MEDIC ST 5009BHO - Geriatrics and General Practice Part 2
Teaching Hospitals - Semester 2 - 2017
General Course Information
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 and 4000BHO 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 Coordinator: Professor Renuka VisvanathanGeneral Practice
Urban Student Coordinator
Telephone: 08 8313 3460
Facsimile: 08 8313 3511
Dr Simon Vanlint
Telephone: 08 8313 4634
Facsimile: 08 8313 3511
Assoc./Professor Renuka Visvanathan
Director & University Academic
Telephone: 08 8222 8178
Facsimile: 08 8222 8593
Dr Robert Prowse
Contactable via the secretary
Department of Geriatric Medicine
Extension 25215 at the RAH
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.
Monday Tuesday Wednesday Thursday Friday GP Tutorial GP Placement GP Tutorial GP Tutorial GP Placement
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.
Course Learning OutcomesOverall Course Objectives:
You will have already been introduced to some of the medical problems of old age during your course. This attachement is intended:
1. To add to your knowledge base and to clarify the management of specific conditions
2. To permit you to see the range of services for the elderly, particularly those outside the acute medical wards
3. To broaden your understanding of the work of the various members of the rehabilitation team
4. To encourage you to be thorough in your assessment of disabled patients
5. To stimulate discussion on some wider issues concerning old people
Rural Specific Learning Objectives:
6. Be expected to develop an understanding about the rights and needs of older people.
7. Be introduced to ‘geriatric syndromes’ and will acquire the core knowledge needed to manage these common problems.
8. Become skilled at taking a complete history from an older person and examine the older person appropriately, i.e. develop an
understanding about comprehensive geriatric assessment tools (Barthel ADL & IADL scores, MMSE, GDS, FAB, MNA).
9. Acquire the basic skills needed to manage the complex frail older person
10. Develop an understanding of rehabilitation principles.
11. Gain exposure to the rural multidisciplinary team.
12. Be expected to develop an understanding about the differences between high level (nursing homes) and low level (hostel) care. You 13. should develop an understanding of the function of the Aged Care Assessment Teams.
14. Be expected to develop an understanding about the support services that exist within the community (e.g. domiciliary care services).
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)
1,2,4 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
1,2,3 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
1,2, 5 Career and leadership readiness
- technology savvy
- professional and, where relevant, fully accredited
- forward thinking and well informed
- tested and validated by work based experiences
3,6 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
5,6 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
Required ResourcesGeriatrics – not applicable
GP – not applicable
Recommended ResourcesGeriatrics: 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 LearningGeriatrics: 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 ModesGeriatrics
Teaching during the Geriatrics component of the rotation is primarily delivered in the clinical setting but supplemented with lectures and tutorials.
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.
Each week will have four topics covered by specific lectures- 2 at TQEH (Tuesday afternoons) and 2 at RAH (Thursday afternoons)
To: Aged Care Assessment Team, Aged care complex (nursing home), Domiciliary care, Alzheimer’s association, Centre for physical activity in Ageing
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.
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 SummarySee Teaching and Learning Modes above
Specific Course RequirementsGeriatrics: 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 ExperienceThe predominant learning method for the MBBS Program is small group discovery learning.
The University's policy on Assessment for Coursework Programs is based on the following four principles:
- Assessment must encourage and reinforce learning.
- Assessment must enable robust and fair judgements about student performance.
- Assessment practices must be fair and equitable to students and give them the opportunity to demonstrate what they have learned.
- Assessment must maintain academic standards.
Assessment SummaryThe final mark comprises both the individual marks for GP and Geriatrics. A pass in both the Geriatric and GP areas of Geriatrics & General Practice is required to achieve a pass in this subject.
QEH GERIATRICS ASSESSMENT SUMMARY
All TQEH Clinical Placement students are expected as a minimum to attend a mini CEX session with the advanced trainee (or basic trainee) in each of the 2 weeks in geriatric medicine. In terms of rehabilitation mini CEX sessions, these will be coordinated by Dr Nigel Quadros who will provide you with details at the start of you rehabilitation clinical placement attachment. Further information is available in the student handbook.
Students must clerk at least one patient during their geriatric medicine placement and the preceptor will determine how they will assess this.
Mini CEX opportunities and clinical skills development opportunities have been scheduled and feedback will be provided to students during these learning opportunities. Mini CEX are short 5-15 minute sessions with approximately 5 minute feedback opportunity. They may be completed in a group or individually depending on clinician preference.
• 95% expected attendance rule and where leave is because of an illness, a sick certificate needs to be handed in to preceptor. Any other leave needs to be applied for prospectively and it should not be taken for granted that it will be approved.
• Completion of the log book
• Completion of 4 mini CEX and signed off
• Preceptor Assessments for both clinical geriatrics and rehabilitation medicine rotations.
• Submission of completed log book (with all 4 mini CEXs), and the 2 preceptor assessments on the final day of rotation
• Pass on the MCQ test on the final day of rotation
• Pass on the OSCE on the OSCE on the final day of rotation
RAH GERIATRICS ASSESSMENT SUMMARY
This will be gathered from 5 components
1. Rehabilitation case presentation: Students are asked to select a patient, and prepare a case presentation which illustrates the problems involved in assessing and planning the rehabilitation of an elderly disabled person. Detailed information regarding the case presentation is available in the student handbook.
2. Case Taking: During the acute program students are expected to take a history and perform a thorough examination on one patient for presentation to the consultant in the second week. Each student will present their case; with the aim to practise thorough, accurate, concise and logical case taking.
3. Lecture attendance
4. Summary session participation
5. Clinical tutorial performance
GENERAL PRACTICE ASSESSMENT
Assessment in the GP requires completion of the GP Workbook, found in the Course Handbook and completion of the assessment for, also in the Course Handbook by the student’s preceptor.
The Assessment Form provides a banded grade for the placement and must be completed by the GP and returned in the envelope provided to:
Discipline of General Practice
The University of Adelaide
Level 11Terrace Towers
178 North Terrace
Ph: 08 8313 3460
Fax: 08 8313 3511
Please note that it is the student’s responsibility to ensure that the Assessment Form is returned to Nicky Bennett. Failure to do this could result in failing the GP component of Geriatrics & General Practice.
Assessment Related RequirementsSee Assessment Summary above
Assessment DetailGeriatrics (TQEH) Assessment
Grades/Marks25% - MCQ25% - OSCE25% - Geriatric Medicine Clinical Placement as assessed by preceptor25% - Rehabilitation Medicine Clinical Placement as assessed by preceptor
Geriatrics (RAH) Assessment
This will be gathered from 5 components
6. Rehabilitation case presentation (25%)
7. Case taking (second week) (25%)
8. Lecture attendance (15%)
9. Summary session participation (15%)
10. Clinical skills demonstrated – clinical tutorials (20%)
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.
In addition, students will receive a banded result upon completion of their attachment.
Five bands are available to determine the assessment for the Geriatrics and General Practice 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
Final results for this course will be made available through Access Adelaide.Submission details will be outlined at the beginning of the attachment.
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.
Students may access the University Health Practice, 61+ 08 83135050 http://www.adelaide.edu.au/student/health/
- Academic Support with Maths
- Academic Support with writing and speaking skills
- Student Life Counselling Support - Personal counselling for issues affecting study
- International Student Support
- AUU Student Care - Advocacy, confidential counselling, welfare support and advice
- Students with a Disability - Alternative academic arrangements
- Reasonable Adjustments to Teaching & Assessment for Students with a Disability Policy
- LinkedIn Learning
The MBBS Program website has details on Student Well-being resources which can be accessed.
Policies & Guidelines
This section contains links to relevant assessment-related policies and guidelines - all university policies.
Please read the MBBS Program Code of Conduct
- Academic Credit Arrangement Policy
- Academic Honesty Policy
- Academic Progress by Coursework Students Policy
- Assessment for Coursework Programs
- Copyright Compliance Policy
- Coursework Academic Programs Policy
- Elder Conservatorium of Music Noise Management Plan
- Intellectual Property Policy
- IT Acceptable Use and Security Policy
- Modified Arrangements for Coursework Assessment
- Student Experience of Learning and Teaching Policy
- Student Grievance Resolution Process
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.