Barts and The London, School of Medicine and Dentistry


Year 2 HSPH2: Human Sciences and Public Health 2

Teaching Material for this Module


This module is intended for Year 2 MBBS and Year 1 GEP students and will provide a basic structure for carrying out evidence based practice with patients with complex needs. Providing evidenced based practice requires consideration of the individual doctor’s clinical expertise, best available external clinical evidence as well as patient’s values and expectations. Given the increase in prevalence of chronic conditions, a significant proportion of patients seen by doctors will have many co-existing diseases as well as difficult social circumstances. Making sense of these complexities within the conditions and structure of the changing health service and terms of work is a challenge. Now, more than ever, doctors are required to understand complex systems, alongside social determinants of health, and how these contribute to the widening health inequity. This module is unique in that it crosses the disciplines of science, psychology and social sciences in order to provide a critical framework for analysis of interventions with patients who have complex needs, within a challenging health service environment.


The overall aim of the module is to place the science of medical practice within a context. This module explores how social factors can form key effect mediators of any intervention. Thereby perhaps unintentionally increasing disadvantage for patients with multiple complex needs. By placing the science of medical practice in context, students will be able to develop a more inclusive practice, develop an understanding of how social circumstances can effect compliance and adherence to medical interventions, which in turn can effect compassion, empathy and choice of intervention when doctors speak with patients. These factors can all enrich the medical encounter for both doctor and patient potentially leading to better health outcomes. Being aware of the different factors that impact on the doctor-patient relationship helps doctors to adjust their style of interaction. This awareness also provides doctors with more options in how to work with patients who are more at risk of having a difficult journey through healthcare. Throughout this module, common assumptions will be explored about these different aspects of care for patients.



By the end of this module, the student will be able to:


  1. Define evidence based practice including the three main components of clinical expertise, external clinical evidence, and patient values and expectations.
  2. Discuss different types of appraisals of quantitative, qualitative and mixed methods research.
  3. Discuss medical decision making processes within individual clinical expertise.
  4. Describe and evaluate models of patient experience in healthcare and their relevance to health professionals.
  5. Discuss support for self-management of chronic conditions.
  6. Identify those at risk of having a difficult time with self-management for their chronic condition(s).

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