NURSING 7105 - Acute Care Nursing I

North Terrace Campus - Semester 1 - 2019

This course will examine nursing and medical science in relation to acute care nursing in the adult sector and will examine advanced principles of acute care nursing focusing on a systems approach. Pathophysiology and disease progression will be incorporated into a clinically focused agenda. Theoretical concepts and clinical practice will be interwoven. This course will be supported by synchronised online collaborative learning.

  • General Course Information
    Course Details
    Course Code NURSING 7105
    Course Acute Care Nursing I
    Coordinating Unit School of Nursing
    Term Semester 1
    Level Postgraduate Coursework
    Location/s North Terrace Campus
    Units 6
    Contact Flexible delivery mode with online classroom lectures, workshop
    Available for Study Abroad and Exchange N
    Assumed Knowledge Basic anatomy and physiology
    Restrictions Available to M.NurSc and G.DipNurSc students only
    Course Description This course will examine nursing and medical science in relation to acute care nursing in the adult sector and will examine advanced principles of acute care nursing focusing on a systems approach. Pathophysiology and disease progression will be incorporated into a clinically focused agenda. Theoretical concepts and clinical practice will be interwoven. This course will be supported by synchronised online collaborative learning.
    Course Staff

    Course Coordinator: Vivienne Leigh

    Course Coordinator: Sindy Millington
    Phone: +61 8 8313 2996
    Email: sindy.millington@adelaide.edu.au

    Course Timetable

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

  • Learning Outcomes
    Course Learning Outcomes
    1 Retrieves, critically evaluates and applies evidence in the management of patients with complex health care needs who are ill in the acute care setting
    2 Demonstrates/ advocates cultural competence in clinical practice in an acute care scenario
    3 Retrieves, critically evaluates and applies evidence based recommendations to clinical practice in an acute care scenario.
    4 Expresses critical thinking skills through reflection of nursing practice in relation to quality in health care in an acute care scenario
    5 Appraise the rationale and effectiveness of assessment and interventions applied to seriously ill patients in the acute care setting.
    6 Reflects on current skills, knowledge and attitudes and plans ongoing personal development and demonstrates application of contribution to the professional development of others through leadership.
    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)
    1,3-5
    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
    3-5
    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
    4-6
    Career and leadership readiness
    • technology savvy
    • professional and, where relevant, fully accredited
    • forward thinking and well informed
    • tested and validated by work based experiences
    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
    2,6
    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
    1, 4-6
  • Learning Resources
    Required Resources


    McCance, KL & Heuther, SE 2014, Pathophysiology: The Biologic Basis for Disease in Adults and Children, 6th edn, Mosby Elsevier, Missouri.

    Sole, ML Klein, DG & Moseley, MJ 2013, Introduction to Critical Care Nursing, 6th edn, Saunders Elsevier, St Lois, Missouri.

    The prescribed texts are integral to the course and may be purchased from the following :

    Footprint Books Pty Ltd
    4 /8 Jubilee Avenue, Warriewood NSW 2102 Australia
    tel: (+61) 02 9997 3973 fax: (+61) 02 9997 3185
    email: teresafi@footprint.com.au san number : 9030387Texts



    Online Classroom
    To attend Zoom online classroom you will require the following :
    a computer - either a PC based or macintosh- based machine
    Internet access 
    Minimum of 56K modem
    A multimedia headset with both earphones and a microphone

    Recommended Resources
    Readings
    A reading list has been compiled for this course and will be made available through MyUni. Lecture and readings have been carefully chosen. All of these are required and recommended readings have been selected to optimise your knowledge on the topic and so that they will continue to be of use after you graduate.

    The readings for this course are available electronically via MyUni.

    Please note: it is your responsibility to organise printing should you prefer a hard copy of the readings.
    Online Learning
    Zoom Online Classroom
    The Zoom Online classroom (OC) will be used for lectures and tutorial discussions on a weekly basis. There may be some pre-recorded sessions for you to access by close of business the Friday prior to our Zoom online classroom session, please ensure you familiarize yourself with the content available on Canvas before attendance to Zoom OC each week.
    The scheduled specific day will be indicated in Canvas with time frame of  08:30-10:30 during this semester. During these Zoom OC we will discuss case scenarios and clinical events relevant to the topic, which is why it is imperative you have familiarized yourself with the materials made available beforehand. There is information regarding Zoom available on the Canvas course website, you need to familiarize yourself with this technology to become reasonably comfortable with using it prior to the start of the semester.Review the Zoom module on Canvas or access The Zoom help center here

    To connect to the VC you will require:
    • a computer – either a PC-based or a Macintosh-based machine
    • Internet access – there seems to be little difference between broadband and dial-up connections other than the speed of the initial connection
    • minimum of a 56K modem
    • a multimedia headset – it must have both earphones and microphone (These are available in computer variety stores).

    MyUni
    All students enrolled in a postgraduate coursework nursing program have access to the School of Nursing – Postgraduate Coursework Student Centre on MyUni. If you would like the opportunity to network with other students, you can use the Communication features in the site. This site will also feature information about the latest news and events at the School of Nursing.

    Unified
    http://unified.adelaide.edu.au/
    UNIFIED is your one-stop shop for email, calendar, MyUni and Access Adelaide. It even allows you to search the Library.
    UNIFIED is available to all active students; with a single login you can access your student systems and personal information through a central website. Login with your Student ID ("a1234567") and Password.

    For more information, including easy to follow instructions visit https://unified.adelaide.edu.au/web/mycampus/home.

    Library Resources
    Help for Nursing Students
    The University of Adelaide Library has a website to help nursing students use the library and its resource (www.library.adelaide.edu.au/guide/med/nursing).

    Remote student library service
    The University of Adelaide Library provides a document delivery and loans service to non-metropolitan students who do not visit a University of Adelaide campus to attend classes (www.adelaide.edu.au/library/docdel/external.html).
  • Learning & Teaching Activities
    Learning & Teaching Modes
     This course will be delivered through the Flexible Delivery Mode with Zoom online classroom lectures. This can be accessed via the web link on ‘Canvas’ which is the learning platform for the delivery of this course.
    Students will participate in synchronous online collaborative learning for 2 hours each week. The course materials will be available prior to these sessions so that students can prepare for each online classroom.

    You are provided with key points for each of the topics in the course and you are required to address these topics through readings and required activities. On-line learning using ‘Zoom on-line classroom’ (OC) and ‘MyUni’ are used in the delivery of this course. There is also a 2 day workshop associated with this course scheduled in the last teaching week of semester ( in conjunction with the course Recognising & Response to Clinical Deterioration students )where you may present your PowerPoint student presentation to your colleagues for peer review and so attendance is required at the workshop.
    Workload

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

    Zoom online classroom

    The Zoom online classroom (OC) technology will be used for lectures and tutorial discussions on a weekly basis as scheduled during this semester. On-line learning using ‘Zoom on-line classroom’ (OC) and ‘MyUni Canvas ’ are used in the delivery of this course. You are expected to attend a minimum of 80% of these classroom sessions. There is also a 2 day workshop associated with this course in the University's Simulation Centre. Student participation and discussion will be expected in all sessions. You will need to invest about 24 hours per week of study to successfully complete this course.This includes all study activities, attendance at workshops, online activities , readings and assessment. There will be some weeks that will include more content.Your are advised to plan your study commitments to the course at the beginning of the semester.

     Online Readings

    A reading list has been compiled for this course and will be made available through Course on Canvas on MyUni. Lecture and readings have been carefully chosen. There are required and recommended readings that will optimise your knowledge on the topic and will continue to be of use after you graduate.

     
    Learning Activities Summary
    The course content will include but not be limited to the following:

    Fluid and Electrolytes

    Respiratory Physiology
        • Acute Respiratory Failure
        • Respiratory monitoring – oximetry; spirometry, CO2

    Common Respiratory Disorders
        • COPD
        • Asthma
        • PE
        • Pneumonia

    Advanced Respiratory Nursing
        • NIV
        • CXR interpretation
        • Pandemic Flu Precautions

    Cardiac Monitoring
        • Supraventricular arrhythmias
        • AV Blocks
        • Rate control versus rhythm control
        • Inotropic agents

    Cardiovascular Physiology
        • Ventricular arrhythmias
        • Pacemakers

    Common Cardiovascular Disorders
        • Heart Failure
        • Acute Coronary Syndrome
        • 12 Lead ECG

    Drug and Alcohol Issues in Mental Health
        • Comorbidities of mental disorders and substance abuse
        • Mental Health Emergencies

    Neurological Physiology/ Pain Management
        • Pain
        • Delirium
        • Comparison of acute and chronic pain assessment and management

    Cultural Considerations in Clinical Practice
        • Cultural safety/diversity
        • ATSI patients

    Dysmetabolic Syndrome
        • Diagnosis /risk assessment
        • Significance of the disease
    Specific Course Requirements
    This specialist course builds upon your existing knowledge of acute disease and the appropriate management strategies and nursing skills employed to treat acute conditions. This course offers a wide variety of topics that impact the activities of acute care nurses in their practice context. Obviously everything cannot be covered in such a short time frame so issues that are common and of current relevance will be explored. Participation in the tutorials is pivotal in making this course a constructive and enjoyable learning experience.

    On-line learning using 'Zoom On-line Classroom’ (OC) and ‘MyUni’ are used in the delivery of this course and you are expected to attend a minimum of 80% of these classroom sessions. There is also a 2 day workshop associated with this course during week 13 (dates to be confirmed in course planner) in conjunction with Recognising & Response to Clinical Deterioration students) and attendance at this workshop is expected.
  • 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
    Assessment Task Task Type Weighting Learning Outcome(s) being addressed
    Online Quiz Formative Non-graded pass (NGP) 4-6
    Portfolio Summative 40% 1-3
    Presentation Summative 30% 4-6
    Pre-Sighted Exam Summative 30% 2-3, 5-6
    Assessment Detail
    Formative assessment Due Week 3 NGP 0%
    Portfolio (Part 1 & Part 2)(3000 words) 40%
    Presentation (2000 word equivalent) 30%
    Exam (Presighted – 2000 word equivalent) 30%
    Online participation is essential (80% attendance required)

    Formative Assessment : Online Quiz Due Date : Week 3 non-graded pass (NGP ) requires that you to review the articulate storyline presentation prior to completing the online quiz. 

    Portfolio – (40%) Due Date: Week 5 & 9 :
    • The students will complete 2 portfolio responses
    • The first written assessment will allow student to receive feedback prior to week 6 as per University policy, thus provide students with a benchmark for their progress in the course
    • Students will be asked to develop portfolio responses surrounding course topics. These will vary in approach but may include:
    - Using current peer-reviewed literature and best practice guidelines where available to justify the nursing interventions required to prevent Acute Respiratory Failure condition e.g. hospital-acquired pneumonia. Incorporated into this response please explain the clinical manifestations that would alert you to this adverse outcome.
    - Using current peer-reviewed literature and best practice guidelines where available compare the known components of complex condition seen in acute care setting such as dysmetabolic syndrome.


    Presentation – (30%) Due Date : individual student online presentation to class scheduled during Weeks 11- 13.
    • A brief non-graded synopsis paper will be required to facilitate feedback and direction for the 15 minute presentation that students will present to their colleagues
    • The topic can be chosen from any of the subjects and sub-groups of topics, that have been covered in this course, or that is topical and will benefit your clinical environment. The content may reflect clinical issues pertinent to the acute care patient or focussed on specific nursing intervention or equipment in the acute care setting. It must not be a duplicate of work you have already submitted. It is essential that you discuss your topic with the course coordinator at your earliest convenience to ensure a wide variety of topics are presented and that each student presents a different topic. This will benefit all students and maximise learning opportunities.

    Presentation Guidelines
    It is a requirement of the assessment that the presentation is made to fellow students and the course coordinator during Zoom online classroom. It is expected that the presentation will take 15 minutes with 5 minutes allowed for discussion on completion of the presentation. It is mandatory that the presentation be made in PowerPoint. This exercise will be a valuable asset to the student as PowerPoint is a skill that is required in many educational settings and is the standard tool used for conference presentations and interviews. A copy of your presentation must be available to your course coordinator before presentation online.

    Pre-sighted Exam – (30%) Due Date: Exam Week, to be advised on MyUni website.
    • Students will be examined on their understanding of the material presented throughout this course

    This will be a long answer written exam. You will be given five questions three weeks prior to the exam to facilitate your revision. During the Final semester exam you will be required to complete three of the five questions( chosen by course coordinator ) in the alotted time . The questions will only cover the work in this semester. You will have 10 minutes reading time and 2 hours writing time.

    Combined these assessments will distinguish the students’ ability to apply a rigorous academic knowledge of the sciences that inform nursing practice in the specialty of acute care nursing. They will also assess the students’ ability to apply critical thinking skills to problem solving and to evaluate nursing care according to professional standards of practice.
    Submission
    Assessments, unless otherwise stated in your Study guide, are to be submitted electronically via Assignments in MyUni (throughTurnitin)on the due date specified. Instructions for assignment submission are available for all students under Tutorials at www.adelaide.edu.au/myuni/.
    An assessment submitted via MyUni must be submitted as a .doc, .docx or .rtf file. If submitting a PowerPoint presentation for marking, the .ppt or .pptx must be submitted as .pdf file. It is also important to submit your file under your name, such as surname.firstname. MyUni stamps all the other details against your filename once you submit your assessment.
    If you have difficulty submitting your assignment, you can call the MyUni helpdesk from 8am to 6pm 08 8303 3335.
    Course Grading

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

    M10 (Coursework Mark Scheme)
    Grade Mark Description
    FNS   Fail No Submission
    F 1-49 Fail
    P 50-64 Pass
    C 65-74 Credit
    D 75-84 Distinction
    HD 85-100 High Distinction
    CN   Continuing
    NFE   No Formal Examination
    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.

    Late Submission of Work
    All assessments should be submitted by the specified due date. Late submission without an approved extension will be penalised at the rate of 10% of available marks for each day after the due date. Work submitted more than ten days after the due date may be returned unmarked. This action will be taken to prevent students who do get their work in on time being disadvantaged.

    Work Limit
    You are advised to comply with word limits. You are, of course, not expected to achieve exactly the required length and a 10% leeway on either side is acceptable. However, a penalty of 5% of available marks will apply for word limit in excess of the 10% leeway.

    Presentation
    Your written work must comply with the formatting and referencing indicated in the School Academic Manual. Marks will be lost for failing to do so.

    Return of Assignments
    Marked assignments and feedback will be returned via MyUni. For further information relating to assessment refer to the Assessment for Coursework Programs Policy.

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

    Requesting a remark
    Any student who, after discussion of the result with the course coordinator, is still dissatisfied with the final grade awarded for a course, and who has specific grounds for objecting to the grade, may lodge a written request for a review of the result or an independent second assessment with the Head of School within 10 University business days from the date of notification of the result. Such a written request must contain details of the grounds on which the objection is based. Requests must include a summary of the reasons the student believes his or her assessment work deserves a higher grade. These reasons must be directly related to the academic quality of the work. Re-marks, for example, will not be granted where the grounds are that the student has paid tuition fees or incurred liability under HECS-HELP or FEE-HELP, or needs one or two additional marks to get a higher overall grade for the course. The Head of Learning and Teaching may seek the advice of the Postgraduate Learning and Teaching Sub-Committee, and will make a determination on review or second assessment, and inform the student of his or her decision in writing.

    The grade awarded to a piece of work following review or second assessment as provided for in this policy or as a consequence of appeal to the Student Appeals Committee will usually stand as the final grade for the work, regardless of whether it is higher or lower than the grade originally awarded.Further guidelines and policies regarding examinations may be found on the examinations website www.adelaide.edu.au/student/exams/rules_policies.html.

    Resubmitting failed assignments
    In accordance with University Policy, the guidelines and conditions regarding resubmission are stated below. It should be noted that these guidelines concern work that has been assessed as ‘FAIL’.Course coordinators, in consultation with Head of Learning & Teaching and/or the Pre-Registration or Postgraduate Learning and Teaching Sub-Committee Chairperson, are responsible for determining the circumstances in which students may resubmit assessment tasks.

    In determining these circumstances, the following are considered:

    1. Students may only resubmit their work when:
    •  It will allow them to demonstrate that they have understood feedback on their work; and/or
    •  They might otherwise be at risk of failing the course; and/or
    • When they have received a Fail grade with an underlying mark of 45-49%; or
    •  The final assessment task in the course is weighted at 20% or more of the total course assessment.
    2. In granting a resubmission, the deadline will be negotiated.
    3. The resubmitted work will be awarded no more than the minimum pass mark (i.e. 50%).
    4. If the resubmitted work does not achieve a pass, it cannot be submitted a third time, and a fail will be recorded.
    5. Students who accept an offer of resubmission must take into account the possible implications, such as eligibility for graduation should the reassessment not be able to be completed in time for their preferred ceremony.

    Unsatisfactory Academic Progress
    Students whose academic progress is considered to be unsatisfactory may be precluded from taking further studies in the program for which they are enrolled; or further enrolment in that program may not be permitted for one academic year; or they may be permitted to re-enrol, but with a restricted program of study. More information is available at www.adelaide.edu.au/policies/1803/.

    Plagiarism
    Students are reminded that plagiarism and other forms of academic dishonesty constitute a serious offence and can result in disciplinary procedures. Students are advised to read the policy Academic Honesty and Assessment Obligations for Coursework Students Policy & Coursework Students: Academic Dishonesty Procedures policy, available at www.adelaide.edu.au/policies/230/. 

    The following definitions should be noted: 
    Referencing - providing a full bibliographic reference to the source of the citation (in a style as determined by the School).
    Quotation - placing an excerpt from an original source into a paper using either quotation marks or indentation, with the source cited, using an approved referencing system in order to give credit to the original author.
    Paraphrasing - repeating a section of text using different words which retain the original meaning.
    Please note that changing just a few words does not constitute paraphrasing.


    MARKING GUIDES

    Portfolio

    Structure and Writing Style 20%
    Structure (15%)
    •    Introduces/outlines/situates the activity/discussion.
    •    Each section of the portfolio is structured in a logical sequence so that the content flows (headings may be used to develop the structure of the portfolio).
    •    Each section of the portfolio ends with a cogent, defendable conclusion that summarises the discussion within the body of the paper.
    Writing Style (5%)
    •    The portfolio is written with clear sentence structure and the spelling and grammar are correct.

    Content  70%
    •    Demonstrates an understanding of the activities/discussions chosen by identifying the main components/issues/focus of the topic area.
    •    Provides evidence of support from contemporary literature to support argument/points of view.
    •    Has grounded the topic within the clinical area but also includes the broad scope of nursing.

    Referencing  10%
    •    The referencing style used throughout the summary paper is congruent with the School Academic Manual.
    •    The reference list is accurate (i.e. no missing page numbers, volumes, correct title etc), complete (i.e. no references in the body of the paper are missing from the reference list) and consistent with the School Academic Manual.
    •    The references cited are contemporary (i.e. less than 10 years old unless seminal papers).
    •    Primary references are used predominantly (i.e. the original reference has been cited rather than a secondary source).
    •    There is evidence in the summary paper that the student has searched widely for information related to the topic/issue.
    •    The student has acknowledged all sources of information.
    •    Direct quotations are only used to make crucial points or to support the discussion/argument.


    Presentation

    Structure  20%
    •    introduces the topic and states aims of the presentation
    •    clearly describes the way in which the presentation will proceed
    •    the presentation is structured in a logical sequence so that the content flows
    •    the presentation ends with a brief cogent, defendable conclusion that summarises the discussion within the presentation. Final slide must list all references in accordance with the School’s Style guide
    •    time for the presentation is managed well, allowing adequate time for questions/debate at the conclusion of the presentation.

    Content and Critical Analysis  60%
    Content (30%)
    •    the presentation has covered the topic sufficiently
    •    the presentation content has clear links to contemporary nursing theory and clinical practice
    •    the student’s presentation demonstrates a depth of understanding of the topic and associated significant issues
    Critical Analysis (30%)
    •    the presentation demonstrates a high degree of critical thought and insight by:
          - providing justification/rationale for the discussion
          - demonstrating they have reflected on the complex issues surrounding the topic
          - discussing the topic from differing perspectives, thereby providing a balanced discussion.

    Discussion and Presentation Style  20%
    •    material is presented in an interesting manner
    •    the student uses learning resources appropriately
    •    the group's interest is maintained by the student
    •    the student:
          - is audible
          - speaks clearly and slowly
          - responds to questions in an appropriate fashion
          - leads an interactive discussion that challenges the group to issues related to their nursing practice.


    Pre-sighted exam
    This will be a long answer exam. You will be given five questions three weeks prior to the exam for you to use in your revision. At the exam you will need to answer three of those five questions in the time allotted. The questions will only cover the work in this semester.  You will have 10 minutes reading time and 2 hours writing time.

    If you live outside of Adelaide you can arrange to complete the exam remotely. You will need to have someone who is willing to supervise you for the 2 hours. Please contact the course coordinator to arrange this.




  • 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.

    Best apects of course :
    Practice of acute care nursing; critical thinking and knowledge
    The course is well organised and Very relevant content.
    Love the online environment; the online classroom is one of the learning tools that is of the greatest way to make contact with fellow students and staff of the university.
    Well structured and thought of, it is designed in such a way as to match the experiences of the students at their level of clinical knowledge.
    The course has treated us as clinicians and not students.
    I really enjoy the two-day workshop, which helped improve my current nursing practice.
    The lecturer, online classroom and the ability to discuss personal experience.

    Areas for improvement identified by students were the Course workload and navigating online learning platform which has been addressed by reducing weekly online readings and the new Canvas learning platform. Some students required more in-depth lectures that may be achived during workshops. 

  • 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.