Paediatrics and Reproductive Health
Women's and Children's Hospital

Full details are located in MyUni.

OUTCOMES (Curriculum Mapping)

1. On completion of Year 5 Human Reproductive Health, students will be able to demonstrate knowledge and understanding of the:

• physiology and pathology of the female reproductive system in childhood, adult life and old age
• physiology of pregnancy, parturition and the puerperium and its effect on medical and surgical disorders
• diagnosis and management of simple gynaecological disorders and an understanding of the principles and essential features of more complex gynaecological conditions
• epidemiology of the major health and social problems related to obstetrics and gynaecology
• embryology, developmental, physiological, biochemical, anatomical, endocrinological, immunological, morphological, pathological and psychological aspects underpinning obstetrics and gynaecology
• pharmacology of drugs commonly used during pregnancy and in gynaecology
• cultural, legal and social variation in attitudes towards obstetrics and gynaecology
• effect of the woman’s social circumstances on pregnancy or a gynaecological condition
• effect of drugs (prescribed or other) on pregnancy or gynaecological conditions

2. Students will be able to demonstrate competency, as expected of a Year 5 student under appropriate supervision, in the following areas of clinical skills and reasoning:
• conducting an interview that considers the special physical, psychological and social characteristics required to take a full history relevant to human sexuality, obstetrics and gynaecology
• conducting a physical examination which takes into account the special problems encountered in human sexuality, obstetrics and gynaecology, in order to confirm or refute an hypothesis or diagnosis
• providing specific advice to the woman about the arrangements necessary for confinement in an appropriate setting, including referral to a Specialist Obstetrician for further management if risk factors have been identified
• providing specific advice to the woman on the potential hazards of drugs to the conceptus
• requesting appropriate laboratory, psychological or social data in order to reach an appropriate diagnosis
• observing and recording the progress of labour, delivery and the early puerperium
• formulating a plan for care of the patient(s)

3. Students will be able to demonstrate the following professional attributes:
• applying the principles of evidence based medicine in obstetrics and gynaecology
• maintaining the dignity and privacy of the woman
• practising empathetic medicine

Not applicable.

General Texts suitable for student purchase

Obstetrics & Gynaecology. An evidence-based guide. Abbott Jason, Bowyer Lucy, Finn Martha. (2nd edition) 2014 Elsevier.

Essential Obstetrics & Gynaecology. Ian M Symonds and S Arulkumaran. (5th edition) 2013 Churchill Livingstone.


Electronic Based Reference

DAROGA. Dr Alphonse Roex has developed and made available free of charge via a You Tube channel a range of on line lectures that cover “the basics” and come highly recommended. https://www.youtube.com/channel/UCwzPm_jj91MQRziM-fumvug/videos

Lectures in Obstetrics, Gynaecology and Women’s Health. Authors: Gab Kovacs, Paula Briggs
access via http://link.springer.com/book/10.1007/978-3-319-14863-2

Cochrane Library - access via http://www.thecochranelibrary.com/view/0/index.html
or type “Cochrane Library” in to the library catalogue and follow the links

Global Library of Women's Medicine free electronic O & G textbook website at www.glowm.com

Perinatal Practice Guidelines website – http://www.health.sa.gov.au/ppg/
Now also a free app – search app store for “practices guideline reader”. The correct spelling is essential.

Motherisk: www.motherisk.org

OTIS: http://www.teratology.org/OTIS_fact_Sheets.asp

LACTMed : http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT

UKMi: http://www.midlandsmedicines.nhs.uk

Sexual health www.mshc.org.au

On line Lectures: refer to Canvas course, plus

eMedicihttp://emedici.com

There are numerous teaching and learning methods used, with the emphasis on active learning methods including, but not limited to: case based learning, large group lectures, seminars, tutorials and clinics and other sessions in hospital. There will be self-directed research and/or study, case presentations, and critical analysis.


Clinical Learning

Obstetric Duties
Attendance at antenatal clinics, conduct of normal labour and delivery and observation of abnormal cases gives insight into the spectrum of common conditions, most of which will be met at some time in practice.

Students’ personal cases and deliveries require detailed observation of antenatal, labour and postnatal care and infant care. Adequate postnatal care includes observation of lactation, involution and the psychological development of the mother-child relationship.

Labour Ward
Students are rostered to the labour ward four times during their rotation. These are all day sessions and include weekend and after-hours work. They aim to provide students with the opportunity to conduct spontaneous vaginal deliveries with the help of the midwifery staff in charge.

Gynaecological duties
Students are rostered to attend gynaecological outpatient sessions where there will be the opportunity to take a history and examine outpatients with the Consultant/Registrar attending the Clinic. Students should clerk patients being admitted for elective gynaecological surgery, with the opportunity to attend theatre sessions when a patient they have clerked is having an operation. Students should also attend enough other theatre sessions to ensure a familiarity with the commonly performed gynaecological procedures. The postoperative progress of the patient(s) who have been clerked should be followed and the pathology reports should be examined before discharge

Neonatal Medicine
Students will have weekly neonatal tutorials and will also be rostered to follow the neonatal registrar for one morning. It is expected that students will be able to demonstrate skills in the examination of the normal neonate and knowledge of common problems that occur in the neonatal period.

Friday Afternoon Tutorials
Members of the academic and visiting staff will run whole-of-class tutorials in weeks 3-8 in selected topics, between 2:00pm and 5:00pm in the seminar room in the Robinson Institute, 55 King William Rd North Adelaide. The tutorials will be interactive.


e-Learning
Students without their own devices may borrow an iPad for use during the 9 weeks of their attachment. iPads provided by the Discipline must be used to undertake on-line written assessments.

On Line Lectures
A series of on line lectures is available in the Canvas course.

The site includes optional multi-choice questions based on these topics. There is no restriction on the number of attempts at the MCQ's, which are intended to stimulate students’ thinking about the topics.

eMedici
eMedici now includes case material and related formative assessment in Obstetrics and Gynaecology.

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. After hours and weekend work may also be required to meet clinical requirements.

The thematic structure of the Year 5 MBBS Program will be provided and discussed at the start of the program and is discussed in detail in the student handbook (provided to students on the first day of their rotation). Please note that the following applies only to the metropolitan students undertaking Human Reproductive Health. Students attached to the Discipline of Rural Health undergo separate orientation and clinical learning opportunities.

Week Topic Lecture
Week 1 Warm up week Introduction to the course including whole-of-class tutorials covering the basicsand including small group clinical skillssessions.
Weeks 2 - 9 Students are allocated to specific hospital-based attachments and have individual learning timetables for the clinical component of the course. On line lectures are available in Intellilearnand additional on line resources areavailable in eMedici and MyUni, includingaccess to on line formative assessments.A separate lecture timetable for Friday afternoon tutorials held in the RobinsonInstitute seminar room will be announced.
Week 9 Summative assessment week Assessment of knowledge, reasoning and clinical skills will be undertaken from mid week onwards in week 9.

All students will be allocated in 2018 to the Women’s and Children’s Hospital in the metropolitan area. Although allocated to one hospital all students should expect to travel to other hospitals (e.g., The Queen Elizabeth Hospital, Royal Adelaide Hospital) and places for specialty sessions.

All students require a current National Criminal History Record Check for children and vulnerable adults. A Criminal History Check is valid for 3 years and students MUST have the original with them on the first day of term.

All students will be required to do some after-hours and weekend work (see above). Any other requirements will be advised.

A mandatory small group contraception tutorial under expert tuition is held mid-term. A "flipped classroom" approach is used. Advanced preparation by accessing the Contraception module in My Uni is required.

Assessment Task	Assessment Type	Weighting	Learning outcome(s) being addressed
Single best answer written examination end of week 5	Summative and formative	15%	1 and 2
Clinical portfolio end of week 8	Summative	30%	1
Single best answer written examination week 9	Summative	25%	1
OSCE examination week 9	Summative	30%	2

Not applicable.

Clinical Portfolio
There are three components to the Clinical Portfolio all requiring on-line submission via My Uni.

1. Case Report and Essay (20% of final grade – see marking rubric in clinical portfolio section of My Uni).
This is a write up and analysis of a self-selected case in either obstetrics or gynaecology. This can be an obstetrics case (antenatal, intrapartum, postpartum – in any combination) or a gynaecology case (outpatient, inpatient – in any combination). You should choose a case that you have had close involvement in, both in the hospital and/or clinic setting and in the post-hospital/clinic community setting and that demonstrates significant health care requirements. If you write up “in-grown toenail at 16 weeks’ gestation” you are unlikely to score well. Please provide the location, patient UR number, dates of your involvement, and name of the local supervisor who will be able to confirm, for random checking purposes, that you were involved in the care of the patient described in your report. The report is to include critical evaluation as outlined in the marking rubric. If you are unsure of your choice please discuss this with either Associate Professor Duggan or Dr Roex for metropolitan students, or Associate Professor Mills for rural students.
2. Clinical Core Competencies. (10% of final grade – see marking rubric in clinical portfolio section of My Uni).
This is a checklist of clinical tasks that you have been observed to have completed satisfactorily by a designated supervisor, who can be either a registered medical practitioner or registered midwife. Random checks will be undertaken.
3. Submission of copies of the signed consent forms for each vaginal examination you have undertaken as part of your core competencies criteria (not graded but mandatory – it is critical that you understand if you don’t obtain signed consent you leave yourself open to later allegations of criminal assault).

• Marking rubrics are available in My Uni. Be sure that you address the criteria in these rubrics. • You are required to submit via My Uni no later than 5pm Friday of week 8 the above 3 components. • Late submissions will have marks deducted at the rate of 10% of the total available per day. • DO NOT plagiarise or copy the work of another person (refer to University Policy at the following link).

http://www.adelaide.edu.au/policies/230/

Summative written assessments
Summative written assessment is held in weeks 5 and 9. The written assessment comprises single best answer questions, either in MCQ or modified SCT format. You will undertake these assessments on line and using an iPad that we will provide to you. You will be required to hand in the on-loan iPad before you leave the examination room. Overall, these written assessments contribute 40% of your final grade.

OSCE
The OSCE will be a multi-station examination usually to be held on the last day of term (Friday week 9). Each question will be of 8 minutes’ duration plus 2-minutes of reading time. The stations cover a range of clinical skills including history taking, examination, requesting and interpretation of investigations, diagnosis, management, explanation and counselling. Questions may be in obstetrics, gynaecology and neonatology. Stations will be standardised using surrogate patients and anatomical simulations, where applicable. Each of the stations carries equal weighting.
The OSCE examination will contribute 30% to your final grade in HRH.

On-line submission of Clinical Portfolio will be via MyUni.

Written and practical examinations are held at the end of the year to assess competence in the MBBS Program. Included in these exams will be some Obstetrics & Gynaecology questions.

For details please refer to Canvas.

Students may access the University Health Practice

61+ 08 8313 5050 http://www.adelaide.edu.au/student/health/

Please read the MBBS Program Code of Conduct.