Course Coordinator

Name	Phone	Email	Location
Associate Professor Paul Duggan	+61 8 8161 7619	paul.duggan@adelaide.edu.au	Women’s and Children’s Hospital

Additional Academic Staff

Name	Phone	Email	Location
Professor Jodie Dodd	+61 8 81617619	jodie.dodd@adelaide.edu.au	Women’s & Children’s Hospital
Dr Rosalie Grivell	+61 8 81617619	rosalie.grivell@adelaide.edu.au	Women’s & Children’s Hospital
Professor Ben Mol	+61 8 81617619	ben.mol@adelaide.edu.au	Women’s & Children’s Hospital & Lyell McEwin Hospital
Professor Gus Dekker	+61 8 81829306	Gus.dekker@adelaide.edu.au	Lyell McEwin Hospital
Dr Alphonse Roex	+61 8 81829306	Alphosne.roex@adelaide.edu.au	Lyell McEwin Hospital
Professor Robert Norman	+61 8 82224816	Robert.norman@adelaide.edu.au	Royal Adelaide Hospital
Associate Professor Martin Oehler	+61 8 8 82224816	Martin.oehler@adelaide.edu.au	Royal Adelaide Hospital

 General Enquiries

Email:

WCH Precinct wch@adelaide.edu.au

Please refer to the Learning Management System for specific teaching timetable activities.

On successful completion of this course the student will be able to:

1.   Demonstrate knowledge of:

1.1.    the physiology and pathology of the female reproductive system in childhood, adult life and old age.
1.2.    the physiology of pregnancy, parturition and the puerperium and its effect on medical and surgical disorders.
1.3.    the diagnosis and management of simple gynaecological disorders and an understanding of the principles and essential   
features of more complex gynaecological conditions.
1.4.    the application of the principles of evidence based medicine in obstetrics and gynaecology
1.5.    the epidemiology of the major health and social problems related to obstetrics and gynaecology.
1.6.    the embryology, developmental, physiological, biochemical, anatomical, endocrinological, immunological, morphological, pathological and psychological aspects underpinning obstetrics and gynaecology.
1.7.    the pharmacology of drugs commonly used during pregnancy and in gynaecology.
1.8.    the cultural, legal and social variation in attitudes towards obstetrics and gynaecology.
1.9.    the effect of the woman’s social circumstances on pregnancy or a gynaecological condition.
1.10.  the effect of drugs (prescribed or other) on pregnancy or gynaecological conditions.


2.  Demonstrate competence in the performance of:

2.1    an interview that considers the special physical, psychological and social characteristics required to take a full history relevant to human sexuality, obstetrics and gynaecology.
2.2    a physical examination which will take into account the special problems encountered in human sexuality, obstetrics and gynaecology, in order to confirm or refute an hypothesis or diagnosis.
2.3    counselling of a woman, her partner and family about common problems in human sexuality, obstetrics and gynaecology.
2.4    the provision of specific advice to the woman of the arrangements necessary for the woman to be confined in the appropriate setting including referral to a Specialist Obstetrician for further management if risk factors have been identified
2.5    the provision of specific advice to the woman on the potential hazards of drugs to the conceptus.
2.6    the requesting of appropriate laboratory, psychological or social data in order to reach an appropriate diagnosis.
2.7    observation and recording of the progress of labour, delivery and the early puerperium.
2.8    the maintenance of the dignity and privacy of the woman
2.9    the formulation of a plan for care of the patient(s).

There are no required resources. Recommended resources will be advised as appropriate.

General Texts suitable for student purchase  

Obstetrics & Gynaecology.  An evidence-based guide. Abbott Jason, Bowyer Lucy, Finn Martha. (2nd ed) 2014 Elservier.

Hacker and Moore’s Essentials of Obstetrics and Gynaecology. Hacker, Gambone and Moore. (5th edn). 2010 Saunders Elsevier. ISBN 978 1 4160 5940 0.
A student consult titles with online and print access. Medical student level (USA curriculum). 

Obstetrics and Gynaecology. Impey and Child. (4th edn) .Wiley-Blackwell 2012. ISBN 978 0 470 65519 1
Accompanying website with extra resources. Written for medical students (UK curriculum).

Gynaecology by Ten Teachers. Monga, Ash & Dobbs, Stephen (Ed) (2011) 19th edition, Hodder Arnold UK

Obstetrics by Ten Teachers. Monga, Ash & Dobbs, Stephen (Ed) (2011) 19th edition, Hodder Arnold UK Both books have free web resources.

Essentials of Obstetrics and Gynaecology. O’Reilly, Bottomley and Rymer. (2nd ed), 2012. Saunders Elsevier.


Electronic Based Reference

Cochrane Library - access via http://www.thecochranelibrary.com/view/0/index.html
or type “Cochrane Library” in to the library catalogue and follow the links

Sexual Health Website - www.mshc.org.au

Global Library of Women's Medicine free electronic O & G textbook website at www.glowm.com

Perinatal Practice Guidelines website – http://www.health.sa.gov.au/ppg/
Now also a free app – search app store for “practices guideline reader”. The correct spelling is essential.

Motherisk: www.motherisk.org
OTIS: http://www.teratology.org/OTIS_fact_Sheets.asp
LACTMed : http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
UKMi: http://www.midlandsmedicines.nhs.uk

On line Lectures:
http://www.intellilearn.com/

MyUnihttps://myuni.adelaide.edu.au/webapps/login/

eMedicihttp://emedici.com

There are numerous teaching and learning methods used, with the emphasis on active learning methods including, but not limited to: case based learning, large group lectures, seminars, tutorials and clinics and other sessions in hospital. There will be self-directed research and/or study, case presentations, and critical analysis.


CLINICAL LEARNING

Obstetric Duties
Attendance at antenatal clinics, conduct of normal labour and delivery and observation of abnormal cases gives insight into the spectrum of common conditions, most of which will be met at some time in practice.        

Students’ personal cases and deliveries require detailed observation of antenatal, labour and postnatal care and infant care.  Adequate postnatal care includes observation of lactation, involution and the psychological development of the mother-child relationship.

Labour Ward
Students are rostered to the labour ward four times during their rotation. These are all day sessions and include weekend and after-hours work. They aim to provide students with the opportunity to conduct spontaneous vaginal deliveries with the help of the midwifery staff in charge.

Gynaecological duties
Students are rostered to attend gynaecological outpatient sessions where there will be the opportunity to take a history and examine outpatients with the Consultant/Registrar attending the Clinic. Students should clerk patients being admitted for elective gynaecological surgery, with the opportunity to attend theatre sessions when a patient they have clerked is having an operation. Students should also attend enough other theatre sessions to ensure a familiarity with the commonly performed gynaecological procedures. The postoperative progress of the patient(s) who have been clerked should be followed and the pathology reports should be examined before discharge

Neonatal Medicine
Students will have weekly neonatal tutorials and will also be rostered to follow the neonatal registrar for one morning.  It is expected that students will be able to demonstrate skills in the examination of the normal neonate and knowledge of common problems that occur in the neonatal period.

Friday Afternoon Tutorials
Members of the academic and visiting staff will run whole-of-class tutorials in weeks 3-8 in selected topics, between 2:00pm and 5:00pm in the seminar room in the Robinson Institute, 55 King William Rd North Adelaide. The tutorials will be interactive.


E-LEARNING

Online Chapters
A series of on line chapters covering some core topics in
Obstetrics and Gynaecology is available through the Intellilearn web site.
Students will be automatically enrolled at the beginning of the term and must
register with the site.

The site includes optional multi-choice questions based on these
topics.  There is no restriction on the number of attempts at the MCQ's,
which are intended to stimulate students’ thinking about the topics. The
Intellilearn site will be discontinued at the end of the 2016 academic year.


eMedici
eMedici now includes case material and related formative
assessment in Obstetrics and Gynaecology.


Canvas course in Human Reproductive Health
Every student is automatically enrolled in the course in Human
Reproductive Health in the Canvas web site. This site is in 2016 will
predominantly be used for formative on-line and summative on-line assessments
and from 2017 will be the main repository of on line lectures.

Workload for the individual students will vary from week to week but students can assume that on average they will work a 45 hour week which will include clinic sessions, lectures (both delivered and online), seminars, tutorials and private study. After hours and weekend work may also be required to meet clinical requirements.

The thematic structure of the Year 5 MBBS Program will be provided and discussed at the start of the program and is discussed in detail in the student handbook (provided to students on the first day of their rotation). Please note that the following applies only to the metropolitan students undertaking Human Reproductive Health. Students attached to the Discipline of Rural Health undergo separate orientation and clinical learning opportunities.

Week	Topic	Lecture
Week 1	Warm up week	Introduction to the course including whole-of-class tutorials covering the basicsand including small group clinical skillssessions.
Weeks 2-9	Students are allocated to specific hospital-based attachments and have individual learning timetables for the clinical component of the course.	On line lectures are available in Intellilearnand additional on line resources areavailable in eMedici and MyUni, includingaccess to on line formative assessments.A separate lecture timetable for Friday afternoon tutorials held in the RobinsonInstitute seminar room will be announced.
Week 9	Summative assessment week	Assessment of knowledge, reasoning and clinical skills will be undertaken from mid week onwards in week 9.

All students will be allocated to Lyell McEwin Hospital or the Women’s and Children’s Hospital in the metropolitan area.   Although allocated to one hospital all students should expect to travel to other hospitals (Modbury, The Queen Elizabeth Hospital, Royal Adelaide Hospital) and places for specialty sessions.  

All students require a current National Criminal History Record Check for children and vulnerable adults.  A Criminal History Check is valid for 3 years and students MUST have the original with them on the first day of term.

All students will be required to do some after-hours and weekend work (see above). Any other requirements will be advised.

Students are assigned to small groups for the Contraception component of this course. A “Flipped Classroom” approach is used – requiring participation in an eLecture prior to small group participation. Under the supervision of an experienced clinician, students will individually demonstrate their knowledge of a randomly selected method of contraception. The small group will then address a complex clinical problem before reconvening at the end of the day to sit a formative quiz.

Assessment Task	Assessment Type	Weighting	Learning outcome(s) being addressed
Practice Written Examinations (all weeks)	Formative	0%	1
Intellilearn eQuizes (all weeks)	Formative	0%	1
eMedici eQuizes	Formative	0%	1
Contraception Small Group Discovery Experience	Formative	0%	1 and 2
Contraception Quiz Week 4 or 5	Formative	0%	1
Clinical Portfolio to be completed by week 7	Summative and Formative	40%	1 and 2
Written Examination week 9Multiple choice written examination week 9	Summative	30%	1
OSCE week 9	Summative	30%	2

The Clinical Portfolio is a hurdle requirement, which must be completed satisfactorily in order to pass the course. Failure to complete all components will result in a Fail No Submission report to the MBBS Board of Examiners.

Formative Assessment
In addition to informal feedback in tutorials and clinical sessions, formative on-line assessments are available in the “Practice Tests”
section of the Canvas course, and in the Intellilearn and eMedici on line modules.


Summative Assessment
The student’s final grade in this attachment is determined as follows:

Clinical tasks requiring mastery
Some clinical tasks are important but are not readily assessed in an OSCE. At the start of rotation students are given a list of tasks to be completed in a satisfactory manner. Students are required to have their observed performance of the mandatory clinical tasks signed off by an appropriate assessor (a medical graduate or graduate midwife, dependent on the task):

ALL “clinical tasks requiring mastery” must be satisfactorily completed. Failure to satisfactorily complete all tasks will result in a Fail
grade (Band E) for the course regardless of satisfactory completion of the other assessment tasks.


Written assessments
Written assessment is in Week 9.

An online examination comprising single best answer questions will be held at the end of term. All written assessments will be sat online.
 
OSCE
The OSCE will be a 5-station examination usually to be held on the last day of term (Friday week 9).  Each question will be of 5 minutes duration plus 1 minute reading time. The OSCE stations cover a range of clinical skills including history taking, examination, requesting and interpretation of investigations, diagnosis, management, explanation and counselling. Questions may be in obstetrics, gynaecology and neonatology. Stations will be standardised by the use of surrogate patients and anatomical
simulations, where applicable.

Assessment in Human Reproductive Health comprises:

1.    Clinical Portfolio 40% (week 7). This is a hurdle requirement = must pass to pass the course
2.    Written examination 30% (week 9)
3.    OSCE examination 30% (week 9).


Clinical Portfolio
A Clinical Portfolio is a record of your clinical experiences in HRH. There are four components to the Clinical Portfolio:

A case summary of a normal labour and normal or assisted vaginal delivery including management of the third stage of labour, that you have personally attended and been involved in. You are required to produce written evidence that you have undertaken this task.  

A case summary of your involvement in the care of a woman having a major gynaecological surgical procedure. You are required to attend pre- and post-operative rounds and to actively participate in operating thetare.

A case summary of your involvement in the postpartum care of awoman and her baby on the antenatal ward and/or on a domiciliary visit.

 A Clinical Core Competencies Document (see below).

You are required to submit via MyUni no later than 5pm Friday of week 7 a fully completed written clinical portfolio in the required format as detailed in MyUni unless otherwise arranged with the course coordinator or their designated person.  It is recognized that completing all components by the due date may be difficult for some people.  It is your responsibility to request help before the due date.

An assessor (qualified doctor or midwife) who is able to attest that you have performed the task to a satisfactory standard must sign the clinical competency document:

Competency	Date	Print name of assessor	Signature of assessor
Measurement of symphysial-fundal height in third trimester	Column cell	Column cell
Measurement of blood pressure in third trimester of pregnancy	Column cell	Column cell
Detection of the fetal heart using a portable Doppler device in the third trimester	Column cell	Column cell
Detection of fetal lie and presentation in third trimester	Column cell	Column cell
Inspection of a Caesarean section wound	Column cell	Column cell
Examination of a well term neonate	Column cell	Column cell
Attendance and participation in:	Column cell	Column cell
An elective gynaecological operative list for a minimum of three hours	Column cell	Column cell
Postoperative ward rounds on a regular basis	Column cell	Column cell
Antenatal ward rounds on a regular basis	Column cell	Column cell
The care of a woman in labour for a mimimum of 4 hours including attendance at delivery – Case 1#	Column cell	Column cell
The care of a woman in labour for a mimimum of 4 hours including attendance at delivery – Case 2#	Column cell	Column cell
The care of a woman in labour for a mimimum of 4 hours including attendance at delivery – Case 3#	Column cell	Column cell

* Either a consenting patient in outpatients or in operating theatre. Written consent is required for examination under anaesthesia and is to be documented in the medical record. One patient per student.

# One delivery must be normal vaginal the other two may be vaginal or abdominal.

http://www.adelaide.edu.au/policies/230/

Clinical portfolios submitted late or incomplete without permission will receive 0 marks. The clinical portfolio is a hurdle requirement. A member of the academic staff will mark the clinical portfolio. It is necessary to pass the clinical portfolio in order to pass the course. For the purposes of grading, the percentage marks awarded for each component of the clinical portfolio appear in the table below:

 

	Marks available	How marked
Case summary of a normal labour	12%	The examiner will award between 0-12 marks for this component. A score of 7 is required to pass this component.
Case summary of a major gynaecological procedure	12%	The examiner will award between 0-12 marks for this component. A score of 7 is required to pass this component.
Case summary of your involvement in postpartum care	12%	The examiner will award between 0-12 marks for this component. A score of 7 is required to pass this component.
Clinical Core Competencies	4%	Satisfactory completion of all tasks = 4 marks, anything less = zero marks
	Total 40 %

Please note:

It is necessary to pass EACH of the three components in order to pass the clinical portfolioWe will undertake random checks to confirm that you have attended delivery suite and the postnatal wards as claimed.

Candidates who fail the clinical portfolio will receive an “E” band in the course.

Summative written assessments
Summative written assessment is held in week 9.  The written assessment comprises single best answer questions.
You will undertake these assessments on line and using an iPad that we will provide to you.

The OSCE is a multi-station examination held on the last day of term (Friday week 9).  Each question will be of 5 minutes duration plus 1-minute of reading time. The OSCE stations cover a range of clinical skills including history taking, examination, requesting and interpretation of investigations, diagnosis, management, explanation and counseling. Questions
may be in obstetrics, gynaecology and neonatology. Stations will be standardised by the use of surrogate patients and anatomical simulations, where applicable.

The OSCE examination will contribute 30% to your final grade in HRH.  

 

In addition, students will receive a banded result upon completion of their attachment.

Five bands are available to determine the assessment for the Human Reproductive Health rotation in fifth year of MBBS.  The Bands available for determining student performance are: 

A  Above expected competency for Year 5
B  Clearly at expected competency for Year 5
C  Just reaches expected competency for Year 5
D  Below expected competency for Year 5
E  Far below expected competency for Year 5

Calculation of Grades
A candidate MUST pass the core competencies (mastery) by the end of the course or will fail with an E. Otherwise, the calculation of grades is as follows:

Written and practical examinations are held at the end of the year to assess competence in the MBBS Program. Included in these exams will be some Obstetrics & Gynaecology questions.

If a replacement or additional assessment is required, this will normally take the form of a clinical viva assessment, which may include an observed long case and oral assessment covering both the long case and a range of other topics.

A student course evaluation is completed online by all students at the end of the rotation.  SELTS of individual teaching are done on a regular basis.

Not applicable