MEDIC ST 5009AHO - Geriatrics and General Practice Part 1

Teaching Hospitals - Semester 1 - 2018

The clinical attachments are a program of clinical education through a selection of placements so that students will be competent in history-taking, patient examination and management. This includes problem formulation, investigations, treatment (pharmacological and non-pharmacological), counselling, good communication skills, the practice of empathetic medicine, and a sound knowledge base that allows diagnosis and management of common disorders to be carried out under appropriate supervision. Some students will have the opportunity to undertake their training for an extended period of time in a rural or remote setting.

  • General Course Information
    Course Details
    Course Code MEDIC ST 5009AHO
    Course Geriatrics and General Practice Part 1
    Coordinating Unit Medicine
    Term Semester 1
    Level Undergraduate
    Location/s Teaching Hospitals
    Contact attachments, common program & research
    Available for Study Abroad and Exchange N
    Prerequisites MEDIC ST 4000AHO/BHO, MEDIC ST 4013AHO/BHO, MEDIC ST 4014 AHO/BHO, MEDIC ST 4015 AHO/BHO, MEDIC ST 4016 AHO/BHO, MEDIC ST 4017 AHO/BHO, MEDIC ST 4018 AHO/BHO, or by approval of the Dean of Medicine
    Restrictions Available to MBBS students only
    Course Description The clinical attachments are a program of clinical education through a selection of placements so that students will be competent in history-taking, patient examination and management. This includes problem formulation, investigations, treatment (pharmacological and non-pharmacological), counselling, good communication skills, the practice of empathetic medicine, and a sound knowledge base that allows diagnosis and management of common disorders to be carried out under appropriate supervision. Some students will have the opportunity to undertake their training for an extended period of time in a rural or remote setting.
    Course Staff

    Course Coordinator: Professor Renuka Visvanathan

    GP Contact:
    Professor Nigel Stocks
    Head of Discipline
    Telephone: 08 8313 3462
    Email: nigel.stocks@adelaide.edu.au

    Geriatrics

    TQEH
    Professor Renuka Visvanathan
    Director & University Academic
    Telephone: 08 8222 8178
    Facsimile: 08 8222 8593
    Email: renuka.visvanathan@adelaide.edu.au

    Adelaide G-TRAC
    Dr Kareeann Khow
    Senior Lecturer
    Telephone: 8313 2144
    Email: kareeann.khow@adelaide.edu.au

    RAH
    Ms. Delia Ebert ph 70740950 Delia.Ebert@sa.gov.au
    Dr. Alice Bourke ph 70742955 Alice.Bourke@sa.gov.au
    Modbury Hospital
    Dr Kylie Gardner ph 8161 2000 kylie.gardner@sa.gov.au


    Course Timetable

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

    The course timetable for the Geriatrics and General Practice placement is complicated due to the combining of two separately organised and co-ordinated rotations. Detailed information about the GP rotation timetable is available in the Course Handbook, available via the CANVAS and should be referred to. Information regarding the placement site is available via the University of Adelaide Discipline of GP website http://health.adelaide.edu.au/gp/education/


  • Learning Outcomes
    Course Learning Outcomes

    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

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


    Students will demonstrate competency, as expected of a Year 5 student, in the following areas of clinical skills and reasoning:
    diagnostic reasoning skills including integration and weighted interpretation of findings from history and physical examination to arrive at an initial differential diagnosis
    selecting and justifying common investigations, with regards to the pathological basis of disease, utility, safety and cost effectiveness, and interpret their results
    applying therapeutic reasoning skills including identification of appropriate therapeutic objectives in both differentiated and undifferentiated clinical problems
    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
    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


    Students will demonstrate the following professional attributes:
    the ability to communicate effectively and professionally, in a variety of media, with patients, colleagues and others
    accepting responsibility to protect and advance the health and wellbeing of individuals, communities and populations
    understanding the environmental, social and psychological determinants of disease, including issues relating to health inequalities, cultural diversity, and socio-economic and physical environment factors
    the ability to contribute to the teaching and professional development of others
    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)
    1,2
    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
    B 1,2,4,6,7
    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
    B 8, C 1,2
    Career and leadership readiness
    • technology savvy
    • professional and, where relevant, fully accredited
    • forward thinking and well informed
    • tested and validated by work based experiences
    C 3
    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
    C 1,2,3
    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
    B 6,8
  • Learning Resources
    Required Resources
    see CANVAS
    Recommended Resources
    Geriatrics: The Course Handbook contains a wealth of journal articles, reports and links to online material that has been carefully selected to assist students in meeting clinical and placement learning objectives. Students are advised to consult the handbook.

    GP: General Practice is a broad field, and students are advised to seek out resources that will assist them to consolidate their clinical learning.
    Online Learning
    Geriatrics:  An extremely useful website is the Victorian Geriatric Medicine Training Program portal, which has a number of interactive modules that are extremely relevant: http://anzsgm.org/vgmtp/

    GP: students are expected to have completed the e-learning module on Medicare and prescribing prior to attending their tutorials in the first week of the GP block. It is available here:http://www.medicareaustralia.gov.au/provider/business/education/e-learning.jsp

    Other useful online resources are:
    Therapeutic Guidelines: available via The University of Adelaide Library
    The Clinical Practise Guidelines Portal: http://www.clinicalguidelines.gov.au/
    Online databases such as UpToDate: available via The University of Adelaide
  • Learning & Teaching Activities
    Learning & Teaching Modes
    Geriatrics
    Teaching during the Geriatrics component of the rotation is primarily delivered in the clinical setting but supplemented with lectures and tutorials.

    Clinical teaching
    Students are expected to attend and participate in ward rounds, outpatient clinics and academic teaching sessions such as unit meetings and hospital grand rounds. Students need to discuss with their preceptor when these activities take place and how they should engage themselves in them.

    Students are also expected to work up and present patients and as part of the clinical learning experience, students must clerk at least one patient during their geriatric medicine placement for formal assessment. The mode of the assessment of this case write up will be up to the student’s preceptor.

    Lectures
    Each week specific lectures will be provided at TQEH, RAH and Modbury Hospital. Students to refer to their master timetable.

    Visits
    To: Aged Care Assessment Team, Aged care complex (nursing home), Alzheimer’s Association, Centre for physical activity in Ageing, Day therapy centre


    General Practice
    Teaching during the GP component of the rotation is delivered primarily in the clinical setting. It is supplemented by the tutorials and lectures in Week 1.

    As there is limited clinical session time in which to achieve the learning objectives for this program, it is important that time spent observing in clinics is kept to a minimum and that you take a hands-on role as much as possible, reflecting on your learning and making patient management decisions under supervision. You should make every effort to undertake an Extended Primary Care Assessment for a patient. Examples of this include the 75+ Assessment, Asthma 3+ assessment, Indigenous Health Assessment other chronic disease management items.
    Workload

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

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

    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 but does not include after hours call.
    Learning Activities Summary
    See Teaching & Learning Modes above
    Specific Course Requirements
    Geriatrics: A copy of your valid (within 2 years) police check and the original (to be sighted) on the first day of placement.
    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



    SUMMATIVE assessment tasks weighting

    End of rotation OSCE (Geriatrics and General Practice stations) 
    20%
    Supervisor report Geriatrics  30%
    Supervisor report General Practice  20%
    2x Case write ups and presentations  30%




    Assessment Related Requirements
    See Assessment Summary above
    Assessment Detail
    In addition to summative tasks there will be FORMATIVE online MCQ examination
    The format of Case presentation varies at each site
    see CANVAS for furtehr details
    Submission
    Not applicable
    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.




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

    Submission details will be outlined at the beginning of the attachment.
  • 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.