MEDIC ST 4015BHO - Medical Home Unit Part 2

Teaching Hospitals - Semester 2 - 2020

The clinical attachments are a program of clinical education through a selection of placements so that students can gain competence 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 in a rural or remote setting.

  • General Course Information
    Course Details
    Course Code MEDIC ST 4015BHO
    Course Medical Home Unit Part 2
    Coordinating Unit Medicine
    Term Semester 2
    Level Undergraduate
    Location/s Teaching Hospitals
    Units 6
    Contact Attachments, common program & research
    Available for Study Abroad and Exchange N
    Prerequisites MEDIC ST 4015AHO in previous Semester. MEDIC ST 3000A/B, MEDIC ST 3101A/B, MEDIC ST 3102AHO/BHO, MEDIC ST 3103A/B, MEDIC ST 3104A/B 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 can gain competence 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 in a rural or remote setting.
    Course Staff

    Course Coordinator: Professor Hubertus Jersmann

    Course Timetable

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

    Students are strongly advised to check MyUni prior to the commencement of their rotation. Further information can be found in the Course Handbook and students also need to consult with their allocated home team to determine which clinical activities they are required to attend.

    The School of Medicine Teaching Series (SMTS) also runs during the MHU/SHU semester and students.   The SMTS is an examinable component of the course and attendance is compulsory.
  • Learning Outcomes
    Course Learning Outcomes
    The course objectives from the course handbook are replicated in part below. For a full listing of the course learning objectives, particularly the system specific history and examination skills, please consult the course handbook.

    1.    Simple procedural skills
    •    Handwashing and universal precautions
    •    Assessing vital signs – pulse, respiratory rate and BP
    •    Urinalysis
    •    Venepuncture
    •    Injection techniques – subcutaneous and IM
    •    ECG lead placement
    •    Basic life support skills
    •    Blood glucose testing

    2.    Ordering and interpretation of basic investigations, including correlation of results with clinical setting
    •    ECG ordering and interpretation
    •    Radiology – chest, abdominal and skeletal XRs
    •    Ordering and interpretation of basic blood tests – complete blood picture, urea and electrolytes, liver function tests, iron studies

    3.    Prescribing skills
    •    Write a prescription on the National Inpatient Medication Chart
    •    Give advice to a patient on common and serious adverse events and drug interactions
    •    Antibiotic prescription – based on microbiological sensitivity, empiric therapy
    •    Analgesics – simple and opioid
    •    Antihypertensive therapy
    •    Oral rate control therapy for atrial fibrillation
    •    Aspirin for cardiovascular disease prevention
    •    Venous thromboembolism prophylaxis
    •    Topical therapies for common dermatological conditions, including steroids and antifungals
    •    Inhaled therapy for asthma – preventers and relievers

    4.    Presentation skills
    •    Clear and efficient oral and written presentation skills
    •    Formal and informal oral case presentations on the ward
    •    Formal case write ups
    •    Use of abbreviated ISBAR format for oral handover

    5.    System-specific history and examination skills for common presenting problems
    •    Non-specific systemic symptoms
    •    Tiredness
    •    Fever
    •    Confusion
    •    Cardiovascular system
    •    Chest pain
    •    Shortness of breath
    •    Palpitations
    •    Ankle swelling
    •    Claudication
    •    Comprehensive cardiovascular examination including peripheries
    •    Respiratory system
    •    Dyspnoea
    •    Cough
    •    Wheeze
    •    Chest pain
    •    Haemoptysis
    •    Comprehensive respiratory examination
    •    Gastrointestinal system
    •    Abdominal pain
    •    Altered bowel habit
    •    Nausea and vomiting
    •    GIT bleeding
    •    Jaundice
    •    Comprehensive  gastrointestinal examination
    •    Neurological system
    •    Fits, faints and funny turns
    •    Headache
    •    Weakness and paraesthesiae
    •    Memory loss
    •    Visual and speech disturbance
    •    Tremor
    •    Comprehensive neurological system examination including cranial and peripheral nerves and mini-mental state exam
    •    Endocrine system
    •    Diagnosis and complications of diabetes mellitus
    •    Features of thyroid and parathyroid disease
    •    Examination of a diabetic patient
    •    Physical examination with a view to detecting signs of endocrine disease (thyroid, parathyroid, Cushing’s etc)
    •    Musculoskeletal system
    •    Painful joint
    •    Soft tissue pain
    •    Stiffness
    •    Limitation of movement
    •    Deformity
    •    Musculoskeletal examination relevant to joint or presenting complaint
    •    Haematological system
    •    Excessive bleeding
    •    Lymph node enlargement
    •    Pallor
    •    Recurrent infection
    •    Comprehensive haematological examination
    •    Renal/urological system
    •    Dysuria
    •    Haematuria
    •    Prostatic disease
    •    Sexually transmitted infections
    •    Renal failure
    •    Comprehensive renal examination
    •    Ears/Eyes
    •    Competent use of ophthalmoscope
    •    Competent use of auroscope
    •    Skin
    •    Onset, evolution and features of a rash including systemic features
    •    Able to describe the features of a skin lesion or rash
    •    Psychiatry
    •    Basic psychiatric history including symptoms of psychosis, depression and anxiety
    •    Psychiatric mental state examination
    •    Sexual Health
    •    Have knowledge of the components of a complete sexual health history
    •    Understand the importance of taking a sexual health history as part of the routine medical history
    •    Have knowledge and understanding of the communication skills and techniques required to initiate, discuss, diagnose and manage sexual health issues and complaints
    •    Have knowledge of the ways sexual health issues can present
    •    Have knowledge of how chronic disease can affect sexual health
    •    Have knowledge of the history and examination required for assessment of erectile dysfunction
    •    Understand the PLISSIT model used in sexual health interventions
    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)
    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
    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
    Career and leadership readiness
    • technology savvy
    • professional and, where relevant, fully accredited
    • forward thinking and well informed
    • tested and validated by work based experiences
    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
    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
  • Learning Resources
    Required Resources
    Not applicable
    Recommended Resources
    General Medicine is a broad field, and students are advised to seek out resources that will assist them in consolidating their clinical learning.
    Online Learning
    4th year MHU is delivered in the same semester as the School of Medicine Teaching Series and there is a wealth of online content available through MyUni. Students are highly encouraged to work through this material as it is examinable content.
  • Learning & Teaching Activities
    Learning & Teaching Modes
    The primary mode of teaching and learning in this course is in the clinical context. This includes ward rounds, consultant rounds, outpatient clinics and bedside tutorials with the student’s preceptor.

    Learning is supplemented with the School of Medicine Teaching Series lectures, lectures and tutorials organised as part of the MHU schedule and online content delivered via MyUni.

    Students are also advised to participate in academic teaching occurring at the hospital – journal clubs, unit meetings and grand rounds.

    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.

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

    See above - Learning and Teaching modes
    Learning Activities Summary
    See Teaching & Learning Modes above
    Specific Course Requirements
    It is an MBBS entry requirement to obtain a police checks as set out in letters of offer to prospective students. Other requirements will be advised at the start of the course.
    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

    1. Ward Reports (one midterm and one at the end) 35%
    2. Two Case Reports (structured written case histories) 30%
    3. Two Observed clinical long cases (direct bedside interaction with a supervisor) 20%
    4. Diary of Learning experiences (documentation of patient encounters with peer review) 5%
    5. MCQ exam item writing 5%
    6. Pharmacology IPL reflection 5%

    Note: Modified arrangements have been made to assessments (see end of Assessment Summary section)

    To pass this course and the Fourth Year MBBS Examination Annual Examination Part 2 course, students must obtain:

    •    a satisfactory result in each of the components of the summative assessment in semesters 1 and 2; and
    •    a satisfactory performance in the examinations overall

    If an overall borderline grade is achieved in the examinations, a student may be offered an opportunity to sit a Replacement/Additional Assessment examination.

    Academic Progression Requirements
    Progression from one year to the next in the MBBS is dependent on the student successfully completing a compulsory annual examination course in which a full year’s learning is assessed.

    To successfully complete the MEDIC ST 4000AHO and MEDIC ST 4000BHO Fourth Year MBBS Exam Part 1 and Part 2 courses, the student must pass the end of year examinations and have successfully completed all year level component courses (24 units).

    IF a student fails the compulsory examination course no passing grade will be received for any core medical studies courses.

    IF a student has not completed all required MEDIC ST units of the year they must successfully complete an appropriate remedial course of the same or greater value as specified in Term 4 of the same academic year.

    Modified arrangements have been made to assessments and the details provided here reflect recent updates:

    Observed case x2 20% each - 40% (alternative : video-ed patient interaction by a teacher to analyse)

    Witten appraisal of a case study x2 20 % each 40% (Plan A: bedside; plan B: scenario provided by physician)
    Constructing Medical MCQs times 2 5% each 10%
    Topic write up, mini literature review x1 10%

    Assessment Related Requirements
    It is compulsory for students to attend clinical placements and their specific activities in line with the principles and guidelines outlined in the Medical Student Clinical Hours document.

    Exemptions to mandatory clinical placement attendance requirements may be granted by the Program Coordinator in consultation with the relevant course coordinator and year level advisor if there are exceptional medical, compassionate or extenuating circumstances as defined by the Modified Arrangements for Coursework Assessment Policy.

    Core structured learning activities in this course include: ward rounds, clinical unit educational activities, tutorials.
    Assessment Detail
    See Assessment Summary above
    Details regarding submissions can be found in the  course handbook.
    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.

    Any 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 ( 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.