two 6-week blocks. Block 1 (Gastrointestinal tract: absorption and nutrition) uses basic gastrointestinal function and malfunction as the focus for integration of scientific, clinical and professional learning. Block 2 (Liver and kidneys: metabolism and excretion) switches the focus to the more complex functions of the liver and kidneys to integrate learning. Conceptual understanding is developed through a series of "core concepts" lectures which provide learning in the threshold concepts mapped to year 1 of the programme. Core knowledge is then built using a flipped classroom approach, supported by EBL workshops in which learning is consolidated and independent learning skills developed. This learning is supplemented by a series of laboratory practical classes, professional skills workshops and placements in which learning from EBL and lectures is applied to introductory-level scenarios to develop practical, communication, leadership, decision-making and prescribing skills. The unit aims to develop students' basic understanding of the chemistry of medicines' actions and the biology of the human body. This knowledge is then applied in order to understand the structure, function and malfunction and the therapeutic management of diseases of the gastrointestinal tract, kidneys and liver. The unit also develops practical and professional skills important in becoming a pharmacist. The unit initially focusses on the gastrointestinal tract as a site for the delivery of medicines, human nutrition and commonly encountered gastrointestinal conditions (disease process and effective management). In the latter part of the unit, the function of the liver and kidneys are explored, as sites for the metabolism and excretion of drugs, but also their role in human health and illness (including disease process and effective management). This learning is supplemented by laboratory classes to develop analytical skills and students develop their learning about the legal, ethical and professional aspects of practising pharmacy. Students will learn about effective teamwork and further develop their research skills whilst participating in workshops and placements to develop confidence in communication and decision-making.  <ul><li>Demonstrate a conceptual understanding of functional groups, bonding, electronics, nomenclature and depiction.</li><li>Using relevant highly prescribed or top 100 drugs, describe the chemical properties of a drug, which may include its bonding, shape, functional groups, stereochemistry, ionisation (pKa) and lipophilicity (LogP/D).</li><li>Using relevant examples encountered in this unit, demonstrate how the drug interacts with its biological target(s).</li><li>Using relecant examples encountered in this unit, predict and explain the chemical (e.g. hydrolysis or free radical oxidation) and/or biological (metabolism) stability of a drug.</li><li>Using relevant highly prescribed or top 100 drugs, describe the discovery and design of a new therapeutic agent (small molecules and biologics).</li><li>Using relevant examples encountered in this unit, apply appropriate analytical techniques for the characterisation and purity assessment of medicinal compounds.</li><li>Demonstrate an understanding of 1st and 2nd order kinetics.</li><li>Demonstrate an understanding of, and apply the principles of powder flow.</li><li>Define the principles of pre-formulation and describe the differences between molecules vs materials.</li><li>Discuss the basic concepts of molecular solubility, the connection between logD and solubility, and the dissolution of solids.</li><li>Demonstrate an understanding of, and apply the concepts of solid-state stability, crystallinity and different crystal forms; and characteristics of colloidal materials and discuss the underlying physical principles, describe their impact on nano-formulation.</li><li>Define absorption and adsorption and discuss the related interfacial phenomena.</li><li>Demonstrate an understanding of, and apply the principles of chemical stability of drugs and medicines.</li><li>Discuss basic concepts in the biology of cancer including relevant risk factors and role of pharmacist in reducing cancer risk, detection and screening (applied to bowel cancer).</li><li>Describe the (patho) physiology and anatomy of the GI tract (to include acid-related GI disorders, diarrhoea and constipation, bowel cancer) and anatomy of liver and kidneys including adrenal glands.</li><li>Discuss the mechanism of action and use of acid-suppressing medicines, antidiarrhoeals, laxatives and antispasmodics in the management of common GI conditions.</li><li>Discuss the mechanism of action of diuretics.</li><li>Describe nutritional requirements, the role of vitamins and minerals in the maintenance of health and wellbeing and the purpose of nutritional support (oral, enteral and parenteral).</li><li>Identify and interpret basic renal function tests (including calculation of creatinine clearance) and be able to describe the principles of safe medicines use in people with renal impairment.</li><li>Discuss drug-condition interactions relevant to gastrointestinal, liver and kidney disease and the common causes of liver disease (alcohol-related and non-alcoholic fatty liver disease (NAFLD) and management of the most common complications that can occur.</li><li>Identify and interpret basic liver blood tests and be able to describe the principles of safe medicine use in people with liver impairment.</li><li>Identify the pharmacy law that applies to prescription only medicines, prescribers and records and describe how it applies to the role of the pharmacist.</li></ul> Apply and integrate learning from the previous MPharm unit to deepen understanding of new materials encountered in this unit.Demonstrate an understanding of leadership within the context of pharmacy and interprofessional healthcare practice, including the roles and responsibilities of different health care disciplines and equality and diversity in teams.With respect to person demeanour and conducting basic examinations and performing and recording observations/investigations/procedures, to be able to:<ul><li>rationalise whether an examination is necessary or not</li><li>recognise what is normal/abnormal</li><li>detect variations on what is normal</li><li>recognise when urgent action is necessary and need for follow-up and take the appropriate steps to ensure such action is carried out with the relevant safety netting</li><li>describe the principles of history taking and documentation of a medical history, including the use of electronic records</li><li>apply basic pharmacokinetic and medicinal chemistry principles to describe simple mechanisms for dug-drug interactions and discuss their clinical significance</li><li>apply pharmacological principles to be able to recommend how to manage acid-related GI disorders, diarrhoea, constipation and IBS (not IBD nor infections), including OTC management and red flags for referral</li><li>name appropriate statistical tests for analysing ordinal and nominal variables</li><li>demonstrate an understanding of when and how to reference sources of evidence in written work and how to manage those sources</li><li>precis a research article without plagiarism.</li></ul> <ul> <li>Demonstrate an ability to make a qualitative assessment of the solubility of a range of drug and drug-like molecules.</li> <li>Demonstrate an ability to perform separation and purification techniques such as recrystallisation and partitioning.</li> <li>Accurately perform quantitative methods for chemical characterisation such as titration and UV/visible spectroscopy.</li> <li>Demonstrate understanding of the link between chemical structure and medicinally relevant properties including solubility, pKa, permeability and logP.</li> <li>Demonstrate an ability to perform dissolution test according to the British Pharmacopoeia.</li> <li>Demonstrate understanding of the link between dissolution medium and dissolution rate and the connection to the human body.</li> <li>Demonstrate an ability to prepare selected formulations according to prescription.</li> <li>Accurately compare DNA samples using molecular biology techniques, including the polymerase chain reaction (PCR) and agarose gel electrophoresis.</li> <li>Demonstrate basic confidence and resilience in consultation skills (face-to-face) using a person-centred approach and listening to the voice of another person.</li> <li>Demonstrate the ability to effectively use a BNF, including, checking indication, dose and simple guidelines (including using relevant terminology).</li> <li>Dispense prescriptions at the level of “simple patient, simple drug”.</li></ul> <ul><li>Identify and discuss own strengths and development needs.</li><li>Demonstrate the ability to read a scientific paper and key e-resources, extracting relevant information in order to produce a poster without plagiarism, including knowing when and how to reference.</li><li>Discuss the professional standards that are expected of a pharmacy professional (and adhere to these standards).</li><li>Demonstrate the ability to work as part of a team and show awareness of methods that can be used to resolve conflict should it arise.</li><li>Listen and reflect on patient stories of the medication safety errors that they have experienced and the impact this has had on them and their loved ones.</li><li>Demonstrate compassion, dignity, respect, empathy, and how to support others to retain their dignity.</li></ul> The teaching and learning philosophy for the MPharm places an emphasis on learner-centred rather than teacher-centred approaches. Learning is therefore structured to maximise guided self-directed learning, with enquiry driven project work and EBL workshops provided to support greater conceptual understanding of the material and deep, rather than superficial learning. This helps students prepare for their future careers by helping them to develop independence, confidence and resilience. A wide range of teaching and learning activity is included to meet the learning needs of a diverse range of students:<ul><li>Core concepts lectures: A very small number of didactic lectures are included to provide a step-by-step guide to the threshold concepts in pharmacy</li><li>Online learning: All guided self-directed learning in year 1 is provided via Canvas. This consists of videos, bespoke elearning packages (e.g. calculations, first aid and law), NHS elearning (e.g. Skills for health), factsheets and directed reading (which can be accessed online or downloaded)</li><li>EBL workshops: All learning is brought together and consolidated in a series of multidisciplinary integrated sessions. Workshops are led by a team of staff who act as specialist facilitators, directing student learning via discussion of case studies and project work</li><li>Practical skills classes: A series of practical classes spans the first three years of the MPharm. In year 1, students focus on becoming competent in using equipment to master a number of basic skills before learning about experimental design. Practical classes are mapped to core concepts lectures and EBL workshops to ensure learning is applied to practice as a pharmacist</li><li>Professional skills classes: These span the full 4 years of the MPharm to ensure students are prepared to become prescribers after their foundation year. Classes focus on developing consultation skills, assessment and examination skills and clinical decision-making. Regular role play and interaction with medical actors is used to develop confidence and to ensure students receive tailored feedback. Self-study is required using SimConverse and Buttecups.</li><li>MyDispense: This is an online platform utilising real-world cases to recreate prescription processing and to apply pharmacy law. It is used with increasing complexity in all four years of the MPharm course to develop skills in clinical checking, dispensing and accuracy checking</li><li>Placements: Compulsory workplace placements are provided in a variety of workplace sectors, including community and hospital, to gain practical experience in providing pharmacy services and to apply learning to pharmacy practice. A compulsory GP practice simulation is provided as part of placements in year 2.</li><li>Academic adviser meetings: Students meet with their named academic adviser twice per semester in formal timetabled meetings. Academic advisers support students with their personal and professional development throughout the MPharm course.</li></ul> 0 Other 100% <figure class="table"><table><tbody><tr><td style="border:1px solid hsl(0, 0%, 0%);">Assessment task</td><td style="border:1px solid hsl(0, 0%, 0%);">Length</td><td style="border:1px solid hsl(0, 0%, 0%);">How and when feedback is provided</td><td style="border:1px solid hsl(0, 0%, 0%);">Weighting within unit (if relevant)</td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);" colspan="4">Formative</td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);">EBL case-based class work</td><td style="border:1px solid hsl(0, 0%, 0%);">2 hours prep each for 9 classes</td><td style="border:1px solid hsl(0, 0%, 0%);">Feedback provided within EBL class</td><td style="border:1px solid hsl(0, 0%, 0%);">N/A</td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);">Mock integrated case-based exam</td><td style="border:1px solid hsl(0, 0%, 0%);">3 hours online</td><td style="border:1px solid hsl(0, 0%, 0%);">self-marked using mark scheme. Drop-in session for Q&A</td><td style="border:1px solid hsl(0, 0%, 0%);">N/A</td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);">Block 3 coursework (poster) mock</td><td style="border:1px solid hsl(0, 0%, 0%);">Variable</td><td style="border:1px solid hsl(0, 0%, 0%);">Feedback provided in EBL class</td><td style="border:1px solid hsl(0, 0%, 0%);">N/A</td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);">Black 4 coursework (presentation) mock</td><td style="border:1px solid hsl(0, 0%, 0%);">Variable</td><td style="border:1px solid hsl(0, 0%, 0%);">Feedback provided in EBL class</td><td style="border:1px solid hsl(0, 0%, 0%);">N/A</td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);">Pass/Fail components have no grade associated but are worth 12 credits over the first year. Students may take the full year to pass the components with some having more than one attempt. Professional skills credits (calculations, consulting skills and prescribing skills including first aid) fall within PHAR11001, law falls within the formative ‘Preparation for Practice’ exam that takes place in semester 1, while the following components bear credits for PHAR11002.</td><td style="border:1px solid hsl(0, 0%, 0%);">Variable</td><td style="border:1px solid hsl(0, 0%, 0%);">Feedback provided through quizzes, workshops and supervised learning events</td><td style="border:1px solid hsl(0, 0%, 0%);">N/A</td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);">Practical skills, placement and personal development</td><td style="border:1px solid hsl(0, 0%, 0%);">Variable</td><td style="border:1px solid hsl(0, 0%, 0%);">Feedback provided within practical classes, on placement and by academic adviser</td><td style="border:1px solid hsl(0, 0%, 0%);">N/A</td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);" colspan="3">Summative</td><td style="border:1px solid hsl(0, 0%, 0%);"> </td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);">Integrated case-based examination (36 credits)</td><td style="border:1px solid hsl(0, 0%, 0%);">3 hours (split into 2 x 1.5 hours)</td><td style="border:1px solid hsl(0, 0%, 0%);">EBL session devoted to self and peer evaluation of exam performance</td><td style="border:1px solid hsl(0, 0%, 0%);">66% (36 credits)</td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);">Individual coursework - A4 poster linked to Environmental Sustainability (9 credits) (Block 3)</td><td style="border:1px solid hsl(0, 0%, 0%);">A4 Poster (max 250 words)</td><td style="border:1px solid hsl(0, 0%, 0%);">Written feedback provided within 15 days</td><td style="border:1px solid hsl(0, 0%, 0%);">17% (9 credits)</td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);">Group coursework - Group Presentation (with questions) linked LADMET (9 credits) (Block 4)</td><td style="border:1px solid hsl(0, 0%, 0%);">Presentation</td><td style="border:1px solid hsl(0, 0%, 0%);">Written feedback provided within 15 days</td><td style="border:1px solid hsl(0, 0%, 0%);">17% (9 credits)</td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);">Professional skills credits (calculations consulting skills and prescribing skills including first aid) fall within the unit PHAR11001 yet must be gained by the end of semester 2, while the following components bear credits in PHAR11002.</td><td style="border:1px solid hsl(0, 0%, 0%);">Variable</td><td style="border:1px solid hsl(0, 0%, 0%);">Feedback session and drop-in sessions for students who do not pass calculations and supervised learning event feedback within classes</td><td style="border:1px solid hsl(0, 0%, 0%);">Pass/Fail</td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);">Practical skills portfolio</td><td style="border:1px solid hsl(0, 0%, 0%);">Variable</td><td style="border:1px solid hsl(0, 0%, 0%);">Feedback provided within practical classes</td><td style="border:1px solid hsl(0, 0%, 0%);">Pass/Fail</td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);">Personal development e-portfolio (2 credits)</td><td style="border:1px solid hsl(0, 0%, 0%);">Variable</td><td style="border:1px solid hsl(0, 0%, 0%);">Feedback provided by academic adviser</td><td style="border:1px solid hsl(0, 0%, 0%);">Pass/Fail</td></tr><tr><td style="border:1px solid hsl(0, 0%, 0%);">Placements portfolio</td><td style="border:1px solid hsl(0, 0%, 0%);">Variable</td><td style="border:1px solid hsl(0, 0%, 0%);">Feedback provided on placement</td><td style="border:1px solid hsl(0, 0%, 0%);">Pass/Fail</td></tr></tbody></table></figure>  Formative<ul><li>EBL - Feedback provided within EBL class.</li><li>Mock integrated case-based exam - Self-marked using mark scheme. </li><li>Eportfolio - Feedback provided within practical and professional classes, on placement and by academic adviser.</li></ul>Summative<ul><li>Practical skills eportfolio - Feedback provided within practical classes. </li><li>Personal development eportfolio - Feedback provided by academic adviser and PDP lead. </li><li>Placements (Community, GP Simulated, Hospital) eportfolio - Feedback provided on placement.</li><li>Integrated case-based examination. </li><li>Individual coursework - Written feedback provided within 15 working days.</li><li>Group coursework - Written feedback provided within 15 days. </li></ul> MPharm(Hons) MPharm(Hons) First Year Mandatory N The MPharm uses an EBL approach to teaching and learning. As such, learners are required to engage with a number of self-directed learning activities each week, including reading. In year 1, all core reading material is provided for students by staff but they are encouraged to search for their own additional resources to supplement learning. Directed reading consists of up to 8 hours per week from pharmacy journals, ebooks, clinical resources (e.g. BNF, Stockleys Drug Interactions) and NHS elearning (e.g. CPPE, eLfH, Skills for Health). As clinical practice is constantly changing, this material will be reviewed each academic year, and then again before each session is delivered, to ensure it remains relevant.  Lectures 40 Practical classes & workshops 112 0 0 Contact hours:<ul><li>EBL Workshops: 30</li><li>Threshold concepts lectures: 40</li><li>Consultation skills workshops: 6</li><li>Prescribing skills workshops: 7.5</li><li>Practical skills: 17.5</li><li>IPE events (on campus): 2</li></ul>Other Scheduled teaching and learning activities:<ul><li>Placements: 2 or 3 days dependent upon rotation; total 5 days during year 1 (total number of days also dependent upon HEE commission)</li><li>SimConverse/Buttercups learning: 10</li><li>Law self-study: 9</li><li>Personal development reflections: 6</li><li>Academic support sessions (unit, blocks coursework and calculations): 6.5 </li><li>Peer-assisted study scheme sessions: 5</li><li>Academic adviser meetings: 2</li></ul>