MEDIC ST 5009BHO - Geriatrics and General Practice Part 2

Teaching Hospitals - Semester 2 - 2019

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 5009BHO
    Course Geriatrics and General Practice Part 2
    Coordinating Unit Medicine
    Term Semester 2
    Level Undergraduate
    Location/s Teaching Hospitals
    Units 4
    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

    General Practice

    Student Contact
    Nicky Bennett
    Urban Student Coordinator
    Telephone: 08 8313 3460
    Facsimile: 08 8313 3511
    Email: nicky.bennett@adelaide.edu.au

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

    Geriatrics

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

    Adelaide G-TRACMs
    Rosie Bonin
    Centre Coordinator
    Telephone: 83132144
    Email: rosie.bonnin@adelaide.edu.au

    RAH
    Dr Robert Prowse
    Contactable via the secretary
    Department of Geriatric Medicine
    Extension 25215 at the RAH
    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 MLTU website 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/

    As the GP clinics operate independently of the University, students will need to liaise with the clinical director at their placement site to determine useful learning opportunities and develop a timetable that ensures all assessment requirements are met.

    Tutorials will be held in the School of Population health & Clinical Practice, Level 7 Terrace Towers 178 North Terrace on the Monday 3.00pm – 5.00pm, Tuesday 10.00am - 12.30pm & Thursday 9.00am – 11.30am.

    The typical timetable for the 2 week GP rotation can be seen below.  Students will need to ensure that they are aware of School of Medicine Teaching Series session that may be organised during the GP rotation. If a clash occurs, students are to attend SMTS and inform the clinical director of their placement site of their absence in advance.

    Week A
    Monday Tuesday Wednesday Thursday Friday
    GP Tutorial GP Placement GP Tutorial
    GP Tutorial GP Placement

    Week B

    Monday Tuesday Wednesday Thursday Friday
    GP Placement GP Placement GP Placement GP Placement GP Placement
    GP Placement GP Placement GP Placement

    For the Geriatrics rotation, students will be evenly divided between QEH and RAH. At RAH the group will be split into 2 parallel streams, each doing 2 weeks acute and then 2 weeks rehabilitation with a final combined + GP week.


    GERIATRICS AT QEH
    The Geriatrics component of the placement delivered at the QEH is complicated and comprises 3 separate timetables: a master timetable for the lecture series, a rehabilitation medicine clinical placement timetable and the geriatrics clinical placement timetable. Unfortunately, this structure cannot be altered. However, time has been allocated for students during their rotation orientation session on the first day to consolidate these timetables and ask questions directly to A/Prof Visvananathan.

    Students are expected to discuss their individual geriatrics placement timetable with their preceptor. While undertaking the clinical geriatrics placement, students are advised to attend, where it doesn’t clash with other learning commitments:
    1) 0845-0930 Mon unit meeting – Level 5B Seminar Room- except first Monday of every month
    2) 1200-1330 Tuesday Medical Grand Round: Level 2 Lecture Theatre
    3) 1200-1330 Wednesday Unit Clinical Meeting Level 5B Seminar Room (please check withpreceptor or registrars for venue)
    4) 1400-1500 Friday Radiology Meeting Radiology Room behind the information counter,Ground Floor

    Information regarding the Resthaven Day in Week 5 is available in the Course Handbook.


    GERIATRICS AT RAH
    The Geriatrics component of the placement delivered at the RAH has its own detailed timetable available on the MLTU website. Students are advised to consult the MLTU website prior to the commencement of their placement. Further information is also available in the student handbook.



  • 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


    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
    Geriatrics – not applicable
    GP – not applicable
    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: 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. 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 will have four topics covered by specific lectures- 2 at TQEH (Tuesday afternoons) and 2 at RAH (Thursday afternoons)

    Visits
    To: Aged Care Assessment Team, Aged care complex (nursing home), Domiciliary care, Alzheimer’s association, Centre for physical activity in Ageing


    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 and 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 further details
    Submission
    Not applicable
    Course Grading

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

    GS8 (Coursework Grade Scheme)
    Grade Description
    CN Continuing
    FNS Fail No Submission
    NFE No Formal Examination
    F Fail
    NGP Non Graded Pass
    P Pass
    C Credit
    D Distinction
    HD High Distinction
    RP Result Pending

    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.