MEDIC ST 3102AHO - Clinical Skills III Part 1

Teaching Hospitals - Semester 1 - 2014

In Year 3, students continue develop and improve on the clinical interviewing skills required to elicit and record a clinical history and to perform a physical examination. Students move out of the clinical skills laboratory and are placed within a teaching hospital for one day a week.

  • General Course Information
    Course Details
    Course Code MEDIC ST 3102AHO
    Course Clinical Skills III Part 1
    Coordinating Unit Medical School Group
    Term Semester 1
    Level Undergraduate
    Location/s Teaching Hospitals
    Contact Weekly lectures, CBL sessions & resource sessions
    Prerequisites Year 2 MBBS Exam
    Restrictions Available to MBBS students only
    Course Description In Year 3, students continue develop and improve on the clinical interviewing skills required to elicit and record a clinical history and to perform a physical examination. Students move out of the clinical skills laboratory and are placed within a teaching hospital for one day a week.
    Course Staff

    Course Coordinator: Dr Josephine Thomas

    Please refer to the Year 3 Clinical Skills Course Handbook for the appropriate Clinical Skills Office for your clinical attachment.
    Course Timetable

    The full timetable of all activities for this course can be accessed from Course Planner.

    Students will receive a manual specifically for their hospital, which will provide them with relevant site specific details and timetables. Information will also be posted on the bulletin board periodically and morning briefings will occur at each site.
  • Learning Outcomes
    Course Learning Outcomes
    1 Able to confidently approach appropriate patients in hospital and general practice settings
    2 Able to take a full history from a variety of patients including exploration of the patient’s presenting problems in detail, maintaining respect for the patient’s cultural, religious and social background
    3 Able to conduct a physical examination on a real patient, appropriate to the history and with respect for patient comfort at all times
    4 Able to detect common physical signs on real patients
    5 Able to process history and examination findings to formulate a problem list, limited differential diagnosis and basic management plan
    6 Able to present findings in both a written and oral presentation (as would be appropriate for clinical attachments e.g. ward rounds)
    7 Develop an awareness of hospital and general practice care, including investigation and management of common conditions
    8 Increase knowledge of medications used for common conditions and familiarisation with hospital medication charts
    9 Behave in a professional manner in all clinical encounters
    University Graduate Attributes

    This course will provide students with an opportunity to develop the Graduate Attribute(s) specified below:

    University Graduate Attribute Course Learning Outcome(s)
    Knowledge and understanding of the content and techniques of a chosen discipline at advanced levels that are internationally recognised. 1-9
    The ability to locate, analyse, evaluate and synthesise information from a wide variety of sources in a planned and timely manner. 1-9
    An ability to apply effective, creative and innovative solutions, both independently and cooperatively, to current and future problems. 1-9
    Skills of a high order in interpersonal understanding, teamwork and communication. 1, 6
    A proficiency in the appropriate use of contemporary technologies. 1-9
    A commitment to continuous learning and the capacity to maintain intellectual curiosity throughout life. 1-9
    A commitment to the highest standards of professional endeavour and the ability to take a leadership role in the community. 1-9
    An awareness of ethical, social and cultural issues within a global context and their importance in the exercise of professional skills and responsibilities. 1-3, 9
  • Learning Resources
    Required Resources
    Students should have already purchased a standard medical examination kit.
    Recommended Resources
    Recommended resources will be advised as appropriate.

    Suggested texts
    Talley & O’Connor, Clinical Examination
    Swartz, Textbook of Physical Diagnosis: History and Examination
    Tierney & Henderson, The Patient History: Evidence-based Approach
    Lloyd & Bor, Communication Skills for Medicine
    Hampton, The ECG Made easy
    Australian Medicines Handbook (AMH)
    SGRHS DVD, A Guide to Clinical Examination

    Clinical Education Offices Resources
    There are also limited numbers of neurological examination kits, copies of the AMH, textbooks and Physical Examination DVDs available in the clinical education offices.
    Online Learning
    Material for the course will also be provided through the dedicated medical curriculum website: http://curriculum.medicine.adelaide.edu.au/index.asp

    MyUni
    https://myuni.adelaide.edu.au/webapps/login/
    Various resources can be found on the MyUni website, under year 3 clinical skills.
  • Learning & Teaching Activities
    Learning & Teaching Modes
    There are numerous teaching and learning methods used, with the emphasis on active learning methods including, but not limited to: lectures, bedside tutorials, case presentations, case write-ups, other sessions in hospital and outside sessions. There will be self-directed research and/or study. 

    Clinical Learning
    The core element of the clinical program is learning from patients seen on the wards. Students must see patients in pairs and should see at least one patient per week per pair. It is expected one student takes the entire history and perform a physical examination on the patient while the other student observes. The following week roles will be reversed

    Case Write-Ups:
    The examining student will then submit a case write-up by the end of the day. Students will be expected to enter their details and the patients’ details on the sign-off sheet for every case write up that they hand in to ensure patient confidentiality and to authenticate the patient. Students are encouraged to take notes even when acting as the observer, so as to provide feedback to their colleague.

    Case write ups can be submitted in hand written or typed format. Failure to submit a case write up will lead to an automatic E grade band for the relevant case write up.

    Oral Presentations:
    Students will be rostered to small group tutorials in which they will present a patient they have seen on the wards. This will then lead to a discussion on various aspects of the case, including formulating a problem list with differential diagnoses and demonstrating clinical reasoning to support differential diagnoses. Some time may be spent discussing an appropriate management plan. Time will also be spent on discussing presentation skills such as communication skills/ format and chronology of presentation/ amount of relevant detail to include etc. The aim of the oral presentations is to introduce students to what will be expected of them on ward rounds in their clinical years.

    Bedside Tutorials:
    Students will have a bedside tutorial most weeks, where they will meet as a small group with a clinical tutor (intern, resident, registrar or consultant) to see patients and develop techniques in physical examination and history taking.

    Checklists for components of specific physical examinations are included in the handbook all students receive at the beginning of their rotation. There will be timetabled topics to be covered each week – see the list for your Hospital.

    Lectures:
    Each week students may receive a lecture/s regarding that week’s specific learning objectives. The lecture may be given by their specific Clinical Education Lecturer or other academic/clinical staff

    Off-site clinical activities:
    All students will be rostered to attend a number of sessions outside of their main hospital site:
    •    Adelaide Health Simulation & Skills Centre simulation session- this half day morning session will cover ECG lead placement, basic life support, venipuncture technique and sharps safety.

    Pre-reading:
    Pre-reading is required (see MLTU website)
    In the afternoon you will see a patient with your usual partner and perform case write-ups at RAH. Hand up the following week to your usual lecturer.

    •    GP rotation – 2 consecutive Tuesdays of your clinical skills time will be spent in a General Practice setting.
    •    Hampstead Rehabilitation Centre – you will be exposed to the challenges of living with spinal injury.
    •    Shine Workshop – sexual health history and intervention will be covered in this session
    •    Eye (ophthalmology) OPD – visits at TQEH and RAH
    •    Ear (ENT) OPD visits – at RAH, MPH and TQEH
    •    Vascular 'round robin' at TQEH – 2 sessions
    Workload

    The information below is provided as a guide to assist students in engaging appropriately with the course requirements.

    On most days students will be expected to arrive at 8.30 a.m. and stay until 5.00 p.m. not including personal study and preparation time. In Years 1-3, the standard total student workload for 24 units is 48 hours a week.
    Learning Activities Summary
    The structure of the Year 3 Clinical Skills 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).
    Specific Course Requirements
    All students will be allocated to a metropolitan hospital. Although allocated to one hospital students may need to travel to other hospitals and places for specialty sessions.  

    All students must ensure that they have a valid criminal history clearance (CHC), and the student should have the original with them on the first day of term. Please check to ensure that your certificate is valid for the entirety of Year 3.  You should also be aware that you will need to ensure that you have a valid certificate prior to commencing Year 4.

    Three-yearly checks
    Legislation requires that all students who, as part of their program, undertake activities such as internships or research projects involving children or adults who are ill, elderly or vulnerable, must demonstrate that they have an Australian criminal history clearance which will be current for the duration of that activity. Information on specific requirements for individual clinical placements will be provided by the placement coordinator.

    A criminal history clearance is an assessment of an individual's criminal history and is part of the legislated (Child Protection Act and Aged Care Act) risk management requirements of organisations where children or vulnerable adults may be present. Students must ensure the criminal history clearance will be valid for the duration of the placement (for example, the three years should not finish during the placement).

    Students that obtained National Clearance at the beginning of 2013 before the new child, aged person and vulnerable person requirement was introduced, will not be required to obtain the new three-streamed Criminal History Clearance immediately. 'Old' National clearance(s) will be accepted for a period of three years before new Criminal History Clearance is required. Please refer to this location for further information:
    http://www.dcsi.sa.gov.au/services/screening/frequently-asked-questions-faqs
  • Assessment

    The University's policy on Assessment for Coursework Programs is based on the following four principles:

    1. Assessment must encourage and reinforce learning.
    2. Assessment must enable robust and fair judgements about student performance.
    3. Assessment practices must be fair and equitable to students and give them the opportunity to demonstrate what they have learned.
    4. Assessment must maintain academic standards.

    Assessment Summary
    Students are advised to read in detail the information in the Year Level Assessment Document - Part A and Part B. Students will be expected to be aware of the contents of these documents and to abide by the requirements as stated. Students should note that requirements for professional behaviour standards are set out in the year level assessment documents. As medical students, you are registered with the Medical Board of Australia.  Students are required to maintain the expectations of the professionalism standards and associated behaviours required of the profession.

    Students should note that in addition to integrated exams as set out in the year level assessment documents, there are formative and summative tasks which must be completed. There are also attendance requirements which must be met.

    Assessment and the assessment methods used for the medical program will be based on the objectives for: Case Based Learning (CBL) cases (supplied after each case), Clinical Skills (supplied in handbook and as posted online on the Bulletin Board), lectures (supplied in lecture material), MPPD (supplied in handbook), Resource sessions (supplied with resource session notes).

    Complete assessment requirements for the MBBS Program are set out in the year level assessment documents distributed at the start of each year.

    In this course, students will also be assessed on the following:

    Professional Behaviour
    •    Attendance (95% rule applies)
    •    Punctuality
    •    Work load management and ability to adhere to deadlines
    •    Display active engagement with clinical skills activities
    •    Demonstrates respectful behaviour towards others including staff, lecturers, clinicians, patients and fellow students
    •    Maintaining a high level of confidentiality at all times.

    Medical Competence
    •    Case write-ups- 4 to be completed in each semester, including:
    - 1 formative case write-up in semester 1
    - 2 summative case write-ups in semester 1
    •    GP reflection
    •    Oral Case presentations (formative)
    •    Bioskills Training – satisfactory

    Material covered during the Year 3 Clinical Skills course will also be tested during mid-year and end-of-year written examinations as well as end of year OSCE examinations.
    Assessment Detail
    In Semester I, at least four case write-ups will be collected for Formative Assessment and in Semester II each student will select two case write-ups for Summative Assessment as well as another at least two formative case write-ups.

    Complete assessment requirements for the MBBS Program are set out in the year level assessment documents distributed at the start of each year.
    Submission
    As outlined above
    Course Grading

    Grades for your performance in this course will be awarded in accordance with the following scheme:

    NOG (No Grade Associated)
    Grade Description
    CN Continuing

    Further details of the grades/results can be obtained from Examinations.

    Grade Descriptors are available which provide a general guide to the standard of work that is expected at each grade level. More information at Assessment for Coursework Programs.

    Grades for your performance in this course will be awarded in accordance with the following scheme: GS4 Non-graded pass.

    For the purpose of feedback to students a banded result will be provided for each course and examination. This result will not appear on students’ academic transcripts.

    Bands of achievement are:
    A Above expected competency for year level
    B Clearly at expected competency for year level
    C Just reaches expected competency for year level
    D Below expected competency for year level
    E Far below expected competency for year level

    Final results for this course will be made available through Access Adelaide.

  • Student Feedback

    The University places a high priority on approaches to learning and teaching that enhance the student experience. Feedback is sought from students in a variety of ways including on-going engagement with staff, the use of online discussion boards and the use of Student Experience of Learning and Teaching (SELT) surveys as well as GOS surveys and Program reviews.

    SELTs are an important source of information to inform individual teaching practice, decisions about teaching duties, and course and program curriculum design. They enable the University to assess how effectively its learning environments and teaching practices facilitate student engagement and learning outcomes. Under the current SELT Policy (http://www.adelaide.edu.au/policies/101/) course SELTs are mandated and must be conducted at the conclusion of each term/semester/trimester for every course offering. Feedback on issues raised through course SELT surveys is made available to enrolled students through various resources (e.g. MyUni). In addition aggregated course SELT data is available.

    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.
  • Student Support
  • Policies & Guidelines
  • Fraud Awareness

    Students are reminded that in order to maintain the academic integrity of all programs and courses, the university has a zero-tolerance approach to students offering money or significant value goods or services to any staff member who is involved in their teaching or assessment. Students offering lecturers or tutors or professional staff anything more than a small token of appreciation is totally unacceptable, in any circumstances. Staff members are obliged to report all such incidents to their supervisor/manager, who will refer them for action under the university's student’s disciplinary procedures.

The University of Adelaide is committed to regular reviews of the courses and programs it offers to students. The University of Adelaide therefore reserves the right to discontinue or vary programs and courses without notice. Please read the important information contained in the disclaimer.