Course Coordinator - Dr Toby Commerford
Email: toby.commerford@sa.gov.au
Location: Royal Adelaide Hospital

Year 5 Rural Program Coordinator: Bronwyn Herde
Phone: +61 8 8313 4528
Email: bronwyn.herde@adelaide.edu.au
Location: Adelaide Rural Clinical School, The University of Adelaide

Geriatrics:

Course component 1: Video Conference Tutorials & Video Presentation on a medical condition
Duration: 2 hours
Enrolment capacity: na
Quantity: 11 x 2 hours

Course component 2: Geriatric Medicine Case Presentation & Clinical Skills Day
Duration: 1- 2 days
Enrolment capacity: na
Quantity: 1 each per rural site

Course component 3: Rural Geriatrics Outpatient Clinics, Residential Care Visits, Domiciliary Care & ACAT Exposure
Duration: semester
Enrolment capacity: na
Quantity: 16 weeks

Course component 4: Geriatric quizzes (4 quizzes x 5 questions)

Geriatrics tutorials are generally on a Tuesday afternoon from 3.30pm - 5.30pm

General Practice:

Semester 1 - Self directed learning- 10, one hour online modules on a range of topics. Contribution to Padlet discussion after each module. Two Q & A Zoom sessions to discuss modules.

Semester 2 - Fortnightly Zoom tutorials on a range of topics relevant to professional development in general practice.

Geriatrics
A. On completion of Year 5 Geriatrics, students will demonstrate knowledge and understanding of the:
1. concepts and facts regarding problems of hospitalized patients and patients in the community
2. physiologic changes related to ageing
3. consequences of iatrogenesis on health outcomes
4. management of conditions common to older people, including geriatric syndromes
5. range of services for the elderly, including those outside the acute hospital setting
6. work of the various members of the healthcare, aged care and rehabilitation teams
7. influence of environmental, social and financial circumstance on the older person’s health outcomes

B. Students will demonstrate competency, as expected of a Year 5 student, in the following areas of clinical skills and reasoning:
1. obtaining a history, performing an appropriate physical examination and assessing elderly patients in all domains including cognition, emotion, physical function, falls, nutrition, integument, bone health and continence
2. documenting medications, discussing the evidence for and against the use of these medications, the adverse effects and drug interactions that may occur, and the monitoring requirements
3. performing supervised procedures as deemed appropriate by the preceptor
4. interpreting data commonly collected from patients
5. documenting the history and physical examinations and developing a problem list with proposed management and review plan
6. verbal presentation and discussion of assigned patients
7. the concept and application of advanced care planning and capacity assessment
8. communicating with general practitioners, allied health members in the community and family about management plans, ensuring clinical handover

C. Students will demonstrate the following professional attributes:
1. working and communicating with other members of the healthcare team to achieve best outcomes for their patient
2. interacting with the patient and the healthcare team in a professional manner that includes punctuality, attention to appropriate dress code, ensuring dignity in care and attention to confidentiality
3. understanding of and adherence to concepts of patient autonomy, benevolence, and distributive justice of healthcare

General Practice

D. On completion of Year 5 General Practice, students will demonstrate knowledge and understanding of:
1. the normal structure and function of the body (at all levels from molecule to organism), epidemiological, social and behavioural sciences
2. the common problems presenting to general practice and the approaches for their recognition, investigation, treatment and prevention
3. integrating and applying core medical and scientific knowledge to individual patients, population and health systems
4. integrating the principles of disease prevention and health promotion into clinical practice
environmental and psychosocial issues and their effect on the patient
5. the care of people who have one or more chronic illnesses
6. identifying, accessing, critically appraising, interpreting and applying evidence from the medical and scientific literature

E. Students will demonstrate competency, as expected of a Year 5 student, in the following areas of clinical skills and reasoning:
1. diagnostic reasoning skills including integration and weighted interpretation of findings from history and physical examination to arrive at an initial differential diagnosis
2. selecting and justifying common investigations, with regards to the pathological basis of disease, utility, safety and cost effectiveness, and interpret their results
3. applying therapeutic reasoning skills including identification of appropriate therapeutic objectives in both differentiated and undifferentiated clinical problems
4. formulating and justifying appropriate management options, individually and as a member of a team
prescribing therapy safely, effectively and economically, using objective evidence, in acute, chronic and palliative care settings
5. performing and explaining to patients a range of procedures (listed in year 4/5 objectives)
assisting with completion of an Extended Primary Care assessment of a patient

F. Students will demonstrate the following professional attributes:
1. the ability to communicate effectively and professionally, in a variety of media, with patients, colleagues and others
2.accepting responsibility to protect and advance the health and wellbeing of individuals, communities and populations
3.understanding the environmental, social and psychological determinants of disease, including issues relating to health inequalities, 4.cultural diversity, and socio-economic and physical environment factors
5. the ability to contribute to the teaching and professional development of others

Learning Textbooks:
Kane. Essentials of Clinical Geriatrics – 5th Edition (American) Ratnaike. Practical Guide to Geriatric Medicine – (Australian)
Isaacs. The Challenge of Geriatric Medicine –1992, Oxford University Press
Coni. Lecture Notes on Geriatric Medicine – 6th Edition, 2003, Blackwell Publishing Jackson. Prescribing for Elderly Patients – 1st Edition,2009, Wiley-Blackwell

Resource Texts
Evans. Oxford Textbook of Geriatric Medicine – 2nd Ed, 2000
Brocklehurst. Textbook of Geriatric Medicine and Gerontology – 5th Ed, 1998 Hazzard. Principles of Geriatric Medicine and Gerontology – 5th Ed, 2003

Journals
Age and Ageing; Journal of American Geriatrics Society Australasian Journal on Ageing International Journal of Geriatric Psychiatry

Internet sites
www.anzsgm.org
http://www.racgp.org.au/silverbookonline

MyUni Online Course
Content:  Video lectures, topic pre readings and related articles
Communication: Announcements and discussion boards will be used for asynchronous communications.

Web Conference Tutorials
Weekly video/web conference tutorials will be held with students at all rural placement sites.

Rural Placement: This course is part of an community based, longitudinal, integrated year of clerkship, clinical placement and training in rural hospitals and clinical settings.

Geriatrics:
Topic tutorials by video conference: Tutorials will be interactive, based on themes of self-directed learning and the clinical sciences program. Resources are available here in MyUni. Students are encouraged to seek other resources and references.

Geriatric outpatient clinic: Attendance at Outpatient Clinic if available.
Residential care visits: Visits to a nursing home (high level care) or hostel (low level care) accompanying the general practitioner as available at each rural location.
Domiciliary care and ACAT: Exposure to Domiciliary Care and the Aged Care Assessment Teams Psycho-geriatric services as available at each rural location.
General Practice and inpatient care: Involvment in clinical care will provide opportunites to manage geriatric patients.

General Practice:
Diverse opportunities in general practice include obeservation, parallel consulting, care planning and working alongside practice nurses.

LECTURE TOPICS:

Week 1: Course Overview
Week 2: Introduction to Geriatrics, Demography
Week 3: Rehabilitation Principles / Sleep
Week 4: Falls / Osteoporosis
Week 5: Cognitive Dysfunction Part 1
Week 6: Cognitive Dysfunction Part 2
Week 7: Nutrition / Polypharmacy & Iatrogenic Disease
Week 8: Incontinence / Pressure Area Care / Sexuality
Weeks 9 - 12: Medical Case Presentations

This course is the first semester of the community based, integrated Adelaide Rural Clinical School Geriatrics and General Practice Course and the assessment continues over the 36 weeks of the MBBS calendar year. A CN (continuing) grade will be awarded to Part 1 and summative assessment carried out in Part 2.

Summative assessment:
See MEDIC ST 5009BRU for the assessment for this full year course

In addition to the above, in order to pass this course and the Fifth Year MBBS Examination Annual Examination Part 2 course, students must obtain:

•    a satisfactory result in each of the components of the summative assessment in semesters 1 and 2; and

Students are expected to attend all core structured learning activities to achieve a pass in this course. Exemptions to attendance requirements may be granted by the Education Lead in consultation with the relevant course coordinator and year level advisor if there are exceptional medical, compassionate or extenuating circumstances as defined by the Modified Arrangements for Coursework Assessment Policy.

The University has developed a Scope of Practice document which outlines appropriate activities for Year 5 students. Students should be familiar with this document, and adhere to its guidelines. The document can be found in MyUni and here.

Formative Assessment
Students must participate satisfactorily in all components of the geriatrics course, i.e. tutorials, medical case, rehabilitation case, geriatrics outpatient clinics, visits to aged care facilities, ACAT, Domiciliary Care. The tutor must be informed should the student not be able to attend tutorials or any of the visits for a valid reason. Where possible, students must try and organize an alternative time for these experiences (except for tutorials). If the geriatrics tutor has concerns with student participation or attendance, feedback will be provided via e-mail, telephone, in person or via GP preceptors. Tutorial attendance and participation is very important. Failure to provide an explanation for absence will result in a score of 0. Absence without explanation at 3 or more sessions will mean that the student has not completed this component satisfactorily.

Summative Assessment
It is the responsibility of the student to be aware of the date of their medical and rehabilitation case presentations. If changes are required, it is their responsibility to make the tutor and coordinator aware of this. Failure to do this may result in a fail grade in that component.

The MBBS Program has a regular program of evaluation.  In addition, student representatives are appointed to MBBS committees and are encouraged to report on issues of importance to students.
Please refer to CANVAS with regards to the academic response to SELTs.

Students may access the University Health Practice, 61+ 08 83135050  http://www.adelaide.edu.au/student/health/

The MBBS Program website has details on Student Well-being resources which can be accessed.

Please read the MBBS Program Code of Conduct