MEDIC ST 5009BRU - Geriatrics and General Practice Part 2

Teaching Hospitals - Semester 2 - 2017

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.

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Course Details

Course Code	MEDIC ST 5009BRU
Course	Geriatrics and General Practice Part 2
Coordinating Unit	Medical Studies
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 on rural placement only
Assessment	details provided at start of year

Course Staff

Course Coordinator: Dr Lawrence McArthur

Course Coordinator - Dr Toby Commerford
Email: toby.commerford@sa.gov.au
Location: Royal Adelaide Hospital

Year 5 Rural Program Coordinator: Bronwyn Herde
Phone: +61 8 8313 4528
Email: bronwyn.herde@adelaide.edu.au
Location: Rural Clinical School, 122 Frome Street, University of Adelaide

Course Timetable

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

Course component 1: Video Conference Tutorials & Medical Case Presentations
Duration: 1.5 hours
Enrolment capacity: na
Quantity: 11 x 1.5 hours

Course component 2: Geriatric Rehab Case Presentation & Clinical Skills Day
Duration: 1- 2 days
Enrolment capacity: na
Quantity: 1 each per rural site

Course component 3: Rural Geriatrics Outpatient Clinics, Residential Care Visits, Domiciliary Care & ACAT Eposure
Duration: semester
Enrolment capacity: na
Quantity: 16 weeks

Course Learning Outcomes

Overall 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	3

Learning Resources

Recommended Resources

Learning Textbooks:
Kane. Essentials of Clinical Geriatrics – 5th Edition (American) Ratnaike. Practical Guide to Geriatric Medicine – (Australian)
Isaacs. The Challenge of Geriatric Medicine –1992, Oxford University Press
Coni. Lecture Notes on Geriatric Medicine – 6th Edition, 2003, Blackwell Publishing Jackson. Prescribing for Elderly Patients – 1st Edition,2009, Wiley-Blackwell

Resource Texts
Evans. Oxford Textbook of Geriatric Medicine – 2nd Ed, 2000
Brocklehurst. Textbook of Geriatric Medicine and Gerontology – 5th Ed, 1998 Hazzard. Principles of Geriatric Medicine and Gerontology – 5th Ed, 2003

Journals
Age and Ageing; Journal of American Geriatrics Society Australasian Journal on Ageing International Journal of Geriatric Psychiatry

Internet sites
www.anzsgm.org
http://www.racgp.org.au/silverbookonline

Online Learning

MyUni Online Course
Content: Video lectures, topic pre readings and related articles
Communication: Announcements and discussion boards will be used for asynchronous communications.

Web Conference Tutorials
Weekly video/web conference tutorials will be held with students at all rural placement sites.
Learning & Teaching Activities

Learning & Teaching Modes

Rural Placement: This course is part of an community based, longitudinal, integrated year of clerkship, clinical placement and training in rural hospitals and clinical settings. Teaching during the Geriatrics component of the rotation is primarily delivered in the clinical setting but supplemented with lectures and tutorials.

Topic tutorials by video conference: Tutorials will be interactive, based on themes of self-directed learning and the clinical sciences program. Resources are available here in MyUni. Students are encouraged to seek other resources and references.

Medical case history: Preparation and ORAL presentation of a Medical Case involving history, examination and case discussion

Rehabilitation case: Preparation and ORAL presentation of a Rehabilitation Case. The case should be followed over several weeks, where possible, from time of presentation to hospital, through rehabilitation and monitoring progress on discharge. See the Rehab Case guidelines provided

Geriatric outpatient clinic: Attendance at Outpatient Clinic with Dr Mykyta (Port Lincoln, Whyalla, Barossa) or Dr Prowse (Port Augusta)

Residential care visits: Visits to a nursing home (high level care) or hostel (low level care) accompanying the general practitioner Domiciliary care and ACAT: Exposure to Domiciliary Care and the Aged Care Assessment Teams Psycho-geriatric services: Clare and Kadina only when available

Workload

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

Please refer to MyUni.

Learning Activities Summary

LECTURE TOPICS:

Week 1: Course Overview
Week 2: Introduction to Geriatrics, Demography
Week 3: Rehabilitation Principles / Sleep
Week 4: Falls / Osteoporosis
Week 5: Cognitive Dysfunction Part 1
Week 6: Cognitive Dysfunction Part 2
Week 7: Nutrition / Polypharmacy & Iatrogenic Disease
Week 8: Incontinence / Pressure Area Care / Sexuality
Weeks 9 - 12: Medical Case Presentations

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 Summary

Satisfactory completion of all components of the formative and summative assessments is required to pass this course. Students will require a minimum total score of 50% from all the components below to pass. The total score for the year is based on the following components:

Medical case 25%
Rehabilitation Case 25%
Clinical knowledge 30%
Clinical skills 20%
Topics from the geriatrics course will be incorporated as part of the fifth year end-of-year final examination.

Assessment Detail

Formative Assessment
Students must participate satisfactorily in all components of the geriatrics course, i.e. tutorials, medical case, rehabilitation case, geriatrics outpatient clinics, visits to aged care facilities, ACAT, Domiciliary Care. The tutor must be informed should the student not be able to attend tutorials or any of the visits for a valid reason. Where possible, students must try and organize an alternative time for these experiences (except for tutorials). If the geriatrics tutor has concerns with student participation or attendance, feedback will be provided via e-mail, telephone, in person or via GP preceptors. Tutorial attendance and participation is very important. Failure to provide an explanation for absence will result in a score of 0. Absence without explanation at 3 or more sessions will mean that the student has not completed this component satisfactorily.

Summative Assessment
It is the responsibility of the student to be aware of the date of their medical and rehabilitation case presentations. If changes are required, it is their responsibility to make the tutor and coordinator aware of this. Failure to do this may result in a fail grade in that component.

Submission

Please refer to MyUni.

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.

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
Students may access the University Health Practice, 61+ 08 83135050 http://www.adelaide.edu.au/student/health/

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
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.

Authorised by:	Deputy Vice-Chancellor and Vice-President (Academic)
Maintained by:	Course Outlines Administrator