MEDIC ST 3102AHO - Clinical Practice III Part 1

Teaching Hospitals - Semester 1 - 2018

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 Practice III Part 1
    Coordinating Unit Medical Studies
    Term Semester 1
    Level Undergraduate
    Location/s Teaching Hospitals
    Contact Weekly lectures, CBL sessions & resource sessions
    Available for Study Abroad and Exchange N
    Prerequisites MEDIC ST 2000A/B, MEDIC ST 2101A/B, MEDIC ST 2102A/B, MEDIC ST 2103A/B, MICRO 2506 and an approved level II elective; or by approval of the Dean of Medicine
    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: Associate Professor Josephine Thomas


    see CANVAS courses for details

    Course Timetable

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

    Relevant site specific details and timetables are available on CANVAS. 
  • Learning Outcomes
    Course Learning Outcomes
    1 Able to confidently approach appropriate patients in clinical 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 clinical 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)
    Deep discipline knowledge
    • informed and infused by cutting edge research, scaffolded throughout their program of studies
    • acquired from personal interaction with research active educators, from year 1
    • accredited or validated against national or international standards (for relevant programs)
    2,3,4,8
    Critical thinking and problem solving
    • steeped in research methods and rigor
    • based on empirical evidence and the scientific approach to knowledge development
    • demonstrated through appropriate and relevant assessment
    4,5
    Teamwork and communication skills
    • developed from, with, and via the SGDE
    • honed through assessment and practice throughout the program of studies
    • encouraged and valued in all aspects of learning
    1,6
    Career and leadership readiness
    • technology savvy
    • professional and, where relevant, fully accredited
    • forward thinking and well informed
    • tested and validated by work based experiences
    7
    Intercultural and ethical competency
    • adept at operating in other cultures
    • comfortable with different nationalities and social contexts
    • able to determine and contribute to desirable social outcomes
    • demonstrated by study abroad or with an understanding of indigenous knowledges
    2,3,
    Self-awareness and emotional intelligence
    • a capacity for self-reflection and a willingness to engage in self-appraisal
    • open to objective and constructive feedback from supervisors and peers
    • able to negotiate difficult social situations, defuse conflict and engage positively in purposeful debate
    3,4,9
  • Learning Resources
    Required Resources
    A stethoscope and University ID badge are essential equipment. You may find it useful to carry a pen torch, ophthalmoscope and tendon hammer to the wards. Other equipment such as neurological examination kits are usually available for loan from the precinct staff. Students may have already purchased a standard medical examination kit.

    Australian Medicines Handbook is available online and is a required resource.
    Clinical Examination Checklists are provided in the handbook.
    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
    see MyUni website for this course



  • Learning & Teaching Activities
    Learning & Teaching Modes
    The clinical skills course includes lectures, bedside tutorials, oral case presentations, case write-ups, workshops. There is also an emphasis on self-directed learningin the clinical environment.
    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. 
    Case Write-Ups:
    The examining student will  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
    (see "assessment" for submission details).
    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 usually encompass 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 clinical examinations are included in the handbook all students receive at the beginning of their rotation (also available online in MyUni). There will be timetabled topics to be covered each week – see the list for your Hospital.
    Lectures:
    Some clincially oriented lectures occur as part of the program
    Pre-reading:
    Pre-reading is required most weeks, particularly as preparation for bedside tutorials (see MyUni website)
    Workshop activities:
    All students will be rostered to attend a number of sessions outside of their main hospital site:
    • Adelaide Health Simulation & Skills Centre simulation sessions- will include ECG lead placement, basic life support, venepuncture, injection technique and sharps safety.
    • Hampstead Rehabilitation Centre – you will be exposed to the challenges of living with spinal injury.
    • Sexual Health Workshop – sexual health history and intervention will be covered in this session
    • Eye (ophthalmology) outpatient visits at Hospital sites
    • Ear (ENT) outpatient visits at Hospital sites
    • Vascular 'round robin' involving real patients
    • Cancer voices discussion groups with patient tutors
    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 8.00 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 hospital site (NALHN, TQEH, RAH). However, students will need to travel to other sites for some sessions.
    All students must complete the requirements fro clinical placement and maintain up to date documnentation on SONIA.
    https://health.adelaide.edu.au/study-with-us/student-support/clinical-placements



    Small Group Discovery Experience
    The predominant learning method for the MBBS Program is small group discovery learning.
  • 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
    There are no units associated with the Part A (Semester 1, Part 1). Assessment for MEDIC ST 3102A/B is combined. Students will be awarded a Continuing Grade for MEDIC ST 3102A. Students must complete MEDIC ST 3102A/B to gain a pass mark.
    Assessment Task Task Type Timing Weighting
    Confidentiality quiz. Summative- hurdle

    semester 1 (before attending wards)

    0
    Log book of clinical encounters Formative

    semester 1 and 2

    0
    4x Case write ups semester 1 
    (x2 will be marked)
    Summative

    semester 1 

    20%
    4 x Case write ups semester 2
    (x2 will be marked)
    Summative

    semester 2

    40%
    Oral case presentation (x1) Formative

    semester 1

    0
    Oral case presentation (x1) Summative

    semester 2

    20%
    Spinal injury workshop reflection Summative after scheduled attendance at workshop session 10%
    Cancer voices reflection. Summative after scheduled attendance at workshop sessions 10%
    Simulation sessions- competence in BLS, injection technique, venepuncture Summative- hurdle as scheduled 0



    All assessment items will be standard set for competency and the marks used to calculate the composite score adjusted according to standard setting. Students are required to attain an overall composite score from all assessment tasks equal to or greater than 50% to achieve an NGP An additional assessment will be offered to students who fail MEDIC ST 3102A/B with a composite score of 45-49%.

    All additional assessments will take place during the Semester 2 replacement / additional examination period. The result of a passed additional assessment is 50%.

    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.

    Course unit value grade
    MEDIC ST 3102AHO - Clinical Practice III Part 1 3 CN
    MEDIC ST 3102BHO - Clinical Practice III Part 2 3 NGP
    Assessment Related Requirements
    Students must learn and appropriately use a complex set of skills to achieve the learning outcomes in the MBBS courses. These skills cannot be learnt without repeated practice, constructive feedback and then practice again.  As such, attendance at core structured learning activities is mandatory as per the Assessment for Coursework Policy – Procedures Section 1c. Students must attend 90% of the core structured learning activities to achieve a pass in this course. Exemptions to mandatory attendance requirements may be granted by the Program Coordinator 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.

    Core structured learning activities for this course are: bedside tutorials, small group tutorials (e.g. cancer voices), workshops, weekly patient history and examination for case write up. As a developing clinician your professional conduct is important. You are expected to display professionalism as judged by: Punctuality; Work load management and ability to adhere to deadlines; active engagement with clinical skills activities; respectful behaviour towards others including staff, lecturers, clinicians, patients and fellow students; Maintaining a high level of confidentiality at all times
    Assessment Detail

    CASE WRITE UPS

    Students have specific dates allocated for seeing patients for case write ups based on their allocated A or B grouping .
    Due dates for submission of case write ups: 2 cases by mid semester break and 2 by end of semester.
    However, we encourage you to do this as soon as possible after seeing the case
    .

    Students see patients in pairs, but  cannot use the same patient for their case write-up.

    Each student will have two case write-ups selected for assessment each semester.

    LATE SUBMISSION: marks are deducted by 10% each day



    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: GS8 Non-graded pass.




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

    Students should familarise themselves with the University Policy on Additional Assessment/Replacement Assessment.
  • 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.
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  • Policies & Guidelines
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