College of Art & Sciences Biomedical Sciences Program Fall Course No: BIOM 364. Dr Elham Sharif 1

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1 QATAR UNIVERSITY College of Art & Sciences Biomedical Sciences Program Fall 2010 Clinical Chemistry I Course Syllabus Course No: BIOM 364 Dr Elham Sharif 1

2 Course Information Course Title: Clinical Chemistry Course Number: BIOM 346 Credit Hours: 4 Course Status: e.g. Compulsory Curriculum Course Lecture time: Sunday & Tuesday AM Location: D216 Women s Science Bld. Laboratory time: Sunday 12-2:50, Thursday 9-12 PM Location: D120 Women s Science Bld. Required Text: Bishop., ML, Fody., E.P. Schoeff, LE, Clinical Chemistry: Techniques, Principles, Correlations (Bishop, Clinical Chemistry) ISBN: , Publisher: Lippincott Williams & Wilkins; 6 th Edition, Faculty Information Name: Dr. Elham Sharif Academic Title: Assistant Professor Office Location: Biomedical Sciences Department, E122 Office ext: Address: e.sharif@qu.edu.qa Office Hours: 10:00 AM-1:00 PM Monday & Wednesday (Students are always welcome to knock on my door when I am not busy or schedule appointments by ) COURSE DESCRIPTION This is a lecture and laboratory course covering most areas of Clinical Chemistry I. General principles of chemical analysis and clinical utility are reviewed. Analyses performed in the clinical chemistry laboratory are grouped according to function or organ system. Major groupings include carbohydrates metabolism and its respective disorders, proteins and its respective disorders, kidney function tests (KFT), liver function tests (LFT), clinical enzymology, biochemical markers of bone metabolism, cardiac markers, tumor markers, and body water, electrolytes, acid-base balance and blood gases. The principles of testing methods and the physiologic and biochemical changes that occur in disease states are covered. General laboratory principles, laboratory safety, laboratory quality assessment will also be applied to the course. The Dr Elham Sharif 2

3 laboratory practical will include collection and processing of blood specimens, quality control and diagnostic tests for common clinical tests. Prerequisite: CHEM 351, CHEM 352, BIOM215, BIOM211 This syllabus details the course description, learning outcomes and assessment requirements for this course. Students are encouraged to attend both lecture and tutorial classes, as this will enhance the learning experience of these subject areas. In support of the lectures provided, students are expected to study the subject area by referencing the suggested text and peer reviewed journals. General enquires regarding this course can be made via to the course Professor Dr Elham Sharif at: and lecture specific enquires should be made by ing the particular staff member involved. The course will concentrate on the following topics: Philosophy of clinical chemistry/clinical utility An area which under pins all of current diagnostic clinical chemistry, discussing the value of biochemical and molecular biological tests in the investigation of disease. Introducing concepts such as sensitivity, specificity, predictive values and population selection. Plasma proteins in disease The role of the plasma proteins in the investigation of disease. Typical topics studied include: clinical enzymology and applications in the diagnosis of coronary heart disease; examples of specific clinically relevant enzymes. Tissue damage and relationship to diagnostic use of enzymes and isoenzymes are reviewed. Paraproteins as an example of the use of proteins as tumour markers. Clinical enzymology Cardiac markers Tumour markers and disease Liver function/disease Review of fundamental liver biochemistry. Causes of acute and chronic liver disease. Liver function tests. Differential diagnosis of jaundice and other disorders. Investigation of biochemical markers of bone disease. Carbohydrate metabolism and its disorders This chapter will focus on identifying the primary biological function and metabolism of carbohydrates in humans body, identify and explain rule of hormones in glucose metabolism,. It will also discuss the symptoms of hypo and hyper-glycemia in human. The types of DM, and also I will describe laboratory test available for DM investigation and discuss rule of self monitoring devices for diabetics in the measurement of blood. Disorders of detoxification and excretory mechanisms - renal Review of normal kidney functions. Tests of the glomerular function renal clearance, GFR, serum creatinine and urea determinations. Outline of tests of tubular function. Renal calculi and their investigations. Dr Elham Sharif 3

4 Acid base disorders Review of fundamental acid-base concepts. Metabolic and respiratory causes and clinical effects of acidosis and alkalosis. Disturbances to oxygen transport. Assessment of acid-base status; diagnosis and management of acid-base disorders. Electrolyte and water Balance This chapter will cover the mechanism of water balance in the body and critical care analytes used in the ICU and emergency room, for instance sodium, Chloride, potassium, bicarbonate, ph and partial pressure of the oxygen and carbon dioxide. Osmolality and volume regulation will be also reviewed. COURSE OBJECTIVES The course aims for the students are to: 1. Define the following terms: quality assurance, quality control, accuracy, precision, reference interval, compare and contrast the specificity and sensitivity of the most commonly used diagnostic markers. 2. Describe the biochemical structure and metabolism of proteins, their functions and describe the patterns associated with protein abnormalities shown in serum protein electrophoresis. 3. Discuss the tissue sources, major properties, methods of analysis, diagnostic significance, clinical use and sources of error in the analysis for enzymes and tumor markers. 4. Demonstrate how to calculate different important parameters in the field of clinical chemistry. 5. Discuss the basic disorders of the different organs and define which laboratory tests may be performed to diagnose them. 6. Gain practical Skills and common source of errors in clinical chemistry laboratory. 7. Show professional behaviour and receives criticism graciously. 8. Enhance critical reasoning and analytical skills in analyzing cases studies. 9. Develop communication skills in the presentation of scientific material via poster presentation. 10. Apply principles of safety regulations. 11. Participate in the biomedical activities Dr Elham Sharif 4

5 STUDENTS LEARNING OUTCOMES SLOs By the end of this course, the should be able to: 1. Calculate different important parameters used in the field of clinical chemistry. (PLO1,2,5) 2. Recognize and name the fractions, interpret any abnormality in the pattern, and associate these patterns with common disease states given a densitometric scan of a serum protein electrophoresis using the routine method (five zones). (PLO1,2,5) 3. Select appropriate investigations and rank tests used for investigation according to their clinical utility, for different disorders. (PLO5) 4. Perform basic laboratory techniques in clinical chemistry labs. (PLO2) 5. Maintain strong professional principles and morals. (PLO8) 6. Develop skills in the interpretation of biochemical data used in the investigation and diagnosis of disease, through interpreting case study. (PLO5, 6) 7. Communicate, dialogue and present a scientific material by presenting a poster. (PLO4,5,6) 8. Comply with safety regulations. (PLO3) 9. Adjust efficiently in team working. (PLO9) Dr Elham Sharif 5

6 Qatar University College of Arts and Sciences Health Sciences department Mapping program outcomes, course outcomes and assessments Program Learning outcomes PLO1 PLO1,2,5 Course objectives Course learning outcomes Assessment activities (exam, term paper, assignments) Define the following terms: quality assurance, quality control, accuracy, precision, reference interval, compare and contrast the specificity and sensitivity of the most commonly used diagnostic markers. Describe the biochemical structure and metabolism of proteins, their functions and describe the patterns associated with protein abnormalities shown in serum protein electrophoresis. Demonstrate conceptual knowledge in area related to clinical chemistry. (PLO1) Recognize and name the fractions, interpret any abnormality in the pattern, and associate these patterns with common disease states given a densitometric scan of a serum protein electrophoresis using the routine method (five zones). (PLO1,2,5) Exam Case studies Tutorial sessions Exam Case studies Tutorial sessions Assessment tools (if applicable) PLO1,5,6 Discuss the tissue sources, major properties, methods of analysis, diagnostic significance, clinical use and sources of error in the analysis for enzymes and tumor markers. Recognize, analyze and correlate certain organ function test profile & assess the clinical usefulness of various markers. (PLO1,5,6) Exam Case studies Tutorial sessions PLO1,2,5 Demonstrate how to calculate different important parameters in the field of clinical chemistry. Calculate different important parameters used in the field of clinical chemistry. (PLO1,2,5) Exam Case studies Tutorial sessions PLO5 Discuss the basic disorders of the different organs and define which laboratory tests may be performed to diagnose them. Select appropriate investigations and rank tests used for investigation according to their clinical utility, for different disorders. (PLO5) Exam Case studies Tutorial sessions PLO2 Gain practical Skills and common source of errors in clinical chemistry laboratory. Perform basic laboratory techniques in clinical chemistry labs. (PLO2) Exam Case studies Tutorial sessions PLO8 Show professional behavior and receives criticism graciously. Maintain strong professional principles and morals. (PLO8) Rubric PLO5,6 Enhance critical reasoning and analytical skills in analyzing cases studies. Develop skills in the interpretation of biochemical data used in the investigation and diagnosis of disease, through interpreting case study. (PLO5, 6) Case studies Pre-analyzed data PLO4,5,6 Develop communication skills in the presentation of scientific material via poster presentation. Communicate, dialogue and present a scientific material by presenting a poster. (PLO4,5,6). Poster presentation Rubric PLO3 Apply principles of safety regulations. Comply with safety regulations. (PLO3) Exam PLO9 Participate in the biomedical activities Adjust efficiently in team working. (PLO9) Show certificates Rubric Dr Elham Sharif 6

7 Objectives per Chapter Chapter 1 proteins: Chapter Objectives Upon completion of this chapter, the student should be able to: Describe the structures and general properties of amino acids and proteins, including both conjugated and simple proteins. Outline protein synthesis and catabolism. Discuss the general characteristics of the aminoacidopathies, including the metabolic defect in each and the procedure used for detection. Briefly discuss the function and clinical significance of the following proteins: Prealbumin, Albumin, α1-antitrypsin, α1-fetoprotein, Haptoglobin, Ceruloplasmin, Transferrin, Fibrinogen, C-reactive protein, Immunoglobulin, Troponin Discuss at least five general causes of abnormal serum protein concentrations. List the reference intervals for total protein and albumin and discuss any nonpathologic factors that influence the levels. Describe and compare methodologies used in the analysis of total protein, albumin, and protein fractionation. Include the structural characteristics or chemical properties that are relevant to each measurement and the clinical usage of each. Recognize and name the fractions, interpret any abnormality in the pattern, and associate these patterns with common disease states given a densitometric scan of a serum protein electrophoresis using the routine method (five zones). Differentiate the types of proteinuria on the basis of etiology and type of protein found in the urine, and describe the principle of the methods used for both qualitative and quantitative determination and identification of urine proteins. Describe the diseases associated with alterations in cerebrospinal fluid proteins. Chapter 2 Enzymes Chapter Objectives Upon completion of this chapter, the student should be able to: Define the term enzyme, including physical composition and structure. Classify enzymes according to the International Union of Biochemistry (IUB). Discuss the different factors affecting the rate of an enzymatic reaction. Explain enzyme kinetics, including zero-order and first-order kinetics. Explain why the measurement of serum enzyme levels is clinically useful. Discuss which enzymes are useful in the diagnosis of various disorders, including cardiac, hepatic, bone, and muscle disorders, malignancies, and acute pancreatitis. Discuss the tissue sources, diagnostic significance, and assays, including sources of error, for the following enzymes: CK, LD, AST, ALT, ALP, ACP, GGT, amylase, lipase, cholinesterase, and G-6-PD. Evaluate patient serum enzyme levels in relation to disease states. Discuss the clinical importance for detecting macroenzymes. Discuss the role of enzymes in drug metabolism. Dr Elham Sharif 7

8 Chapter 3 Liver: Chapter Objectives Upon completion of this chapter, the student should be able to: Diagram the anatomy of the liver. Explain the following functions of the liver: bile secretion, synthetic activity, and detoxification. List two important cell types associated with the liver and state the function of each. Define jaundice and classify the three different types of jaundice. Discuss the basic disorders of the liver and which laboratory tests may be performed to diagnose them. Evaluate liver-related data and correlate those data with normal or pathologic states. Compare and contrast how total and direct bilirubin measurements are performed. List the enzymes most commonly used to assess hepatocellular and hepatobiliary disorders. Describe the various types of hepatitis, to include cause, transmission, occurrence, alternate name, physiology, diagnosis, and treatment. Chapter 4 cardiac markers: Chapter Objectives Upon completion of this chapter, the student should be able to: Diagram the anatomy of the heart. Explain the origin of six general symptoms of cardiac disease. Discuss the etiology and physiologic effects of the following cardiac conditions: Congenital heart disease, Hypertensive heart disease, Infectious heart diseases Coronary heart disease, Congestive heart failure Identify nine risk factors for coronary heart disease. List six features of an ideal cardiac marker. List and briefly describe three novel markers of inflammation currently under investigation. Compare and contrast the specificity and sensitivity of the most commonly used serum cardiac markers. Assess the clinical utility of the various cardiac markers to assess myocardial infarction. Analyze the role of the clinical laboratory in the assessment of a patient with cardiac disease. Assess the usefulness of point-of-care cardiac markers and the role of the clinical laboratory in the use of these methods. Dr Elham Sharif 8

9 Chapter 5 Tumor markers: Chapter Objectives Upon completion of this chapter, the student should be able to: Discuss the incidence of cancer in the United States. Explain the role of tumor markers in cancer management. Identify the characteristics or properties of an ideal tumor marker. State the major clinical value of tumor markers. Name the major tumors and their associated markers. Describe the major properties, methods of analysis, and clinical use of AFP, CA- 125, CEA, beta-hcg, and PSA. Explain the use of enzymes and hormones as tumor markers. Chapter 6 carbohydrate metabolism: Chapter Objectives Upon completion of this chapter, the student should be able to: Identify the primary biological function and metabolism of carbohydrates in humans body. Identify and explain rule of hormones in glucose metabolism. Discuss the symptoms of hypo and hyper-glycemia in human. Types of DM Describe laboratory test available for DM investigation. Discuss rule of self monitoring devices for diabetics in the measurement of blood. Chapter 7 kidney: Chapter Objectives Upon completion of this chapter, the student should be able to: Diagram the anatomy of the nephron. Describe the physiologic role of each part of the nephron: glomerulus, proximal tubule, loop of Henle, distal tubule, and collecting duct. Describe the mechanisms by which the kidney maintains fluid and electrolyte balance in conjunction with hormones. Discuss the significance and calculation of glomerular filtration rate and estimated glomerular filtration rate. Relate the clinical significance of total urine proteins, urine albumin microalbuminuria, myoglobin clearance, serum β2-microglobulin, and cystatin C. List the tests in a urinalysis and microscopy profile and understand the clinical significance of each. Describe diseases of the glomerulus and tubules and how laboratory tests are used in these disorders. Distinguish between acute and chronic renal failure. Discuss the therapy of chronic renal failure with regard to renal dialysis and transplantation. Dr Elham Sharif 9

10 Chapter 8 electrolyte balance: Chapter Objectives Upon completion of this chapter, the student should be able to: Define electrolyte, osmolality, anion gap, anion, and cation. Discuss the physiology of each electrolyte described in the chapter. State the clinical significance of each of the electrolytes mentioned in the chapter. Calculate osmolality, osmolal gap, and anion gap and discuss the clinical usefulness of each. Discuss the analytic techniques used to assess electrolyte concentrations. Correlate the information with disease state, given patient data. Identify the reference ranges for sodium, potassium, chloride, bicarbonate, magnesium, and calcium. State the specimen of choice for the major electrolytes. Discuss the role of the kidney in electrolyte excretion and conservation in a healthy individual. Discuss the usefulness of urine electrolyte results: sodium, potassium, calcium, and osmolality. Chapter 9 acid base balance: Chapter Objectives Upon completion of this chapter, the clinical laboratory scientist should be able to: Describe the principles involved in the measurement of ph, PCO2, PO2, and the various hemoglobin species. Outline the interrelationship of the buffering mechanisms of bicarbonate, carbonic acid, and hemoglobin. Explain the clinical significance of the following ph and blood gas parameters: ph, PCO2, PO2, actual bicarbonate, carbonic acid, base excess, oxygen saturation, fractional oxyhemoglobin, hemoglobin oxygen (binding) capacity, oxygen content, and total CO2. Determine whether data are normal or represent metabolic or respiratory acidosis or metabolic or respiratory alkalosis using the Henderson-Hasselbalch equation and blood gas data. Identify whether the data represent uncompensated or compensated conditions. Identify some common causes of nonrespiratory acidosis and alkalosis, respiratory acidosis and alkalosis, and mixed abnormalities. State how the body attempts to compensate (kidney and lungs) for the various conditions. Describe the significance of the hemoglobin oxygen dissociation curve and the impact of ph, 2,3-diphosphoglycerate (2,3-DPG), temperature, ph, and PCO2 on its shape and release of O2 to the tissues. Discuss problems and precautions in collecting and handling samples for ph and blood gas analysis. Include syringes, anticoagulants, mixing, icing, and capillary and venous samples as well as arterial samples in the discussion. Describe instrumental approaches to measuring various hemoglobin species and ph and blood gas parameters. Describe approaches to quality assurance, including quality control, proficiency testing, and delta checks to assess analytic quality. Discuss the reasons for possible discrepancies, given oxygen saturation data Dr Elham Sharif 10

11 calculated by the blood gas analyzer and measured by the cooximeter. Calculate partial pressures for PCO2 and PO2 for various percentages of carbon dioxide and oxygen. In doing these calculations, account for the barometric pressure and vapor pressure of water. Dr Elham Sharif 11

12 Distribution of Contents Lecture Schedule Week Session 1 Sunday: AM Session 2 Tuesday: AM Notes Chapter 1 st week 19-21/9/ nd week 26-28/9/10 Introduction and overview of course content Proteins and amino acids in plasma Use of biochemical tests in clinical medicine/ clinical utility Instrumentation: Spectrophotometer, Abnormalities of proteins in plasma Posters presentati on forum to manage with students Chapter/ Chapter 11-15/ 3d week 3-5/10/10 Abnormalities of proteins in plasma (2) Plasma Enzyme tests in diagnosis (1) Protein Quiz Chapter W4/ 4 th week 10-12/10/10 Plasma Enzyme tests in diagnosis (2) Midterm exam Chapter/ 5 th week 17-19/10/10 Investigations of liver disease Liver diseases- Biochemical markers of bone metabolism Chapter/ 6 th week 24-26/11/10 Liver diseases cont d Liver Tutorial Enzyme Quiz Chapter/ 7 th week 31/10-2/11/10 Biochemical markers of Cardiac injuries Biochemical markers of Cardiac injuries/tutorial Chapter/ 8 th week 7-9/11/10 Tumour markers 1 Tumour markers 2 /Tutorial Liver Quiz Chapter/ 9 th week 14-16/11/ Eids Holiday Eids Holiday Chapter/ 10 th week 21-23/11/ Eids Holiday Midterm exam Dr Elham Sharif 12

13 11 th week 28-30/11/10 12 th week 5-7/12/10 Carbohydrate metabolism Renal disease Disorders of carbohydrate metabolism cont d/case studies Renal disease cont d/tutorial Carbohydr ates Quiz Chapter/ Chapter/ 13 th week 12-14/12/10 Electrolytes and water balance Acid/Base balance Chapter/ 14 th week 19-21/12/10 National Day Holiday th week 26-28/12/10 Acid/Base balance cont d-tutorial 16 th week Final Exam 12/1/2010 Poster Forum Chapter/ Review exams Chapter / Final Exams 12/1/2010 Exams dates: Exam 1: 12/10/2010 Exam 2: 23/11/2010 Final exam: 12/1/2010 For Quizzes dates look above. Course works submission dates: Assignment 1 case study (2.5 %): Submission date: 3/12/2010 Assignment 2 poster presentations forum (7.5 %): Submission Date: 21/12/2010 All work should be submitted online Dr Elham Sharif 13

14 Clinical Chemistry Practical section: Learning goals: Upon completion of this course, the student will: 1. Become familiar with the best practices of laboratory procedures in clinical chemistry. 2. Demonstrate adequate knowledge and application of the theory and practical skills. Laboratory Learning objectives Upon completion of this Clinical Chemistry lab course, the student will: 1. Apply principles of basic safety laboratory procedures and management at all time. 2. Apply principles of phlebotomy to collect blood, process it and either store it or perform a profile on it, where appropriate controls are prepared for the testing procedure. 3. Apply principles of basic laboratory procedures like dilution of samples, calibration of spectrophotometer and pipetters in order to perform tests. 4. Perform specific manual clinical chemical tests with precision, accuracy and efficiency, with recognition for safety, appropriate scientific vocabulary, and proper reagent and equipment. 5. Utilize basic spectrophotometers according to established procedures. 6. Identify the type of samples & anticoagulant used for each procedure. 7. Select the appropriate controls for each method. 8. Develop skills to manage time required to perform several laboratory tests in single lab session. 9. Apply knowledge to identify sources of errors in laboratory testing, e.g. testing for false positives and false negatives result. 10. Calculate test results data obtained from laboratory procedures and to be able to correlates the data to assess test results. 11. Evaluates laboratory data to check for possible source of errors. Dr Elham Sharif 14

15 Laboratory student learning Outcomes/Competencies Upon completion of this course, the student will: 1. Demonstrate safety procedures as related to pertinent testing. 2. Effectively perform phlebotomy and collect blood in a correct test tubes with correct anticoagulant. 3. Demonstrate an understanding of the principles and techniques of quantitative procedures used in clinical chemistry laboratory. 4. Perform routine clinical chemistry testing according to established protocols. 5. Perform a complete routine blood analysis on 3 specimens within 1:30 hours with 80% accuracy. 6. Effectively evaluate the testing results of the 3 specimens. 7. Recognize common errors associated with blood sampling and be able to accept or reject blood sample, e.g. hemolysed sample is rejected to avoid source of error. 8. Calculate, interpret and validate the obtained result, and accurately interpret and report test results. 9. Plan strategies to perform several tests at single lab session. 10. Obtain reproducible results by repeating the experiments, as lab experiments will be run in accumulative basis. 11. Evaluate, prioritize and perform procedures in a timely manner. 12. Perform quality assurance procedures, assessing the validity and accuracy of results using quality control data and quality assurance practices. 13. Recognize errors that occur and demonstrate proper problem-solving techniques. Dr Elham Sharif 15

16 Distribution of Contents Laboratory Schedule Week Lab 1 Sunday 12-14:50 1 st week Safety instructions 19-21/9/2010 & laboratory orientation 2 nd week Pipet calibration 26-28/9/10 Spectrophotometer function test, simple calculation 3d week 3-5/10/10 Phlebotomy & processing of blood sample Lab 2 Tuesday 12-14:50 Safety instructions & laboratory orientation Pipet calibration Spectrophotometer function test, simple calculation Phlebotomy & processing of blood sample Notes General laboratory principles Phlebotomy instruction, type of specimens, anticoagulant Laboratory quality assessment Chapter Lab Manual Lab Manual Lab Manual 4 th week Total proteins, Total proteins, Lab Manual 10-12/10/10 Quality control lab, Quality control lab, 5 th week Albumin Albumin Lab Manual 17-19/10/10 6 th week Glucose Glucose Lab Manual 24-26/11/10 7 th week Practical Exam 1 Practical Exam 1 Midterm written Lab Manual 31/10-2/11/10 and practical 8 th week Lab Manual 7-9/11/10 Bilirubin test Bilirubin test 9 th week Eid s holiday Eid s holiday Lab Manual 14-16/11/10 10 th week Eid s holiday Phlebotomy task Lab Manual 21-23/11/10 11 th week 28-30/11/10 12 th week 5-7/12/10 13 th week 12-14/12/10 14 th week 19-21/12/10 15 th week 26-28/12/10 Lactate dehydrogenase LD Cholesterol, HDL, TG Lactate dehydrogenase LD Cholesterol, HDL, TG Lab Manual Lab Manual Serial dilution Serial dilution Lab Manual Uric acid Uric acid Lab Manual Laboratory practical Laboratory practical Final written and Lab Manual final Exam final Exam practical Dr Elham Sharif 16

17 Assessment Policy and Tools-Grading system The grades will be assessed according to the table shown below; A % B % B % C % C % D % D % F 59.9 % The breakdown of the points is shown in the table below: Theoretical 60 % Mid-term Exam 1 10 % Mid-term Exam 2 10 % Quizzes 10 % Final Exam 30 % Activity & tasks 15 % Performing procedures and 7.5 % demonstrating techniques by: Poster presentation Course work: 2.5 % Class discussions & professional behaviour (tutorial sessions) DHS activity participations and/or 2.5 % community service, Attendance & tardies Thinking critically and making 2.5 % judgments: Case studies Laboratory 25 % Practical exam 1 5 % Final practical exam 10 % Laboratory reports 1 % Quiz 2.5 % Final written exam for practical 5 Phlebotomy task 1.5 Dr Elham Sharif 17

18 Course components: A) Theory 75% The theoretical section weighting about 75 % of the course grade. In general, midterms and final exams are composed of multiple choice questions (MCQ) or short answer questions (SAQ), or one of them. Exams will be marked and the answers will be posted on the, and students have the right to discuss their marks within a week, only incorrect or misinterpreted results will be taken into consideration. Fixed examination dates are apparent at the lectures outline. B) Laboratory 25% The laboratory part of the course worth 25 %. The laboratory exam will include an unknown samples and the student will be asked to do certain type of experiments not less than 5-7 test at the same time within the three hours of laboratory period. The theoretical section of the laboratory will be MCQ and SAQ type questions and will be questioned with the theoretical part of the course. Lab reports will be collected after each class and worth 2.5 % of the total marks. Methods of teaching: The methods of teaching will include: 1. Lectures: This course will be delivered in discrete sections, following the subject areas outlined in the syllabus. Each topic area will be introduced with underpinning lectures followed by a series of tutorials where extensive use of case studies will be made. Interpretation of clinical chemistry tests takes place. The lectures will focus on power point slides present in the and the textbook provided. It is recommended that the student read the chapter before appearing to the lecture session. Dr Elham Sharif 18

19 2. Lectures with discussion: - students can question, clarify & challenge. 3. Brainstorming: mainly a topic is selected, this is a listening exercise that allows creative thinking for new ideas, encouraging full participation, draws on group's knowledge and experience, moreover a spirit of congeniality is created. 4. Video clips: are presented in some of the lectures, this is an entertaining way of teaching content and raising issues, keeping group's attention, looking professional and stimulating discussion. 5. Case Studies: a defined cases is prepared and integrated within the lectures: by this will develop analytic and problem solving skills, allowing for exploration of solutions for complex issues and allowing student to apply new knowledge and skills. 6. Interactive engagement (IE) methods: are much more effective than "traditional" methods in promoting conceptual understanding of the course. Therefore the lecturer will integrate dialogues during the tutorial sessions and encourage interactive teaching. 7. In class group tutorials: each chapter is followed by a tutorial session, handouts for the tutorial session is uploaded in the together with the chapter. Tutorials will use indicative lists of questions to guide student learning. It is expected that the exercise will be completed before the tutorial. Therefore, the tutorial will engage active discussion on individual and group findings. Tutorial sessions and the problem based cases is a part of the final exam assessment and therefore attendance at tutorials is strongly encouraged. 8. Reading week: students will be asked to pick up a topic in current research and will be encouraged to be engaged in conversation and debates to expand their knowledge and integrate ideas. Dr Elham Sharif 19

20 9. E-Learning: This part include online components, which can be an assessed part of the course. A virtual learning environment which is the Blackboard is used from day of class. The students are able to study online using material created by the lecturer, download papers, articles and take online tests, or access relevant audio and video material. 10. Take home assignments: are uploaded in the for students to prepare and submit online. Teaching aids: 1) Blackboard: course syllabus, lectures, case studies 2) Text books for theoretical section & Handouts 3) Electronic resources: Journals, articles, newsletters etc 4) Web sites indicated. 5) Video clips 6) Group discussions & Class participations 7) Interactive engagement during class Methods of students evaluation/ assessments: 1. Online exams: (tests, midterms & final), all exams will be composed of MCQ questions, interpretation of illustrations, calculations of a given data, problem solving questions and true & false questions. Demonstrating knowledge and understanding and showing the ability to answer critical thinking and problem based questions in the 2 nd and 3d taxonomic level. 2. Quizzes: each quiz is 10 minutes, after completing each chapter. Demonstrating knowledge and understanding through recalling, describing, reporting, recounting, recognizing, identifying, relating & interrelating) and answering written exams. 3. Poster presentation: performing procedures and demonstrating techniques by: producing a poster presentation, a rubric is designed for student evaluation. 4. Communicating: while describing and defending their posters: through (One and two-way communication; communication within a group, verbal, arguing, describing, defending. Students are evaluated using a rubric. 5. Course work: activity, participation during classes a rubric is used to assess students based on the percentage of participation. Dr Elham Sharif 20

21 6. In class assignments: after completing each chapter, students will be asked to read the assignment at home and then work in a group of 3-4 students to complete and answer the task during the class period. 7. Attendance, tardies and participation at community service or DHS activities: are assessed using a designed rubric. 8. Solving problems, developing plans and thinking critically and making judgments: through analysing work based problem (case studies) 9. Performing procedures and demonstrating techniques by performing experiments in the practical final and midterm exams. 10. Lab reports: performing procedures and demonstrating techniques following laboratory demonstration and carrying out instructions, and handing laboratory reports. 11. Phlebotomy task: performing 2 successful blood collections. 12. Laboratory practical sessions: students will be required to work on the lab with patients serum provided from Hamed Medical Corporation HMC for investigation with available kits for example, glucose, iron, HDL, cholesterol, TG, LDH etc. Quality control and safety management will be also introduced. The students will be required to sign a form for agreeing on the safety control during their presence at the lab. Learning activities and tasks 1. DEBATE DISCUSSION STUDIES Case studies will be used to provide the basis of the tutorial program. Each case study will develop a theme outlined in one of the core lectures. Each case study will be followed by a number of questions directly relevant to that case. Also, there will be an additional set of questions, which are more wide-ranging, designed to link together other aspects of clinical chemistry with the case. Before the tutorial, you will have to prepare answers to the questions and be ready to discuss your answers within small groups with the lecturer. The questions given with each case study should be used to direct your reading and study. 2. Poster presentation: Students will also be required to prepare a poster presentation on a piece of current research in the area of clinical chemistry allowing the student to critically evaluate scientific literature. An element of peer assessment will be used in the poster presentation allowing the development of critical skills. The posters will be presented in a forum where each student will stand beside his poster and will be able to defend his poster for the public audience from other faculties. In addition to the poster, the student needs to provide a one-page handout that summarizes the most important points of the Dr Elham Sharif 21

22 poster. Some faculty members will view the posters and ask the students questions about their project. Then their fellow students will do the same. At the end of poster session the winning poster will be announced and a simple prize will be given. 3. Take home assignment Students will also be required to evaluate and interpret an assignment, calculations, problem solving and review of new methodology should be evaluated. All assignments should be submitted online. 4. Perform phlebotomy task Follow the competency of the task and practice the procedure several times. 5. Tutorial sessions: students should be prepared and work in groups. A uniform poster template will be designed and provided by Dr Elham Sharif for the students to add their information of current research in clinical chemistry. For more information of how to prepare effective poster look at the appendix. Dr Elham Sharif 22

23 Instructions for students and course Regulations Classroom Discipline The use of mobile telephones inside the classroom is NOT allowed. In the incidence of student using blackberry or mobile phone during the lecture, the student will be asked to leave the class. Any student disciplinary issues, which may arise, will be referred to the head of the Department. It is expected that students will be prepared for instruction by having appropriate writing tool, textbook, handouts, and/or paper ready for taking notes or referring to their text. Student Responsibilities and Attendance Policies and Procedures 1. Class Attendance: Class attendance is compulsory. In accordance with University regulations, a student s absence cannot exceed 25% of the total number (entire semester) of class meetings. If your absence rate exceeds 25%, including both excused and unexcused absences, you will NOT be allowed to take the final examination and will receive an F barred grade for the course. 2. Blackboard: Students are responsible to frequently check the course site on Blackboard for handouts and other documents. Failure to do this required task will result in grade deductions. The exact policy will be communicated to separately. 3. Tardies: Students are intended to be on time (3 late class arrivals will be counted as 1 class absence) in class attendance. Students are expected to behave in an adult and professional way. Three late attendances to class will result in a 1 point (1%) subtraction from the Final course grade/mark. Four (4) late attendances will result in a 2% deduction and so on. 4. Class behaviour: Food is not permitted during class hours. In between chit chatting is prohibited, and any kind of interference during the lecture is not accepted. Dr Elham Sharif 23

24 Classroom etiquette: during class please refrain from conversing with other students, at any interval in which the Professor or another student is replying. Exclusive attention must be a priority which concludes that non-academics activities and distractions must be abstained. Disrespectful behaviour will not be tolerated at any cost. For that reason the professor obtains the right to dismiss student from class if any non-academic behaviour is observed. Only in an emergency will the student be permitted to leave the class. Interruption during the lecture is unfavourable unless there is an urgent need. Open discussion regarding the subject is encouraged after the completion of the lecture. 5. Unit Examinations Examinations should only be missed in justifying circumstances with approval of the instructor. A student who misses an exam will be required to bring a medical excuse to make up the exam on the next day of lecture, otherwise the exam will not be repeated. Contact the instructor prior to the next lecture day to make arrangements to take the exam. A student who misses an exam, without instructor approval, will have ten percent (10%) deducted from the grade achieved on the exam. Course assignments should be worked independently unless otherwise communicated. Course assignments should be submitted in an organized format as directed and any late assignments will be penalized. Plagiarism (Academic Dishonesty) All students are expected to turn in work that is their own. Any attempt to pass off another's work as your own will constitute an "F" in the entire course unless it is communicated as acceptable to work as a group. Using part of, or the entire work, prepared by another or turning in a homework assignment prepared by another student or party are examples of plagiarism. You may discuss assignments and projects with each other, but you should do the work yourself. In the case of group projects, you will be expected to do your share of the work. If you use someone else's words or ideas, you must cite your sources. Plagiarism is considered a serious academic offence and can result in your work losing marks or being failed. QU expects its students to adopt and abide by the highest standards of conduct in their interaction with their professors, peers, and the wider University community. As such, a student is expected not to engage in behaviours that compromise his/her own integrity as well as that of QU. You may discuss assignments and projects with each other, but you should do the work yourself. In the case of group projects, you will be expected to do your share of the work. If you use someone else's words or ideas, you must cite your sources. Dr Elham Sharif 24

25 Plagiarism includes the following examples and it applies to all student assignments or submitted work: Use of the work, ideas, images or words of someone else without his/her permission. Use of someone else's wording, name, phrase, sentence, paragraph or essay without using quotation marks. Misrepresentation of the sources that were used. For further information see: The instructor has the right to fail the coursework or deduct marks where plagiarism is detected Dr Elham Sharif 25

26 References and resources: The recommended course textbooks are: Bishop., ML, Fody., E.P. Schoeff, LE, Clinical Chemistry: Techniques, Principles, Correlations (Bishop, Clinical Chemistry) ISBN: , Publisher: Lippincott Williams & Wilkins; Sixth Edition edition, Marshall, W.J., Bangert, S.K.; Clinical Chemistry 6 th edition, ISBN Publisher: Mosby, Release date: Christenson, R.H., Gregory, L.C., Johnson, J.L.; APPLETON & LANGES OUTLINE REVIEW CLINICAL CHEMISTRY1st edition, ISBN Publisher: McGraw-Hill Medical Publishing Division-Release date Printed sources: It is recommended that the students read these pieces of literature; HOWEVER the students are not required to DO SO: Tietz, N.W.; Fundamentals of Clinical Chemistry. ISBN Publisher: Saunders - Release date: Luxton, R.; Biomedical Sciences Explained Clinical Biochemistry. ISBN Publisher: Arnold Publishers - Release date: Devlin, T.M.; Textbook of Biochemistry with Clinical Correlations. ISBN Publisher: Wiley-Liss - Release date: Gowenlock, A.H. Varley's Practical Clinical Biochemistry. ISBN Publisher: Crc Pr I Llc - Release date: Whitby, L.G., Smith, A.F., Beckett, G.J. and Walker, S.W.; Lecture Notes on Clinical Biochemistry. ISBN Publisher: Blackwell Science (UK) - Release date: Bishop, M.J., Fody, E.P. and Schoeff, L.; Clinical Chemistry, Principles, Procedures, Correlations 5 th edition. ISBN Publisher: Lippincott Williams & Wilkins, - Release date: Gaw, A., Murphy, M.J., Cowan, R.A., Denis, S.T., O Relly, J., Stewart, M.J., and Shepherd, J.; Clinical Biochemistry 3 rd edition, An illustrated colour text. ISBN Publisher: Churchill Livingstone, Genetics: Jorde, L.B., Carey, J.C., Bamshad, M.J., and White, R.L. Medical Genetics 3 rd edition, ISBN Publisher: Mosby, Nussbaum, R.L., McInnes, R.R., and Willard, H.F.; Thompson & Thompson Genetics in Medicine 6 th edition. ISBN Publisher: Elsevier, Turnpenny, P., and Ellard, S.; Emery s Elements of Medical Genetics 12 th edition. ISBN Publisher: Elsevier, Dr Elham Sharif 26

27 Journals Annals of Clinical Biochemistry British Medical Journal Clinical Chemistry Current Advances in Clinical Chemistry Journal of Endocrinology Nature The Lancet New England Journal of Medicine Biochemistry Online Online sources: GENETests: y&fw=fl3c&filename=/ this is a publicly funded medical genetics information resource developed for physicians, other healthcare providers, and researchers, available at no cost to all interested persons. Endotext.org: is the web-based source of information on endocrine disease directed to physicians around the world caring for patients with these problems. It is comprehensive, authoritative, constantly up-dated, and available without cost. This site covers the broad area of Clinical Endocrinology, emphasizing clinical endocrine practice, including the most current information on the manifestations of endocrine disease, diagnosis and treatment. International Federation of Clinical Chemistry and Laboratory Medicine: Association of Clinical Biochemists: The Royal Collage of Pathologists: American Association of Clinical Chemists: Lab tests online: Dr Elham Sharif 27

28 Appendices Matrix of Objectives and Outcomes Dr Elham Sharif 28

29 Dr Elham Sharif 29

30 Dr Elham Sharif 30

31 Student Name: Activities & Course Participation Rubric* Total Score (5 %) Criteria Demonstrates initiative. Excellent (5 points) Always participates in class discussions, asks questions, and recognizes tasks that need to be performed and completes them. Good (4 points) Quality Often participates in class discussions, asks questions, and recognizes tasks that need to be performed and completes them. Satisfactory (3.5 points) Seldom participates in class discussions, asks questions, or recognizes tasks that need to be performed and completes them. Needs Improvement (2 points) Does not participate in class discussions, ask questions, or demonstrate initiative. Score Professional behavior Receives criticism graciously, attempts to integrate feedback, and provides purposeful rational for design choices. Receives criticism graciously. Has difficulty receiving criticism or makes little or no attempt at integrating critical Frequently defensive and/or combative while receiving feedback. Dr Elham Sharif 31

32 feedback from peers and faculty. Tardies Always arrives to class on time, attends the entire class session, and promptly notifies the instructor regarding absences Often arrives to class on time, attends the entire class session, and promptly notifies the instructor regarding absences. Seldom arrives to class on time, attends the entire class session, or notifies the instructor regarding absences. Does not arrive to class on time, attend the entire class session, or notify the instructor regarding absences. Attendance No unexcused absences. Rare (1 or 2) unexcused absence. Few (3 or 4) absences. More than 4 absences. Participation at DHS activities and community service More than three participate at DHS activities and/or community service > Two participate at DHS activities and/or community service > One participate at DHS activities and/or community service One participate at DHS activities and/or community service Demonstrates initiative & Professional behavior: 2.5 % Tardies, Attendance and Participation at DHS activities and community service: 2.5 % Dr Elham Sharif 32

33 Clinical chemistry Poster assessment Mark sheet Poster Number ( -- ) Exceeds Expectations Meets Expectations Does Not Meet Expectations Point earned or 0 Section 1 Presentation Clarity of presentation legible print, font. Clear diagram Figure legends Originality Section 2 Content Introduction: Appropriate background Puts subject into context Factual content: Clear presentation of facts Diagrams with adequate information Have reference been given & cited. Conclusions Current thinking if any Potential future trends if any Section 3 verbal defence Understanding of topic Clear communication skills, professional attitude Total number of marks /7.5 marks Score Comment Dr Elham Sharif 33

34 Appendix 1 Suggestions for preparing effective posters Your poster should be designed to be self-explanatory because it may be viewed when you are absent or busy. The poster should begin with an introduction and end with clear conclusions. Many people look at the conclusions first to decide whether they want to read the entire poster. Important material should be in large enough print to be read by people six feet away; methodological detail should be held to a minimum. The optimal length is approximately (roughly 100 x 70 cm). Place your poster on the fiberboard by means of pushpins or thumbtacks. Be sure to bring your own! You will need approximately 50. Specific suggestions are given below:- 1. The top of the poster should have a 2-3 foot-wide banner printed with type 1 inch high (72 points cm) or larger stating the title of the poster, the names and affiliations of the authors (underline the presenting author), and the abstract number. 2. Start the poster with an introduction in large print that explains what you are doing and why. The introduction should give any necessary background information, the rationale for the work, and the scope of the study. One effective way to interest readers is to focus on one or two questions that are answered by your research. In general, the poster will suffer if you are excessively ambitious or include too much information. 3. Make the flow of information in the poster explicit by the use of inch-high numerals on each panel and/or by having simple selfexplanatory headings for each major point. The flow of information should be organized in columns running down the poster. The transition from one section to the next or the reason for doing the next experiments should be explained. Using different colours of background matting for different parts of the work is often an effective way to help the reader. 4. Each Table or Figure should have a heading in large print describing the essential finding or point. The text below each figure, in smaller type, should describe results and/or conclusions. You may want to highlight key results or use arrows to make important points. Have clear labels on Figures and Tables to identify each curve, bar or other result. Keep things simple! It is usually not necessary to include all of the data. 5. The conclusions in large print should state the key principles shown by the results, the answers to the questions raised in the introduction and the significance of the results. It can be useful to identify the Figure or Table that supports each conclusion in parentheses after the conclusion. Cartoons or simplified schematic drawings are often the most useful way of summarizing the big picture. 6. Prepare a short presentation of 2-5 minutes. Let people look at your poster for a minute before asking whether they would like you to lead them through it. Dr Elham Sharif 34