MEDIC ST 4016AHO - Surgical Home Unit Part 1

Teaching Hospitals - Semester 1 - 2022

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 4016AHO
    Course Surgical Home Unit Part 1
    Coordinating Unit Medicine
    Term Semester 1
    Level Undergraduate
    Location/s Teaching Hospitals
    Contact Attachments, common program & research
    Available for Study Abroad and Exchange N
    Prerequisites MEDIC ST 3000A, MEDIC ST 3000B, MEDIC 3102AHO, MEDIC ST 3102BHO, MEDIC ST 3103A, MEDIC ST 3103B, MEDIC ST 3104AOL and MEDIC ST 3104BOL in addition to all previous years core courses, 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: Adrian Anthony

    Clinical and academic staff from the Discipline of Surgery
    Course Timetable

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

    The course timetable is available in the Course Handbook. As students undertake their placements at different hospitals and in different clinics, timetables will vary. Students are advised to consult the Course Handbook for details regarding the weekly tutorial program, end of rotation assessments and discuss with their allocated team what their particular timetable and activities are. This information should be obtained from interns and/or registrars on the allocated team.
  • Learning Outcomes
    Course Learning Outcomes
    Learning Outcomes
    The SHU clinical attachments provide first hand experiences in how surgical patients are managed. From this experience, students are expected to expand their knowledge base, develop clinical competence and learn and model appropriate professional attributes.

    Aim
    Students are required to demonstrate effective cognitive, psycho-motor, behavioural and affective skills in assessing and managing patients with surgical presentations.

    Outcomes
    Students are required to develop clinical skills in the following areas:

    1. History taking
    2. Physical examination
    3. Developing a management plan
    4. Case presentation

    Regarding physical examination, students are expected to be able to undertake an examination of the following body regions and systems:

    - Head and neck
    - Breast and axilla
    - Skin and subcutaneous lesions
    - Abdomen
    - Groin, scrotum, perineum
    - Neurovascular assessment of limbs including hands


    Key Learning Outcomes
    The student should be able to:

    1. Take a history – enquire about clinical symptoms and signs; assess for co-morbidities and risk factors; demonstrate patient-centred communication skills; adopt an orderly, comprehensive and focussed approach
    2. Perform a physical examination – obtain consent; adopt an orderly and systematic approach; appropriately and correctly elicit symptoms and signs; ensure patient safety, dignity and comfort; perform hand hygiene and take universal precautions
    3. Weigh up available information to provide a likely condition or diagnosis
    4. Identify the spectrum of presentation for a given condition or diagnosis
    5. Justify a list of differential diagnosis
    6. Refer to an appropriate evidence-base and understanding of theoretical knowledge to explain clinical reasoning
    7. Explain associated anatomy and pathophysiological processes and how this links to clinical presentation
    8. Identify and quantify aetiological, predisposing and risk factors
    9. Select and explain reason for relevant investigations as it relates to diagnosis and management
    10. Interpret results of investigations and explain how this relates to the diagnosis
    11. Describe key principles of an appropriate management plan including treatment options
    12. Anticipate and describe expected desired and adverse outcomes of management, referencing prognostic factors of outcome
    13. Present clinical information in a structured, orderly and concise manner
    14. Discuss clinical problems in a coherent and sensible manner – provide rational explanation for opinions and decisions
    15. Discuss certainties and uncertainties of assessment and management
    16. Document patient assessment and management in a contemporaneous, coherent, concise, structured and ordered format
    17. Identify and access appropriate resources to gain knowledge and understanding of clinical presentation
    18. Reflect on cognitive, behavioural and affective performance – self-identify what was done well and why, what should be done differently and how

    Core Surgical Topics
    Students are advised to review the Surgical Syllabus.pdf document for the SHU Course. This outlines core topics in which students are to demonstrate a coherent understanding of related information and concepts, which can then be applied to surgical practice.
    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)

    Attribute 1: Deep discipline knowledge and intellectual breadth

    Graduates have comprehensive knowledge and understanding of their subject area, the ability to engage with different traditions of thought, and the ability to apply their knowledge in practice including in multi-disciplinary or multi-professional contexts.

    1 - 8

    Attribute 2: Creative and critical thinking, and problem solving

    Graduates are effective problems-solvers, able to apply critical, creative and evidence-based thinking to conceive innovative responses to future challenges.

    6

    Attribute 3: Teamwork and communication skills

    Graduates convey ideas and information effectively to a range of audiences for a variety of purposes and contribute in a positive and collaborative manner to achieving common goals.

    1,4

    Attribute 4: Professionalism and leadership readiness

    Graduates engage in professional behaviour and have the potential to be entrepreneurial and take leadership roles in their chosen occupations or careers and communities.

    1 - 8

    Attribute 5: Intercultural and ethical competency

    Graduates are responsible and effective global citizens whose personal values and practices are consistent with their roles as responsible members of society.

    6

    Attribute 6: Australian Aboriginal and Torres Strait Islander cultural competency

    Graduates have an understanding of, and respect for, Australian Aboriginal and Torres Strait Islander values, culture and knowledge.

    TBA

    Attribute 7: Digital capabilities

    Graduates are well prepared for living, learning and working in a digital society.

    TBA

    Attribute 8: Self-awareness and emotional intelligence

    Graduates are self-aware and reflective; they are flexible and resilient and have the capacity to accept and give constructive feedback; they act with integrity and take responsibility for their actions.

    2
  • Learning Resources
    Required Resources
    Not applicable
    Recommended Resources
    * Essential Surgery. Burkitt HG, Quick CRG, Reed JB. Fourth Ed. Churchill Livingstone. 2007
    * Clinical Problems in Medicine and Surgery. Devitt PG, Mitchell J, Hamilton-Craig C., Elsevier. Edinburgh. 2011. www.fleshandbones.com
    * Textbook of Surgery. Tjandra JJ, Clunie GJA, Kaye AH, Smith JA. Blackwell Publishing. 2006
    Online Learning
    http://www.emedici.com: this site contains the online case studies. To gain access to the eMedici cases go to www.emedici.com. Please register there to gain access to your cases. Details of many of the problems, topics and diseases with which the graduating student is expected to have a clear understanding with respect to their recognition and principles of management can be found in the eMedici modules.
  • Learning & Teaching Activities
    Learning & Teaching Modes
    Learning Opportunities
    As a guide, students should aim to have significant interactions with at least five new patients per week throughout their 9-week clinical placement. This can be achieved by the following activities;

    - seeing in-patients
    - participating on ward rounds
    - observing on consults
    - attending outpatient clinics
    - attending pre-admission clinics
    - attending peri-operative high-risk clinics
    - attending anaesthetic high-risk clinics
    - participating on on-call to see acute patients
    - attending operating lists

    Patient interactions and participation in unit activities should be recorded in the logbook that forms part of the assessment ward reports.

    Other learning opportunities include;

    - multi-disciplinary meetings
    - unit and, or hospital-based tutorials
    - online resources within CANVAS

    It is important that during the 9-week attachment students take the initiative to seek exposure to a broad range of surgical problems. Even when students have rotations to two units, it is unlikely that the full spectrum of surgery will be seen within the confines of the allocated units. It is therefore appropriate that students seek learning opportunities offered by other surgical clinics at the hospital to which they are attached. For example, attendance at a Breast or ENT clinic will provide a valuable learning opportunity for students who might not otherwise see patients with such presentations during their nine-week attachment. A request to the Consultant or Registrar running a particular out-patient clinic will generally be met with a positive response.

    The RAH, TQEH, LMH & MPH deliver weekly hospital-based tutorial programs aligned to the course syllabus. These are typically face-to-face, small group, interactive sessions over 60 to 90 minutes. Students will be forwarded information on the program.

    For students at Rural Surgical Units, a weekly virtual tutorial program will be delivered via Zoom. The 60 to 90-minute session will be facilitated from Whyalla Hospital and will include students from all rural sites. Students will be forwarded information on the program.
    Workload

    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 & Learning Modes
    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.
  • 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

    Assessment task Assessment type % Weighting Hurdle?
    1. Mid-term logbook & ward report summative 20% No
    2. End-term logbook & ward report summative 20% No
    3. Case study write up summative 20% No
    4. MCQ examination summative 40% No 

    It is the student's responsibility to ensure logbooks with ward reports and the case study write up are submitted via CANVAS by the due dates. Marks will not be credited if an assessment is not submitted by the due date.

    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.
    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.

    In addition, the University has developed a Scope of Practice document which outlines appropriate activities for Year 4 students. Students should be familiar with this document, and adhere to its guidelines. The document can be found in MyUni and here.

    Assessment Detail
    Assessment Task Task Type Due Weighting Learning Outcome
    Mid-term logbook and ward report 

    Summative

    Mid Term

    20 1,2,13,14,15,16
    End-term logbook and ward report summative

    Summative End of Term 20% 1,2,13,14,15,16
    Case study write up

    Summative End of Term 20% 3,4,5,6,7,8,9,10,11,12,13,17,18
    MCQ examination  Summative End of Term 40% 3,4,8,9,10,11,12
    Submission
    Not applicable
    Course Grading

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

    NOG (No Grade Associated)
    Grade Description
    CN Continuing

    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.

    MEDIC ST 4016 AHO

    Grades for your performance in this course will be awarded in accordance with the following Grades for your performance in this course will be awarded in accordance with the following scheme: GS8

    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 (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.

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