MEDIC ST 3102AHO - Clinical Practice III Part 1

Teaching Hospitals - Semester 1 - 2022

In Year 3, students continue develop and improve on the clinical interviewing skills required to elicit and record a clinical history and to perform a physical examination. Students move out of the clinical skills laboratory and are placed within a teaching hospital for one day a week.

  • General Course Information
    Course Details
    Course Code MEDIC ST 3102AHO
    Course Clinical Practice III Part 1
    Coordinating Unit Medicine
    Term Semester 1
    Level Undergraduate
    Location/s Teaching Hospitals
    Contact Weekly lectures, CBL sessions & resource sessions
    Available for Study Abroad and Exchange N
    Prerequisites MEDIC ST 2000A/B, MEDIC ST 2101A/B, MEDIC ST 2102A/B, MEDIC ST 2103A/B, MICRO 2506 and an approved level II elective; or by approval of the Dean of Medicine
    Restrictions Available to MBBS students only
    Course Description In Year 3, students continue develop and improve on the clinical interviewing skills required to elicit and record a clinical history and to perform a physical examination. Students move out of the clinical skills laboratory and are placed within a teaching hospital for one day a week.
    Course Staff

    Course Coordinator: Ekta Paw

    See CANVAS courses for details
    Course Timetable

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

    Relevant site specific details and timetables are available on CANVAS. 
  • Learning Outcomes
    Course Learning Outcomes
    1 Conduct a focused patient history in a professional manner, including demonstrating respect for the patient’s cultural, religious, and social background, to determine the nature of patients presenting issues.
    2 Conduct a clinical examination, relevant to the patient’s history, with appropriate components in a systematic, safe, logical approach while maintaining respect for patient comfort.
    3 Analyse and communicate the information both in writing and verbally, gathered in the history and clinical examination to justify a provisional diagnosis and possible differential diagnoses for common medical conditions.
    4 Select and interpret the appropriate initial investigations for common medical conditions to appropriately investigate the presenting complaint, relevant to the formulated differential diagnosis list.
    5 Explain the non-pharmaceutical, pharmaceutical, interventional, and surgical management of common medical conditions and the role of in hospital allied health and medical professionals in providing patient centred care.
    6 Demonstrate a comprehensive understanding of the hospital environment including the role of in-hospital staff allied health staff, non-medical staff and medical staff digital technologies, and support services required to facilitate patient centred care.
    7 Apply critical self-evaluation to improve professional practice, and provide ongoing ethical, compassionate patient centred care.
    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.

    1,2,3,4,5,6

    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.

    1,2,3,4,5

    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.

    3,5,6

    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.

    3,6

    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.

    1,2,7

    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.

    1,7

    Attribute 7: Digital capabilities

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

    4,5,6

    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.

    1,2,5,7
  • Learning Resources
    Required Resources
    A stethoscope and University ID badge are essential equipment. You may find it useful to carry a pen torch, ophthalmoscope and tendon hammer to the wards. Other equipment such as neurological examination kits are usually available for loan from the precinct staff. Students may have already purchased a standard medical examination kit.

    Australian Medicines Handbook is available online and is a required resource.
    Clinical Examination Checklists are provided in the handbook and online on My Uni
    Recommended Resources
    Recommended resources will be advised as appropriate.

    Suggested texts
    Talley & O’Connor, Clinical Examination
    Swartz, Textbook of Physical Diagnosis: History and Examination
    Tierney & Henderson, The Patient History: Evidence-based Approach
    Lloyd & Bor, Communication Skills for Medicine
    Hampton, The ECG Made easy
    Australian Medicines Handbook (AMH)

    Clinical Education Offices Resources
    There are also limited numbers of neurological examination kits, copies of the AMH, textbooks and Physical Examination DVDs available in the clinical education offices.
    Online Learning
    See MyUni website for this course
  • Learning & Teaching Activities
    Learning & Teaching Modes

    The clinical skills course includes lectures, bedside tutorials, oral case presentations, case write-ups and workshops. There is also an emphasis on self-directed learning in the clinical environment.

    Clinical Learning
    The core element of the clinical program is learning from patients seen on the wards. Students must see patients in pairs and should see at least one patient per week per pair.

    It is expected one student takes the entire history and perform a physical examination on the patient while the other student observes.

    Other elements of learning include, but are not limited to, opportunistic education by peers, allied health and senior staff on the wards, as well as round-robin style supplementary teaching and online modules. 

    Case Write-Ups:
    There will be 6 Case-Write-Ups (CWUs) per student per annum in total. The write-ups will be based upon a patient examined by the student during the Tuesday sessions.

    4 CWUs (2 formative and 2 summative) will be due in Semester 1, and 2 CWU will (1 formative and one summative) will be due in Semester 2.

    The examining student will  submit a case write-up by the end of the day. Students will be expected to enter their details and the patients’ details on the sign-off sheet for every case write up that they hand in to ensure patient confidentiality and to authenticate the patient. Students are encouraged to take notes even when acting as the observer, so as to provide feedback to their colleague (see "assessment" for submission and format details).


    Oral Presentations:
    Students will be rostered to small group tutorials in which they will present a patient they have seen on the wards. This will usually encompass discussion on various aspects of the case, including formulating a problem list with differential diagnoses and demonstrating clinical reasoning to support differential diagnoses. Some time may be spent discussing an appropriate management plan. Time will also be spent on discussing presentation skills such as communication skills/ format and chronology of presentation/ amount of relevant detail to include etc. The aim of the oral presentations is to introduce students to what will be expected of them on ward rounds in their clinical years. Semester 1 will focus on the core elements of presenting a case, building from experience from CBL-style case presentations and shifting towards a more ward-appropriate and ISBAR style case presentation. Semester 2 will introduce the concept of case presentations for clinical advice and phone consults. 

    Bedside Tutorials:
    Students will have a bedside tutorial most weeks, where they will meet as a small group with a clinical tutor (intern, resident, registrar or consultant) to see patients and develop techniques in physical examination and history taking.
    Checklists for components of specific clinical examinations are included in the handbook all students receive at the beginning of their rotation (also available online in MyUni). There will be timetabled topics to be covered each week – see the list for your Hospital.

    The Clinical Lecturer team will ensure that these resources are available to the tutors delivering the material, to allow for a standardised approach to teaching where practical. 

    Lectures:
    A combination of face-to-face masterclasses (workshop format) and online lectures will be delivered throughout the clinical practice course. To ensure standardised teaching across sites, there will be a focus on delivering the content live at a single site, with live streaming to neighbouring sites. 

    The location of the live presentation will rotate to ensure equal distribution. The site clinical lecturers will facilitate the lecture stream and be available to provide the workshop components of the masterclass.

    All content, where consented, will be recorded and available on Echo360 for students to revisit at their leisure. 

    Pre-reading:
    Pre-reading is required most weeks, particularly as preparation for bedside tutorials (see MyUni website)

    Workshop activities:
    All students will be rostered to attend a number of sessions outside of their main hospital site:

    • Adelaide Health Simulation & Skills Centre simulation sessions- will include ECG lead placement, basic life support, injection technique and sharps safety, PPE donning/doffing, vital signs/RDR chart documentation, hand-hygeine and A-E primary survey scenario
    • Hampstead Rehabilitation Centre – you will be exposed to the challenges of living with spinal injury.
    • Sexual Health Workshop – sexual health history and intervention will be covered in this session
    • Eye (ophthalmology) outpatient visits at Hospital sites
    • Ear (ENT) outpatient visits at Hospital sites
    • Vascular 'round robin' involving real patients
    • Cancer voices discussion groups with patient tutors
    Workload

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

    On most days students will be expected to arrive at 8.00 a.m. and stay until 5.00 p.m. not including personal study and preparation time.
    If the lecture is being delivered online (note: not a masterclass or workshop), and students are not rostered elsewhere, they may live stream from home.
    Students need to take into consideration travel time to sites and not missing out on ward based activities in this scenario. In Years 1-3, the standard total student workload for 24 units is 48 hours a week.

    Learning Activities Summary
    The structure of the Year 3 Clinical Skills 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, and available on MyUni thereafter).
    Specific Course Requirements
    All students will be allocated to a hospital site (NALHN, TQEH, RAH). However, students will need to travel to other sites for some sessions.
    All students must complete the requirements for clinical placement and maintain up to date documentation on SONIA.
    https://health.adelaide.edu.au/study-with-us/student-support/clinical-placements
  • 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 Timing Weighting Course Learning Outcome Assessed
    1. Orientation week quizzes (cofidentiality, case write up declaration, professionalism) Summative - hurdle

    Semester 1 (before attending wards)

    0%  1, 2, 6
    2. Simulation session orientation week (PPE, Hand Hygiene, Basic Life Support) Summative - hurdle

    Semester 1 (before attending wards)

    0% 1, 2, 6
    3. Simulation session semester 1 AND 2 Summative - hurdle

    Semester 1 and 2

    0% 1, 2, 6
    4. Case Write Up 1: Clerking Formative Semester 1 0% 1, 2, 3, 4, 5
    5. Case Write Up 2: Clerking  Summmative Semester 1 10% 1, 2, 3, 4, 5
    6. Case Write Up 3: Clerking  Summmative Semester 2 10% 1, 2, 3, 4, 5
    7. Case Write Up 4: Clerking  Summmative Semester 2 15% 1, 2, 3, 4, 5
    8. Oral Case Presentation: ISBAR Formative Semester 2 0% 1, 2, 3, 4, 5
    9. Oral Case Presentation: ISBAR Summmative Semester 2 15% 1, 2, 3, 4, 5
    10. Sexual Health Poster Summative After scheduled attendance at workshop 10% 1, 2, 3, 4, 5, 6, 7
    11. Logbook/Portfolio Summative - hurdle Semester 1 and 2 0% 1, 2, 7
    12. Fundamentals of Prescribing Formative 0% 5

    13. Mini-CEX 1

    Formative

    Semester 1

    0% 1, 2
    14. Mini-CEX 2 Summative - hurdle Semester 1 20% 1, 2
    15. Mini-CEX 3 Formative Semester 2 0% 1, 2
    16. Mini-CEX 4 Summative - hurdle Semester 2 20% 1, 2
    Students are required to attain an overall composite score from all assessment tasks equal to or greater than 50% to achieve an NGP An additional assessment will be offered to students who fail MEDIC ST 3102A/B with a composite score of 45-49%.

    All additional assessments will take place during the Semester 2 replacement / additional examination period. The result of a passed additional assessment is 50%.

    Students may be offered a resubmission on one occasion in the semester (or two occasions per year in year-long courses) if they communicate sufficient cause for a below standard summative assessment task. It is the student’s responsibility to contact the course coordinator if they wish to resubmit a summative assessment task. The offer of the resubmission is at the discretion of the course coordinator based on the communicated circumstances. The nature of the resubmission and the due date is determined by the course coordinator. The maximum score that can be obtained on a resubmission is 50%. Reasonable opportunities to remediate and educate will be provided in the setting of below standard hurdle assessment tasks.

    Material covered during the Year 3 Clinical Practice course will also be tested during mid-year and end-of-year written examinations as well as end of year OSCE examinations.

    Course Unit Value
    Grade
    MEDIC ST 3102AHO - Clinical Practice III Part 1 3

    CN

    MEDIC ST 3102BHO - Clinical Practice III Part 2 3 NGP


    In addition to the above, in order to pass this course and the Third 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 3000A and MEDIC ST 3000B Third Year MBBS Examination 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.

    A student will only be eligible for summer school if the following criteria are met:
    • The student does not have a recorded breach of genuine academic misconduct;
    • The student has completed all formative and summative assessment tasks within the failed course;
    • The student has attended more than 80% of teaching activities for which attendance is recorded across the academic year, within the failed course.


    Assessment Related Requirements
    The University has developed a Scope of Practice document which outlines appropriate activities for Year 3 students. Students should be familiar with this document, and adhere to its guidelines. The document can be found in MyUni and here

    CASE WRITE UPS
    Students have specific dates allocated for seeing patients for case write ups based on their allocated A or B grouping.

    Students see patients in pairs, but cannot use the same patient for their case write-up.

    Format of CWUs will be
    - 2 x FULL CWU (S1)
    - 2 x Admission note CWU (S1)
    - 2 x Discharge Summary CWU (S2)

    Due dates for submission of case write ups Sem 1:
    2 cases by mid semester break and 2 by end of semester.
    However, we encourage you to do this as soon as possible after seeing the case, as it will allow lecturers to provide feedback and allow you to reflect and therefore improve with subsequent submissions.

    Due dates for submission of case write ups Sem 2:
    1 case by mid semester break and 1 by end of semester. 
    However, we encourage you to do this as soon as possible after seeing the case, as it will allow lecturers to provide feedback and allow you to reflect and therefore improve with subsequent submission


    A total of 3 summative (1 of each format as mentioned above) summative CWUs will be marked by the end of the year
    A total of 3 formative CWU will be marked (1 of each format as mentioned above) by the end of the year

    Please refer to MyUni for further details 

    LATE SUBMISSION: marks are deducted by 10% each day



    ORAL CASE PRESENTATIONS

    Oral case presentations (OCPs) can be sourced from a students own CWU or from another patient seen on a Tuesday. 

    Students see patients in pairs, but cannot use the same patient for their oral case presentation.

    Format of OCPs will be
    - 2 x FULL OCP (S1)
    - 2 x ISBAR OCP

    Due dates for OCPs Sem 1:
    2 time slots will be allocated for OCP presentation in semester 1
    Students need to ensure they familiarise themselves with their allcoated time as there will be limited ability to reschedule

    Due dates for OCPs Sem 2:
    2 time slots will be allocated for OCP presentation in semester 2
    Students need to ensure they familiarise themselves with their allcoated time as there will be limited ability to reschedule


    A total of 2 summative (1 of each format as mentioned above) summative OCP will be marked by the end of the year
    A total of 2 formative OCP will be marked (1 of each format as mentioned above) by the end of the year

    Please refer to MyUni for further details



    SIMULATION - O-WEEK ASSESSMENT

    A hurdle assessment will be provided in the format of a Simulation Session in O-week. 

    Students will be allocated a specific timeslot to complete the assigned task (details will be availble prior). 

    There will be set pre-reading and preparation to ensure that all students have equitable exposure prior to participating.

    A video demonstrating the correct performance of the assessments will be provided prior to the assessment. 

    Result will be graded as competent / not competent. 
     
    Students will not be able to begin clinical placements until they are competent. As such, reasonable opportunites to remediate and educate will be provided in the setting of a not competent outcome. 

    Please refer to MyUni for further details

    REFLECTIONS

    Reflections will be required following the Cancer Voices and Spinal Injuries workshops.

    The format will be a short reflection (min 500 to max 800 words).

    These will be due 2 weeks following workshop attendance

    LATE SUBMISSION: marks are deducted by 10% each day

    Please see MyUni for further details


    ONLINE MODULES AND QUIZZES

    The hand hygeine online module and certificate, as well as the confidentiality quiz, will be made availble in the lead up to and prior to O-Week.

    These form fundamental tasks required to be completed before commencing clinical placements.

    The Hand Hygeine Module will supplement the Simulation Examination Assessment

    Please see MyUni for further details


    SEXUAL HEALTH WORSKSHOP

    An activity aimed at promoting critical thinking around evidence base of Sexual Health Conditions will be assigned following the workshop

    Please see MyUni for further details 

    Assessment Detail

    No information currently available.

    Submission
    As outlined above
    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.

    Grades for your performance in this course will be awarded in accordance with the following scheme: GS8 Non-graded pass.

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

    Students should familarise themselves with the University Policy on Additional Assessment/Replacement Assessment.
  • 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.
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