Unit MEDICAL AND SCIENTIFIC METHODOLOGY II

Course: Medicine and surgery
Study-unit Code: GP005549
Curriculum: In all curricula
CFU: 7
Course Regulation: Coorte 2022
Offered: 2023/24
Type of study-unit: Obbligatorio (Required)
Type of learning activities: Attività formativa integrata

BIOINGEGNERIA ED INFORMATICA MEDICA

Code	GP005612
CFU	2
Learning activities	Affine/integrativa
Area	Attività formative affini o integrative
Academic discipline	ING-INF/06
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

Teacher

Paolo Valigi

Teachers

Paolo Valigi

Hours

25 ore - Paolo Valigi

Language of instruction

Italian

Contents

Introduction to health informatics and bioengineering, with discussion on classic and innovative applications.

Reference texts

Material from the instructor and scientific papers.
Selected pages from “Health Informatics: Practical Guide For Healthcare And Information Technology Professionals (Seventh Edition)” Robert E Hoyt

Educational objectives

To understand basic concept of medical computer science and bioengineering, their limits and areas of application.

Prerequisites

None.

Teaching methods

Frontal lessons and discussions.

Other information

During the classes also detailed discussions on selected topics will be given.

Learning verification modality

Mode of conducting the examination: Written test with 34 closed-ended questions and one open-ended question devoted to the presentation of a medical procedure, simplified, in the form of an algorithm.
Two intermediate tests are scheduled during the course of the lectures, with closed-answer questions only, which can replace the examination in the case of an average grade in the two tests higher than 18/30.
The module grade is assessed as 32/30; honors are awarded with 32/30, grades below 32/30 and up to 30/30 correspond to 30/30, grades below 30/30 correspond to the final grade. In case of rounding (e.g., in midterm tests) the nearest whole number is chosen.
Verification of clinical skills: Not provided in the module.
Verification of skills acquired during internship: Not provided in the module.
Method of awarding final grade: Arithmetic mean of the marks achieved in the individual disciplines, rounded up (30L=31)

Extended program

Course introduction and motivation.
Classical and innovative applications.
Basic on Artificial Intelligence applications to Medicine, and ethical implications.
Information, binary code, and disease classification. Algorithms and medical applications.
Health information systems.
Signals, frequency analysis.
Systems and responses. Medical examples.
Compartment models and medical applications and examples.

Cognomi M-Z

CFU

Teacher

Elisabetta Zanetti

Teachers

Elisabetta Zanetti

Hours

25 ore - Elisabetta Zanetti

Language of instruction

Italian

Contents

Health informatics and main concepts concerning medical instrumentation

Reference texts

- Slides and notes available on Unistudium
- Webster JG "Medical Instrumentation: Application and Design, 4th Edition"
- Bemmel, J.van “Handbook of Medical Informatics”
- Robert E Hoyt “Health Informatics: Practical Guide For Healthcare And Information Technology Professionals (Fifth Edition)”

Educational objectives

The student will achieve the following results:
• Ability to understand the performance of different sensors and data acquisition systems to make a reasoned choice.
• Awareness of the main techniques of signal analysis in the time domain and frequency.
• Capacity for critical analysis of the images.
• Awareness of electrical hazards and precautions to minimize them.
• being able to interact with the technology of ICT in the medical field,
• knowledge of coding tools in general and in the medical field in particular,
• Knowledge of main components of computers
• Internet and its protocols
• knowledge of databases and how to interact with these
• Main health information systems and their peculiarities
• Telemedicine

Prerequisites

Maths and Physics from secondary school

Teaching methods

Lectures with the use of slides (this material is uploaded on UNISTUDIUM for all registered students.
Practical lessons to the computer.
"Flipped classroom" approach for pratical applications.

Other information

The students can require further infromation by emails

Learning verification modality

Written 1h30'-hour test, made of two parts: Bioengineering and Medical Informatics- 10 questions with short answers.
The final score will be computed form the airthmetic average of the score obtaines in Medical statistics and Bioengineering, rounded up (30L=31)

Extended program

Bioengineering
• Sensors (4h)
o Sensor specifications: accuracy, precision, bias, repeatability, linearity, range, sensitivity, hysteresis, temperature drift.
o Calibrating a sensor
o Meaning of the impedance in the input and output of a sensor
o Transduction principles: piezoresistive, potentiometric, inductive, capacitive, piezoelectric sensors
o Temperature sensors: thermocouples, RTDs, thermistors, pyrometers;
o Fiber optic sensors
• Signals and their treatment (4h)
o Frequency analysis: utility, possible errors
o Dynamic systems response
o Analog / digital converters
o Sampling a signal, Nyquist theorem, antialiasing filters
o Amplifiers
o Filters
o Disturbances in the transmission of signals
o Images and Bioimaging: resolution and depth, encryption, compression techniques
o Specifications of a display
o Editing an image: value processing of color or luminance; morphological operations
o CT: operating principle
• Risk factors in hospital (2h)
o Classification of medical equipment according to risk classes
o Electrical Hazard: Zone 'Patient', Effects of electricity (microshock, macroshock)
o Classification of medical locations rooms.
o Usefulness of 'grounded', earth contact, isolation transformer.
o Equipment type B, BF, CF

Medical Informatics
• Information and Medical Coding (2 h)
o Alphabet and semantics
o Numerical, textual, Boolean information and respective coding
o Algorithms (reference structures: sequence, iteration, selection )
o Data structures (vectors, records, trees, graphs)
• Classification in medicine (2 h)
o Classification of diseases (ICD)
o DRG: meaning, assessment, indices of Performance and case-mix
o Electronic health record: SNOMED
• Computer architecture and how it works (2 h)
o Main components: bus, memoria (RAM, cache, mass storage), CPU, I/O devices and respective classifications
o Operative systems
o File System
• Data base (6h)
o Introduction
o ER models
o Relational models
o Data base query (SQL language)
o Examples: Pubmed and others
• Computer networks: (2 h)
o Server, Host, web link
o Protocols (http, IMAP, POP3, SMTP)
o IP address: static or dynamic
o State of the art in health informatics: RIS, PACS, DICOM standard and electronic health record (FSE)
o Telemedicine

NURSING

Code	GP005614
CFU	1
Learning activities	Affine/integrativa
Area	Attività formative affini o integrative
Academic discipline	MED/45
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

Teacher

Mirella Giontella

Teachers

Mirella Giontella

Hours

12.5 ore - Mirella Giontella

Language of instruction

Italian

Contents

Hygiene aspects and prevention of infections related to welfare practices Personal protective equipment and behavioral standards in a care setting
Assessment of vital parameters

Reference texts

- WHO "" Global Patient Safety Challenge 2005 - 2006 Clean Care is Safer Care ".
- D. Lgs.vo 09 April 2008 n. 81
- R. Crafen, C. J. Hirnle "Fundamental Principles of Nursing Care" 4th Edition - Ambrosiana Publishing House - Milan 2011

Educational objectives

know the use and management of PPE-
Know the prevention measures for care-related infections-
Acquire skills for detecting the patient's vital parameters

Prerequisites

no reqiurement

Teaching methods

Lectures - Laboratory exercises in small groups; educational video projection.

Other information

Office hours: at the end of the lessons on site

Learning verification modality

Written exam consisting of n. 25 multiple choice questions, of which only one answer is correct.
The questions are related to the program carried out.
The test lasts 30 minutes.

Extended program

Infections in health organizations.
Presentation "Global Patient Safety Challenge 2005 - 2006 Clean Care is Safer Care" WHO
Nosocomial transmission through the hands of health personnel
- the five key moments for hand hygiene
- handwashing: social, antiseptic, surgical • Legislative Decree 09 April 2008 n. 81
Professions that expose to biological risk - definition of "risk" and "biological risk"
Choice of Personal Protective Equipment (PPE): sterile and non-sterile gloves, respiratory protection, gowns, footwear, eye protection, head protection.
Recommendations of the Centers for Disease Control (C.D.C.) of Atlanta;
Relationship between the operator, the assisted person and the care giver.
Body temperature
- regulation of body temperature;
- heat production, heat loss;
- factors that influence body temperature;
- factors that influence the measurement of body temperature.
Arterial pulse
- features;
- factors that influence the pulse rate;
- wrist assessment.
Breath
- factors that influence the breath;
- assessment of the breath;
- methods.
Blood pressure
- physiological factors that determine arterial pressure;
- factors influencing blood pressure;
- detection of arterial pressure

Cognomi M-Z

CFU

Teacher

Mirella Giontella

Teachers

Mirella Giontella

Hours

12.5 ore - Mirella Giontella

Language of instruction

Italian

Contents

Hygiene aspects and prevention of infections related to welfare practices Personal protective equipment and behavioral standards in a care setting
Assessment of vital parameters

Reference texts

Educational objectives

know the use and management of PPE-
Know the prevention measures for care-related infections-
Acquire skills for detecting the patient's vital parameters

Prerequisites

no reqiurement

Teaching methods

Lectures - Laboratory exercises in small groups; educational video projection.

Other information

Office hours: at the end of the lessons on site

Learning verification modality

Written exam consisting of n. 25 multiple choice questions, of which only one answer is correct.
The questions are related to the program carried out.
The test lasts 30 minutes.

Extended program

MEDICAL STATISTICS

Code	GP005613
CFU	3
Learning activities	Caratterizzante
Area	Inglese scientifico e abilità linguistiche, informatiche e relazionali, pedagogia medica, tecnologie avanzate e a distanza di informazione e comunicazione
Academic discipline	MED/01
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

Teacher

Fabrizio Stracci

Teachers

Fabrizio Stracci

Hours

37.5 ore - Fabrizio Stracci

Language of instruction

Italian

Contents

The basis of scientific investigation
The role of statistic methods in biomedical research
Descriptive statistics
Inferential statistics
Regression models to analyze relationships among variables

Reference texts

Primer of biostatistics by Stanton A. Glantz

or

Principles of Biostatistics by Marcello Pagano, Kimberlee Gauvreau

Educational objectives

Basic data analysis
Understanding of the role of statistics in medicine
Critical reading of methods and results in published biomedical research

Prerequisites

none

Teaching methods

Lesson
Practical exercises

Other information

Learning verification modality

Oral exam. Duration about 15-20 minutes based on two questions. A question will be devoted to explore knowledge of common statistics, the concept of statistical testing and regression models. Another question will investigate competence in the application of simple statistical techniques and critical reading of methods applied in epidemiologic and clinical research. Final grade will be obtained as the arithmetic mean of results of integrated courses.

Extended program

1.1 Statistics definitions and scope
1.2 Statistical methods in medical research

2. Data
2.1 Types of variables
2.2 Tabulation and processing of data
2.3 Diagrams
2.4 Descriptive statistics
2.5 Measures of central tendency
2.6 Measures of variability

3. Probability
3.1 Frequentist definition of probability
3.2 Probability distributions
3.3 The normal or Gaussian distribution
3.4 Probability distributions and applications

4. Populations and samples
4.1 Parameters and their estimation
4.2 Sampling

5. Statistical inference
5.1 Point and interval estimation
5.2 Confidence interval for the sample mean
5.3 Significance testing
5.4 Parametric Hypothesis Tests: Student’s t test and Analysis of Variance
5.5 Confidence interval for the difference between two means
5.6 Non-Parametric Hypothesis Tests: chi-squared test

6. Regression and correlation
6.1 Regression models
6.2 Linear regression
6.2.1 Linear regression equation: parameters estimation using the ordinary least squares method
6.2.2 Tests of significance in regression
6.2.3 Confidence interval for the linear regression coefficient b
6.3 Correlation
6.4 Critical reading of results from multivariable regression models
6.5 Multivariable modeling, an introduction

Cognomi M-Z

CFU

Teacher

Fabrizio Stracci

Teachers

Fabrizio Stracci

Hours

37.5 ore - Fabrizio Stracci

Language of instruction

Italian

Contents

The basis of scientific investigation
The role of statistic methods in biomedical research
Descriptive statistics
Inferential statistics
Regression models to analyze relationships among variables

Reference texts

Primer of biostatistics by Stanton A. Glantz

or

Principles of Biostatistics by Marcello Pagano, Kimberlee Gauvreau

Educational objectives

Basic data analysis
Understanding of the role of statistics in medicine
Critical reading of methods and results in published biomedical research

Prerequisites

none

Teaching methods

Lesson
Practical exercises

Other information

Learning verification modality

Extended program

PROFESSIONALISING TRAINING IN NURSING

Code	GP005615
CFU	1
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/45
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

Teacher

Mirella Giontella

Teachers

Mirella Giontella

Hours

25 ore - Mirella Giontella

Language of instruction

Italian

Contents

This practical activity contributes to the student acquiring operational skills to complete the theoretical training, in relation to the care needs of the patient; It also has the aim of introducing the future doctor to teamwork with nursing staff.

Reference texts

- WHO ““Global Patient Safety Challenge 2005 - 2006 Clean Care is Safer Care”.
- Legislative Decree 09 April 2008 n. 81
https://www.epicentro.iss.it/dispositivi-di-protezione-individuale/informazioni-generali
Useful resources:
download the CDC guide “Guidance for Selection and Use of Personal Protective Equipment (PPE) in healthcare Settings” read the CDC fact sheets
- ISS COVID-19 Report n. 2/2020 Rev.2 – Version dated May 10, 2020
- ISS COVID-19 Report n. 12/2021 Rev.2 – Version dated May 20, 2021

Educational objectives

• Ability to communicate with professionalism, clarity and empathy with the person and family members, within the scope of nursing skills;
• Ability to adapt to the necessary behavior in a specialized and/or protected environment;
• Ability to collaborate in the nursing management of the person by carrying out the detection of vital parameters and observing some simple maneuvers (techniques for positioning the patient for instrumental examinations, techniques for taking venous blood samples, techniques for positioning the nasogastric tube);
• Ability to observe, together with the nursing team, the critical issues of the person based on their care complexity.

Prerequisites

Attendance of theoretical lessons of the Nursing Sciences Module.
Passing the final module check.

Teaching methods

Frequency planned within the
Operational Units (UU.OO) with support activities and tutorial supervision.

Other information

The internship activity consists of the attendance of 25 hours/student with presence in the assigned Service on 5 days a week, from Monday to Friday. Saturday is planned as a possible recovery day.
To carry out the internship, the student will be entrusted to the Nursing Coordinator.

Learning verification modality

Internship evaluation form completed by the assigned nursing tutor. Result: insufficient; sufficient, good, excellent.
The evaluation form also requires an extended comment from the tutor on the students.

Obiettivi Agenda 2030 per lo sviluppo sostenibile

Quality education

Cognomi M-Z

CFU

Teacher

Mirella Giontella

Teachers

Mirella Giontella

Hours

25 ore - Mirella Giontella

Language of instruction

Italian

Contents

Reference texts

Educational objectives

Prerequisites

Attendance of theoretical lessons of the Nursing Sciences Module.
Passing the final module check.

Teaching methods

Frequency planned within the
Operational Units (UU.OO) with support activities and tutorial supervision.

Other information

Learning verification modality

Obiettivi Agenda 2030 per lo sviluppo sostenibile

Quality education