MEDIC ST 5015AHO - Paediatrics and Child Health Part 1

Teaching Hospitals - Semester 1 - 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.

  • General Course Information
    Course Details
    Course Code MEDIC ST 5015AHO
    Course Paediatrics and Child Health 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 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 Staff

    Course Coordinator: Professor Jennifer Couper

    Course Coordinator: Professor Declan Kennedy
    Phone: +61 8 8161 6398
    Email: declan.kennedy@adelaide.edu.au
    Location: University Department of Paediatrics, Women’s and Children’s Hospital

    Academic Staff: Professor Jennifer Couper
    Phone: +61 8 8161 6242
    Email: jennifer.couper@adelaide.edu.au
    Location: University Department of Paediatrics, Women’s and Children’s Hospital

    Administrative Contact: Gemma Provis
    Phone: +61 8 8161 6346
    Email: gemma.provis@adelaide.edu.au
    Location: University Department of Paediatrics, Women’s and Children’s Hospital
    Course Timetable

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

    The course timetable for the  rotation is made available to students on the first day of the placement.
  • Learning Outcomes
    Course Learning Outcomes
    1 Knowledge of normal growth, development, puberty, immunisation, sleep, feeding requirements with demonstrated competency in identifying normal and abnormal variations in these areas. Competency in the ability to carry out developmental assessments.
    2 Knowledge of common general paediatric conditions such as fever, vomiting and diarrhoea, UTI’s respiratory infections, asthma, cardiac murmur, rashes, obesity, failure to thrive, abdominal pain, enuresis, seizures and development problems.
    3 Knowledge of the common chronic conditions of childhood with demonstrated ability in taking a detailed clinical history, examination, discussion of appropriate differential diagnoses, investigations and treatment for each organ system with an understanding of the different roles and responsibilities of the treating clinical team. (A detailed list of common organ system disorders will have been provided to each student)
    4 Knowledge of the emergency care of children, common surgical conditions, resuscitation procedures, competency in common procedures such as blood sampling, urine sample collection.
    5 Knowledge of child and adolescent mental health with the demonstrable ability to take a psychiatric history from children and their families, the ability to engage e.g. with a reluctant or angry young person and the formulation of appropriate treatment plans. The demonstrable ability to understand the responsibilities and approaches to revelations of child physical/sexual abuse and the structure of Psychiatric services in South Australia. Knowledge of attachment theory and its implications for psychological health and the principles of transference and counter transference and how this is applied in a paediatric setting.
    6 Knowledge of the role of the family and the community in providing for the needs of the child with an clear understanding of the rights of children and young people and the relevant health and welfare agencies and their roles.
    7 Knowledge of the privacy issues that apply to children, proven ability to communicate and empathise with children and their families
    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)
    1,2,4,5
    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
    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
    6,7
    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
    5,6,7
    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
    7
  • Learning Resources
    Required Resources
    There are no required resources
    Recommended Resources
    Essential reading

    Practical Paediatrics   (7th ed, 2012)                             
    ISBN: 9780443102806
    Dist: Elsevier        
    RRP:   $153.00                       

    Paediatric Handbook   (2004)
    Women’s and Children’s Hospital
    Dist: Available from the Emergency Department
    RRP:  $25.00 (folder), $15.00 (insert only)


    Recommended reading

    Paediatric Clinical Examination Made Easy   (5th ed revised, 2006)  
    ISBN: 9780443103957
    Dist: Elsevier                     
    RRP: $ 47.00        

    Great Ormond Street Colour Handbook of Paediatric Medicine and Surgery (2007)
    ISBN: 9781874545279         
    Dist: Woodslane Pty Ltd                
    RRP: $ 120.00                         

    Jones’ Clinical Paediatric Surgery (6th ed, 2008)                       
    ISBN: 9781405162678
    Dist: Wiley and Sons                      
    RRP: $ 130.00                   

    Illustrated Textbook of Paediatrics (4th ed, 2011)                               
    ISBN: 9780723435655
    Dist: Elsevier                     
    RRP: $ 62.00

    Paediatrics and Child Heath (3rd ed, 2011)                
    ISBN: 9781405194747
    Dist: Wiley                          
    RRP: $77.95                                                                           

    Understanding Children and Young People's Mental Health
    Claveirole, Anne  &  Martin Gaughan
    ISBN: 9780470723456
    Dist: Wiley


    Further useful reading

    Apley’s Concise System of Orthopaedics and Fractures   (3rd ed, 2005)          
    ISBN: 9780340809846
    Dist: Cengage                   
    RRP: $87.95                                       

    Lecture Notes on Diseases of the Ear, Nose and Throat  (10th ed rev, 2007)   
    ISBN: 9781405145084      
    Dist: Wiley & Sons                           
    RRP: $49.95       

    Nelson’s Essentials of Paediatrics      (6th ed, 2010) 
    ISBN: 9781437706437
    Dist: Elsevier                     
    RRP: $ 104.00     

    Vaughn and Ashbury’s General Ophthalmology (18th ed, 2011)                
    ISBN: 9780071634205
    Dist: McGraw-Hill Education Aust         
    RRP: $ 100.00     

    Lecture Notes – Paediatrics   (8th Ed, 2011)                     
    ISBN: 9781405145091
    Dist: Wiley & Sons           
    RRP: $47.95                                         


    Major text references

    Nelson’s Textbook of Paediatrics (19th ed, 2011)                   
    ISBN: 9781437707557
    Dist: Elsevier   
    RRP: $ 150.00     


    Useful websites

    Online Medelian Inheritance in Man (OMIM)
    http://www.ncbi.nlm.nih.gov/Omim/

    American Academy of Paediatrics
    http://www.aap.org/ 
    Online Learning
    Online Lectures:      
    https://curriculum.adelaide.edu.au/groups/5/course_notes_detail.asp?year=2010&case=149       

    Formative MCQ’s in relation to lecture topics are available through MyUni:
    https://myuni.adelaide.edu.au/

    Spotting the Sick Child:
    https://www.spottingthesickchild.com/   
  • Learning & Teaching Activities
    Learning & Teaching Modes
    History taking and physical examination
    During the first 5 weeks of the Paediatrics and Child Health attachment, there will be small group (3 to 5 student) clinical tutorials on history taking and examination in children from 0-18 years. These tutorials are conducted by consultant clinicians at the Women’s and Children’s Hospital and Lyell McEwin Hospital. They will involve learning and practice of clinical skills in taking histories in Paediatrics, and undertaking physical examination of children at different ages.

    The Clinical Skills Tutorials will provide information regarding the unique features of the Paediatric History.

    Differences in the Paediatric History
    •    History often from third party
    •    Same problem may have different presentation at different ages
    •    Additional parameters:
    Pregnancy, Birth and Neonatal history
    Developmental status and history
    Playgroup/Kindergarten/School history
    History of growth and nutrition
    Immunisation History
    •    Impact of illness on family unit
    •    Relevant social history
    •    Detailed family history including siblings

    And ensure that students have strong abilities in the following.

    Differences in Paediatric Examination
    •    Assessment of growth
    •    Plotting percentiles on relevant charts
    •    Assessment of development
    •    Understanding of assessment techniques at different stages
    e.g. neonate, toddler, school aged child, adolescent
    •    The need for observational skills in examination
    •    The need for patience and opportunism
    •    Ability to measure blood pressure, perform ENT and eye examination at different ages 

    Internships
    Each student will undertake 3 internships which will each be of 3 weeks duration. These will be clinical attachments, where the student will be part of the clinical unit providing patient care.  Each of the internships will be with a different clinical unit/s. For some internships students will be attached to clinical units in pairs.  Attachments will be at the Women’s and Children’s Hospital and Lyell McEwin Health Services.  Students will be responsible to the unit Registrar and Consultant. Students will take part in all unit activities i.e. acute and elective admissions, outpatient sessions and other ambulatory care, operating theatre sessions, unit audit and teaching meetings, etc.

    Learning in Child and Adolescent Mental Health
    Students will add to their knowledge of child and adolescent mental health by:
    •    Learning how to take a developmental and psychiatric history from children and their families
    •    Being able to assess mental health symptoms in children and adolescents, and generating a relevant management plan
    •    Gaining an understanding of the inter-relationship between the mental health of children and adolescents and other health problems, family problems and social circumstancesDeveloping a working knowledge of other health and welfare agencies
    •    Gaining confidence in approaching clinical situations that contain an element of risk e.g. self-harm and suicidality
    •    Developing an approach to interviewing young people and their families with a focus on enhancing therapeutic alliance and obtaining accurate historical information.

    Structure:
    •    Students will have an opportunity to practice interviewing and generating management plans for young people facing emotional challenges in a simulated clinical environment. This interactive component of the course will take place twice a week, on Tuesdays and Thursdays in iLab (Norwich Building). Structured feedback and on-the-fly review of interview footage is undertaken after each session to enhance skill development for students.
    •    Seminars in child and adolescent mental health will cover common issues in developmental mental health and illness.
    •    Students join clinicians for outpatient appointments in the Department of Psychological Medicine, and observe live video streams of clinical reviews with an associated tutorial.

    The Department of Psychological Medicine is a Consultation-Liaison psychiatry service for the WCH.

    Seminars, Tutorials, Pathology Session, Plastering Sessions & ICU Sessions
    Over the student’s 9 week attachment seminars, tutorials, and group learning exercises will be provided. These will be held at the Women’s and Children’s Hospital.  These sessions will involve specific aspects of Paediatric Medicine, Paediatric Surgery, Child and Adolescent Mental Health, Paediatric Emergency Care, Pathology, ICU & practical skills.  


    Workload

    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.

    Students are also expected to participate in at least three on-call evenings throughout their attachment.

    Timing of Assessments:
    The following provides details of the timing of the assessment processes, in chronological order for completion of the assessment tasks.

    1.    End of Internship Supervisor Final Assessments:
    Timing: Assessment forms titled ‘Summative Clinical Assessment” which are the Internship Supervisor Final Assessments are required for each of the three internships. They are due on the Friday at the completion of each internship.

    2.    Observed Clinical Assessment:
    Timing: In Week 6 of the Clinical Attachment in Paediatrics and Child Health.

    3.    Log Book
    Timing: Submission of the Log Book to the Clinical Studies Officer in the Department of Paediatrics is required by the last Friday of internship 3 of the Clinical Attachment in Paediatrics and Child Health.

    4.    OSCE
    Surgical OSCE:
    Timing: The OSCE will be on the Friday morning of Week 9 of the Clinical Attachment in Paediatrics and Child Health.

    Medical OSCE:
    Timing: The OSCE will be on the Friday afternoon of Week 9 of the Clinical Attachment in Paediatrics and Child Health.
    Learning Activities Summary
    Lectures, seminars and tutorials are scheduled for Friday afternoons and three Wednesday mornings over the students’ 9 week attachment.  These sessions cover information regarding Paediatric medicine, Paediatric surgery, Child and Adolescent Mental Health & Paediatric Emergency Care.  The lecture topics are:

    Paediatric Surgery
    Surgical Quiz 1- Mr Sanjeev Khurana
    The Acute Abdomen in Children-   Mr Sanjeev Khurana
    Lumps and Bumps- Mr Chris Kirby
    Neonatal Surgery- Dr Cathy Cord-Udy    
    Surgical Quiz 2- Mr Sanjeev Khurana
    Inguino-scrotal Pathology / Hypospadias- Mr Tony Sparnon        
    Acute Infections of Bone and Joint-   Mr Phil Brook    
    Principles of Fractures, Common Fractures of Upper & Lower Limbs- A/Prof Peter Cundy
    Back Pain and Spinal Deformity-   A/Prof Peter Cundy
    Neonatal Orthopaedics-   Mr Bruce Foster
    Pain in the Hip & Knee Joint-   Mr Joff Middleton    
    Lower Limb Development in Children / Bone Tumours- Dr Peter Viiret
    ENT Lecture- Dr John Ling
    Plastic Surgery- Dr Roger Woods
    Neurosurgery Lecture- Mr Stephen Santoreneos

    Paediatric Medicine
    Asthma, Pneumonia, Bronchiolitis & Croup-   Dr Declan Kennedy
    Audiology Lecture – Hearing Assessments-   Dr Tony Marciano
    Physical & Sexual Abuse of Children-   Dr Jane Edwards
    Gastroenteritis, Diarrhoea & Malabsorption- Dr Richard Couper
    The Atopic & Allergic Child-  Dr Michael Gold/Dr Patrick Quinn
    Childhood Immunisation- Dr Christina Boros
    Heart Disease-  Dr Terry Robertson/Dr Malcolm Richardson
    Diabetes and Obesity-  Professor Jennifer Couper    
    Imaging 1-  Dr Tony Smith
    Imaging 2- Dr Robyn Grant
    Neurology Lecture-   Dr Nicholas Smith    
    Genetic Counselling-  Dr Eric Haan
    Acute and Chronic Renal Disorders- Dr Paul Henning/Dr Sam Crafter
    Growth & Puberty-  Dr Jan Fairchild
    Acute Leukemia and Major Clotting Disorders- A/Prof Tom Revesz
    Paediatric Ophthalmology- Dr Theresa Casey    
    Serious Infections (Sepsis, Meningitis, Osteomyelitis, UTI)-  Professor John Turnidge

    Child and Adolescent Mental Health
    Behavioural Disorders-   Prof Michael Sawyer
    The Distressed Mother & Child: Perinatal & Infant
    Mental Health & COPMI - Dr Ros Powrie
    Mental Health in Indigenous Youth-    Dr Emma Hanieh
    A Sick Child – What About the Family?-   Dr Simon Hein
    Drugs, Alcohol and the Difficult Adolescent- Dr Ben Wells
    A Depressed Adolescent. How Do I Know if it is Serious?- Dr Prue McEvoy

    Paediatric Emergency Care
    Resus4Kids Simulation Workshop- Dr Lesley Woodard-Knight/Leanne Stacy

    Bedside Teaching Tutorials
    During the first 5 weeks of the Paediatrics and Child Health attachment, there will be small group (3 to 5 student) clinical tutorials on history taking and examination in children from 0-18 years. These tutorials are conducted by consultant clinicians at the Women’s and Children’s Hospital and Lyell McEwin Hospital. They will involve learning and practice of clinical skills in taking histories in Paediatrics, and undertaking physical examination of children at different ages.

    Extra small group teaching sessions
    Each student will also attend one Plastering Teaching Session, one Pathology teaching session and one ICU teaching session throughout the 9 weeks, students will be split into small groups for these sessions.





    Specific Course Requirements
    Police Check
    All students are required to submit a Department for Communities and Social Inclusion (DCSI) Criminal History Check to the Clinical Studies Officer on the first day of their attachment.  This will need to be the original and not a copy.

    Identification badges
    Women’s and Children’s Hospital identification badges will be issued to each student on the first day of their attachment.  Students will need to pay a $20 deposit to receive their ID.  The deposit will be given back to the student on return of their ID badge at the end of their attachment.  These are to be worn by students at all times within the hospital. This is a security requirement and access to hospital facilities may be refused if identification badges are not available. All badges are to be returned to the Clinical Studies Officer of the Department of Paediatrics before the commencement of the end of term examination.

    Dress
    Students are requested to dress neatly at all times. Parents, who are often under considerable stress because of the illness of their children, have certain expectations of professionals. As many children are often frightened by white coats, staff do not wear them. Therefore, students are not expected to wear white coats.

    Out of Hours Work
    All students will be required to do out of hours on-call work at some time during their attachment.
    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
    Assessment Task Assessment Type Weighting Learning Outcome(s) being addressed
    Three Internship Supervisor Final Assessments Summative N/A
    (Submitted/Not Submitted)
    1-7
    Observed Clinical Assessment Summative 10 marks 1-3
    Medical OSCE Summative 75 marks 1-7
    Surgical OSCE Summative 45 marks 4
    Mental Health Attachment- iLab component Summative 40 marks 5
    Log Book Compulsory Formative N/A
    (Submitted/Not Submitted)
    Assessment Related Requirements
    Internship Supervisor Final Assessments and Log Books need to be submitted by their due dates in order for a student to be able to sit the OSCE’s in Week 9. Students need to receive a satisfactory grade on all 3 of their Internship Supervisor Final Assessments and have all 12 signatures completed on their Log Book.

    Attendance at ICU, Plastering and Pathology Teaching Sessions is compulsory.
    Assessment Detail
    Log Book
    The Log Book is provided on the first day of the student’s attachment. It is for documentation of the minimum number of unit and ambulatory service responsibilities during the internships. The entire front page of the log book is to be completed and signed by the appropriate supervisors, the back page is beneficial and completion of the majority of these exercises should be attempted.

    Internship Supervisor - Final Assessments
    The ‘Summative Clinical Assessment' forms for each internship are provided on the first day of the student’s attachment.   Guides to performance (Clinical Knowledge and Clinical Skills) are also  provided. Forms should be given to the internship supervisor (Unit Consultant or Registrar) at the end of the internship, and the supervisor will complete these with the student, using the guide provided. Forms will be signed by the supervisor and the student, and will be submitted by the student to the Clinical Studies Officer by the last day of each internship.  If a student receives a Borderline/ Unsatisfactory assessment from a supervisor, they should discuss remediation with their Clinical Tutorial Group tutor/ mentor at the earliest opportunity.

    Observed Clinical Assessment (OCA)
    This assessment is undertaken with a member of the Department of Paediatrics. Each Clinical Skills Tutorial group will be allocated to one of the members of the Department of Paediatrics for assessment. Each student will be observed performing a 10-minute clinical short case. These cases could be, for example, examination of the chest of a child with asthma, or examination of the abdomen of a child with an enlarged liver. It is expected that students will demonstrate competence in their examination technique and be able to detect important signs such as wheeze or hepatomegaly.  Assessments will encompass the domains of Clinical Examination technique, and identification and interpretation of clinical signs. Feedback regarding performance in this assessment will be provided in the final clinical skills tutorial.

    OSCE (Medical & Surgical)
    The Medical OSCE consists of 5 stations each 5 minutes in duration testing core competencies in Paediatric Medicine.  There may be a combination of 4 active stations (with examiners) and 1 static station (written responses to questions).

    The Surgical OSCE consists of 3 stations each 7 minutes in duration on Paediatric surgical topics.  There may be a combination of 2 active stations (with examiners) and 1 static station (written responses to questions).
    Submission
    All assessment components must be submitted to the Clinical Studies Officer by the due date.
    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.

    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.

    SELT forms will be given to each student on the last day of their attachment.  Students may also be asked to fill in SELT forms on a particular tutor or lecturer.  

    An iLab evaluation form will be given to all students on the last day of their attachment.  
  • 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.